The New Healthcare Challenge For Seniors
Posted by Jenny Peters on March 27, 2012 11:01 AM
They called it a "Conversation Summit," the event held at the Palm Restaurant in downtown Los Angeles on March 15. It brought together a host of experts to discuss the changing landscape of healthcare as the Baby Boomer generation roars into their Medicare years.
But first, as host Jim McMahon, the WellPoint, Inc., vice president of product management/innovation, pointed out, the assembled experts, reporters and bloggers needed to get on the same page. The terms "seniors" and "the silent generation" are the ones currently used to describe the over-65 population that Medicare serves, but now that the Baby Boomers are coming of age, those terms are passé. Not to mention the fact that those born from 1946 to 1964, that huge, lump-in-the-snake group of Americans, don't like to be called seniors, even if the oldest of them have recently hit age 65.
So "Baby Boomers" it is, the moniker that has traveled with the post-World War Two generation since the 1970s and will follow them into the grave. But before they get there, most have a ways to go, as Americans are living longer and longer. So as the 76 million Boomers make their way into (gasp!) old age, the conversation has to take place, as McMahon framed it: "What will the landscape of healthcare look like for Boomers as the years unfold?"
Weighing in on that question were a variety of experts, from Jennifer Kowalski, a director of Avalere Health, a D.C.-based healthcare consulting firm, and Lindsay Resnick, the chief marketing officer for KBM Group (a marketing services company that specializes in healthcare), to Peter Holtgrave and Nat Hutton of the Oasis Institute, a non-profit organization dedicated to promoting successful aging. Also on hand was Dr. Sheldon Zinberg, the longtime advocate of healthful aging and founder of Nifty after Fifty, the fitness centers that cater to, as he explained, "the 50- to 95-year-old market."
Kowalski noted that, "Baby Boomers understand more about the differences between Medicare, Medicare Advantage and Medicare Supplement plans than their parents, the so-called 'silent generation,' mostly because they understand how to find information on the Internet." But she insisted that, despite attempts by the government (with www.medicare.gov, www.healthcare.gov and other information channels) to make those choices easy to understand, "it all needs to be much simpler."
That is particularly true of what Resnick identified as the 50 million Boomers that are currently uninsured, "who when they reach 65 will be lining up for care that they haven't had before." The experts agree that one way to begin to understand options is coming by way of the Affordable Care Act signed into law two years ago by the Obama administration; part of that act is a soon-to-be-implemented Medicare Advantage rating system designed to help people choose the best care possible.
"Healthcare has never been data driven in the past," said WellPoint's McMahon, "but all that is changing now. It just makes sense to pay for quality care if you can, so this new ratings system will definitely help make that easier."
The experts agreed that implementing simpler ways for Boomers to figure out the maze of Medicare and its plans is a key element in the changing landscape of healthcare for the aging population; the other is finding ways to keep all those millions of people healthier than the generation that preceded them, thus saving on healthcare costs as they all dive into their golden years. That's where the Oasis Institute and Nifty after Fifty come in, being proactive in making sure that Boomers do not succumb to the ravages of age.
"It's important to engage people over 50 in ways that will improve their overall well being," Holtgrave insisted. "Our 'Active Generations' program at Oasis encourages over-50 volunteers to interact with kids as part of the CATCH [the Coordinated Approach to Child Health] initiative, getting them moving with various games and exercises, which is helping to stop the spread of childhood obesity. And it keeps the 50-plus volunteers doing more exercise themselves, in keeping with our goal of promoting healthy aging for everyone."
That successful "intergenerational program" is currently in 18 cities across the United States, with plans for rollouts in many more. Meanwhile, Nifty after Fifty goes even further toward keeping Baby Boomers in good shape and out of the hospital, by providing what Zinberg explained is "a customized health and wellness plan for each person, finding that person's area of frailty – and we all have weaknesses – and then developing a full-body training program that addresses any problems and promotes overall strength." Considering that, as Zinberg stated, "one out of three over-65 seniors takes a serious fall every year," it seems that his health centers are on the right track, as "we've decreased the incidence of falling in our members by 85 percent." That, the doctor said, "keeps people out of our hospitals and nursing homes and makes a huge difference in the quality of life as we age."
By the end of the summit, a few things about Baby Boomer healthcare in the coming years were clear. With so many Boomers heading into their retirement years in the next decade, the experts agreed that it is important for the healthcare landscape to shift, making insurance and Medicare choices easier to navigate (especially via the Internet) and more in tune with what the Boomer generation expects – quality care with a minimum of complications.
And at the same time, the Boomers must continue to embody the seismic shift they have already created during their lives up to now, in being a force of nature for changing the way that aging is perceived and lived. For while 50 may not actually be the new 30 (as some Boomers are known to proclaim), being age 50 and above is a distinctly different thing than it was for the generations that preceded them. And if Boomers are going to keep their reputation as being the generation that changed it all, they must be proactive in keeping themselves healthy, strong and independent – and out of nursing homes and hospitals if at all possible.
http://www.thirdage.com/whats-next/the-new-healthcare-challenge-for-seniors?page=4
"Learn About Senior In Home Health Care in Austin, Texas
Senior Helpers Provides Many services in the Austin, Texas area. We provide a full array of Home Care services for seniors and the elderly living in this beautiful area. Our Home Care Services are provided by bonded and insured employees and all employees pass a National Background check.
