Nurses laugh as a 89-year-old veteran dies in nursing home

An 89-year-old World War II veteran in a nursing home bed called for help, saying he couldn’t breathe.

A hidden camera recorded nurses failing to take life-saving measures for the patient and laughing as he struggled to breathe, and eventually died. The man’s family had secretly recorded a video, which was kept from the public for 3 years until a television station, WXIA-TV, persuaded courts to unseal it.

The family of James Dempsey of Woodstock, Georgia, sued the Northeast Atlanta Health and Rehabilitation Center in 2014. Two nurses lost their licenses after the video was made public in September, with a link sent to the Georgia Board of Nursing. The nurses did not start CPR immediately and did not follow emergency procedures; then they laughed while trying to start his oxygen machine.

The nursing home issued a statement claiming that care has improved since the incident, under different leadership. But records show continued problems at the home, including $813,000 in Medicare fines since 2015.

Watch the video here: https://youtu.be/lU6NlK3OQDc

The video will probably cause families to think seriously about care options for their loved ones, including home care in some cases. A long term care insurance policy can support care either at home or in a facility. Find out more and get insurance quotes at Guide To Long Term Care.

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Millennials are most aware about long term care insurance

Only 20% of Americans have taken steps towards financing long term care, including even researching the costs. Millennials, who have long known that Social Security may not exist by the time they retire, are the generation most likely to have taken action on long term care insurance, according to Genworth Life Insurance Company, a long term care insurer since 1974.

Of people age 65 and older, 70% will need long term care at some point. However, only 52% of baby boomers believe they will need care. Millennials and members of Generation X are more realistic; 64% of Millennials (age 34 and younger) and 65% of Generation X (age 35-50) expect they may need long term care in the future.

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Most Americans (66%) mistakenly believe government programs will cover the costs of long term care. But Medicare only pays for skilled services or rehabilitative care, not for non-skilled assistance with activities of daily living, which is the bulk of long term care services.

Here are the 2016 national average costs for long term care in the United States (costs vary by state): $225/day or $6,844/month for a semi-private room in a nursing home; $253/day or $7,698/month for a private room in a nursing home; $119/day or $3,628/month for a one-bedroom space in an assisted living facility; $20.50/hour for a health aide; $20/hour for homemaker services; $68/day in an adult day health care center.

For those who are not prepared financially to handle their care costs, the burden will fall on their families and communities. It’s important for people who are growing older to talk with their families about their possible future needs and develop a plan — including how they will pay for care if needed.

Other facts the Genworth study showed Americans were uninformed about: 52% did not know that long term care insurance can cover help in their homes; 61% did not know that long term care can be personalized and that the insurer can help them find good care providers.

Insurers say people are never too young to begin planning for long term care costs, which can be a major expense and quickly use up retirement savings. To find out about long term care insurance, see the Guide To Long Term Care

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More insights on Alzheimer’s disease – how some brains are protected

A feature of the brain’s neurons called dendritic spines may protect against dementia, according to new findings.

Neurofibrillary tangles and amyloid plaques appear in the brains of people with Alzheimer’s, but not everyone who has these formations goes on to develop the disease. Between 30 and 50 percent of patients with the plaques and tangles do not develop Alzheimer’s disease. Why not? Scientists have been looking for the reasons.

Researchers at the University of Alabama at Birmingham found the answer may lie in dendritic spines. The dendritic spines of a neuron help it make connections with other neurons and send information. These parts of the neuron may protect against Alzheimer’s disease.

Dendrites, the branched projections of a neuron that transfer electrochemical stimulation from other neural cells to the cell body, have small membranous protrustions called dendritic spines. Each dendritic spine receives input from a single axon at the synapse. The loss of dendritic spines results in the loss of synapses, which can impair cognition. Logically, subects with normal brains would have healthy dendritic spines, and those with dementia would not. The researchers tested the structures and published the results in the journal Annals of Neurology.

The scientists compared dendritic spines in 21 patients with Alzheimer’s, 8 patients who had Alzheimer’s brain changes but no symptoms, and 12 healthy patients. Using bright-field microscopy, Professor Jeremy Herskowitz and the team took images of the dendritic spines, then used the images to create a 3-D digital reconstruction.

