Those twinges of forgetfulness that appear to be getting more pronounced may worry you. After all, the statistics are scary: Every 70 seconds, someone in the USA develops Alzheimer's. But every lapse isn't a signal that your memory is kaput.
Cheryl Edwards-Cannon, 57, says she relies on Post-it notes and spiral notebooks to help her remember, since she's multitasking "the majority of the time."
Edwards-Cannon, of Belmont, Mich., is married and works for a company that manages charter schools. She travels 10 to 15 days a month. She also oversees care of her father, who is in assisted-living, and her mother, who suffers from dementia and requires a different place, four miles from her father's.
Click here to read more...
By Sharon Jayson, USA TODAY
Thursday, September 30, 2010
Friday, June 11, 2010
How to Choose the Right Sun Block for the Elderly
As we age, skin thins and becomes more fragile and susceptible to the sun's damaging rays. Protecting this sensitive skin means selecting a nurturing and effective sunscreen that blocks the sun's UV rays. Protecting elderly skin with hats and clothing in addition to sunscreen provides the best defense.
1. Consult with a physician or dermatologist to discuss the best options for sun block and additional protection methods. Physicians suggest drinking ample water and fluids to hydrate skin. They also recommend wearing a wide brimmed hat and long sleeved clothes
2. Select a sunscreen for sensitive skin with an SPF rating of at least 15, but SPF 30 is preferable. Also, choose PABA-free products with titanium dioxide or zinc oxide because these are less likely to trigger an allergic skin reaction.
3. Choose a sunscreen with broad spectrum UVA and UVB protection. Sunscreen with added vitamin A, vitamin D and vitamin E benefit elderly skin's health.
4. Use sunscreen that is easy to apply such as sunscreen towelettes in SPF 15, SPF 30 and SPF 45. Powder, sticks and gel sunscreens are also easy to apply.
5. Counter elderly skin's dryness with water-based sunscreens or chemical free sun block alternatives. Burt's Bees offers chemical free sunscreens with SPF 15 or SPF 30 online and in many drugstores.
For more information, visit eHow.
1. Consult with a physician or dermatologist to discuss the best options for sun block and additional protection methods. Physicians suggest drinking ample water and fluids to hydrate skin. They also recommend wearing a wide brimmed hat and long sleeved clothes
2. Select a sunscreen for sensitive skin with an SPF rating of at least 15, but SPF 30 is preferable. Also, choose PABA-free products with titanium dioxide or zinc oxide because these are less likely to trigger an allergic skin reaction.
3. Choose a sunscreen with broad spectrum UVA and UVB protection. Sunscreen with added vitamin A, vitamin D and vitamin E benefit elderly skin's health.
4. Use sunscreen that is easy to apply such as sunscreen towelettes in SPF 15, SPF 30 and SPF 45. Powder, sticks and gel sunscreens are also easy to apply.
5. Counter elderly skin's dryness with water-based sunscreens or chemical free sun block alternatives. Burt's Bees offers chemical free sunscreens with SPF 15 or SPF 30 online and in many drugstores.
For more information, visit eHow.
Tuesday, June 8, 2010
Know the 10 Signs by Alzheimer's Association
Have you noticed any of these warning signs?
There are 10 warning signs of Alzheimer's disease. Along with the advice of a doctor, these signs are critical to detecting Alzheimer's.
1. Memory changes that disrupt daily life. One of the most common signs of Alzheimer’s, especially in the early stages, is forgetting recently learned information. Others include forgetting important dates or events; asking for the same information over and over; relying on memory aides (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own. What's typical? Sometimes forgetting names or appointments, but remembering them later.
2. Challenges in planning or solving problems. Some people may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before. What's typical? Making occasional errors when balancing a checkbook.
3. Difficulty completing familiar tasks at home, at work or at leisure. People with Alzheimer’s often find it hard to complete daily tasks. Sometimes, people may have trouble driving to a familiar location, managing a budget at work or remembering the rules of a favorite game. What’s typical? Occasionally needing help to use the settings on a microwave or to record a television show.
4. Confusion with time or place. People with Alzheimer's can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there. What's typical? Getting confused about the day of the week but figuring it out later.
5. Trouble understanding visual images and spatial relationships. For some people, having vision problems is a sign of Alzheimer's. They may have difficulty reading, judging distance and determining color or contrast. In terms of perception, they may pass a mirror and think someone else is in the room. They may not recognize their own reflection. What's typical? Vision changes related to cataracts.
6. New problems with words in speaking or writing. People with Alzheimer's may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves. They may struggle with vocabulary, have problems finding the right word or call things by the wrong name (e.g., calling a "watch" a "hand-clock"). What's typical? Sometimes having trouble finding the right word.
7. Misplacing things and losing the ability to retrace steps. A person with Alzheimer’s disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. Sometimes, they may accuse others of stealing. This may occur more frequently over time. What's typical? Misplacing things from time to time, such as a pair of glasses or the remote control.
8. Decreased or poor judgment. People with Alzheimer's may experience changes in judgment or decision-making. For example, they may use poor judgment when dealing with money, giving large amounts to telemarketers. They may pay less attention to grooming or keeping themselves clean. What's typical? Making a bad decision once in a while.
9. Withdrawal from work or social activities. A person with Alzheimer's may start to remove themselves from hobbies, social activities, work projects or sports. They may have trouble keeping up with a favorite sports team or remembering how to complete a favorite hobby. They may also avoid being social because of the changes they have experienced. What's typical? Sometimes feeling weary of work, family and social obligations.