If you need Home Care services in Austin, Bartlett, Bertram, Briggs, Burnet, Cedar Park, Florence, Georgetown, Granger, Holland, Hutto, Jarrell, Johnson City, Killeen, Leander, Liberty Hill, Manor, Marble Falls, Pflugerville, Round Mountain, Round Rock, Salado, Spicewood, Taylor and the surrounding areas we are an excellent choice with impeccable references. Home Health Care for your elderly loved ones is never an easy choice but we can promise we will do our best to make it as painless as possible. From our family to yours we sincerely thank you for considering Senior Helpers of Austin Home Health Care Company. "
Friday, March 30, 2012
Sunday, March 25, 2012
Compassion Fatigue Strikes Family, Even Animal Caregivers
By SUSAN DONALDSON JAMES | Good Morning America – Wed, Mar 21, 2012
Reggie Gooch led an active social life, gardened and traveled the world with his wife Millie -- until she was diagnosed with Alzheimer's disease and soon needed round-the-clock care.
Every morning for two years, Gooch, who's now 98, rose at 4 a.m. to prepare and have breakfast with Millie. He stayed by her side all day long until 10 p.m. in their Hollywood, Calif., home.
"The furthest I could get away would be the entrance hall to pick up the mail," said Gooch, a former carpenter who helped his wife in real estate. "I don't think I could have gone on much longer."
He gave up hobbies that once gave him joy -- growing vegetables and pruning a myriad of trees in a community garden. "Everything came to a dead stop," he said.
Millie Gooch found peace and died in February at age 102, but her beloved husband of 76 years was left physically and emotionally exhausted.
Gooch, like thousands of other Americans, was suffering from compassion fatigue, a term used to describe the symptoms of secondary post-traumatic stress caused by caregiving.
Caring for others too much can hurt, according to the Compassion Fatigue Awareness Project, no matter how old you are or in what capacity you're providing care.
"You take on the pain of others and suffer, bottled up, angry and suppressing feelings," said project founder Patricia Smith. "Your impulse is to rescue. You don't have any personal boundaries, but you become isolated and lose your self-care in the process."
Without paying attention to their own needs, caregivers can turn to destructive behaviors such as substance abuse.
"It's a natural consequence of stress," said Smith. "In healthy caregiving you are 100 percent present in their care with empathy and compassion. But it's unhealthy when things in your own life are not resolved and you take on their suffering as your own."
More than 65 million Americans, about 29 percent of the population, is providing care for someone who is chronically ill or disabled and spend an average of 20 hours a week looking after a loved one, according to the National Alliance for Caregiving in collaboration with AARP.
Gooch split the caregiving tasks with a home aide, but the mental focus that was required for looking after his dying wife was draining. They couldn't let Millie out of their sight, for fear she would wander off.
"I am a strong person, but one of us had to be with Millie all the time for the last two years," he said. "I fed her by hand in bed for the last two or three weeks. It was dreadful. I had run out of gas; the engine had run out of power."
Compassion fatigue can affect anyone who is involved with the care of others -- from medical professionals to funeral directors to financial advisors "in a downturn," according to Smith.
In one shocking case earlier this year in Sunnyvale, Calif., a mother "so tired" from caring for her 22-year-old autistic son, shot him, then turned the gun on herself.
"There was help, but she couldn't find it," said Smith, who has written a guide to healthy care giving, "To Weep for a Stranger."
Smith experienced compassion fatigue firsthand, working not with people, but with animals at a shelter that housed 45,000.
"You see how society treats them, the abuse and neglect," she said. "Part of the work is also euthanasia, killing the animals you love.
"People called with all kinds of horrible situations -- rattlesnakes on their front porches to hoarders. We got 65 guinea pigs that had been starved."
She said caregivers have to learn to "let go" when their day is eventually done. "And try to find authentic sustainable health care practices every day to help build you back up."
For some it could be walking in nature, for others being near water. Go to a movie or have a date with your husband, she advises. Ask for help.
"Compassion fatigue empties you out and you never fill yourself up," she said.
As for Reggie Gooch, just days before his wife's death, as he was ready to collapse, his doctor of 23 years told him he needed the help of a full-time nurse. She carried the heavy load, and he was able to be by Millie's side when she died.
Today his health is good, despite an approaching 99th birthday. "I had a new hip a year ago and I don't use a cane in the house," he said. "I am very maneuverable and keep up the yard. Everyone says it looks beautiful."
"Life is getting back together again," he said. "Angela [his home aide] takes care of me and we go out to dinner and have some laughs."
Sometimes he feels guilty that Millie is not here to share his renewed vitality.
"I surely miss her, especially when I go to bed at night," said Gooch. "You can't live with someone for 76 years and not feel that. We were always love birds."
He doesn't regret caring for Millie until the end, although it nearly killed him.
"But that's part of life," he said. "We got married for better or worse. We always took care of one another."
http://gma.yahoo.com/compassion-fatigue-strikes-family-even-animal-caregivers-202818789--abc-news.html
"Learn About Senior In Home Health Care in Austin, Texas
Senior Helpers Provides Many services in the Austin, Texas area. We provide a full array of Home Care services for seniors and the elderly living in this beautiful area. Our Home Care Services are provided by bonded and insured employees and all employees pass a National Background check.
