For seniors like Sears who wish to remain in their homes, here are seven 'life-hacks' -- simple tools and tips that some people find helpful as they "age in place" -- courtesy of Allyson Evelyn-Gustave, a senior occupational therapist at Johns Hopkins School of Nursing who is currently part of a team examining how relatively easy home repairs can boost independence for low-income seniors.
"The idea that we can provide care to individuals with Parkinson disease regardless of where they live is both a simple and revolutionary concept," said University of Rochester Medical Center (URMC) neurologist Ray Dorsey, M.D., M.B.A., senior author of the study which appears today in the journal Neurology: Clinical Practice. "This study demonstrates that, by employing essentially the same technology that grandparents use to talk to their grandchildren, we can expand access to the specialized care that we know will improve patient's quality of life and health."
More than 40 percent of people with Parkinson's disease do not see a neurologist, placing these individuals at greater risk for poor health outcomes. For example, people with the disease who do not see a specialist are 20 percent more likely to fall and fracture a hip, 20 percent more likely to end up in a skilled nursing facility, and 20 percent more likely to die.
While it has often been said that the most frequent users of overburdened hospital emergency departments are mentally ill substance abusers, results of a study just released by researchers from NYU Wagner and the University of California, San Francisco, has found that this belief is unfounded - an "urban legend."
(T)he new analysis of hospital emergency department (ED) use in New York City by Medicaid patients reveals that conditions related to substance abuse and mental illness are responsible for a small share of the emergency department visits by frequent ED users, and that ED use accounts for a small portion of these patients' total Medicaid expenditures. However, according to the study, frequent emergency department users have a substantial burden of disease, often having multiple chronic conditions and many hospitalizations.
When Medicaid expands next year under the federal health law to include all adults living close to the poverty line, one group of eligible beneficiaries will be several million men and women who have spent time in state and federal prisons and jails.
The Department of Justice estimates former inmates and detainees will comprise about 35 percent of the people who will qualify for Medicaid coverage in the states expanding their programs to anyone earning less than 138 percent of the federal poverty level, or about $15,000 for an individual in 2013. The Congressional Budget Office estimated earlier this year that 9 million people will get that new coverage next year.
In addition, the expansion could help states cover the medical costs of some current inmates who need hospitalization or other expensive specialized care outside of prison.
Michigan, which has long been recognized as an innovator in inmate health care, is expanding its Medicaid program. Officials here say that funding could help cover the needs of some seriously ill inmates as well as provide new coverage for released offenders, which could be a valuable tool in curbing recidivism.
Seniors who take certain blood pressure medications might be at a dramatically reduced risk for developing dementia associated with Alzheimer’s disease, according to findings published in the journal Neurology.
A team led by a researcher from the Johns Hopkins University School of Medicine analyzed results of the Gingko Evaluation of Memory Study. This was intended to see whether the herb gingko biloba reduces the risk of Alzheimer’s. The herb does not, according to the study, but the researchers took another approach, looking at the blood pressure drugs that some of the 3,000 participants were taking.
People older than 75 who had normal cognition and took diuretics, angiotensin-1 receptor blockers (ARBs) and ACE inhibitors demonstrated a 50% reduced risk of Alzheimer’s dementia, the researchers found. Among those with mild cognitive impairment, diuretic use was associated with a 50% reduced risk.
Beta blockers and calcium channel blockers did not have this effect, according to the researchers. Check with your doctor.
With medical advances, even the sickest patients now often survive potentially life-threatening conditions after a stay in intensive care. Many experience aftereffects, not only of the illness but also of the very medical care that may have saved their lives.
Doctors call it "post-intensive care syndrome" and say it is becoming more common. In the ICU, patients may be heavily sedated and hooked up to a ventilator, keeping them immobile, breathing and free of pain. But they can develop a temporary brain injury known as "ICU delirium," that is linked to later problems with memory and thinking. As many as 80% of ICU survivors have some form of cognitive or brain dysfunction, according to the Society of Critical Care Medicine, and some never recover. Many experience post-traumatic stress symptoms, depression, fatigue and prolonged muscle weakness.
More than five million patients are admitted to an intensive care unit each year for conditions such as respiratory failure and heart failure, and for monitoring after invasive surgery.
The results of the study revealed that patients who took a combination of multivitamins and selenium had a lower risk of reaching a CD4 cell count of 250/µL or less - a level that prompts initiation of ART in Botswana - compared with patients who took placebos.
Furthermore, a mix of multivitamins and selenium was found to reduce the risk of a combination of measures for HIV progression, including CD4 cell count less than 250/µL, acquired immunodeficiency syndrome (AIDS)-defining conditions, or AIDS-related death.
Commenting on their findings, the researchers say:
"This evidence supports the use of specific micronutrient supplementation as an effective intervention in HIV-infected adults in early stages of HIV disease, significantly reducing the risk for disease progression in asymptomatic, ART-naive, HIV-infected adults."
This randomized controlled trial (RCT) is the first to include both objective (investigator administered) and subjective measures (patient and family self-report). Investigators looked at the impact of the modified Story Memory Technique (mSMT) on learning and memory in 86 participants with MS with documented memory deficits (41 mSMT group, 45 placebo). Not only did objective measures improve, patients and families reported improvements in daily function in everyday life - improvements that had a positive impact on satisfaction with life and everyday contentment.
"Our results show that cognitive rehabilitation works," said Nancy Chiaravalloti, Ph.D., director of Neuroscience & Neuropsychology Research at Kessler Foundation, "and moreover, the effects of the 10-session protocol persisted for six months." a unique aspect of the protocol is the inclusion of 2 sessions that focus on translating cognitive strategies to daily life.
The investigators note that previous research has shown that patients with fibromyalgia can have increased neural activity in the insula of the brain - a region associated with processing pain and emotion.
Research has also shown that heightened activity in the insula could be linked to increased levels of glutamate - a stimulative neurotransmitter in the brain.
Using proton magnetic resonance spectroscopy, functional magnetic resonance imaging (fMRI) and functional connectivity magnetic resonance imaging, the researchers found that pregabalin, commercially known as Lyrica, partly works by reducing glutamate concentration in the insula - which the researchers say is consistent with animal studies.
Furthermore, it was found that alongside decreased glutamate concentration, there were reductions in insula connectivity and patients' rating of clinical pain.
The California Department of Social Services issued more than $2 million in fines against assisted living facilities throughout the state from 2007 to 2012.
But a ProPublica review of department records shows it collected less than half of that. Indeed, the agency failed to wrest any money from the vast majority of facilities it hit with the most serious sanctions.
Of the 50 largest fines assessed over those years, the review showed, the department collected no money in 39 cases. In one instance, a facility in a tiny Shasta County town that was operating without a license accrued more than $250,000 in penalties and paid none of it.