10. Changes in mood and personality. The mood and personalities of people with Alzheimer's can change. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, at work, with friends or in places where they are out of their comfort zone. What's typical? Developing very specific ways of doing things and becoming irritable when a routine is disrupted.
To read the full article, click here Alzheimer's Association.
There are 10 warning signs of Alzheimer's disease. Along with the advice of a doctor, these signs are critical to detecting Alzheimer's.
1. Memory changes that disrupt daily life. One of the most common signs of Alzheimer’s, especially in the early stages, is forgetting recently learned information. Others include forgetting important dates or events; asking for the same information over and over; relying on memory aides (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own. What's typical? Sometimes forgetting names or appointments, but remembering them later.
2. Challenges in planning or solving problems. Some people may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before. What's typical? Making occasional errors when balancing a checkbook.
3. Difficulty completing familiar tasks at home, at work or at leisure. People with Alzheimer’s often find it hard to complete daily tasks. Sometimes, people may have trouble driving to a familiar location, managing a budget at work or remembering the rules of a favorite game. What’s typical? Occasionally needing help to use the settings on a microwave or to record a television show.
4. Confusion with time or place. People with Alzheimer's can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there. What's typical? Getting confused about the day of the week but figuring it out later.
5. Trouble understanding visual images and spatial relationships. For some people, having vision problems is a sign of Alzheimer's. They may have difficulty reading, judging distance and determining color or contrast. In terms of perception, they may pass a mirror and think someone else is in the room. They may not recognize their own reflection. What's typical? Vision changes related to cataracts.
6. New problems with words in speaking or writing. People with Alzheimer's may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves. They may struggle with vocabulary, have problems finding the right word or call things by the wrong name (e.g., calling a "watch" a "hand-clock"). What's typical? Sometimes having trouble finding the right word.
7. Misplacing things and losing the ability to retrace steps. A person with Alzheimer’s disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. Sometimes, they may accuse others of stealing. This may occur more frequently over time. What's typical? Misplacing things from time to time, such as a pair of glasses or the remote control.
8. Decreased or poor judgment. People with Alzheimer's may experience changes in judgment or decision-making. For example, they may use poor judgment when dealing with money, giving large amounts to telemarketers. They may pay less attention to grooming or keeping themselves clean. What's typical? Making a bad decision once in a while.
9. Withdrawal from work or social activities. A person with Alzheimer's may start to remove themselves from hobbies, social activities, work projects or sports. They may have trouble keeping up with a favorite sports team or remembering how to complete a favorite hobby. They may also avoid being social because of the changes they have experienced. What's typical? Sometimes feeling weary of work, family and social obligations.
10. Changes in mood and personality. The mood and personalities of people with Alzheimer's can change. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, at work, with friends or in places where they are out of their comfort zone. What's typical? Developing very specific ways of doing things and becoming irritable when a routine is disrupted.
To read the full article, click here Alzheimer's Association.
Monday, June 7, 2010
9 Things to Consider in Your Search for an Assisted Living Facility
The decision to move shouldn't be taken lightly, say experts. Here's some guidance
As people age and need more help with daily activities, such as bathing or taking medication, moving to a facility that provides some assistance, without sacrificing independence, may be an option. This type of environment, known as assisted living, has emerged in the past two decades as an increasingly available option for housing and long-term care. In 1999, one third of the facilities that offered assisted living services had been in existence for less than five years, and 60 percent had existed for less than a decade, according to research published in January in the journal Health Affairs. The growth of assisted living facilities has leveled off in recent years, however, as the economic downturn hampered new construction and occupancy rates.
In 2007, there were approximately 38,000 assisted living facilities nationwide, serving about 975,000 residents. The overwhelming majority of assisted living residents in the United States are female, according to the National Center for Assisted Living. One of the most common types of facilities that provide assisted living are called community care retirement communities, which offer a stepwise approach to care, says Kerry Peck, an elder law attorney based in Chicago. "The concept is you age in place," meaning you never have to leave the grounds for housing, he says, "You buy an apartment or cottage, and then as your health declines, the facility agrees to provide continuing care. Some of the most successful [centers] have independent living, then assisted living, then a nursing home for acute care."
But much like deciding whether a nursing home is necessary, the decision to move into an assisted living facility is not an easy one. So what factors should you consider when looking for a place to move to? First, think about what activities you or your loved one need help with. People residing in assisted living facilities may need assistance with any number of daily activities, such as bathing, dressing, using the bathroom, cooking, or eating. About 87 percent of residents need help preparing meals, for example, and 81 percent need help with managing or taking their medications, reports the NCAL. Most residents come from living in private homes or apartments; fewer come from living with adult children or other family members, from nursing home facilities, retirement or independent living communities, or another assisted living or group home.
For some people, however, assisted living may not be an option, mostly for financial reasons. Assisted living facilities cost an average of $34,000 annually in 2009, compared to about $74,000 per year for a nursing home, according to research published in January in Health Affairs. How this expense is paid varies. Residents can buy into a facility by paying a large, upfront sum of money, followed by smaller monthly assessment fees. Or if the resident opts for a facility where he can rent instead, he would pay monthly for the cost of housing and care. The facilities are also mostly located in areas where home values are higher and people nearby have higher incomes. Because of this, people with low incomes, minority groups, and those living in rural areas do not have much access to assisted living facilities, the study reports. Also, some states are home to more assisted living facilities than others. Minnesota, Oregon, and Virginia each had more than 40 facilities per 1,000 elderly residents, according to the research, while Connecticut, Hawaii, and West Virginia each had fewer than 10 facilities per 1,000 elderly.
