Each year, one in three Americans 65 and older falls, and 30 percent of the falls cause injuries requiring medical attention. Caused by a bump or blow to the head, traumatic brain injuries may be missed or misdiagnosed among older adults.

 

Traumatic brain injuries due to falls among Americans 65 and older caused nearly 8,000 deaths and 56,000 hospitalizations in 2005, according to a new Centers for Disease Control and Prevention (CDC) report. Brain injuries accounted for half of these deaths. 

 

Most people think older adults may only break their hip when they fall, but research shows that traumatic brain injuries also can have serious consequences, said Dr. Ileana Arias, director of the CDC’s National Center for Injury Prevention and Control.

 

While falls are not an inevitable consequence of aging, they do occur more frequently among older adults whose health and aging conditions are associated risk factors.

 

To help prevent these injuries, the CDC developed the “Help Seniors Live Better, Longer: Prevent Brain Injury” initiative for seniors, their caregivers and healthcare providers. It features easy-to-use materials in a concise question-and-answer format to help prevent, recognize and respond to traumatic brain injuries. The materials are available at www.cdc.gov/BrainInjuryInSeniors.

 

The Food and Drug Administration has warned that a certain group of psychiatric drugs given to seniors suffering from dementia can increase their risk of death.

Manufacturers of “conventional” antipsychotic drugs will be required to make safety-related changes to prescribing information, or labeling, to warn about an increased risk of death associated with the off-label use of these drugs to treat behavioral problems in older people with dementia.

In 2005, the FDA announced similar labeling changes for “atypical” antipsychotic drugs.

Neither class of antipsychotic is FDA-approved for use in the treatment of dementia-related symptoms, which can include forgetfulness, poor memory, and an inability to recognize familiar objects, sounds or people. The drugs are FDA-approved primarily for the treatment of symptoms associated with schizophrenia. The decision to use antipsychotic medications in the treatment of patients with symptoms of dementia is left to the discretion of the physician. Such use is often called “off-label” use and falls within the practice of medicine.

For more information, see the FDA news release at http://www.fda.gov/bbs/topics/NEWS/2008/NEW01851.html.

Researchers at Washington University School of Medicine in St. Louis have identified a genetic variation associated with an earlier age of onset in Alzheimer’s disease.

Unlike genetic mutations previously linked to rare, inherited forms of early onset Alzheimer’s disease that can strike people as young as in their 30s and 40s, these variants influence an earlier presentation of symptoms in people affected by the more common, late-onset form of the disease.

The research team found that individuals who carry genetic variations that lead to higher levels of a protein called tau in cerebrospinal fluid have an earlier age of onset of Alzheimer’s disease than those who carry variants that are associated with lower levels of tau.

Marcelle Morrison-Bogorad, Ph.D., director of the Division of Neuroscience at the National Institute on Aging, said the study may help researchers understand why the disease begins earlier in some persons than in others.

For more information on the study, read the news release at http://mednews.wustl.edu/news/page/normal/11867.html.

Remember - Home Instead Senor Care prides itself in providing in-home non-medical personal care and companionship for seniors living with dementia, essentially making it possible for folks living with Alzheimer’s to live at home and maintain their quality of life.  To find out how a Home Instead CAREGiver can help you, call our office at 248-203-2273.

Research presented at the annual meeting of the Associated Professional Sleep Societies reports a link between normal sleep and healthy aging. A study first reported strong associations between disturbed rest/activity rhythms and mortality rates in older, community-dwelling men. A separate study found that less daytime sleeping and fewer complaints of insomnia best predicted successful aging in the women.

“It is uncertain whether the relationship between rest/activity circadian rhythms and mortality in older people is casual, or whether rest/activity circadian rhythms represent a potent biomarker related to increased risk of death,” said Misti L. Paudel of the University of Minnesota-Twin Cities.

Researchers at the University of California-San Diego assessed 2,226 women ages 60 and older for use of sleeping aids, daytime sleepiness, napping, insomnia, early morning awakening, snoring, overall sleep quality and sleep duration, U.S News & World Report says. Based on the results, 20.8 percent of the women were categorized as “successful agers.”

“Our findings reinforce the idea that good sleep is of utmost importance for good health,” said study author Sonia Ancoli-Israel. “Healthcare professionals need to ask their patients – of all ages – about sleep and help those with poor sleep to find ways for improvement.”

The Center for Elder Law in Troy, Michigan has been a partner of Home Instead Senior Care for many years.  Their firm has a powerful team of attorneys who are ready and capable of helping you and your loved one work through your difficult edler law issues.  The following article is written by Andrew Mayoras, one of the firm’s partners.  Information on how to link ot this e-newsletter is located at the bottom of the post.  Enjoy!

by: Andrew Mayoras, Partner, Barron, Rosenberg, Mayoras & Mayoras, and  The Center for Probate Litigation

 

Many people believe that once someone signs a Power of Attorney, for either health care or financial decisions, or a Patient Advocate Designation, then all control has been surrendered to the person designated to make decisions (called the Attorney-in-Fact or Agent). They feel that the rest of the family has no choice but to step aside. In reality, the appointment of an Attorney-in-Fact or Agent is often just the beginning.
 

