Propublica is offering anyone with a story about assisted living facilities, maybe a parent or a spouse, and persons who worked in assisted living, a chance to tell their story of poor care, violation of rights, and other similar problems:
Has Your Loved One Lived In an Assisted Living Facility?: http://goo.gl/3ZuKgG
Have You Worked In an Assisted Living Facility?: http://goo.gl/VOjBqr
This article notes that almost half of older persons in surgery show delirium during recovery. That isn't all that new, though the percentage is certainly disturbing. My real point in posting it is their conclusion. They think that such delirium is not cause for reexamining their use of general anesthetics. Rather, they believe that the delirium is an indicator for nursing home placement.
Anesthetics are known to produce delirium if you aren't knocked out fast enough, and post recovery confusion is common enough regardless of age. Also, there is more and more evidence that repeated general anesthesia produces long term negative changes in cognition. These findings would suggest a general review of currently available surgical anesthetics, not increased referral to nursing homes.
Delirium occurring early after surgery is linked to decreased cognitive (mental) function and an increased rate of nursing home admission, according to the study by Dr Karin J. Neufeld of Johns Hopkins University and colleagues. They write, "Recognizing delirium in the PACU may be important for identifying patients at higher risk of in-hospital harms...as well as cognitive impairment and institutionalization at hospital discharge."
"For employers, there are three different options: They can provide adequate coverage, inadequate coverage or no coverage at all," she said. "In terms of loopholes, they could offer adequate insurance but could ask job applicants about their coverage in an attempt not to hire people who may seek coverage. They could offer inadequate insurance, but threaten employees not to elect coverage through the health exchanges, because then the employers would have to pay a fine. Or employers could offer no coverage at all and pay the fines, which do increase over time; it might be worth it if they calculate that they come out ahead monetarily by not offering coverage."
A POLST is a direct threat to anyone with a chronic disability, and represent the leading edge of the medical community's resurgent notions of the uselessness of people with chronic disabilities. The fact that they are useful in some contexts doesn't in any way eliminate their potential for deadly judgements on the quality of life of people with severe disabilities. You should also take a look at the pamphlets big box hospitals provide freely to convince you to sign advance directives. They include fairly competent attempts to convince you your life isn't worth living.
And don't forget the woman who recently woke up to find an operating team getting ready to remove her organs. See http://goo.gl/sNYzV
“'How do we know the POLST medical order actually reflects the desires of the individual?' [We worry] that depending on how POLSTs are presented, they can make life-sustaining treatments—such as the use of feeding tubes—seem unbearable, even though many disabled people are able to live full lives because of them."
In her more extensive written comments, Coleman called attention to documented evidence of problems from various states that have implemented POLST, including a Delaware state order discontinuing the use of POLST, and a February 2013 report from Disability Rights California entitled, The Deadly Failure of a Hospital to Follow a Patient's Decisions About his Medical Care.
Coleman also addressed POLST provisions contained in a new federal bill called the “Personalize Your Care Act” that was introduced on March 14, 2013, by Representative Earl Blumenauer (D-Oregon):
"[The bill] would provide Medicare funding for physicians to have a conversation with their patients about “end-of-life care.” If done well, we agree that such a conversation can be a good thing, and I object to the 'death panel' accusations that obstructed rational discussion of such a provision in the Affordable Care Act.
"But there’s another section of the new bill, H.R. 1173, that would provide grants to promote POLST across the country. If we can conclude anything from the current level of information we have about how POLST is being implemented in the states that have it, it’s that many questions remain unanswered, strong reasons for concern exist, and federal funding to promote POLST is premature. The POLST provisions of H.R. 1173 should be amended to fund independent research to answer the serious questions and concerns that many have raised. That’s what the Institute of Medicine and this Committee should support."
Chinese herbal medicine, which has been used for thousands of years in China, has long been considered an effective treatment for vascular dementia.
The results suggested that Chinese herbal medicine appears to be safer and more effective than control measures in the treatment of vascular dementia. Chinese herbal medicines for vascular dementia exert characteristics of syndrome differentiation of traditional Chinese medicine, and have good potential in the clinic.
A podcast
For Michael Bloom of Bloom Coaching and Performance LLC, the challenges of caregiving hit home when he found himself caring for both of his elderly parents and are reflected in his book “The Accidental Caregiver’s Survival Guide.” From his knowledge and experience he has developed valuable insights into the role of caregiving, specifically as it affects gay men and women.
Their findings revealed that NPD1=PD1 not only alleviated the pain, but also reduced nerve swelling following the injuries. Its analgesic effect stems from the compound's ability to inhibit the production of cytokines and chemokines, which are small signaling molecules that attract inflammatory macrophages to the nerve cells. By preventing cytokine and chemokine production, the compound protected nerve cells from further damage. NPD1=PD1 also reduced neuron firing so the injured animals felt less pain.
Ji believes that the new discovery has clinical potential. "Chronic pain resulting from major medical procedures such as amputation, chest and breast surgery is a serious problem," he said. Current treatment options for neuropathic pain include gabapentin and various opioids, which may lead to addiction and destruction of the sensory nerves.
Thanks and a hat tip to Kathryn.
When we listen to the language of people with dementia, we often hear ‘empty speech’ which lacks nouns and specific names, and over time becomes more repetitive with less content and more jargon. People with dementia often retain reading, writing, and some pragmatic skills at later stages of the disease. We can monopolize on these intact skills with AAC strategies. The goals of treatment are to increase language production and comprehension for daily conversation, and to reduce memory-related problem behaviors (such as perseveration, irritability or hallucinations). AAC for dementia is often referred to as external memory strategies. So here are some ideas for treatment.
Ben-Gurion University of the Negev (BGU) researchers have discovered that a single dose of methylphenidate (MPH), used to treat Attention Deficit Hyperactivity Disorder (ADHD) and narcolepsy, helps to improve balance control during walking, hence reducing the risk of falls among elderly adults.