If you are contemplating an assisted living facility for yourself or a loved one, here are 9 considerations to help guide you:
Reflect on what is most valuable in you or your loved one's life. What gives your life purpose and meaning? "Keep that in mind when choosing your living environment," says Linda Fodrini-Johnson, president of National Association of Professional Geriatric Care Managers. Think about where your doctors, your church, your children, and grandchildren are located. Is the assisted living facility near the things and people you hold dear? Will you have transportation to get where you need to go? "Choose a place that can keep you connected to your medical team, church, clubs you belong to, [and] your family," Fodrini-Johnson says. "You want to keep as much [of a] social network as you can."
Think about your current and future needs. If you have a progressive illness such as Parkinson's disease, for example, look for a facility that can accommodate you as your mobility changes, Fodrini-Johnson advises. You might ask questions like: What are the levels of care that you offer? How long can a resident stay? Will you be provided with wheelchair escorts to the dining room? Are there ramps located throughout the facility? Is your room or apartment fully accessible if you require a wheelchair in the future? Also, if you have dementia and you eventually become at risk of wandering off, does the facility offer a secure unit that they could transfer you to? "That helps you narrow down your choices," Fodrini-Johnson says.
Assess the financial stability of the facility. Although assisted living occupancy rates remain stable industry-wide, some newer facilities and locations that attempted to expand during the recession have struggled to fill their beds, according to the Health Affairs study. And because many prospective residents use the profit from the sale of their homes to pay for their assisted living stays, the downturn in the housing market has hurt facilities located in parts of the U.S. where home values were hit hardest in recent years. Because of this, some assisted living companies have filed for bankruptcy—which can be problematic for residents who have paid a lump sum up front that they expected to cover their housing and care for as long as they're able to live there; if the assisted living facility goes bankrupt, the resident may be out that money, says Craig Reaves, an elder law attorney based in Kansas City, Mo.
Make sure the facility is licensed to ensure it meets your state's assisted living regulations. To confirm this, check with the agency that licenses assisted living facilities in your state. The agency tasked with doing so varies by state. In Maryland, for example, the Maryland Department of Health and Mental Hygiene's Office of Health Care Quality is responsible. To find the appropriate agency in your state, start by searching Eldercare.gov and drilling down by Zip code. Also, check with the Better Business Bureau to find out if there are complaints against the assisted living facility you're interested in.
Get referrals. Go to people you know who have done the search before you, advises Joy Loverde, author of The Complete Eldercare Planner (Random House, revised and updated, 2009). Also, contact your local agency on aging or a geriatric care manger to find out if they can provide a list of facilities they'd recommend in your area.
Ask if there is a waiting list when you make first contact with the facility. "Most of the good assisted living communities have a waiting list," Loverde says. "Don't assume that there's going to be room when you need it." So start your search early and get on the list if you find a place you love.
Visit a few times before you agree to move in. Stop by the community at least twice—once during the day and once at nighttime, Loverde advises, and go on at least one guided tour. Show up unannounced for your other visits, experts say, so you can see what happens when they're not expecting visitors. The nighttime visit is especially important because most of the staff has likely gone home. That's when you can get a good sense of "who is left in the evening shift," she says. "Observe whether the evening shift is aware of the needs of the residents. Ask current residents if they've had problems at night," such as not being able to get assistance in the wee hours due to low staff levels.
Talk to current residents. Talk to residents you meet during your on-site visits and ask if they've experienced any problems at the facility. Probe them about issues with the facility's staff, quality of meals, and on-site thefts, for example. Also, ask the facility if they have a resident council, and ask to talk to the resident in charge of the council to find out what complaints, if any, occupants have about the facility, Loverde suggests.
Get a copy of the contract and show it to a lawyer. The contract or written agreement should detail how the facility handles residents as they age or become sicker, and should include a staff-to-resident ratio, and information about any costs associated with leaving the facility—such as how much of your money you will be refunded and in what time frame. An elder law attorney can help you understand the contract and may advise you to ask the facility for changes that may work to your benefit, Loverde says, such as negotiating future rate increases—especially important for those on a fixed income.
Still, many times, assisted living residents do not get their contracts reviewed prior to moving in. "People underestimate [the] need to have contracts reviewed," Reaves says. "It depends on the facility, but there can be some provisions in those contracts that you may not want," and the facility may be willing to remove them if asked, he says. For example, some contracts allow facilities to kick a resident out if he runs out of money to pay for continuing housing or care. This can be negotiated before the contract is signed, so that a resident can tap into Medicaid, for example, to help cover the costs, Reaves says.
For more information, click here U.S. News.
As people age and need more help with daily activities, such as bathing or taking medication, moving to a facility that provides some assistance, without sacrificing independence, may be an option. This type of environment, known as assisted living, has emerged in the past two decades as an increasingly available option for housing and long-term care. In 1999, one third of the facilities that offered assisted living services had been in existence for less than five years, and 60 percent had existed for less than a decade, according to research published in January in the journal Health Affairs. The growth of assisted living facilities has leveled off in recent years, however, as the economic downturn hampered new construction and occupancy rates.