The healthy control subjects had more dendritic spines than the subjects with Alzheimer’s. The subjects with Alzheimer’s brain changes but no symptoms also had more spines than the Alzheimer’s subjects — and almost the same dendritic spine density as the healthy subjects. The group with pathology but no symptoms group had very long dendritic spines, longer than both the other groups.

Longer dendritic spines might indicate greater neuroplasticity — the capacity to change and form new neural connections. Increased neuroplasticity could enable the neurons to bypass plaques and tangles, and still communicate with other neurons. If so, this phenomenon could explain why some people who have Alzheimer’s pathology do not show cognitive impairment.

The research suggests that it may be possible for the brain to rebuild neurons. The information gained in the study may help scientists to develop new therapies, especially when brain changes are detected before symptoms appear.

In 2014, a study at NYU Langone Medical Center in New York, published in the journal Science, showed that getting sleep after learning helps neurons form connections, through dendritic branches, that may help brain cells pass information to each other and facilitate long-term memory.

The scientists observed mice that were genetically modified so a particular protein in their brain cells would fluoresce when viewed with a laser scanning microscope. The fluorescence allowed the team to track the growth of new spines along each branch of a dendrite. The mice sprouted new dendritic spines within 6 hours of learning a new task. Different structural changes occurred for different types of learning.

Healthier and more numerous dendritic spines may be a genetic trait, but the brain also may respond to healthy diet and lifestyle. According to Medical News Today, research suggests that as many as a third of dementia cases can be prevented by regular exercise and an active social life.

For more information on Alzheimer’s and dementia, and care choices, see the Guide To Long Term Care.

 

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After Disaster: New Emergency Requirements for Nursing Homes

During Hurricane Irma, 14 people died at The Rehabilitation Center at Hollywood Hills, Florida, due to a power outage that left residents in extreme heat. Lack of air conditioning made the building heat up like an oven. One of the victims died with a body temperature of 109.9 degrees. The nursing home’s owners now face criminal investigation and civil lawsuits.

In response to the tragedy, Florida Governor Rick Scott issued an emergency order requiring nursing homes to have generators that can run air conditioners.

The nursing home industry has brought court cases to challenge the emergency order. But in the meantime, state senators Lauren Book and Rene Garcia have filed bills to make the generator requirement a state law. Also, state senator Gary Farmer is preparing a more comprehensive Florida nursing home reform bill.

On the Federal level, U.S. Representative Debbie Wasserman Schultz is sponsoring a bill that will require nursing homes to have generators that can run air conditioning for at least 96 hours in the event of an emergency power outage. The bill will also put nursing homes on the top priority list, along with hospitals, for restoring power after a hurricane.

The Federal bill provides for loans to help small facilities comply with the new regulation. Homes that have fewer than 50 beds, or a private room monthly rate of $6,000 or less could qualify for a loan to get the generators and other required equipment. This bill also sets up higher fines for facilities that break the rules and adds nursing homes to the critical infrastructure list so power will be restored there first.

Nursing homes are among the most important resources for long term care. For more information about long term care insurance see the Guide To Long Term Care.

 

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Most Americans Incorrectly Believe Health Insurance or Medicare Pays For Long Term Care

More than half of Americans, 55%, incorrectly believe health insurance or Medicare will pay for long term care, the assistance with daily living that some people need because of illness or injury.

People who are sick or injured may need help with activities of daily living such as bathing, dressing, preparing food, and so forth that they would normally do for themselves.

A recent online survey asked adults how they would pay for assistance with activities of daily living if they are unable to take care of themselves for an extended period of time. More than half, 55%, said they would use Medicare or health insurance. But Medicare and health insurance, although they cover some of the medical costs, do not pay for long term assistance with daily living. See “Who Pays for Care”

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Medicare covers these costs for a maximum of 100 days (or until you stop improving). Medicaid will pay for these costs only when the individual’s assets are down to around $2,000 or $3,000 – depending on the state of residence – and Medicaid will recover the costs from the estate after death. This is often done with a lien on the Medicaid recipient’s primary residence.  How long will your savings/investments last if paying $75,000 a year per person for care?