If you need Home Care services in Austin, Bartlett, Bertram, Briggs, Burnet, Cedar Park, Florence, Georgetown, Granger, Holland, Hutto, Jarrell, Johnson City, Killeen, Leander, Liberty Hill, Manor, Marble Falls, Pflugerville, Round Mountain, Round Rock, Salado, Spicewood, Taylor and the surrounding areas we are an excellent choice with impeccable references. Home Health Care for your elderly loved ones is never an easy choice but we can promise we will do our best to make it as painless as possible. From our family to yours we sincerely thank you for considering Senior Helpers of Austin Home Health Care Company. "
Reggie Gooch led an active social life, gardened and traveled the world with his wife Millie -- until she was diagnosed with Alzheimer's disease and soon needed round-the-clock care.
Every morning for two years, Gooch, who's now 98, rose at 4 a.m. to prepare and have breakfast with Millie. He stayed by her side all day long until 10 p.m. in their Hollywood, Calif., home.
"The furthest I could get away would be the entrance hall to pick up the mail," said Gooch, a former carpenter who helped his wife in real estate. "I don't think I could have gone on much longer."
He gave up hobbies that once gave him joy -- growing vegetables and pruning a myriad of trees in a community garden. "Everything came to a dead stop," he said.
Millie Gooch found peace and died in February at age 102, but her beloved husband of 76 years was left physically and emotionally exhausted.
Gooch, like thousands of other Americans, was suffering from compassion fatigue, a term used to describe the symptoms of secondary post-traumatic stress caused by caregiving.
Caring for others too much can hurt, according to the Compassion Fatigue Awareness Project, no matter how old you are or in what capacity you're providing care.
"You take on the pain of others and suffer, bottled up, angry and suppressing feelings," said project founder Patricia Smith. "Your impulse is to rescue. You don't have any personal boundaries, but you become isolated and lose your self-care in the process."
Without paying attention to their own needs, caregivers can turn to destructive behaviors such as substance abuse.
"It's a natural consequence of stress," said Smith. "In healthy caregiving you are 100 percent present in their care with empathy and compassion. But it's unhealthy when things in your own life are not resolved and you take on their suffering as your own."
More than 65 million Americans, about 29 percent of the population, is providing care for someone who is chronically ill or disabled and spend an average of 20 hours a week looking after a loved one, according to the National Alliance for Caregiving in collaboration with AARP.
Gooch split the caregiving tasks with a home aide, but the mental focus that was required for looking after his dying wife was draining. They couldn't let Millie out of their sight, for fear she would wander off.
"I am a strong person, but one of us had to be with Millie all the time for the last two years," he said. "I fed her by hand in bed for the last two or three weeks. It was dreadful. I had run out of gas; the engine had run out of power."
Compassion fatigue can affect anyone who is involved with the care of others -- from medical professionals to funeral directors to financial advisors "in a downturn," according to Smith.
In one shocking case earlier this year in Sunnyvale, Calif., a mother "so tired" from caring for her 22-year-old autistic son, shot him, then turned the gun on herself.
"There was help, but she couldn't find it," said Smith, who has written a guide to healthy care giving, "To Weep for a Stranger."
Smith experienced compassion fatigue firsthand, working not with people, but with animals at a shelter that housed 45,000.
"You see how society treats them, the abuse and neglect," she said. "Part of the work is also euthanasia, killing the animals you love.
"People called with all kinds of horrible situations -- rattlesnakes on their front porches to hoarders. We got 65 guinea pigs that had been starved."
She said caregivers have to learn to "let go" when their day is eventually done. "And try to find authentic sustainable health care practices every day to help build you back up."
For some it could be walking in nature, for others being near water. Go to a movie or have a date with your husband, she advises. Ask for help.
"Compassion fatigue empties you out and you never fill yourself up," she said.
As for Reggie Gooch, just days before his wife's death, as he was ready to collapse, his doctor of 23 years told him he needed the help of a full-time nurse. She carried the heavy load, and he was able to be by Millie's side when she died.
Today his health is good, despite an approaching 99th birthday. "I had a new hip a year ago and I don't use a cane in the house," he said. "I am very maneuverable and keep up the yard. Everyone says it looks beautiful."
"Life is getting back together again," he said. "Angela [his home aide] takes care of me and we go out to dinner and have some laughs."
Sometimes he feels guilty that Millie is not here to share his renewed vitality.
"I surely miss her, especially when I go to bed at night," said Gooch. "You can't live with someone for 76 years and not feel that. We were always love birds."
He doesn't regret caring for Millie until the end, although it nearly killed him.
"But that's part of life," he said. "We got married for better or worse. We always took care of one another."
http://gma.yahoo.com/compassion-fatigue-strikes-family-even-animal-caregivers-202818789--abc-news.html
"Learn About Senior In Home Health Care in Austin, Texas
Senior Helpers Provides Many services in the Austin, Texas area. We provide a full array of Home Care services for seniors and the elderly living in this beautiful area. Our Home Care Services are provided by bonded and insured employees and all employees pass a National Background check.