In 2007, there were approximately 38,000 assisted living facilities nationwide, serving about 975,000 residents. The overwhelming majority of assisted living residents in the United States are female, according to the National Center for Assisted Living. One of the most common types of facilities that provide assisted living are called community care retirement communities, which offer a stepwise approach to care, says Kerry Peck, an elder law attorney based in Chicago. "The concept is you age in place," meaning you never have to leave the grounds for housing, he says, "You buy an apartment or cottage, and then as your health declines, the facility agrees to provide continuing care. Some of the most successful [centers] have independent living, then assisted living, then a nursing home for acute care."
But much like deciding whether a nursing home is necessary, the decision to move into an assisted living facility is not an easy one. So what factors should you consider when looking for a place to move to? First, think about what activities you or your loved one need help with. People residing in assisted living facilities may need assistance with any number of daily activities, such as bathing, dressing, using the bathroom, cooking, or eating. About 87 percent of residents need help preparing meals, for example, and 81 percent need help with managing or taking their medications, reports the NCAL. Most residents come from living in private homes or apartments; fewer come from living with adult children or other family members, from nursing home facilities, retirement or independent living communities, or another assisted living or group home.
For some people, however, assisted living may not be an option, mostly for financial reasons. Assisted living facilities cost an average of $34,000 annually in 2009, compared to about $74,000 per year for a nursing home, according to research published in January in Health Affairs. How this expense is paid varies. Residents can buy into a facility by paying a large, upfront sum of money, followed by smaller monthly assessment fees. Or if the resident opts for a facility where he can rent instead, he would pay monthly for the cost of housing and care. The facilities are also mostly located in areas where home values are higher and people nearby have higher incomes. Because of this, people with low incomes, minority groups, and those living in rural areas do not have much access to assisted living facilities, the study reports. Also, some states are home to more assisted living facilities than others. Minnesota, Oregon, and Virginia each had more than 40 facilities per 1,000 elderly residents, according to the research, while Connecticut, Hawaii, and West Virginia each had fewer than 10 facilities per 1,000 elderly.
If you are contemplating an assisted living facility for yourself or a loved one, here are 9 considerations to help guide you:
Reflect on what is most valuable in you or your loved one's life. What gives your life purpose and meaning? "Keep that in mind when choosing your living environment," says Linda Fodrini-Johnson, president of National Association of Professional Geriatric Care Managers. Think about where your doctors, your church, your children, and grandchildren are located. Is the assisted living facility near the things and people you hold dear? Will you have transportation to get where you need to go? "Choose a place that can keep you connected to your medical team, church, clubs you belong to, [and] your family," Fodrini-Johnson says. "You want to keep as much [of a] social network as you can."
Think about your current and future needs. If you have a progressive illness such as Parkinson's disease, for example, look for a facility that can accommodate you as your mobility changes, Fodrini-Johnson advises. You might ask questions like: What are the levels of care that you offer? How long can a resident stay? Will you be provided with wheelchair escorts to the dining room? Are there ramps located throughout the facility? Is your room or apartment fully accessible if you require a wheelchair in the future? Also, if you have dementia and you eventually become at risk of wandering off, does the facility offer a secure unit that they could transfer you to? "That helps you narrow down your choices," Fodrini-Johnson says.
Assess the financial stability of the facility. Although assisted living occupancy rates remain stable industry-wide, some newer facilities and locations that attempted to expand during the recession have struggled to fill their beds, according to the Health Affairs study. And because many prospective residents use the profit from the sale of their homes to pay for their assisted living stays, the downturn in the housing market has hurt facilities located in parts of the U.S. where home values were hit hardest in recent years. Because of this, some assisted living companies have filed for bankruptcy—which can be problematic for residents who have paid a lump sum up front that they expected to cover their housing and care for as long as they're able to live there; if the assisted living facility goes bankrupt, the resident may be out that money, says Craig Reaves, an elder law attorney based in Kansas City, Mo.
Make sure the facility is licensed to ensure it meets your state's assisted living regulations. To confirm this, check with the agency that licenses assisted living facilities in your state. The agency tasked with doing so varies by state. In Maryland, for example, the Maryland Department of Health and Mental Hygiene's Office of Health Care Quality is responsible. To find the appropriate agency in your state, start by searching Eldercare.gov and drilling down by Zip code. Also, check with the Better Business Bureau to find out if there are complaints against the assisted living facility you're interested in.
Get referrals. Go to people you know who have done the search before you, advises Joy Loverde, author of The Complete Eldercare Planner (Random House, revised and updated, 2009). Also, contact your local agency on aging or a geriatric care manger to find out if they can provide a list of facilities they'd recommend in your area.
Ask if there is a waiting list when you make first contact with the facility. "Most of the good assisted living communities have a waiting list," Loverde says. "Don't assume that there's going to be room when you need it." So start your search early and get on the list if you find a place you love.
Visit a few times before you agree to move in. Stop by the community at least twice—once during the day and once at nighttime, Loverde advises, and go on at least one guided tour. Show up unannounced for your other visits, experts say, so you can see what happens when they're not expecting visitors. The nighttime visit is especially important because most of the staff has likely gone home. That's when you can get a good sense of "who is left in the evening shift," she says. "Observe whether the evening shift is aware of the needs of the residents. Ask current residents if they've had problems at night," such as not being able to get assistance in the wee hours due to low staff levels.
Talk to current residents. Talk to residents you meet during your on-site visits and ask if they've experienced any problems at the facility. Probe them about issues with the facility's staff, quality of meals, and on-site thefts, for example. Also, ask the facility if they have a resident council, and ask to talk to the resident in charge of the council to find out what complaints, if any, occupants have about the facility, Loverde suggests.