The survey involved 2,065 U.S. adults age 18 and older. People over age 55 were more likely to say they would pay for long term care needs with health insurance and/or Medicare. People ages 18-54 were more likely to say they would borrow money from family and friends or use a credit card or loan. Long term care costs are estimated to be $70,000 a year or more, most of which will not be covered by health insurance or Medicare.

The U.S. Government Accounting Office and The Wall St. Journal report that 72% of Americans will need long term care at some time, either part-time assistance at home or full-time care in a facility. But people need to be educated about the costs of care and how to pay for it. Long term care insurance will relieve some of the burden. Many states now have available a Partnership insurance policy that protects assets by exempting the policyowner from Medicaid spend-down. Read more about The Partnership.

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Urgent Need for Alzheimer’s Disease Study Volunteers

Many researchers are working on a cure for Alzheimer’s disease. But they have run into an obstacle recently: a shortage of volunteers for clinical trials.

There are more than 100 research studies needing around 50,000 volunteers to help. Many studies have been funded, but there are not enough participants.

177851075The trials do not necessarily require people who are elderly or who suffer from dementia, and are not all drug trials. Some studies require participants to do cognitive tests on home computers. Some record data on lifestyle factors such as diet and exercise, or genetic risk factors.

There are studies where the volunteers try out wearable technology. All these tests collect information that can help scientists find ways to help people with Alzheimer’s.

Study subjects can benefit from participating. For example, some people who have Alzheimer’s disease may find a treatment that works. Some people may discover they have a genetic risk of dementia or already are in the early stages, and get prevention or treatment when it is most effective. Many volunteers in these studies will receive medical care for free. Also, some of the drug trials pay participants.

For people with dementia who are isolated, taking part in a study may help them socially. They can make friends with people running the studies and be part of a team. They can also feel good about helping to advance science and benefit others.

Some of the problems scientists have in recruiting study participants: In some studies both the dementia patient and a care partner must be involved. It’s harder to enroll two people. Some drug trials exclude people with certain medical conditions from participating.

Many drug studies require subjects in the early stages of dementia; at this stage there are few, or no, symptoms, so the disease hasn’t yet been identified, making it hard to find subjects.

There are sometimes legal obstacles if a dementia patient is not considered competent enough to give consent. And there are risks with experimental therapies, even though animal studies and FDA reviews are done before human trials.

For information on upcoming trials and on volunteering, visit the Alzheimer’s Association website, they have TrialMatch, a free database where you can find studies that may be right for you.

 

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The rate of dementia among seniors is going down

The rate of Alzheimer’s and other forms of dementia among seniors has declined significantly over the last ten years, according to a new study.

The Einstein Aging Study followed 1400 men and women age 70 and older from 1993 through 2015. When they entered the study they did not have dementia. Carol Derby, research professor at the Albert Einstein College of Medicine in New York City, analyzed the data. The report was published in JAMA Neurology.

Of 369 people born before 1920, 73 ended up with dementia. Of 285 born 1920-24, 43 developed dementia. Of 344 born 1925-29, 31 developed dementia. Of 350 born after 1929, only 3 got dementia. Similar declining rates have been found in Europe.

Researchers say the reasons for the decline in dementia cases are not known, but there is also a declining rate of stroke and heart attack from one generation to another (though diabetes is increasing).

Efforts to prevent cardiovascular disease in recent decades may be paying off; the incidence of stroke has declined. Since dementia risk is correlated with the health of blood vessels in the brain, it makes sense that the rate of dementia is falling alongside the rate of strokes. A recent study found that healthy lifestyles, including exercise, good diet, no smoking, and proper treatment of chronic medical conditions could prevent 35% of dementia cases.

Although the rate of dementia is going down, the actual number of people with dementia is increasing dramatically as the baby boomer generation ages, inflating the percentage of elderly people in the U.S. population.

Around the world, more than 47 million people suffer from dementia, and 7 million new cases develop each year. The number of cases of dementia is projected to double every 20 years. The number of people with Alzheimer’s disease is expected to reach 106 million by 2050.

Dementia is one of the most expensive health conditions, costing patients and families in medical fees and caregiving time. Long term care insurance can help pay for the costs. You must insure before the diagnosis! For more information see the Guide To Long Term Care – Alzheimer’s.

 

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