Health and Disability

The truth about nursing homes is sobering. Though we assume that seniors in nursing homes or assisted living facilities receive a basic level of comfort and safety, the National Center on Elder Abuse (NCEA) reports that in 2012 nearly 1 in 3 nursing homes were cited for violating federal standards over a two-year period, and over half of nursing home staff members admitted to mistreating senior residents over the prior year.

Abuse has always been a problem, but with today’s large population of aging seniors, in conjunction with the depressed economy, families really need to be diligent when finding nursing homes. In fact, according to Elder Care Attorney Rich McIver, whose law practice specializes in fighting nursing home elder abuse, “2012 is the worst year on record for nursing home violations.” McIver continues, “In terms of both the gross number of violations, and on a per capita basis, the quality of care provided at nursing homes is at its worst in decades.”

The study estimates that raising Medicare’s eligibility to 67 in 2014 would generate an estimated $5.7 billion in net savings to the federal government, but also result in an estimated net increase of $3.7 billion in out-of-pocket costs for 65- and 66-year-olds, and $4.5 billion in employer retiree health-care costs.  In addition, the study projects that the change would raise premiums by about 3 percent both for those who remain on Medicare and for those who obtain coverage through health reform's new insurance exchanges.  The study assumes both full implementation of the health reform law and the higher eligibility age in 2014 in order to estimate the full effect of both the law and the policy proposal.
In the absence of the health reform law, raising Medicare's age of eligibility would result in an increase in the uninsured, according to other studies, as many older Americans would have difficulty finding affordable coverage in the individual market in the absence of Medicare.  With health reform, virtually all 65- and 66-year-olds would be expected to obtain alternative sources of coverage. 

The average cost of a semi-private room in a nursing home rose 3.7% in 2012, from $214 daily or $78,110 annually in 2011, to $222 or $81,030 annually.

Assisted living base rates increased by 2.1%, from $3,477 monthly or $41,724 annually to $3,550 or $42,600.

The average rate for a homemaker increased by 5.3%, from $19 to $20 per hour.

Only rates for home health aides and adult day services were unchanged year to year, remaining at $21 per hour and $70 per day respectively.  

In their study, post-doctoral researcher Sabrina Segal and neurobiologists Carl Cotman and Lawrence Cahill had people 50 to 85 years old with and without memory deficits view pleasant images - such as photos of nature and animals - and then exercise on a stationary bicycle for six minutes at 70 percent of their maximum capacity immediately afterward.

One hour later, the participants were given a surprise recall test on the previously viewed images. Results showed a striking enhancement of memory by exercise in both the healthy and cognitively impaired adults, compared with subjects who did not ride the bike.

The results showed a significant link between the frequency of mental activity and diffusion anisotropy values: more mental activity was linked to higher values.

"Keeping the brain occupied late in life has positive outcomes," says Arfanakis, after explaining what they found:

"Several areas throughout the brain, including regions quite important to cognition, showed higher microstructural integrity with more frequent cognitive activity in late life."

Arfanakis says diffusion anisotropy values start falling at around age 30.

"Higher diffusion anisotropy in elderly patients who engage in frequent cognitive activity suggests that these people have brain properties similar to those of younger individuals," he adds.

"Collaborative dementia care -- sensitive to local needs and concerns -- combines human interaction of all those involved plus technology. Regular face-to-face meetings of caregivers, clinicians and researchers provide invaluable opportunities to balance human need and the flood of information as we develop and deliver new and innovative dementia care," said Regenstrief Institute investigator Malaz Boustani, M.D., MPH, associate director of the IU Center for Aging Research and IU School of Medicine associate professor of medicine. The senior author of the new study in Clinical Interventions in Aging, a peer-reviewed, open-access online journal, Dr. Boustani is founding director of the Indianapolis Discovery Network for Dementia and sees patients at the Wishard Healthy Aging Brain Center.

Duh!

"As a result of age-related declines in health and functioning, older adults are particularly vulnerable to the hazards of exposure to unhealthy air," Ailshire said. "Air pollution has been linked to increased cardiovascular and respiratory problems, and even premature death, in older populations, and there is emerging evidence that exposure to particulate air pollution may have adverse effects on brain health and functioning as well."

This is the first study to show how exposure to air pollution influences cognitive function in a national sample of older men and women. It suggests that fine air particulate matter - composed of particles that are 2.5 micrometers in diameter and smaller, thought to be sufficiently small that if inhaled they can deposit deep in the lung and possibly the brain - may be an important environmental risk factor for reduced cognitive function

None of his physical assessments since then have shown any sign of awareness, or ability to communicate.

But the British neuroscientist Prof Adrian Owen - who led the team at the Brain and Mind Institute, University of Western Ontario - said Mr Routley was clearly not vegetative.

"Scott has been able to show he has a conscious, thinking mind. We have scanned him several times and his pattern of brain activity shows he is clearly choosing to answer our questions. We believe he knows who and where he is."

A new federal program designed to expand community living options for people with disabilities is one step closer to reality this week with the first state cleared to take part.

The Centers for Medicare and Medicaid Services said Tuesday that California will be the first to participate in the Community First Choice Option. The program, established as part of the Affordable Care Act, offers states more Medicaid dollars for community living in exchange for agreeing to eliminate caps on the number of people served in the community.

But not all nursing home residents get to exercise that right.  Survey reports from the Centers for Medicare and Medicaid Services in ProPublica’s Nursing Home Inspect [1] database show that over the past few years, dozens of nursing homes have been cited for violating residents’ voting rights.

At a nursing home in Anchorage, state inspectors reported [2] that the facility failed to ensure residents the opportunity to vote in a municipal election.  One resident was “visibly tearful” and said she had voted in every election, according to an inspection report.