If you need Home Care services in Austin, Bartlett, Bertram, Briggs, Burnet, Cedar Park, Florence, Georgetown, Granger, Holland, Hutto, Jarrell, Johnson City, Killeen, Leander, Liberty Hill, Manor, Marble Falls, Pflugerville, Round Mountain, Round Rock, Salado, Spicewood, Taylor and the surrounding areas we are an excellent choice with impeccable references. Home Health Care for your elderly loved ones is never an easy choice but we can promise we will do our best to make it as painless as possible. From our family to yours we sincerely thank you for considering Senior Helpers of Austin Home Health Care Company. "
Sunday, March 18, 2012
Constant Stress Linked to Memory Loss
By Kristina Fiore, Staff Writer, MedPage Today
Published: March 07, 2012
Reviewed by Zalman S. Agus, MD; Emeritus Professor, Perelman School of Medicine at the University of Pennsylvania and Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner
Chronic stress may lead to memory problems by interfering with glutamate signaling in the prefrontal cortex, according to a study in mice.
Young male rats exposed to repeated stress had significant memory impairment and suppression of glutamate transmission in that brain region, Zhen Yan, PhD, of the State University of New York at Buffalo, and colleagues reported in Neuron.
The findings suggest that the prefrontal cortex "is a more sensitive area in response to repeated stress, especially during the adolescent period when this region is still undergoing significant development," the researchers wrote.
Chronic stress can impair executive functions, such as memory and attention, and has been shown to trigger maladaptive changes associated with stress-related mental disorders. The major stress hormone cortisol, for instance, has been linked with depression.
Some work has shown that stress hormones impair behaviors mediated by the prefrontal cortex, the brain region responsible for executive function.
Yet the underlying mechanisms remain elusive, the researchers said.
To delve deeper into those potential mechanisms, Yan and colleagues looked at glutamate receptor-mediated synaptic transmission, which has been suggested to be crucial for working memory, in mice.
They found that repeatedly exposing juvenile male rats to stress significantly impaired the temporal order recognition memory, a cognitive process controlled by the prefrontal cortex (P<0.01).
At the same time, they found that glutamatergic transmission in pyramidal neurons in the prefrontal cortex was significantly suppressed in those rats, although there was no loss of synaptic connections, they said.
Different downstream mechanisms have been identified in the effect of stress on glutamatergic signaling. Chronic stress reduces the expression of several receptors and proteins involved in glutamate transmission, including GluR1 and NR1 subunits (GluR1: 45% to 51% decrease, NR1: 55% to 63% decrease, P<0.01).
Chronic stress also reduced functional AMPAR and NMDAR current densities in prefrontal cortext neurons:
"Our results suggest that repeated stress dampens prefrontal cortex glutamatergic transmission by facilitating glutamate receptor turnover, which causes the detrimental effect on ... cognitive processes," they wrote.
The findings may also help explain why stress responses can act as a trigger for many mental illnesses, they added.
"Since prefontal cortex dysfunction has been implicated in various stress-related mental disorders, delineating molecular mechanisms by which stress affects [this brain region] should be critical for understanding the role of stress in influencing the disease process," Yan said in a statement.
The researchers reported no conflicts of interest.
Primary source: Neuron
Source reference: Yuen EY, et al "Repeated stress causes cognitive impairment by suppressing glutamate receptor expression and function in prefrontal cortex" Neuron 2012; DOI: 10.1016/j.neuron.2011.12.033.
http://www.medpagetoday.com/Psychiatry/AnxietyStress/31528
"Learn About Senior In Home Health Care in Austin, Texas
Senior Helpers Provides Many services in the Austin, Texas area. We provide a full array of Home Care services for seniors and the elderly living in this beautiful area. Our Home Care Services are provided by bonded and insured employees and all employees pass a National Background check.
If you need Home Care services in Austin, Bartlett, Bertram, Briggs, Burnet, Cedar Park, Florence, Georgetown, Granger, Holland, Hutto, Jarrell, Johnson City, Killeen, Leander, Liberty Hill, Manor, Marble Falls, Pflugerville, Round Mountain, Round Rock, Salado, Spicewood, Taylor and the surrounding areas we are an excellent choice with impeccable references. Home Health Care for your elderly loved ones is never an easy choice but we can promise we will do our best to make it as painless as possible. From our family to yours we sincerely thank you for considering Senior Helpers of Austin Home Health Care Company. "
Published: March 07, 2012
Reviewed by Zalman S. Agus, MD; Emeritus Professor, Perelman School of Medicine at the University of Pennsylvania and Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner
Chronic stress may lead to memory problems by interfering with glutamate signaling in the prefrontal cortex, according to a study in mice.
Young male rats exposed to repeated stress had significant memory impairment and suppression of glutamate transmission in that brain region, Zhen Yan, PhD, of the State University of New York at Buffalo, and colleagues reported in Neuron.
The findings suggest that the prefrontal cortex "is a more sensitive area in response to repeated stress, especially during the adolescent period when this region is still undergoing significant development," the researchers wrote.
Chronic stress can impair executive functions, such as memory and attention, and has been shown to trigger maladaptive changes associated with stress-related mental disorders. The major stress hormone cortisol, for instance, has been linked with depression.
Some work has shown that stress hormones impair behaviors mediated by the prefrontal cortex, the brain region responsible for executive function.
Yet the underlying mechanisms remain elusive, the researchers said.