Get a copy of the contract and show it to a lawyer. The contract or written agreement should detail how the facility handles residents as they age or become sicker, and should include a staff-to-resident ratio, and information about any costs associated with leaving the facility—such as how much of your money you will be refunded and in what time frame. An elder law attorney can help you understand the contract and may advise you to ask the facility for changes that may work to your benefit, Loverde says, such as negotiating future rate increases—especially important for those on a fixed income.
Still, many times, assisted living residents do not get their contracts reviewed prior to moving in. "People underestimate [the] need to have contracts reviewed," Reaves says. "It depends on the facility, but there can be some provisions in those contracts that you may not want," and the facility may be willing to remove them if asked, he says. For example, some contracts allow facilities to kick a resident out if he runs out of money to pay for continuing housing or care. This can be negotiated before the contract is signed, so that a resident can tap into Medicaid, for example, to help cover the costs, Reaves says.
For more information, click here U.S. News.
Wednesday, May 12, 2010
Senior Housing Types - Descriptions, Payment Options & Average Monthly Costs
Assisted Living
Assisted Living communities provide a residential setting for seniors to live safely. They offer assistance with medication reminders, bathing, dressing and special dietary requirements. Amenities typically include three meals a day, social activities, transportation, housekeeping and laundry. Most living areas offer walk in showers, wide doors for wheelchair access, emergency call services and more. Many assisted livings also offer specialized Alzheimer’s/Dementia Care. They may be stand alone communities or part of a retirement community.
Payment Options: Mostly Private Pay; Some Accept Medicaid
Average Monthly Cost: $2500-4000
Alzheimer’s/Dementia Care
Alzheimer’s/Dementia Care communities are designed with the memory impaired or Alzheimer’s resident in mind. The environment is secured allowing residents to explore and wander safely. The staff is typically well trained and more experienced in working with memory loss and Alzheimer’s care. They may be stand alone communities or part of an assisted living community.
Payment Options: Mostly Private Pay; Some Accept Medicaid
Average Monthly Cost: $3000-6000
Retirement Living
Retirement Living communities provide independent seniors an active apartment style living environment. Apartment types include studio, 1 bedroom or 2 bedroom units with full kitchens. Most retirement communities offer 1-2 meals a day in a dining room or restaurant style setting, weekly housekeeping, social activities and transportation to shopping and doctor appointments.
Payment Options: Mostly Private Pay; Some Government Funded
Average Monthly Cost: $1500-3500
Residential Care Home
Residential Care Homes provide personal assistance to residents in a smaller homelike environment. Most are operated by their owners and offer help with meals, medications, bathing, dressing and social activities. The number of residents varies, but most are less than 10 residents.
Payment Options: Mostly Private Pay; Some Accept Medicaid
Average Monthly Cost: $1500-3000
Senior Apartment
Senior Apartments are designed specifically for independent seniors 55 years or older who desire maintenance free living. Most do not offer meals, housekeeping, transportation or medical assistance. Many senior apartments are subsidized and offer lower monthly rates.
Payment Options: Mostly Private Pay; Some Government Funded
Average Monthly Cost: $750-1500
Nursing Home/Skilled Nursing Facility
Nursing Homes are designed for seniors who require medical attention 24/7 in a hospital like setting. Typical services involve managing complex medical problems such as infections, wound care, IV therapy and coma care. Most facilities offer short term and long term care options. They may be stand alone facilities or part of a retirement community.
Payment Options: Private Pay; Medicaid; Medicare
Average Monthly Cost: $5000-9000
Continuing Care Retirement Community (CCRC)
Continuing Care Retirement Communities (CCRC) provide a continuum of care from independent living, assisted living and skilled nursing all in one location. Amenities typically include daily activities, meals, transportation, housekeeping and laundry. Traditionally, most CCRCs required a buy-in or membership fee, but now many offer month-to-month leasing.
Payment Options: Private Pay; Most Require Buy-In
Average Monthly Cost: $2000-6000
Home Care
Home Care services help individuals with activities of daily living including medications, bathing, dressing, housekeeping, meal preparation, transportation and more. Most are private pay and based on an hourly rate. Home care services are provided in all types of settings including private residences, assisted livings, retirement communities or wherever the client resides.
Payment Options: Mostly Private Pay
Average Hourly Cost: $14-30
For more information, click here Senior Housing Types.
Assisted Living communities provide a residential setting for seniors to live safely. They offer assistance with medication reminders, bathing, dressing and special dietary requirements. Amenities typically include three meals a day, social activities, transportation, housekeeping and laundry. Most living areas offer walk in showers, wide doors for wheelchair access, emergency call services and more. Many assisted livings also offer specialized Alzheimer’s/Dementia Care. They may be stand alone communities or part of a retirement community.
Payment Options: Mostly Private Pay; Some Accept Medicaid
Average Monthly Cost: $2500-4000
Alzheimer’s/Dementia Care
Alzheimer’s/Dementia Care communities are designed with the memory impaired or Alzheimer’s resident in mind. The environment is secured allowing residents to explore and wander safely. The staff is typically well trained and more experienced in working with memory loss and Alzheimer’s care. They may be stand alone communities or part of an assisted living community.
Payment Options: Mostly Private Pay; Some Accept Medicaid
Average Monthly Cost: $3000-6000
Retirement Living
Retirement Living communities provide independent seniors an active apartment style living environment. Apartment types include studio, 1 bedroom or 2 bedroom units with full kitchens. Most retirement communities offer 1-2 meals a day in a dining room or restaurant style setting, weekly housekeeping, social activities and transportation to shopping and doctor appointments.