First, a Power of Attorney or Patient Advocate Designation is only valid if it was executed in compliance with Michigan law. This means that it must be in writing, and properly dated, and met certain other legal requirements.
 
Second, and often more importantly, the person signing the document must have been legally competent at the time of execution. The test for legal competence is whether the person is of “sufficient mind to understand in a reasonable manner the nature and effect of the act in which the person is engaged.”
 
When the person signing the document has dementia or Alzheimer’s, often it is not easy to determine whether they were competent or not. Individuals suffering from these conditions have good days and bad, may be sharp and lucid one moment, and not the next. Medical records and opinions from doctors and experienced elder law attorneys are the most important ways to establish whether someone was or was not competent.
 
Third, even when dealing with a valid Power of Attorney or Patient Advocate Designation, the Attorney-in-Fact, or Agent, has a fiduciary duty to act in the best interests of the principal. For health care decisions, this means deciding on where to live and whom to provide care. These decisions should be based on what is best for the person in need of care, not what is most convenient for the Attorney-in-Fact. Often Agents want to make these decisions based on what will maximize their inheritance or what is easiest for them. This does not meet the Agent’s fiduciary obligation!
 
When families do not get along, visitation problems often arise. Sometimes, an  Agent-in-Fact does not want family members to spend time with their elderly parent or other loved one. Other times, there is complete isolation. These are often warning signs of abuse. Families should never passively accept these situations.
 
Other times, visitations are restricted for legitimate reasons, such as when another family member is verbally abusive or aggressive towards the elderly person. Disputes frequently begin around visitation issues, especially in second marriage situations and families who have unresolved sibling rivalries. Legally, the key always is what is in the best interests of the vulnerable adult. Frequent visits by loving and caring family members are usually in their best interests.
 
For financial decisions, the legal duty requires the Attorney-in-Fact to, at the very least, refrain from self-dealing. Although no Michigan case law has definitively addressed it, such an Agent-in-Fact must likely conform to Michigan’s prudent investor rule. This means that he or she must “invest and manage assets held in a fiduciary capacity as a prudent investor would” based on the terms of the governing document and the circumstances.
 
What does this mean? Simply, the Agent has a duty to manage the assets prudently, and with the goal of helping the person who owns the assets. Often, a person with Alzheimer’s or dementia requires much more conservative investments than he or she had previously chosen earlier in life. This may require a sale of stock or other securities, and insuring the portfolio is suitable, diversified, liquid and safe from extreme market fluctuations.
 
When the loved one has significant assets, following the advice of a credentialed, knowledgeable and ethical financial planner is essential to fulfilling the prudent investor rule.  But Agents must use common sense, too—just because a licensed stock broker or annuity salesmen recommends an investment does not make it suitable for a senior citizen with Alzheimer’s or dementia. In fact, it is unfortunate, but some financial advisors prey on elderly clients by selling them unsuitable, high risk investments that generate large commissions.  Those helping a senior adult with their investments must always be aware of this danger.
 
If you ever have doubts about whether a certain investment is appropriate, have it reviewed by a disinterested financial planner experienced in working with seniors, or an elder law attorney knowledgeable about spotting unsuitable investments.
 
What do you do if you believe that a Power of Attorney or Patient Advocate Designation is being abused, or that a vulnerable adult’s best interests are not being protected, either financially or otherwise? There are several options.
 
One is to talk to the family member you have concerns about. Sometimes, simply opening a dialogue can clear up misunderstandings. A second option is to file a complaint with adult protective services. Unfortunately, this approach usually does not work except in cases of extreme abuse, neglect or exploitation.
 
The best options are to either consult with an attorney experienced in dealing with issues of this nature, or to seek guardianship and/or conservatorship in probate court.  Our next article will discuss these proceedings.

 

  

As always, we appreciate your feedback. Should the links in this email not work, you can find our newsletter online at www.elderandspecialneedslaweletter.com.

Age-adjusted death rates in the United States declined significantly between 2005 and 2006, and life expectancy hit a record high, according to preliminary figures from the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics. (Read news release at

http://www.cdc.gov/nchs/pressroom/08newsreleases/mortality2006.htm).

 

According to World Health Organization data included in an Associated Press report. Japan is No. 1 on the list for estimated life expectancy, with a life expectancy of 83 for children born in 2006. Switzerland and Australia were also near the top of the list.

Among the 2006 findings regarding U.S. rates:

The age-adjusted death rate fell to 776.4 deaths per 100,000 population from 799 deaths per 100,000 in 2005.

Death rates for eight of the 10 leading causes of death dropped significantly, including a very sharp decrease in mortality from influenza and pneumonia.

Life expectancy for a child born in 2006 reached a record high of 78.1 years, a 0.3 increase from 2005. Record high life expectancy was recorded for white males (76 years), black males (70 years), white females (81 years) and black females (76.9 years).