To delve deeper into those potential mechanisms, Yan and colleagues looked at glutamate receptor-mediated synaptic transmission, which has been suggested to be crucial for working memory, in mice.
They found that repeatedly exposing juvenile male rats to stress significantly impaired the temporal order recognition memory, a cognitive process controlled by the prefrontal cortex (P<0.01).
At the same time, they found that glutamatergic transmission in pyramidal neurons in the prefrontal cortex was significantly suppressed in those rats, although there was no loss of synaptic connections, they said.
Different downstream mechanisms have been identified in the effect of stress on glutamatergic signaling. Chronic stress reduces the expression of several receptors and proteins involved in glutamate transmission, including GluR1 and NR1 subunits (GluR1: 45% to 51% decrease, NR1: 55% to 63% decrease, P<0.01).
Chronic stress also reduced functional AMPAR and NMDAR current densities in prefrontal cortext neurons:
- AMPAR: 81.9 picoamperes/picofarad (pA/pF) for control versus 42.9 pA/pF for stressed (P<0.01)
- NMDAR: control: 93.3 pA/pF for control versus 40.4 pA/pF for stressed (P<0.01)
"Our results suggest that repeated stress dampens prefrontal cortex glutamatergic transmission by facilitating glutamate receptor turnover, which causes the detrimental effect on ... cognitive processes," they wrote.
The findings may also help explain why stress responses can act as a trigger for many mental illnesses, they added.
"Since prefontal cortex dysfunction has been implicated in various stress-related mental disorders, delineating molecular mechanisms by which stress affects [this brain region] should be critical for understanding the role of stress in influencing the disease process," Yan said in a statement.
The researchers reported no conflicts of interest.
Primary source: Neuron
Source reference: Yuen EY, et al "Repeated stress causes cognitive impairment by suppressing glutamate receptor expression and function in prefrontal cortex" Neuron 2012; DOI: 10.1016/j.neuron.2011.12.033.
http://www.medpagetoday.com/Psychiatry/AnxietyStress/31528
"Learn About Senior In Home Health Care in Austin, Texas
Senior Helpers Provides Many services in the Austin, Texas area. We provide a full array of Home Care services for seniors and the elderly living in this beautiful area. Our Home Care Services are provided by bonded and insured employees and all employees pass a National Background check.
If you need Home Care services in Austin, Bartlett, Bertram, Briggs, Burnet, Cedar Park, Florence, Georgetown, Granger, Holland, Hutto, Jarrell, Johnson City, Killeen, Leander, Liberty Hill, Manor, Marble Falls, Pflugerville, Round Mountain, Round Rock, Salado, Spicewood, Taylor and the surrounding areas we are an excellent choice with impeccable references. Home Health Care for your elderly loved ones is never an easy choice but we can promise we will do our best to make it as painless as possible. From our family to yours we sincerely thank you for considering Senior Helpers of Austin Home Health Care Company. "
Saturday, March 10, 2012
Alzheimer's: 5 Greatest Risk Factors
By Lisa Genova, PhD
Mon, Feb 06, 2012
Alzheimer's disease begins at the synapse, the space where neurons connect. The biggest bad guy in this disease is a sticky protein called beta-amyloid. Either too much is made or not enough is cleared away, and as beta-amyloid accumulates, it creates a gooey clog in the synapse, preventing the neurons that meet there from communicating. As a result, the information those neurons carry can't be transmitted or retrieved. The beta-amyloid "goo" prevents these two neurons from "talking" to each other. We notice this molecular event because we forget something.
When too much beta-amyloid causes the synapse to fail, we begin to see the symptoms of Alzheimer's. There are many risk factors that can contribute to having too much beta-amyloid. What are these risk factors?
First, let's imagine a seesaw-style scale and the risk factors, which each vary in weight, are being piled on one arm of the scale. When that arm hits the floor, we have Alzheimer's.
The biggest risk factor for developing Alzheimer's is age. For reasons we still don't entirely understand, as we get older, we accumulate more beta-amyloid. The chances of being diagnosed with Alzheimer's increase steadily as we age. Right now, the risk of Alzheimer's doubles every year after the age of 65. About half of people who are 85 and older have Alzheimer's.
2. Genetics
Another risk factor is genetics. There is a rare form of Alzheimer's called Familial Alzheimer's, which always begins well before the age of 65 (typically in the 40s and 50s) and runs in families, that is autosomal dominant. This means that a single genetic mutation causes the disease. Picture the seesaw scale again. Genetic mutation is the only risk factor on the scale, and the arm is sitting on the floor.
Scientists have discovered three genetic mutations that cause this early-onset Familial Alzheimer's. All three of these mutations result in molecular changes that cause an excess of beta-amyloid.
But this type of genetic risk factor is relatively rare, accounting for only about 5% of Alzheimer's cases. The contribution of genetic risk factors to the development of Alzheimer's for the vast majority of cases weighs much less on the scale, tipping the arm only a little bit.
For example, ApoE4 is a known genetic risk factor for Alzheimer's. Forty to 65% of people with Alzheimer's carry at least one copy of this mutation. But you can have two copies of this mutation (one inherited from each parent) and not have the disease. Again, imagine the arm of the scale tipped a bit with each copy of this mutation, but the arm is still well above the floor. Likewise, you can have zero copies of ApoE4 but have Alzheimer's. The arm of your scale would be free of ApoE4 but piled high with other risk factors that tipped the scale over, leading to expression of the disease.
