Recognizing and supporting the role of family caregivers may be a way home health agencies can strengthen the current concerning state of care for older adults in the United States, according to a recent report from The National Academics of Sciences, Engineering and Medicine. This should include revising Medicare to provide more reimbursement for involving family caregivers, the report authors assert.

The 297-page report, Families Caring for an Aging America, was compiled over the last two years and released today with support from 15 sponsors by an expert committee from The National Academies of Sciences, Engineering and Medicine.

A larger emphasis needs to be put on family caregivers, whether older adults are receiving other services like home health care or not, the report explains. If caregivers are not recognized, there is a larger risk to the well-being of elders and their families.

One of the most recent regulations in this area is being pushed by the Centers for Medicare & Medicaid Services (CMS), which is finalizing a set of proposed revisions to Medicare regulations around the home health benefit.

The revisions that are proposed would require home health agencies to identify the care recipient’s primary family caregiver and then develop the Medicare beneficiary’s plan of care in partnerships with the older adult as well as the caregiver. The plan could include education and training for the caregiver specific to the needs of their loved one, according to the report.

Chronic fatigue syndrome (CFS) is a mysterious and maddening condition, with no cure or known cause. But researchers, using a variety of techniques to identify and assess targeted metabolites in blood plasma, have identified a characteristic chemical signature for the debilitating ailment and an unexpected underlying biology: It is similar to the state of dauer, and other hypometabolic syndromes like caloric restriction, diapause and hibernation.

Dauer is the German word for persistence or long-lived. It is a type of stasis in the development in some invertebrates that is prompted by harsh environmental conditions. The findings are published online in the August 29 issue of PNAS.

"CFS is a very challenging disease," said first author Robert K. Naviaux, MD, PhD, professor of medicine, pediatrics and pathology and director of the Mitochondrial and Metabolic Disease Center at UC San Diego School of Medicine. "It affects multiple systems of the body. Symptoms vary and are common to many other diseases. There is no diagnostic laboratory test. Patients may spend tens of thousands of dollars and years trying to get a correct diagnosis."

"Despite the heterogeneity of CFS, the diversity of factors that lead to this condition, our findings show that the cellular metabolic response is the same in patients," said Naviaux. "And interestingly, it's chemically similar to the dauer state you see in some organisms, which kicks in when environmental stresses trigger a slow-down in metabolism to permit survival under conditions that might otherwise cause cell death. In CFS, this slow-down comes at the cost of long-term pain and disability."

Naviaux said the findings show that CFS possesses an objectively identifiable chemical signature in both men and women and that targeted metabolomics, which provide direct small molecule information, can provide actionable treatment information. Only 25 percent of the metabolite disturbances found in each person were needed for the diagnosis of CFS. Roughly 75 percent of abnormalities were unique to each individual, which Naviaux said is useful in guiding personalized treatment.

Healthcare Stories is a new video advocacy tool in DREDF’s ongoing campaign for healthcare justice for people with disabilities. We are deeply grateful to The Special Hope Foundation and The Manuel D. and Rhoda Mayerson Foundation for their visionary support of the project, which began collecting stories in 2011.

Our stories, dispatches from the front lines of health care, add an essential human dimension to a large body of research showing that people with disabilities experience both health and healthcare disparities and face specific, persistent barriers to care. We know firsthand that poor health care inevitably affects the quality and length of our lives as well as our productivity, autonomy and independence. Because we experience unequal healthcare every day, out of necessity we have become experts in what must be done to remove barriers and increase access to the care we need. We invite you to watch the videos, meet the people behind the stories, and learn what you can do to spark change.

New data from the Centers for Medicare & Medicaid Services finds that almost all states improved on preventable hospital readmissions between 2010 and 2015, while readmissions declined 8 percent nationwide in the same period.

Preventable readmissions dropped in 49 states and the District of Columbia, according to a CMS blog post. Vermont's rate remained the same. 

The drops aren’t small, either; according to the data, the decline exceeded 5 percent in 43 states and 10 percent in 11. Across all states, hospitals averted about 100,000 readmissions in 2015 and a projected 565,000 since 2010.

Hawaii (13.4 percent) and New Jersey (13.3) had the biggest drop in readmissions.

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It's normal to forget things from time to time, and it's normal to become somewhat more forgetful as you age. But how much forgetfulness is too much? How can you tell whether your memory lapses are within the scope of normal aging or are a symptom of something more serious?

Healthy people can experience memory loss or memory distortion at any age. Some of these memory flaws become more pronounced with age, but — unless they are extreme and persistent — they are not considered indicators of Alzheimer's or other memory-impairing illnesses.

(My personal favorite...)

3. Blocking

Someone asks you a question and the answer is right on the tip of your tongue — you know that you know it, but you just can't think of it. This is perhaps the most familiar example of blocking, the temporary inability to retrieve a memory. In many cases, the barrier is a memory similar to the one you're looking for, and you retrieve the wrong one. This competing memory is so intrusive that you can't think of the memory you want.

Scientists think that memory blocks become more common with age and that they account for the trouble older people have remembering other people's names. Research shows that people are able to retrieve about half of the blocked memories within just a minute.

Lisinopril is an ACE inhibitor, used to treat high blood pressure, congestive heart failure, and to improve survival after heart attack. It is sold under the brand names Prinivil and Zestril. Lisinopril has been linked to a life-threatening allergic reaction called angioedema. Users have experienced severe and fatal liver problems. When taken by pregnant women, lisinopril can cause fetal injury and death.