Don’t Fall.

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The reason for the majority of Emergency Room visits by older adults may surprise you. It’s not heart attacks, or illness, or accidents. It’s falls.

Falls lead to more nonfatal injuries in seniors than anything else, and falls are also the number one cause of injury-related deaths in older Americans.

Almost 15,000 people 65 and older died from falls and about 1.9 million were treated for injuries in emergency rooms.

1 in 3 over 65 have a fall each year, 70% of accidental deaths in people over 75 are caused by falls.

Falls are responsible for over 40% of nursing home admissions.

Injuries from falls in the elderly can include broken wrists, elbows, arms and hips.

Falling can be caused by many factors:
* Internal factors such as slowed reflexes, balance disorders, low blood pressure, visual deficits, etc.
* External factors such as poor lighting, poor room layout, the effects of medications.

What can be done?
* Make an assessment of the risk you have by answering the questions below:
* Add up your score on a separate paper or print this.
* Read information listed at bottom of this page on prevention.

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SCORE:
0-5 = Low Risk
6-8= Moderate Risk
8+ = High Risk


Prevention:
* Tell your doctor about any falls you have taken.
* Talk with your doctor and pharmacist about medications you take.
* Inspect your home for any safety problems such as lighting, flooring, and furniture.
* Make your home safer by installing night lights, bathroom grab bars and slip-resistant floors.
* In addition to strength exercising certain exercises — yoga, tai chi, and trying to balance on one leg with your eyes closed — can help improve balance.

OTHER INFORMATION:
American Academy of Orthopedic Surgeons
National Athletic Trainers’ Association
Centers for Disease Control and Prevention – Injury

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Caregivers At Risk.

It is not easy to talk about our parents or even ourselves getting older and some day needing help with very basic things. Here is information designed to educate the public about these issues.

Finding the words to begin a long term care conversation. (Genworth)

Beyond Dollars Infographic exposing the true costs of a long term care event. (pdf)

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LongTermCare.gov – Basic information about what is covered by Medicare and Medicaid.

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There are different ways to fund long term care: self-insure, long term care insurance*, life insurance or annuity with a long term care rider*, life insurance with a chronic illness rider*, Medicaid.
* Insurance is medical underwritten. Insuring locks in age and health.
27% of applicants ages 60-69 are declined because of health.

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A Solution for Caregiver Shortage: Robots

The government of Japan expects a shortage of 370,000 caregivers for the elderly by 2025, and is will look to robots to help provide care in institutions and at home.

Robots can transfer patients who are unable to move themselves from bed to a wheelchair, or to a bath, for example.

A new robot named Named RIBA (Robot for Interactive Body Assistance) has been developed by RIKEN and Tokai Rubber Industries (TRI). Using the latest sensor, control, information processing, mechanical and materials technology, it is the first of its kind in the world. So far, RIBA can safely lift and move a human patient of up to 61 kg (around 135 lb.).

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RIBA’s arms have high-precision tactile sensors and its human-like body has a soft exterior of urethane foam, for patient safety and comfort. Having robots do the lifting will ease the burden on staff, reduce injuries to health care workers, and help patients who want to live at home.

Another use of robot tech is a walking aid that can give a boost when the person is walking uphill and a braking action going down hills. The robot prevents falls and helps the user carry loads safely.

There are monitor systems that collect information aimed at improving nursing care services, and robots that can detect when a patient falls down or needs help. For example, robots are being developed that can predict when a person needs to go to the toilet and guide them there at the right time, helping them with removing clothing and other necessary motions.

In addition to their uses in nursing homes, robots can contribute to self-reliance for people who have some disabilities but want to remain at home.

The Japanese government wants patients to get used to robot helpers, hoping that by 2020, 80% of patients will accept having some of their care provided by robots. Several Japanese government agencies want to encourage businesses to develop care robots, and popularize them.

The RIKEN-TRI Collaborative Center for Human-Interactive Robot Research (RTC), where RIBA was developed, expects to bring care robots to market in the near future.

Priority Areas to Which Robot Technology is to be Introduced in Nursing Care – get information at METI.

For more information on long term care issues, see the Guide To Long Term Care,

 

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Promising New Research May Lead To Reversal of Alzheimer’s Dementia

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Scientists have recently discovered a possible new way to reverse Alzheimer’s disease.

A new study found that amyloid protein plaques, associated with Alzheimer’s disease, were eliminated when researchers removed a naturally occurring enzyme called BACE1 from the brains of mice.

Riqiang Yan and his team at the Cleveland Clinic studied mice that were genetically engineered to have a rodent form of Alzheimer’s disease. BACE1, known as beta-secretase, clings to the amyloid precursor protein, resulting in the production and buildup of plaques.

When the BACE1 enzyme was removed from the mouse brains, formation of amyloid plaques stopped, and plaque already in the brains of the mice disintegrated. Removal of the enzyme also improved learning and memory in the mice.

In the study, the scientists gradually removed BACE1 from the mice as they aged. By the time the mice were 10 months old (equivalent to the human age of 50 years) they no longer had any amyloid plaque in their brains.