Payment Options: Mostly Private Pay; Some Government Funded
Average Monthly Cost: $1500-3500
Residential Care Home
Residential Care Homes provide personal assistance to residents in a smaller homelike environment. Most are operated by their owners and offer help with meals, medications, bathing, dressing and social activities. The number of residents varies, but most are less than 10 residents.
Payment Options: Mostly Private Pay; Some Accept Medicaid
Average Monthly Cost: $1500-3000
Senior Apartment
Senior Apartments are designed specifically for independent seniors 55 years or older who desire maintenance free living. Most do not offer meals, housekeeping, transportation or medical assistance. Many senior apartments are subsidized and offer lower monthly rates.
Payment Options: Mostly Private Pay; Some Government Funded
Average Monthly Cost: $750-1500
Nursing Home/Skilled Nursing Facility
Nursing Homes are designed for seniors who require medical attention 24/7 in a hospital like setting. Typical services involve managing complex medical problems such as infections, wound care, IV therapy and coma care. Most facilities offer short term and long term care options. They may be stand alone facilities or part of a retirement community.
Payment Options: Private Pay; Medicaid; Medicare
Average Monthly Cost: $5000-9000
Continuing Care Retirement Community (CCRC)
Continuing Care Retirement Communities (CCRC) provide a continuum of care from independent living, assisted living and skilled nursing all in one location. Amenities typically include daily activities, meals, transportation, housekeeping and laundry. Traditionally, most CCRCs required a buy-in or membership fee, but now many offer month-to-month leasing.
Payment Options: Private Pay; Most Require Buy-In
Average Monthly Cost: $2000-6000
Home Care
Home Care services help individuals with activities of daily living including medications, bathing, dressing, housekeeping, meal preparation, transportation and more. Most are private pay and based on an hourly rate. Home care services are provided in all types of settings including private residences, assisted livings, retirement communities or wherever the client resides.
Payment Options: Mostly Private Pay
Average Hourly Cost: $14-30
For more information, click here Senior Housing Types.
Friday, March 26, 2010
Gardening for Seniors
Gardening has many health and therapeutic benefits for older people, especially when you create an edible garden. Garden beds, equipment and tools can all be modified to create a garden that is interesting, accessible and productive.
Some medical conditions and physical disabilities may restrict or prevent older people from participating in gardening. However with planning and a few changes, you can create a safe, accessible, and pleasant space.
Gardening keeps you fit and healthy
Everyone can benefit from creating an edible garden. Seniors can get particular benefits because gardening:
- Is an enjoyable form of exercise.
- Increases levels of physical activity and maintains mobility and flexibility.
- Encourages use of all motor skills – walking, reaching and bending – through activities such as planting seeds and taking cuttings.
- Improves endurance and strength.
- Helps prevent diseases like osteoporosis.
- Reduces stress levels and promotes relaxation.
- Provides stimulation and interest in nature and the outdoors.
- Improves wellbeing as a result of social interaction.
- Provides nutritious, home-grown produce.
Physical and mental considerations
Some physical, mental and age-related conditions must be considered when older people work in the garden. These include:
- Skin – fragile, thinning skin makes the elderly susceptible to bumps, bruises and sunburn.
- Vision – changes in the eye lens structure, loss of peripheral vision and generally poorer eyesight can restrict activities.
- Mental abilities – mental health, thinking and memory abilities may be affected by dementia and similar conditions.
- Body temperature – susceptibility to temperature changes and tendency to dehydrate or suffer from heat exhaustion are common concerns with outdoor physical activity for older people.
- Skeletal – falls are more common because balance is often not as good. Osteoporosis and arthritis may restrict movement and flexibility.
Changes to equipment, tools and the garden
Garden spaces, tools and equipment can be modified or adapted to help reduce the physical stress associated with gardening. Suggestions include:
- Use vertical planting to make garden beds accessible for planting and harvesting – try using wall and trellis spaces.
- Raise beds to enable people with physical restrictions to avoid bending and stooping.
- Provide retractable hanging baskets, wheelbarrows and containers on castors to make suitable movable and elevated garden beds.
- Find adaptive tools and equipment – these are available from some hardware shops.
- Use foam, tape and plastic tubing to modify existing tools.
- Use lightweight tools that are easier to handle.
- Provide shade areas for working in summer months.
- Have stable chairs and tables to use for comfortable gardening.
- Ensure that there is a tap nearby or consider installing a drip feeder system for easy watering.
- Make sure the toilet is nearby.
Safety in the garden
Here are a few safety tips that older people and their carers should follow.
- Attend to any cuts, bruises or insect bites immediately.
- Take care in the use of power tools.
- Secure gates and fences if memory loss is an issue.
- Ensure that paths and walkways are flat and non-slip.
- Warm up before gardening and encourage frequent breaks.
- Prevent sun exposure by working in the garden early in the morning or late in the day. Wear a hat and apply sunscreen frequently.
- Drink water or juice, and avoid alcohol.
- Wear protective shoes, lightweight comfortable clothes that cover exposed skin, a hat and gardening gloves.
- Store garden equipment safely.
Legionnaire’s disease and gardening
Legionnaire’s disease is sometimes linked to handling potting mixes. Always follow these safety rules:
- Wear a facemask and gloves.
- Do not lean over an open bag of potting mix. This avoids the risk of breathing in spores.
- Moisten contents of potting mix bags when you open them.
