ADVANCE Perspective: LTC : Alzheimer's

Salsa at 3 a.m.?

Maureen Salera — Thu, 24 Sep 2009 14:23:00 GMT

This morning, Good Morning America ran a segment about a program that allows patients with Alzheimer's or dementia to stay active all night long.

The program, which is billed as the first of its kind, takes place in the Hebrew Home for the Aged, Riverdale, N.Y. It addresses the insomnia that often occurs with Alzheimer's or dementia and old age, according to the article on ABCNews.com.

The 11-year-old program offers various activities--from salsa dancing to art class and even field trips to restaurants and movie theaters--for patients with dementia every night of the week, from 7 p.m. to 7 a.m. The program also provides van service to pick up patients and bring them to the facility.

Because Medicare and Medicaid cover the program, it can help alleviate the financial burden that families can incur from providing nightly nursing supervision to patients.

While the program is widely supported by the state of New York, people all around the world are taking notice. In fact, representatives from senior centers in Ireland, Canada and Great Britain have sought recommendations from the Hebrew Home, and are hoping to replicate the nightly program.

Still Alice

Maureen Salera — Fri, 11 Sep 2009 02:11:00 GMT

My book club recently started reading Still Alice, a novel by Lisa Genova. The book chronicles a 50-year-old woman's experience with early-onset Alzheimer's disease.

In doing some research on the book, I came across the author's Web site, and found the Still Alice blog. It's here that Genova shares some of what she's learned about Alzheimer's and other general musings. The information could potentially be useful for anyone caring for patients with Alzheimer's.

Studying Adult Day Care’s Impact on Stress Levels

Maureen Salera — Wed, 12 Aug 2009 21:16:00 GMT

A Penn State researcher is looking the role of adult day care in helping family caregivers deal with stress. The National Institute on Aging awarded a $3 million grant to Steven Zarit, professor and head of the Department of Human Development and Family Studies at Penn State, to study the effects of caregiving on family caregivers, according to the Penn State newswire. He will examine people who care for family members with dementia and how adult day care impacts their stress levels.

Zarit will interview and collect saliva samples from caregivers on eight consecutive days to test self-perceptions of stress and physiological stress. Because adult day care is typically used three or four days a week, he will be able to gauge how stress levels fluctuate when day care is used.

Through his research, Zarit will be able to assess whether using day care truly improves the health of people suffering from dementia and their family members. He will work with 180 participants over three years, primarily with adult day care centers in New Jersey.

Guest Blog: "Some Life Lessons to Hold Off Alzheimer’s Disease"

Liz Rosto — Mon, 20 Apr 2009 18:13:00 GMT

This is a guest blog by Anthony Cirillo, FACHE, ABC:

A new report suggests that health care costs of Alzheimer's disease patients are more than triple those of other older people. Alzheimer's victims are hospitalized more, use more home health and nursing home care.

That all adds up to at least $33,007 in annual costs compared with $10,603 for an older person without Alzheimer's, according to the report by the Alzheimer's Association.

In addition nearly 10 million caregivers, mostly family members, provide 8.5 billion hours of unpaid care for Alzheimer's patients.

An estimated 5.3 million Americans have the disease; by next year nearly half a million new cases will be diagnosed, according to the Alzheimer's Association.

From 2000 to 2006, while deaths from heart disease, stroke, breast and prostate cancer declined, Alzheimer's deaths rose 47 percent.

I believe there are things individuals can do to help themselves and that the industry can do to be more proactive.

First for individuals. I spend a lot of time around older folks so much so that I have learned a great many lessons. I am so presumptuous that I even have a keynote I give called The Meaning of Life. I make eight simple points about life, many of which you know. Let me call out a few in terms of how they relate to Alzheimer's.

A study of elderly people by Chicago's Rush University Medical Center suggests that those who see themselves as self-disciplined, organized achievers have a lower risk for developing Alzheimer's disease than people who are less conscientious. To me that translates to people who have purpose. A purposeful personality may somehow protect the brain, perhaps by increasing neural connections that can act as a reserve against mental decline, said study co-author Robert Wilson.

Rush University examined the brains of older folks and found that older people with broad social networks, who had the tangles and plaques associated with Alzheimer's never manifested the disease suggesting that having and nurturing friendships can help ward off Alzheimer's.