Reducing BACE1 levels in the offspring mice also reversed other conditions found in Alzheimer’s disease, such as microglial cell activation and the formation of abnormal neuronal processes.

Yan published some of his discoveries about BACE1 in 1999 in the journal Nature. This recent study, published in the Journal of Experimental Medicine, is the first one in which researchers have seen a dramatic reversal of amyloid deposits in the brains of mice. It may lead to new therapies that could reverse Alzheimer’s disease. The next step will be to see if human brains react the same way.

Find out about the care of people with Alzheimer’s disease at the Guide To Long Term Care.

 

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Nursing home patients’ response to music opens new avenues for diagnosis and therapy

A nursing home in California began playing music for residents suffering from dementia, and got responses from patients once considered unreachable.

There are thousands of nursing homes participating in an international music and memory program.

At Villa Coronado, a nursing home in San Diego, 10 residents with traumatic brain injury were given an iPod to listen to music. Over 4,500 residents in 300 California nursing homes are taking part in a statewide experiment. One of the aims of the study is to find out whether music can replace antipsychotic drugs and restraints for agitated patients. With some patients, it seems to work.

This patient population receives little or no therapy, and are mostly bedridden, isolated from the world around them. Researchers are looking to see if the music program can reduce aggressive behavior.

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For some people, music brings back memories. It can help dementia patients become more aware of their surroundings. Music will bring a smile to some patients, and can calm those who are agitated. Some patients listening to the music will smile, move rhythmically, and be more responsive to their loved ones.

Music is said to activate more parts of the brain than any other stimulus. New research suggests music therapy could help people in a coma or in a vegetative state.

The patients’ response to music may even help physicians to diagnose consciousness. Studies show there is a high rate of misdiagnosis in vegetative patients, where it is important to determine a patient’s chance of recovery. Observing these patients leads some workers to conclude that rather than a steady state, there is a spectrum of consciousness, and patients drift in and out.

Caroline Schnakers is an associate clinical professor in the Department of Psychiatry at UCLA. Her research indicates there is a 40 to 50 percent error rate in diagnosing a patient’s consciousness. Some patients appear to be unconscious, and yet have some signs of consciousness and awareness of their surroundings.

A patient in a minimally conscious state (MCS) is considered to have more chance to recover than a patient in a vegetative state. If a patient is observed to be sometimes conscious, there is more hope of recovery. The diagnosis of a patient determines medical treatment and end-of-life decisions, so it’s important to diagnose correctly.

Some patients thought to be in a vegetative state are actually in a minimally conscious state, and they respond to the music. One nursing home activities director was excited to see how music affected the residents, saying they just come alive.

Researchers at UC Davis plan to have the initial results of their nursing home study by the end of this year. But regardless of whether music is able to replace medication, it’s worth giving patients music to improve their quality of life.

For more information on the care of dementia patients: Alzheimer’s on Guide To Long Term Care.

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Insomnia increases Alzheimer’s risk

Just one night without enough sleep can cause harmful proteins to build up in the brain, increasing the risk of Alzheimer’s disease, according to a new study.

Past studies already linked insufficient sleep to increased risk of Alzheimer’s and other chronic diseases — but this recent study from Washington University,published in the Annals of Neurology, discovered what insomnia actually does to the brain.

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One of the functions of sleep is to clear the brain of waste, including amyloid beta proteins which can bond with each other and form plaques on nerve cells. These plaques build up in the brains of people with Alzheimer’s disease.

People with a genetic tendency for Alzheimer’s disease have higher than normal levels of beta amyloid proteins, even before they develop symptoms. After a night without sleep, these higher levels appeared in the healthy study participants.

Inadequate sleep has been linked to a 1.5 fold increase in the odds of developing Alzheimer’s. It’s not surprising, therefore, that research shows that sleep disorders such as sleep apnea increase the risk.

In the study, eight participants with no previous sleep or memory problems were instructed to either stay awake all night, get a normal night’s rest, or use the drug sodium oxybate to help them sleep. The sleep aid is supposed to increase the period of deep, dreamless sleep when the brain is thought to restore itself.

The scientists tested the cerebrospinal fluid surrounding each participant’s brain for amyloid proteins. Measurements were taken before the night of the test, and then every 2 hours the next day, to show how the night of sleep or no sleep affected the accumulation of these proteins in the brain.

Study participants who went without sleep for just one night had a 25-30% increase in the beta-amyloid proteins in their cerebrospinal fluid, bringing the levels to what researchers would expect to see in people who have genes for Alzheimer’s disease. Before the test, the participants all had normal levels. The pills designed to promote the deep sleep did not affect the levels of amyloid protein.

In a healthy person, normal sleep eliminates waste and restores the brain each night. But repeated nights of insufficient rest may overwhelm the brain’s recovery system, allowing amyloid proteins to build up and form plaques which interfere with the brain’s functioning.

For information on Alzheimer’s and also long term care insurance, see Alzheimer’s Section on the Guide To Long Term Care.

 

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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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