- Wash hands with soap and water after handling soil.
Plant selection
An edible garden is a garden that contains flowers, herbs, seeds, berries and other plants that you can eat. You should also consider using varieties of plants that have sensory and textural qualities. Sensory plants include those that have special smell, taste, touch and sight qualities.
Gardening activities
There are many activities associated with cultivating an edible garden that seniors may enjoy. These include:
- Digging
- Planting
- Watering
- Harvesting food and flowers
- Crafts and hobbies associated with plants
- Food preparation.
Where to get help
Community or local garden groups
Local council
Cultivating Community Email: info@cultivatingcommunity.org.au
Occupational Therapists Victoria Tel. (03) 9481 6866
Horticultural Therapy Association of Victoria Tel. (03) 9848 9710.
Things to remember
- Gardening is a healthy, stimulating physical activity that can be enjoyed by seniors.
- The garden, equipment and tools can all be modified to suit the needs of older people.
- Make sure your edible garden is a safe and accessible space.
For more information, visit Better Health Channel.
Some medical conditions and physical disabilities may restrict or prevent older people from participating in gardening. However with planning and a few changes, you can create a safe, accessible, and pleasant space.
Gardening keeps you fit and healthy
Everyone can benefit from creating an edible garden. Seniors can get particular benefits because gardening:
- Is an enjoyable form of exercise.
- Increases levels of physical activity and maintains mobility and flexibility.
- Encourages use of all motor skills – walking, reaching and bending – through activities such as planting seeds and taking cuttings.
- Improves endurance and strength.
- Helps prevent diseases like osteoporosis.
- Reduces stress levels and promotes relaxation.
- Provides stimulation and interest in nature and the outdoors.
- Improves wellbeing as a result of social interaction.
- Provides nutritious, home-grown produce.
Physical and mental considerations
Some physical, mental and age-related conditions must be considered when older people work in the garden. These include:
- Skin – fragile, thinning skin makes the elderly susceptible to bumps, bruises and sunburn.
- Vision – changes in the eye lens structure, loss of peripheral vision and generally poorer eyesight can restrict activities.
- Mental abilities – mental health, thinking and memory abilities may be affected by dementia and similar conditions.
- Body temperature – susceptibility to temperature changes and tendency to dehydrate or suffer from heat exhaustion are common concerns with outdoor physical activity for older people.
- Skeletal – falls are more common because balance is often not as good. Osteoporosis and arthritis may restrict movement and flexibility.
Changes to equipment, tools and the garden
Garden spaces, tools and equipment can be modified or adapted to help reduce the physical stress associated with gardening. Suggestions include:
- Use vertical planting to make garden beds accessible for planting and harvesting – try using wall and trellis spaces.
- Raise beds to enable people with physical restrictions to avoid bending and stooping.
- Provide retractable hanging baskets, wheelbarrows and containers on castors to make suitable movable and elevated garden beds.
- Find adaptive tools and equipment – these are available from some hardware shops.
- Use foam, tape and plastic tubing to modify existing tools.
- Use lightweight tools that are easier to handle.
- Provide shade areas for working in summer months.
- Have stable chairs and tables to use for comfortable gardening.
- Ensure that there is a tap nearby or consider installing a drip feeder system for easy watering.
- Make sure the toilet is nearby.
Safety in the garden
Here are a few safety tips that older people and their carers should follow.
- Attend to any cuts, bruises or insect bites immediately.
- Take care in the use of power tools.
- Secure gates and fences if memory loss is an issue.
- Ensure that paths and walkways are flat and non-slip.
- Warm up before gardening and encourage frequent breaks.
- Prevent sun exposure by working in the garden early in the morning or late in the day. Wear a hat and apply sunscreen frequently.
- Drink water or juice, and avoid alcohol.
- Wear protective shoes, lightweight comfortable clothes that cover exposed skin, a hat and gardening gloves.
- Store garden equipment safely.
Legionnaire’s disease and gardening
Legionnaire’s disease is sometimes linked to handling potting mixes. Always follow these safety rules:
- Wear a facemask and gloves.
- Do not lean over an open bag of potting mix. This avoids the risk of breathing in spores.
- Moisten contents of potting mix bags when you open them.
- Wash hands with soap and water after handling soil.
Plant selection
An edible garden is a garden that contains flowers, herbs, seeds, berries and other plants that you can eat. You should also consider using varieties of plants that have sensory and textural qualities. Sensory plants include those that have special smell, taste, touch and sight qualities.
Gardening activities
There are many activities associated with cultivating an edible garden that seniors may enjoy. These include:
- Digging
- Planting
- Watering
- Harvesting food and flowers
- Crafts and hobbies associated with plants
- Food preparation.
Where to get help
Community or local garden groups
Local council
Cultivating Community Email: info@cultivatingcommunity.org.au
Occupational Therapists Victoria Tel. (03) 9481 6866
Horticultural Therapy Association of Victoria Tel. (03) 9848 9710.
Things to remember
- Gardening is a healthy, stimulating physical activity that can be enjoyed by seniors.
- The garden, equipment and tools can all be modified to suit the needs of older people.
- Make sure your edible garden is a safe and accessible space.
For more information, visit Better Health Channel.
Wednesday, March 3, 2010
Words for Seniors Facing Loss by Paula Span
My father is a relentlessly upbeat guy. “Up and around!” he reports when I call. “Keeping busy!” He tells me about his volunteer work, his card game winnings, the (seated) yoga class he enrolled in at the library. His favorite refrain is, “I can’t complain.” (And yes, yes, yes, my sister and I do know how lucky we are.)
