Health and Disability

Halton is pleased to announce the continued success of a program that is providing jobs to Ontario Works (OW) participants and preparing Halton to meet the needs of a growing seniors population. The highly effective Personal Support Worker (PSW) program, which trains OW participants for careers in the long-term care and home care fields, graduated 23 new PSW's at a ceremony on Friday, January 11 at the Halton Region.

“Graduates of the PSW program will help ensure that Halton is ready to meet the needs of its growing seniors population,” said Regional Chair Gary Carr. “The program is also helping Ontario Works participants gain their financial independence and contribute to the success of Halton’s economy – it’s a win-win situation.”

The PSW program has cost $237,965 with a total savings to date of $1,175,852 based on reductions to social assistance costs. Since OW costs are shared at an 80/20 ratio between the Province and the Region, Halton’s share of the savings has been $235,170. Investments in this worthwhile program pay off in participant outcomes and will continue to result in ongoing reductions to social assistance costs. For more information, please contact Susan Lazzer at 1-866-442-5866 or visit www.halton.ca.

An extraordinary new scientific study, which for the first time documents marked improvement in Alzheimer’s disease within minutes of administration of a therapeutic molecule, has just been published in the Journal of Neuroinflammation.

This new study highlights the importance of certain soluble proteins, called cytokines, in Alzheimer’s disease. The study focuses on one of these cytokines, tumor necrosis factor-alpha(TNF), a critical component of the brain’s immune system. Normally, TNF finely regulates the transmission of neural impulses in the brain. The authors hypothesized that elevated levels of TNF in Alzheimer’s disease interfere with this regulation. To reduce elevated TNF, the authors gave patients an injection of an anti-TNF therapeutic called etanercept. Excess TNF-alpha has been documented in the cerebrospinal fluid of patients with Alzheimer’s.

The new study documents a dramatic and unprecedented therapeutic effect in an Alzheimer’s patient: improvement within minutes following delivery of perispinal etanercept, which is etanercept given by injection in the spine. Etanercept (trade name Enbrel) binds and inactivates excess TNF. Etanercept is FDA approved to treat a number of immune-mediated disorders and is used off label in the study.

The use of anti-TNF therapeutics as a new treatment choice for many diseases, such as rheumatoid arthritis and potentially even Alzheimer’s, was recently chosen as one of the top 10 health stories of 2007 by the Harvard Health Letter.

Elder care managers: The Los Angeles Times on Sunday examined how elder care managers are "emerging to bridge the gap between far-off relatives and aging parents who may be overwhelmed by the labyrinth of medical and other services designed to help the aged and infirm survive in their own homes.

Home care: The Minneapolis Star Tribune on Sunday examined how a "shift in focus and in resource allotments needs to happen in the near future to accommodate" the "overwhelming preference for home care" among elderly patients. According to the Star Tribune, despite the recent growth of the home elder care industry, the "infrastructure ... is not yet in place to handle this coming age wave of American retirees."

AARP has petitioned the U.S. Supreme Court to review whether the Equal Employment Opportunity Commission had the authority to issue a Dec. 26, 2007, regulation that allows employers to legally eliminate or reduce health benefits for retirees when they reach age 65 and become eligible for Medicare while retaining benefits for retirees under age 65, CQ HealthBeat reports (Reichard, CQ HealthBeat, 1/3).

The ruling allows employers to create two classes of retirees -- those younger than age 65 and those older than 65 -- and offer different benefits to each group. In addition, the ruling allows employers to eliminate or reduce benefits provided to spouses or dependents of retirees older than 65. EEOC proposed the rule in response to a 2000 U.S. Court of Appeals decision that required benefits to be offered at the same level for Medicare-eligible retirees and those younger than 65 (Kaiser Daily Health Policy Report, 1/2). A June 2007 decision by the Third Circuit Court of Appeals found that EEOC has the authority to create the exemption under the Age Discrimination in Employment Act.

The House Hearing for the Community Choice Act has been set!

The hearing on CCA and other long term care issues will be held on
Wednesday, January 16, 2008 at 10 am.
The hearing will held by the Health Subcommittee of the House Energy and
Commerce committee. we still don't have the details on what room but we will
let
you know when we get them.

We want a BIG turnout, like we had for the Senate hearing. If you have a
orange shirt, wear it because it showed up very well not only in the hearing
room, but on the internet as well!

This hearing will keep the momentum going for passage of CCA and reform of
the long term services and supports system.

Let's keep pushing MFP and getting it implemented in the states, BUT let's
also focus on passage of CCA! This hearing is the next step.

A successful effort to improve quality of life for home care workers and the people they assist is described in HHA Partnering Collaborative Evaluation: Practice/Research Brief, a publication of the U.S. Department of Health & Human Services Office of Assistant Secretary for Policy & Evaluation.

The initiative was launched in 2003 by the Visiting Nurse Service of New York. Its goal is to improve the work life of home care aides and increase support for their patients' improvement in key activities of daily living. Components include:

• Implementation of the "Five Promises" -- a set of field supervision practices designed to promote positive and effective communication among all caregivers while in the patient's home.
  
• Use of an ADL Tool to structure common goal-setting among nurses, patients, and aides in order to improve functional health.
  
• Proactive communication between patient service managers and licensed agency coordinators to cover aide supervision and service delivery issues.
  
• Increase in field support and supervision provided to aides.

In addition, it has changed the culture of health service delivery by moving from a purely professional model toward one of self-care management. In the self-care management model, patients and informal caregivers are active participants in decision-making and goal-setting, and home health aides play a key supportive role.

Patients over the age of 60 who have elective surgeries such as joint replacements, hysterectomies and other non-emergency, inpatient procedures, are at an increased risk for long-term cognitive problems, according to a new study led by Duke University Medical Center researchers.

The study also found that elderly patients who developed these postoperative cognitive problems were more likely to die in the first year after surgery.

A very interesting take on LTC and community-based options:

It reminds me way too much, of moving day. That is, moving day to a Long Term Care Facility. The day that our parent or grandparent moves out of their home community and into Long-Term Storage. Dropped off. All looking alike. All gathering dust. Fade out. The end.

Long Term Storage facilities. They all look and act very similar. They are all miles out of town, have a nice long entry driveway through a pastoral setting that ends at a drop-off porte cochere that enters a massive building that houses 50 to 100 residents in a setting that is quite unlike the home these residents have left behind. It is far away from their social network. And, this is really the only option for a lot of people. The only option, by default, is the best option. Also by default, it is the worst....

A new report by AARP's Public Policy Institute (PPI) identifies effective practices for monitoring court-appointed adult guardians, reducing the chances for abuses that occur when oversight is lax.

Conducted with the American Bar Association (ABA) Commission on Law and Aging, the report follows a 2006 AARP survey showing that a large number of state courts around the country fail to assign a monitor to visit vulnerable individuals under guardianship, leaving many Americans open to physical neglect and financial abuse. The 2006 survey also found that, in many jurisdictions, no one verifies the information in guardianship reports.