There have also been enough studies to suggest that keeping your brain stimulated, what I consider lifelong learning, also plays a role.

To professionals in the field I use this keynote to stress that you must first take care of yourself. That will make you better able to care for those around you. And to those in the field I suggest that we don't wait until Alzheimer's residents show up at our door. Eventually many will because despite all the best efforts some people are predisposed to this.

I am talking more about proactively getting involved. When I speak to facilities about marketing I stress several points that help spread word of mouth marketing, the best and lowest cost marketing there is. For example, as a facility adopt the cause of Alzheimer's. When people see you involved, when they need you many years from now, that gesture will help. Similarly bring communities of people together, perhaps hosting a forum on aging or healthy aging or preparing for aging. I contend people make choices about aging when in a crisis. Educate them, help them and when they need care you will be top of mind.

Just a few thoughts. What do you think?

Anthony Cirillo, FACHE, ABC is a healthcare consultant, ombudsman and expert blogger for Wellsphere in the area of aging and senior health. He consults with long-term care facilities and is available for management retreats and association keynotes. He is the author of "Who Moved My Dentures?" a book that dispels myths about long-term care. To read more, go to www.4wardfast.com/ and www.anthonyssong.com/

Brain Awareness Week

Liz Rosto — Thu, 19 Mar 2009 18:59:00 GMT

Did you know it's brain awareness week? We place so much emphasis on physical wellness, but it's important not to forget cognitive health too. Researchers believe mental exercise can ward off the brain's functional decline.

If you're not already doing so, why not try incorporating some of these activities into your wellness program? As suggested by the Dana Foundation:

Coordinate a lecture or series of lectures about the brain. Find a speaker(s) who can address the specific interests of your organization and its constituents and the importance of brain research.

Organize a health fair. Invite local nonprofit organizations to participate by staffing exhibit booths, disseminating educational materials, offering free health screenings, and much more.

Team up with local businesses to sponsor classes and workshops for employees to raise awareness about brain function and fitness, brain diseases and disorders.

Use the crossword puzzles, brain quizzes, anagrams and word scrambles as fun activities for your audiences at the start of your program or during a break in your activities.

For more information, see the Dana Foundation's Web site.

Certain hobbies can delay memory loss

Maureen McAndrews — Wed, 18 Feb 2009 17:55:00 GMT

Reading a book, quilting or playing computer games can delay the onset of dementia, a U.S. study suggests, according to a story from the BBC news. But watching TV may hasten memory loss, researchers found.

Researchers from the Mayo Clinic in Minnesota compared almost 200 people aged 70 to 89 with mild memory problems to a group who had no impairment. They asked volunteers about their daily activities within the past year and how mentally active they had been between ages 50 to 65.

Participants who had read, played games or engaged in craft hobbies like patchworking or knitting had a 40 percent reduced risk of memory impairment. In later life, those same activities reduced the risk by between 30 and 50 percent.

Those who watched TV for less than seven hours a day were also 50 percent less likely to develop memory loss than those who watched TV for longer periods of time.

The findings are to be presented to an American Academy of Neurology meeting.

An Apple a Day….

Maureen McAndrews — Tue, 03 Feb 2009 15:32:00 GMT

You've surely heard the adage about an apple a day keeping the doctor away, but what about apple juice? New research is now touting the sweet beverage for its possible health benefits. In fact, the January issue of the Journal of Alzheimer's Disease suggests that drinking apple juice may help prevent the development of Alzheimer's disease.

By studying mice, researchers found that dietary supplementation with apple juice concentrate in drinking water alleviated the increase in beta-amyloid, a protein that causes the plaques commonly found in the brains of people with Alzeheimer's disease. Read the abstract here.

Is apple juice on the beverage menu at your facility?

Cutting Calories May Improve Memory

Liz Rosto — Mon, 02 Feb 2009 20:19:00 GMT

Cutting calories may improve memory among healthy seniors, according to a new study. German researchers found that people who cut their calorie intake by approximately 30 percent performed better on standard memory tests.

Diets low in calories and rich in unsaturated fatty acids have long been said to benefit brain function. In this study, a pool of 50 normal- to overweight individuals (average age 60) was divided into three groups: one group restricted by up to 30 percent the amount of calories they consumed; a second group increased their consumption of unsaturated fatty acids by up to 20 percent; and a third group made no changes.

