Health and Disability

http://goo.gl/qC9B5Q

Toles and his colleagues also examined whether factors such as race and diagnosis increased the likelihood that older adults discharged from a nursing facility would return to the hospital. They found that men and African Americans were more likely to need additional acute care along with older adults with cancer or respiratory diseases. Other factors associated with a higher need for acute care included a high number of previous hospitalizations, comorbid conditions, and receiving care from a for-profit facility.

Toles explained that researchers currently don't know how many of these rehospitalizations and emergency room visits are preventable. Because the Affordable Care Act penalizes hospitals for readmitting Medicare patients, there has been more focus on improving patients' transition from the hospital to their home. Toles hopes this study will convince decision makers to pay attention to transitions from nursing facilities as well.

http://goo.gl/Gpy7lZ

Executive Summary

This issue of the Health Advocate provides an overview of Medicaid Home and Community Based Services (HCBS). HCBS programs are intended to support states in creating a comprehensive system of long-term care services in the community, as is consistent with the community integration mandate established by the Supreme Court in the Olmstead v. L.C. case in 1999.

http://goo.gl/mkArnC

Antidepressant drug citalopram could help significantly relieve agitation in patients with Alzheimer's disease, but at the cost of slightly decreasing cognitive function and increasing heart attack risk, according to results of a clinical trial released Tuesday.

However, the drug, sold under the brand names Celexa and Cipramil and also available as a generic medication, might be safer than antipsychotic drugs currently used to treat the condition, according to the study led by Johns Hopkins Medicine researchers that included seven other academic medical centers in the United States and Canada.

I have had a mild version of this since I returned from Vietnam, and I started taking increased Vitamin D because of my age. I too got significantly reduced hives, and now I guess I know the reason....

http://goo.gl/zDREjK

Over 12 weeks, 38 study participants daily took a triple-drug combination of allergy medications (one prescription and two over-the-counter drugs) and one vitamin D3, an over-the-counter supplement. Half of the patient's took 600 IUs of vitamin D3 and the other half took 4000 IUs.

Researchers found after just one week, the severity of patients' symptoms decreased by 33 percent for both groups. But at the end of three months, the group taking 4000 IUs of vitamin D3 had a further 40 percent decrease in severity of their hives. The low vitamin D3 treatment group had no further improvement after the first week.

http://goo.gl/Ab3gan

According to research by a professor at the University of Chicago, extreme loneliness can increase an older person's risk of premature death by 14%.

This makes extreme loneliness a risk factor for premature death that is nearly as potent as disadvantaged socioeconomic status. Disadvantaged socioeconomic status is known to cause an increase of 19% in risk of early death.

The researcher notes that a 2010 study even found that loneliness has twice the impact on early death as obesity does.

http://goo.gl/mL9OD6

The study investigated stressful aspects of transport accident or workers' compensation claims, and the impact of that stress on long-term recovery.

It found those who had experienced stressful claims had greater levels of anxiety, depression and disability and a slower recovery from injury.

http://goo.gl/ccTmzQ

Researchers in the U.K. report that non-restorative sleep is the strongest, independent predictor of widespread pain onset among adults over the age of 50. According to the study published in Arthritis & Rheumatology (formerly Arthritis & Rheumatism), a journal of the American College of Rheumatology (ACR), anxiety, memory impairment, and poor physical health among older adults may also increase the risk of developing widespread pain.

http://goo.gl/Qkfo8o

The trial, known as Maximizing Independence (MIND) at Home, involved 303 people 70 years and older with memory disorders, primarily dementia and mild cognitive impairment. One hundred and ten of them received an in-home visit from a memory care coordinator and nurse that assessed a range of care needs including diagnosis of memory problems, review of medications, behavior problems, daily activities, and untreated medical problems such as hearing or vision problems, andhigh blood pressure or diabetes. The care team then developed a personalized care plan and worked with the family over time to oversee progress and attend to new needs that arose.

The goal was to see if a dementia care coordination model that incorporated evidence-supported care practices could delay or prevent the need to move from home to other settings like nursing homes or assisted living facilities.

In a report published online in The American Journal of Geriatric Psychology, the Johns Hopkins investigators say that those who got 18 months of care coordination with home visits were able to safely stay in their homes a median of 288 extra days, or around 9.5 months over a median follow-up period of about 2 years.

I don't agree with all of them, but the list provokes thought.....

http://goo.gl/TAlijI

1. Simple pleasures can bring great joy to a person with Alzheimer's: Even the simplest activities can be enjoyable to people with Alzheimer's. Ed was once deeply engrossed in examining a coat of mine that had numerous pockets. He spent 30 minutes with it. Another thing I learned is that -- like all of us -- people with Alzheimer's usually enjoy receiving presents regardless of how big or how little. I gave one of my ladies a gift once. I told her it was just a small gift. She said, "I know honey, but it's a present.

2. Pets, children, music and art may reach them on levels we cannot: I have experienced numerous examples of the positive effects these things can have on people with Alzheimer's.There's no question about it. Sometimes pets, children, music or art can bring about connections even with people who no longer talk and no longer recognize their loved ones.

3. What it means (and what to do) when they keep repeating the same story or asking the same question over and over: Ed and my ladies sometimes kept telling me the same story or asking me the same question over and over. They didn't remember that they had just told the story or asked the question. What I learned from this is that the subjects of this repetition must be very important to them. It's best to respond each time as though it were the first time.

http://goo.gl/zxihFo

A new study published in the Journal of Trauma and Acute Care Surgery finds that diaphragm pacing (DP) stimulation in spinal cord-injured patients is successful not only in weaning patients from mechanical ventilators but also in bridging patients to independent respiration, where they could breathe on their own without the aid of a ventilator or stimulation.

The stimulation is provided by the Diaphragm Pacing System (DPS), a technology providing electrical stimulation to nerves running through the diaphragm, the major muscle involved in breathing. When stimulated, the diaphragm contracts, allowing patients to breathe more naturally than having air forced into their lungs as a mechanical ventilator would do. The system is implanted through minimally invasive laparoscopic surgery.