Alzheimer’s disease passed diabetes to become the sixth leading cause of death.

 

“The international comparisons are not that appealing, but we may be in the process of catching up,” said Samuel Preston, a University of Pennsylvania demographer. He is co-chair of a National Research Council panel looking at why America’s life expectancy is lower than other nations’.

 

A new study has found that elderly dementia patients exposed to bright light during daytime hours do better mentally and physically than those patients not exposed.

Brightening the rooms of dementia patients, in combination with a daily dose of the sleep hormone melatonin, improved mood, sleep patterns and overall well being, Dutch scientists said in a report published in the Journal of the American Medical Association.

In the study, dementia patients at a long-term facility who were exposed to bright lights – both more sunlight and better bulbs – scored 5 percent better on cognitive tests and had 19 percent fewer depressive symptoms than patients in less well-lit facilities.

 

Home Instead Senior Care CAREGivers are trained to help clients with dementia to maintain an active lifestyle that provides for their quality of life.  One way we look to help our clients with dementia is to provide for stimulating activities and an enhanced environment which may include better lighting, depending on the client’s needs and physician’s assessment.  To find out how Home Instead Senior rae can help you, please call 248-203-2273, or visit www.homeinstead.com/283.

Caregivers, only a small percentage of America’s 228 million adults have the skills to manage their own healthcare proficiently, the Agency for Healthcare Research and Quality (AHRQ) says.

The survey is based on data from the 2007 National Healthcare Disparities Report, which examines disparities in Americans’ access to and quality of healthcare, with breakdowns by race, ethnicity, income and education. The study measures respondents’ health literacy skills, which are the ability to obtain and use health information to make appropriate healthcare decisions.

Health literacy also includes evaluating the risks and benefits of different treatments, filling out complex medical forms, and calculating the cost of health insurance. Inadequate and poor health literacy can result in increased medical errors and inefficient results from healthcare.

The survey of health literacy skills divided adults into four categories, with only 12 percent deemed proficient. Results showed 53 percent had intermediate skills, such as being able to read instructions on a prescription label and determine the right time to take medication; 22 percent had basic skills, such as being able to read a pamphlet and understand two reasons why a disease test might be appropriate despite a lack of symptoms; and 14 percent had below-basic skills, meaning they could accomplish only simple tasks.

This study shows the importance of using home care management services such as Home Instead Senior Care.  Our CAREGivers are trained and proficient to the point that we can work with a family or client to create a plan of care that allows a person to continue living independently at home.  Our CAREGivers are trained to provide care for seniors with dementia and/or Alzheimer’s, are trained for transfers and risk management and reduction of falls, and are able to help seniors with common activities for daily living, including meal planning and preparation, travel/transportation issues, keeping doctors appointments, and maintaining an overall quality fo life.

To learn more about how Home Instead Senior Care can help you, call 248-203-2273.  With more than 750 franchises throughout the world, we can assist you, wherever you are.

An article on CNN.com points to the importance of watching elderly persons for possible signs of drug complications. The article reports on a 66-year-old woman who was found stumbling around her house, confused and slurring her words. Doctors first thought she had a stroke, then diagnosed Alzheimer’s disease when tests showed it wasn’t a stroke. A second opinion by a geriatrician pointed to overmedication.

Every year, 38 million older Americans suffer drug complications, and 180,000 of these are life threatening, according to research by Dr. Jerry Gurwitz, chief of geriatric medicine at the University of Massachusetts Medical School. The risk for drug errors is seven times greater in seniors than in people under age 65, according to Medco Health Solutions, a pharmacy benefits manager.

While only a doctor can tell if a person is suffering from medication side effects or from an actual disease, the CNN article includes steps a caregiver can take to help a doctor sort out what an elderly relative is really experiencing. It includes links to lists of drugs that often cause problems for older persons and drug interaction information.

Geriatricians say it is especially important for seniors to have a doctor review their medications regularly to make sure they don’t interact and all medications are needed.

The CNN article is available online at http://us.cnn.com/2008/HEALTH/conditions/05/28/ep.age.meds/index.html.

New information is available to help seniors learn about financial abuse and take steps to avoid having their money, financial resources or property being misused without their consent or understanding. It was made available in conjunction with World Elder Abuse Awareness Day, which was recognized June 15 around the globe.

“One of the most common forms of elder abuse is financial, which can result in a senior losing some or all of his or her savings,” said Mary Anne Jablonski, Minister of Seniors and Community Supports. “To help prevent this, we partnered with the Alberta Elder Abuse Awareness Network to develop and distribute information on this serious issue to seniors and organizations that support them.”

Abuse can also be physical, sexual or emotional abuse, and it can affect the physical and mental health of a senior.

A card and fact sheet with information on financial abuse was sent to more than 2,400 organizations across Alberta, as well as 900 financial institutions. These documents, which include tips for protecting oneself, warning signs of financial abuse, information on how to help victims and where to get help, are available online. Go to www.seniors.gov.ab.ca and select the New Financial Abuse Awareness Materials for Seniors link. This is good information to share with clients and their families.