The calorie-restricted group saw a 20 percent average increase in verbal memory scores after three months, while no significant changes in memory performance were documented in the two other groups.

With memory loss being such a complex problem, restricting calorie intake appears to be a viable potential solution. And a simple one, at that.

Click on the link to read the entire study from the National Academy of Sciences.

HHS Announces Grant Programs for Older Americans & Veterans

Maureen McAndrews — Mon, 29 Sep 2008 19:29:00 GMT

The U.S. Department of Health and Human Services today announced $36 million in new grant programs to 28 states to help older Americans and veterans remain independent and to support people with Alzheimer's disease to remain in their homes and communities. Just over $19 million of this funding involves a new collaboration with the U.S. Department of Veterans Affairs (VA).

HHS Secretary Mike Leavitt and VA Secretary James Peake, MD, announced the joint effort to provide essential consumer-directed home and community-based services to older Americans and veterans of all ages, as part of a Nursing Home Diversion (NHD) grants program. In addition, Leavitt announced a $17 million investment to improve the delivery of home- and community-based services to people with Alzheimer's disease and their family caregivers.

In collaboration with the Veterans Health Administration, HHS' Administration on Aging will administer the new program. Under the program, $10.5 million is being provided by HHS through AoA, and $5.7 million by the states. VA estimates purchasing at least $3 million in veteran-directed home and community-based services for older veterans and for recently returned veterans with long-term care needs. The number of veterans over age 85 has tripled during the past decade, creating a significant expansion in the need for long-term care.

The $17 million for individuals with Alzheimer's disease and their caregivers involves grants to 22 states under AoA's Alzheimer's disease demonstration programs. States were able to apply for two types of grants: Innovation Grants and Evidence-Based Program Grants. Innovation Grants will demonstrate new approaches to delivering services and supports, and the Evidence-Based Grants will support the replication of science-based interventions that have already proven to be effective at helping people with Alzheimer's disease and related disorders to continue to live in the community.

See funding information here.

The Forgetting

Liz Rosto — Wed, 06 Aug 2008 13:59:00 GMT

While it is a few years old, I urge everyone to watch the PBS documentary on Alzheimer's: The Forgetting. This powerful and touching program follows the lives of several families coping with the disease, and the work of scientists searching for a cure.

PBS has been re-airing it recenlty, but you can also order the DVD or watch it online. It only serves to reinforce the devastation of the disease, the important work long-term care providers do to help these residents, and the hope for future generations.

Falls Cause More Than Broken Hips

Maureen McAndrews — Thu, 26 Jun 2008 20:00:00 GMT

Fall-induced traumatic brain injuries caused almost 8,000 deaths and 56,000 hospitalizations in 2005 among Americans 65 and older, reports the Centers for Disease Control and Prevention in the June issue of the Journal of Safety Research.

In 2005, TBIs were responsible for 50 percent of unintentional fall deaths and 8 percent of nonfatal fall-related hospitalizations among older adults.

"Most people think older adults may only break their hip when they fall, but our research shows that traumatic brain injuries can also be a serious consequence," Dr. Ileana Arias, director of CDC's National Center for Injury Prevention and Control, said in a press release.

This study analyzed 2005 data from the National Center for Health Statistics' National Vital Statistics System and the Agency for Healthcare Research and Quality's Nationwide Inpatient Sample.

Older & Wiser Brains

Maureen McAndrews — Thu, 22 May 2008 21:57:00 GMT

According to a New York Times article, an increasing number of studies are finding that brain power doesn't decrease with aging. Rather, the aging brain takes in more information and attempts to filter through a clutter of information, often to its long-term benefit.

The studies are analyzed in a new edition of a neurology book, "Progress in Brain Research." While Alzheimer's disease and dementia do make some brains deteriorate with age, the authors say much of what occurs is a gradually widening focus of attention that makes it more difficult to latch onto just one fact, like a name or a telephone number.

For example, in studies where subjects are asked to read passages that are interrupted with unexpected words or phrases, adults 60 and older work much more slowly than college students. That indicates that they are not just stumbling over the extra information, but are taking it in and processing it.