Health and Disability

The issue is not always—in fact, not usually—an intra-family feud. Often it’s a nursing home or assisted-living facility or even a publicly funded long-term-care agency that goes after children, grandchildren and other family members to repay outstanding LTC bills. For financial advisors and their clients, this is a wake-up call: Clients not only have to plan for their own future needs but also make sure their parents’ LTC finances are in order.

"Our work demonstrates that words can hurt and older adults who suffer from verbal mistreatment have serious sequela," said Terry Fulmer, a member of the research team. "All of us have a responsibility to better understand verbal mistreatment and develop interventions to help stop these unwanted behaviors. Further, we need to develop strategies that help older adults cope with verbal mistreatment."

When your loved one needs just a little bit of help, CareTree helps you coordinate amongst family. As needs change, the system allows you to securely invite caregivers to participate in the discussion while protecting private information.

We know from research that adults with intellectual or other developmental disabilities, such as autism or Down syndrome, frequently face a cascade of health disparities. They may:

• have complex, multiple or difficult-to-treat medical conditions
• experience difficulty accessing health care, either because of physical barriers or financial barriers
• receive inadequate health care
• have difficulties expressing their symptoms and pain
• receive little attention to wellness, preventive care and health promotion

And these adults deserve quality, patient-centered health care.

The Special Hope Foundation, of Palo Alto, Calif., saw this need and provided funding for the IDD Toolkit, a website devoted to medical information for the health care of adults with intellectual and developmental disabilities (IDD). The toolkit came online earlier this year, and is accessible on a PC, tablet or smartphone. As of early August, the site has had more than 11,000 visits with more than 33,500 page views.

For the pilot study, participants underwent evaluation of memory performance and brain activity at baseline, immediately following memory retraining, and at 6-month followup. Results showed that the patterns of increased cerebral activation that correlated with learning were maintained at 6-month followup. "These results support the long-term effectiveness of cognitive rehabilitation in individuals with cognitive impairment caused by MS," saidNancy Chiaravalloti, PhD, director of Neuroscience & Neuropsychology and Traumatic Brain Injury (TBI) Research at Kessler Foundation. “For optimal care, it is crucial for clinicians who care for this population to become familiar with the mSMT protocol.”

In the Commonwealth Fund report, Hong and his co-authors - Timothy Ferris, MD, MPH, vice president, Population Health Management, at MGH and Partners HealthCare System and Allison Siegel, MPH, formerly with the Stoeckle Center for Primary Care Innovation at MGH - review characteristics of successful care management programs. Foremost among these are close collaboration of care managers with all the providers taking care of a complex patient. They note that small, one- and two-physician primary care practices may lack the resources required for complex care management. In cases like that, regional organizations - either public or private - can provide the infrastructure for care management that remains closely tied to patients' known providers.

In the NEJM article, Hong, Ferris and Melinda Abrams, vice president, Delivery System Reform, at the Commonwealth Fund note that the primary barrier to broader adoption of care management is the fee-for-service payment system, which provides little or no support for essential care management functions. Instead, reimbursement systems that provide global payments covering all services a complex patient requires or those that share cost savings among both payers and providers may be better options. Another option that provides a monthly, per-patient care management fee might encourage the participation of providers unable to take on the financial risks involved in global payment contracts. Other barriers include the start-up costs associated with staff training and new information technology, which could be covered by supplemental payments. Unrealistic expectations for a rapid return on investment could be addressed by increasing the duration of payer-provider contracts.

In fact, eight of the nine non-profit free clinics in West Virginia this year began participating in Medicaid. The shift – which also occurred to a lesser degree in Ohio and Illinois, among other states – is being closely watched nationwide and reflects how facilities are adapting in the 26 states that expanded Medicaid.

The authors of the study, published in Neurology, state that low concentrations of vitamin D are associated with the development of Alzheimer's disease. Worryingly, there are high rates of vitamin D deficiency in older adults - the group most at risk from developing dementia.

The CDC report that one third of the US population do not get sufficient amounts of vitamin D, with 8% of the population at risk of vitamin D deficiency. Vitamin D is obtained from sun exposure and foods such as milk, eggs, cheese and fatty fish.

During this follow-up period, 171 of the participants developed dementia and 102 participants developed Alzheimer's disease. The researchers found the participants with low levels of vitamin D were 53% more likely to develop dementia, and those who were severely deficient were 125% more likely, when compared with participants with regular levels of vitamin D.

Similarly, participants with low levels of vitamin D saw a 70% increased risk of developing Alzheimer's disease, and those with severe deficiency had an increased risk of 120%, again when compared with participants with normal levels of the vitamin.

Bood sugar surges -- after-meal glucose "spikes" -- can be life threatening for the 29 million Americans with diabetes. Diabetic blood sugar spikes have been linked to cardiovascular disease, cancer, Alzheimer's disease, kidney failure, and retinal damage. Now a new Tel Aviv University study, published in Diabetologia, suggests a novel way to suppress these deadly post-meal glucose surges: the consumption of whey protein concentrate, found in the watery portion of milk separated from cheese curds, before breakfast.