Articles Posted in Home Care

carehands-300x205Life can be hard, lonely, and difficult for adults who must become caregivers for their parents. If that sounds like the challenging story for tens of millions of millennials and Gen-Xers, yes, it’s true. But Judith Graham, in a column for the Kaiser Health News Service, describes what may be an even tougher role for startling numbers of seniors who find themselves solo caregivers for still older moms and dads.

Graham reported that a new analysis from the Center for Retirement Research at Boston College has found that 1 in 10 Americans between the ages 60 and 69 take care of parents in their 80s, 90s, and even older. For those 70 and older, the numbers increase, so 12 percent of these seniors care for even more elderly relatives. The research is based on data from 80,000 interviews (some people were interviewed multiple times) conducted from 1995 to 2010 for the Health and Retirement Study.

The analysis found that roughly “17 percent of adult children care for their parents at some point in their lives, and the likelihood of doing so rises with age. That’s because parents who’ve reached their 80s, 90s or higher are more likely to have chronic illnesses and related disabilities and to require assistance.”

asthma-300x123Even as they rake in big bucks and ride  a tsunami of mergers and consolidations sweeping the U.S. health care system, big hospitals and academic medical centers must step up on patients’ behalf, doing much more, for example, to battle America’s growing asthma woes and the opioid drug abuse epidemic.

Kaiser Health News, the Capital News Service, and the Washington Post deserve credit for their report on “Forgetabout Neighborhood,” the “worst asthma hot spot” in Baltimore. This part of the city is filled with “decrepit houses, rodents and bugs” that “trigger [asthma] and where few community doctors work to prevent asthma emergencies,” the news organizations have found. They say that residents of this neighborhood “visit hospitals for asthma flare-ups at more than four times the rate of people from the city’s wealthier neighborhoods.”

This area, zip code 21223, also sits in the shadow of not just one but two renowned medical centers, noted, among other things, for their respiratory expertise: Johns Hopkins, and the University of Maryland Medical Center. As the news organizations have reported:

srdrugs-300x178When families and friends visit Kansas nursing homes, they may be startled to see how listless and lethargic their elderly loved ones may be, especially if the facility residents suffer from dementia. There’s a sad, simple, and likely reason—the seniors may be drugged up with potent anti-psychotics.

The Kansas City Star deserves credit for providing a powerful reminder that nursing homes, not just in the Heartland but nationwide, persist in over-relying on off-label dosing of their sometimes difficult to handle patients with drugs such as olanzapine (more commonly known by the branded product Zyprexa), aripiprazole (Abilify), risperidone (Risperdal), or quetiapine (Seroquel).

As the newspaper reported:

caregiver-300x200Pick up that phone. Dash off a text or an email. Issue a dinner invitation or make a date for a casual lunch. Or just drop by to see that friend or loved one who struggles with the burdens of caring for someone in poor physical or mental health.

Why now? Why not? Paula Spann deserves credit for her latest New York Times column highlighting the “unbearable” loneliness and isolation that caregivers confront as, other experts estimate,  43.5 million Americans provide $470 billion in tough, unstinting, and unpaid work for loved ones.

Even as they do so, however, they often must abandon their own careers and chunks of their own lives, watching with sadness as their social contacts and intellectual interests narrow, especially as their worlds become consumed with washing, feeding, entertaining, and keeping safe a spouse, grandparent, uncle, aunt, or other loved one. Their woes can be especially great if they’re caring for loved ones with the increasingly common and hugely demanding conditions of dementia and Alzheimer’s.

Dr. Bruce Leff explains why geriatric healthcare is best practiced out of the hospital

It wasn’t that long ago — see those classic black-and-white movies — when hospitals commonly cared for many different kinds of patients in large open wards. Young volunteers, women known as “candy stripers,” could be seen rolling carts down the aisles between the many rows of beds, selling cigarettes. Families might pop in for a visit, carrying for their sick kin a chicken dinner on a plate covered by a white napkin.

With the huge changes that the Affordable Care Act has brought to hospitals and American health care, and with the shifts that are yet to come if Obamacare gets repealed and replaced, it’s easy to forget how significantly and rapidly medical services continue to transform.