3. Head Trauma
Prior experience with head trauma, especially if consciousness was lost, increases the risk of developing Alzheimer's. Always wear a seat belt and helmets.
4. Diabetes
In a recent study out of Japan that looked at over 1000 men and women over the age of 60, it was found that people with diabetes (especially type 2) were twice as likely to develop Alzheimer's. Researchers are now trying to understand the molecular mechanisms that link diabetes to Alzheimer's. It's thought that the link may be twofold.
Nerve cells require a lot of energy to do the work of communicating. They get this energy from oxygen and glucose in the blood. With diabetes, cells lose their ability to respond to insulin, the molecule that transports glucose from the blood into the neurons, and so neurons have to cope with less glucose. Diabetes also often leads to damaged blood vessels, which compromises the delivery of oxygen to the nerves in the brain. Neurons already struggling to communicate despite too much beta-amyloid may lose the battle if glucose and oxygen are deprived.
Think of the scale arm with a bunch of risk factors piled on it. It's hovering above ground but fighting to maintain that position. Things aren't looking good for that synapse, but it's still managing to function. Those neurons are still able to talk to each other. We aren't showing any symptoms of Alzheimer's yet. Add diabetes, and less oxygen and glucose to provide the energy the neurons need, and the scale arm goes crashing to the ground. Now we have Alzheimer's.
5. Cardiovascular Disease
Eighty percent of people with Alzheimer's disease also have cardiovascular disease. Scientists are trying to better understand the link between heart health and Alzheimer's disease, but we do know a few things about this relationship.
Cholesterol drives the production of beta-amyloid. For a brain that is already struggling to keep beta-amyloid levels in check, high cholesterol can be a risk factor that tips the scale. Doctors prescribe statins for people diagnosed with Alzheimer's to help keep cholesterol levels down.
Again, the neurons in your brain need a lot of oxygen to do their job. If you have high blood pressure and if you have plaques in your blood vessels, your blood vessels are less efficient at delivering this oxygen to your brain. Not enough oxygen can be the weight that tips the Alzheimer's scale.
All the risk factors for heart disease (things like poor diet, lack of exercise) are also risk factors for Alzheimer's. And this means that things like a healthy, Mediterranean diet (whole grains, red and purple fruits and vegetables, fish, nuts) and exercise may not only protect the heart, they may protect us from Alzheimer's. In fact, in animal studies, exercise has been shown to clear beta-amyloid better than any pharmaceutical we know of. Think of diet and exercise as weights on the other arm of the scale.
There is currently no cure for Alzheimer's, but understanding these risk factors offers us some good news. While we can't do anything about getting older or the genes we've inherited from our parents, eating smart, keeping cholesterol levels and blood sugar low, exercising, wearing a helmet when bicycling or skiing, and wearing a seat belt in the car are among the things we can do to keep the arm of the Alzheimer's scale from tipping to the ground.
http://health.yahoo.net/articles/aging/alzheimers-5-greatest-risk-factors
"Learn About Senior In Home Health Care in Austin, Texas
Senior Helpers Provides Many services in the Austin, Texas area. We provide a full array of Home Care services for seniors and the elderly living in this beautiful area. Our Home Care Services are provided by bonded and insured employees and all employees pass a National Background check.
If you need Home Care services in Austin, Bartlett, Bertram, Briggs, Burnet, Cedar Park, Florence, Georgetown, Granger, Holland, Hutto, Jarrell, Johnson City, Killeen, Leander, Liberty Hill, Manor, Marble Falls, Pflugerville, Round Mountain, Round Rock, Salado, Spicewood, Taylor and the surrounding areas we are an excellent choice with impeccable references. Home Health Care for your elderly loved ones is never an easy choice but we can promise we will do our best to make it as painless as possible. From our family to yours we sincerely thank you for considering Senior Helpers of Austin Home Health Care Company. "
Mon, Feb 06, 2012
Alzheimer's disease begins at the synapse, the space where neurons connect. The biggest bad guy in this disease is a sticky protein called beta-amyloid. Either too much is made or not enough is cleared away, and as beta-amyloid accumulates, it creates a gooey clog in the synapse, preventing the neurons that meet there from communicating. As a result, the information those neurons carry can't be transmitted or retrieved. The beta-amyloid "goo" prevents these two neurons from "talking" to each other. We notice this molecular event because we forget something.
When too much beta-amyloid causes the synapse to fail, we begin to see the symptoms of Alzheimer's. There are many risk factors that can contribute to having too much beta-amyloid. What are these risk factors?
First, let's imagine a seesaw-style scale and the risk factors, which each vary in weight, are being piled on one arm of the scale. When that arm hits the floor, we have Alzheimer's.
Risk Factors
1. AgeThe biggest risk factor for developing Alzheimer's is age. For reasons we still don't entirely understand, as we get older, we accumulate more beta-amyloid. The chances of being diagnosed with Alzheimer's increase steadily as we age. Right now, the risk of Alzheimer's doubles every year after the age of 65. About half of people who are 85 and older have Alzheimer's.
2. Genetics
Another risk factor is genetics. There is a rare form of Alzheimer's called Familial Alzheimer's, which always begins well before the age of 65 (typically in the 40s and 50s) and runs in families, that is autosomal dominant. This means that a single genetic mutation causes the disease. Picture the seesaw scale again. Genetic mutation is the only risk factor on the scale, and the arm is sitting on the floor.
Scientists have discovered three genetic mutations that cause this early-onset Familial Alzheimer's. All three of these mutations result in molecular changes that cause an excess of beta-amyloid.
But this type of genetic risk factor is relatively rare, accounting for only about 5% of Alzheimer's cases. The contribution of genetic risk factors to the development of Alzheimer's for the vast majority of cases weighs much less on the scale, tipping the arm only a little bit.
For example, ApoE4 is a known genetic risk factor for Alzheimer's. Forty to 65% of people with Alzheimer's carry at least one copy of this mutation. But you can have two copies of this mutation (one inherited from each parent) and not have the disease. Again, imagine the arm of the scale tipped a bit with each copy of this mutation, but the arm is still well above the floor. Likewise, you can have zero copies of ApoE4 but have Alzheimer's. The arm of your scale would be free of ApoE4 but piled high with other risk factors that tipped the scale over, leading to expression of the disease.
3. Head Trauma
Prior experience with head trauma, especially if consciousness was lost, increases the risk of developing Alzheimer's. Always wear a seat belt and helmets.
4. Diabetes
In a recent study out of Japan that looked at over 1000 men and women over the age of 60, it was found that people with diabetes (especially type 2) were twice as likely to develop Alzheimer's. Researchers are now trying to understand the molecular mechanisms that link diabetes to Alzheimer's. It's thought that the link may be twofold.
Nerve cells require a lot of energy to do the work of communicating. They get this energy from oxygen and glucose in the blood. With diabetes, cells lose their ability to respond to insulin, the molecule that transports glucose from the blood into the neurons, and so neurons have to cope with less glucose. Diabetes also often leads to damaged blood vessels, which compromises the delivery of oxygen to the nerves in the brain. Neurons already struggling to communicate despite too much beta-amyloid may lose the battle if glucose and oxygen are deprived.
Think of the scale arm with a bunch of risk factors piled on it. It's hovering above ground but fighting to maintain that position. Things aren't looking good for that synapse, but it's still managing to function. Those neurons are still able to talk to each other. We aren't showing any symptoms of Alzheimer's yet. Add diabetes, and less oxygen and glucose to provide the energy the neurons need, and the scale arm goes crashing to the ground. Now we have Alzheimer's.
5. Cardiovascular Disease
Eighty percent of people with Alzheimer's disease also have cardiovascular disease. Scientists are trying to better understand the link between heart health and Alzheimer's disease, but we do know a few things about this relationship.
Cholesterol drives the production of beta-amyloid. For a brain that is already struggling to keep beta-amyloid levels in check, high cholesterol can be a risk factor that tips the scale. Doctors prescribe statins for people diagnosed with Alzheimer's to help keep cholesterol levels down.
Again, the neurons in your brain need a lot of oxygen to do their job. If you have high blood pressure and if you have plaques in your blood vessels, your blood vessels are less efficient at delivering this oxygen to your brain. Not enough oxygen can be the weight that tips the Alzheimer's scale.
All the risk factors for heart disease (things like poor diet, lack of exercise) are also risk factors for Alzheimer's. And this means that things like a healthy, Mediterranean diet (whole grains, red and purple fruits and vegetables, fish, nuts) and exercise may not only protect the heart, they may protect us from Alzheimer's. In fact, in animal studies, exercise has been shown to clear beta-amyloid better than any pharmaceutical we know of. Think of diet and exercise as weights on the other arm of the scale.
There is currently no cure for Alzheimer's, but understanding these risk factors offers us some good news. While we can't do anything about getting older or the genes we've inherited from our parents, eating smart, keeping cholesterol levels and blood sugar low, exercising, wearing a helmet when bicycling or skiing, and wearing a seat belt in the car are among the things we can do to keep the arm of the Alzheimer's scale from tipping to the ground.
http://health.yahoo.net/articles/aging/alzheimers-5-greatest-risk-factors
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Saturday, March 3, 2012
Millions now manage aging parents' care from afar
Logistics, communication difficult for 7 million Americans who are long-distance caregivers
By MATT SEDENSKY
WEST PALM BEACH, Fla. — Kristy Bryner worries her 80-year-old mom might slip and fall when she picks up the newspaper, or that she'll get in an accident when she drives to the grocery store. What if she has a medical emergency and no one's there to help? What if, like her father, her mother slips into a fog of dementia?
Those questions would be hard enough if Bryner's aging parent lived across town in Portland, Ore., but she is in Kent, Ohio. The stress of caregiving seems magnified by each of the more than 2,000 miles that separate them.
"I feel like I'm being split in half between coasts," said Bryner, 54. "I wish I knew what to do, but I don't."
As lifespans lengthen and the number of seniors rapidly grows, more Americans find themselves in Bryner's perilous position, struggling to care for an ailing loved one from hundreds or thousands of miles away.