The events of recent days ─in Texas, Louisiana, and Minnesota─ have been so tragic that it’s easy to despair. Here are four health-related people stories worth reading to remind us of humanity’s enduring better side:

  • In the horrors of Syrian combat, medical Samaritans strive to maintain some kind of care

syriaFirst, let’s stipulate that there’s almost as much barbarous conduct as can be imagined in this recent New Yorker report about the struggle to maintain medical care in combat-ravaged Syria. President Assad’s predation on his own people has become an international abomination, including his forces unleashing snipers to maim emergency medical personnel, and their dropping barrel bombs, laden with lacerating shrapnel, on hospitals or known care-giving sites (February, 2016, photo of a bombed hospital from Doctors Without Borders/Medicins san Frontieres).

Flag_of_South_Dakota.svgSevere diabetics, the blind, and the mentally ill all too often get sent to sterile and restrictive group or nursing homes by South Dakota officials who can’t seem to find other care options because they discriminate against thousands of the disabled, the federal government says.

The Justice Department is investigating the state under federal laws affirmed by the U.S. Supreme Court. As the New York Times reports, the feds aim to protect the disabled from needless confinement in highly regimented group or nursing homes because:

[A] 1999 Supreme Court decision, Olmstead v. L.C. [held] that, unless a nursing home is medically necessary, people have a right under the Americans With Disabilities Act to receive care without being segregated from society. Advocates for the disabled have compared that ruling to Brown v. Board of Education, which declared racial segregation in schools unconstitutional.

An elderly couple wait to cross the road
With the United States getting grayer by the day and a national crisis looming in dementia- and senior-care, new information from one of the larger, longer running, and more significant health studies has offered a glimmer of optimism. Experts say dementia risks are showing a  decline─by as much as 20 percent. They’re uncertain exactly why. But increased education and individuals’ improved overall health, especially their cardiovascular wellness, may be helping.

An elderly couple wait to cross the road (Photo by Garry Knight/ Creative Commons)

The surprising dementia trend emerges from the legendary Framingham Heart Study, which has monitored and detailed the health of thousands of Americans for decades. Framingham research led to greatly improved heart and lung care with information on such issues as high blood pressure, high blood cholesterol, smoking, obesity, diabetes, and physical inactivity.

Americans are legend for their discomfort in discussing death. That makes conversations about end-of-life care a big challenge, even though the medical attention paid to the dying can drive up health care costs.  A quarter of traditional Medicare spending for health care is for services provided to program beneficiaries in their last year of life—a proportion that has remained steady for decades. But new studies shed interesting light on the end-of-life experiences of patients with cancer, as well as how physicians themselves spend their last days. And it is worth watching how California grapples with the tough issues tied to doctors’ roles in assisting the dying in ending their lives.

Let’s look first at the provocative, published findings of an oncologist and a radiation oncologist about aggressive care for those with late-stage cancer. The researchers compared U.S. patients with patients in other countries. They focused on cancer because, “in developed countries, it is the second leading cause of death and the most expensive per patient.” The researchers found that just under a quarter of Americans with cancer die in hospitals — a lower rate than occurs in Canada, England, Norway, the Netherlands, Belgium, Germany, and six other industrialized nations they studied. Further, as they wrote in a New York Times Op-Ed:

America was not the most expensive country in which to die. On average, $21,840 was spent on the last six months of hospital-related care for dying cancer patients in Canada and $19,783 in Norway. In the United States, the bill was $18,500 per patient. (That figure does not include physician costs, which are part of hospital spending in other nations. Including them brings America’s costs up by about 10 percent, leaving us still below Canada and about equal with Norway.)

Letters to the editor in the New York Times come with the provocative headline: “Can There Be Good Mental Asylums?” As the father of a 25-year-old son with severe autism, I think about this a lot.

Our son Brendan now lives in a group home which we helped set up in Silver Spring, Maryland. It seems to work for him, although for a parent, eternal vigilance is required. Brendan is out and about in the community every day: at his day program sheltered workshop, and with his “one-on-one” at weekend activities like Special Olympics, trips to museums, dinner at our house, and all sorts of good fun. That’s the ideal for any human being.

But look around you. Huddled in the doorway of an office building, sitting in a prison cell — lots of mentally disabled people have no real home.

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