The National Institute on Aging estimates around 7 million Americans are long-distance caregivers. Aside from economic factors that often drive people far from their hometowns, shifting demographics in the country could exacerbate the issue: Over the next four decades, the share of people 65 and older is expected to rapidly expand while the number of people under 20 will roughly hold steady. That means there will be a far smaller share of people between 20 and 64, the age group that most often is faced with caregiving.
"You just want to be in two places at once," said Kay Branch, who lives in Anchorage, Alaska, but helps coordinate care for her parents in Lakeland, Fla., about 3,800 miles away.
There are no easy answers.
Bryner first became a long-distance caregiver when, more than a decade ago, her father began suffering from dementia, which consumed him until he died in 2010. She used to be able to count on help from her brother, who lived close to their parents, but he died of cancer a few years back. Her mother doesn't want to leave the house she's lived in for so long.
So Bryner talks daily with her mother via Skype, a video telephone service. She's lucky to have a job that's flexible enough that she's able to visit for a couple of weeks every few months. But she fears what may happen when her mother is not as healthy as she is now.
"Someone needs to check on her, someone needs to look out for her," she said. "And the only someone is me, and I don't live there."
Many long-distance caregivers say they insist on daily phone calls or video chats to hear or see how their loved one is doing. Oftentimes, they find another relative or a paid caregiver they can trust who is closer and able to help with some tasks.
Yet there always is the unexpected: Medical emergencies, problems with insurance coverage, urgent financial issues. Problems become far tougher to resolve when you need to hop on a plane or make a daylong drive.
"There are lots of things that you have to do that become these real exercises in futility," said Ed Rose, 49, who lives in Boston but, like his sister, travels frequently to Chicago to help care for his 106-year-old grandmother, Blanche Seelmann.
Rose has rushed to his grandmother's side for hospitalizations, and made unexpected trips to solve bureaucratic issues like retrieving a document from a safe-deposit box in order to open a bank account.
But he said he has also managed to get most of the logistics down to a routine.
He uses Skype to speak with his grandmother every day and tries to be there whenever she has a doctor's appointment. Aides handle many daily tasks and have access to a credit card for household expenses. They send him receipts so he can monitor spending. He has an apartment near his grandmother to make sure he's comfortable on his frequent visits.
Even for those who live near those they care for, travel for work can frequently make it a long-distance affair. Evelyn Castillo-Bach lives in Pembroke Pines, Fla., the same town as her 84-year-old mother, who has Alzheimer's disease. But she is on the road roughly half the year, sometimes for months at a time, both for work with her own Web company and accompanying her husband, a consultant for the United Nations.
Once, she was en route from Kosovo to Denmark when she received a call alerting her that her mother was having kidney failure and appeared as if she would die. She needed to communicate her mother's wishes from afar as her panicked sister tried to search their mother's home for her living will. Castillo-Bach didn't think she could make it in time to see her mother alive once more.
"I won't get to touch my mother again," she thought.
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She was wrong. Her mother pulled through. But she says it illustrates what long-distance caregivers so frequently go through.
"This is one of the things that happens when you're thousands of miles away," Castillo-Bach said.
Lynn Feinberg, a caregiving expert at AARP, said the number of long-distance caregivers is likely to grow, particularly as a sagging economy has people taking whatever job they can get, wherever it is. Though caregiving is a major stress on anyone, distance can often magnify it, Feinberg said, and presents particular difficulty when it must be balanced with an inflexible job.
"It's a huge stress," she said. "It can have enormous implications not only for someone's quality of life, but also for someone's job."
It can also carry a huge financial burden. A November 2007 report by the National Alliance for Caregiving and Evercare, a division of United Health Group, found annual expenses incurred by long-distance caregivers averaged about $8,728, far more than caregivers who lived close to their loved one. Some also had to cut back on work hours, take on debt of their own and slash their personal spending.
Even with that in mind, though, many long-distance caregivers say they don't regret their decision. Rita Morrow, who works in accounting and lives in Louisville, Ky., about a six-hour drive from her 90-year-old mother in Memphis, Tenn., does all the juggling too.
She has to remind her mother to take her medicine, make sure rides are lined up for doctor's appointments, rush to her aid if there's a problem. She knows her mom wants to stay in her home, to keep going to the church she's gone to the past 60 years, to be near her friends.
"We do what we have to do for our parents," she said. "My mother did all kinds of things for me."
Copyright 2012 The Associated Press. All rights reserved.
http://www.msnbc.msn.com/id/46150872/ns/health-aging/#
"Learn About Senior In Home Health Care in Austin, Texas
Senior Helpers Provides Many services in the Austin, Texas area. We provide a full array of Home Care services for seniors and the elderly living in this beautiful area. Our Home Care Services are provided by bonded and insured employees and all employees pass a National Background check.
If you need Home Care services in Austin, Bartlett, Bertram, Briggs, Burnet, Cedar Park, Florence, Georgetown, Granger, Holland, Hutto, Jarrell, Johnson City, Killeen, Leander, Liberty Hill, Manor, Marble Falls, Pflugerville, Round Mountain, Round Rock, Salado, Spicewood, Taylor and the surrounding areas we are an excellent choice with impeccable references. Home Health Care for your elderly loved ones is never an easy choice but we can promise we will do our best to make it as painless as possible. From our family to yours we sincerely thank you for considering Senior Helpers of Austin Home Health Care Company. "
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