He does tell me about the funerals, though. At 87, watching his peers struggle with the physical and psychological trials of old age, he goes to a lot of them. He keeps losing people he’s known for years — onetime co-workers, senior members of his synagogue, neighbors in his tightly knit apartment building.
His friend Molly, too frail in her 90s to remain alone in her house, recently moved to the Midwest to live with her son; they’ll probably never see each other again. The weekly card game now involves an entirely different group of guys than when he started years ago, and it sometimes stalls for several weeks as the players have health crises or move or die. Replacement players are growing harder to find.
“These things keep happening when you’re over 80,” he told me.
He goes to funerals because, he said: “It’s just the right thing to do. It shows that you feel bad, that you’ve lost a friend.”
What do you say to this litany? You want to offer something reassuring, something to lighten the sense of loss, but you can’t evade the reality: He’s outliving his friends and family members. His cohort is thinning.
Luckily, I can turn for counsel to Barbara Moscowitz, senior social worker at the Massachusetts General Hospital’s Senior Health program. (One benefit of writing this blog is that you can call up experts and pose questions, supposedly on behalf of readers, that you really want answered yourself.) Ms. Moscowitz hears such litanies from clients and their adult children all the time.
And her personal guideline is to remove age from the equation and ask yourself how you would respond if the one suffering losses was a peer, not an older person.
“We impose our expectations,” she said.
When old people lose their friends, she added: “We think, ‘You should be able to manage this. This is what happens. You should be used to it.’ Because if we ask what it’s like, we may hear what it’s like. We fear opening the floodgates of sadness.”
But we wouldn’t tell a 55-year-old friend who had attended three funerals in two months to just buck up, would we?
“When there’s been loss, to expect happiness is just denying the truth,” Ms. Moscowitz continued. “It opens up a divide between older people who then deal with the sorrow privately, knowing nobody wants to hear about it, and younger people who want them to be cheerful all the time.”
Of course, some older people don’t want to talk about the illnesses or deaths of their friends or neighbors, either — but in her experience, Ms. Moscowitz said, most do.
“Those people are part of their history, their legacy,” she said. “If we send a message that we don’t want to hear about it, it says: That person is not worth remembering.”
Grief — feeling sad, weepy, temporarily at sea — is different from clinical depression, it’s important to recognize. Grief is a normal response to loss; depression is an illness that’s usually treatable, both in young people and old ones. Symptoms that persist — like appetite loss, sleep problems, loss of interest in normal activities, thoughts of suicide and, in older people, confusion or agitation — are red flags that signal the need for a medical evaluation.
But my father is not depressed. He’s coping with one of the more difficult aspects of a long life. So I listen to the funeral reports and try not to respond by pointing out all the reasons he has to feel fortunate.
I try to remember to say things like: “Ah, that’s so sad. How long had you known this person? What was he like? Do you need help arranging a ride to the funeral home? I’m sorry, Dad. It must be hard. I bet you’ll miss him.”
Read “Words for Seniors Facing Loss” from The New York Times.
Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”
He does tell me about the funerals, though. At 87, watching his peers struggle with the physical and psychological trials of old age, he goes to a lot of them. He keeps losing people he’s known for years — onetime co-workers, senior members of his synagogue, neighbors in his tightly knit apartment building.
His friend Molly, too frail in her 90s to remain alone in her house, recently moved to the Midwest to live with her son; they’ll probably never see each other again. The weekly card game now involves an entirely different group of guys than when he started years ago, and it sometimes stalls for several weeks as the players have health crises or move or die. Replacement players are growing harder to find.
“These things keep happening when you’re over 80,” he told me.
He goes to funerals because, he said: “It’s just the right thing to do. It shows that you feel bad, that you’ve lost a friend.”
What do you say to this litany? You want to offer something reassuring, something to lighten the sense of loss, but you can’t evade the reality: He’s outliving his friends and family members. His cohort is thinning.
Luckily, I can turn for counsel to Barbara Moscowitz, senior social worker at the Massachusetts General Hospital’s Senior Health program. (One benefit of writing this blog is that you can call up experts and pose questions, supposedly on behalf of readers, that you really want answered yourself.) Ms. Moscowitz hears such litanies from clients and their adult children all the time.
And her personal guideline is to remove age from the equation and ask yourself how you would respond if the one suffering losses was a peer, not an older person.
“We impose our expectations,” she said.
When old people lose their friends, she added: “We think, ‘You should be able to manage this. This is what happens. You should be used to it.’ Because if we ask what it’s like, we may hear what it’s like. We fear opening the floodgates of sadness.”
But we wouldn’t tell a 55-year-old friend who had attended three funerals in two months to just buck up, would we?
“When there’s been loss, to expect happiness is just denying the truth,” Ms. Moscowitz continued. “It opens up a divide between older people who then deal with the sorrow privately, knowing nobody wants to hear about it, and younger people who want them to be cheerful all the time.”
Of course, some older people don’t want to talk about the illnesses or deaths of their friends or neighbors, either — but in her experience, Ms. Moscowitz said, most do.
“Those people are part of their history, their legacy,” she said. “If we send a message that we don’t want to hear about it, it says: That person is not worth remembering.”
Grief — feeling sad, weepy, temporarily at sea — is different from clinical depression, it’s important to recognize. Grief is a normal response to loss; depression is an illness that’s usually treatable, both in young people and old ones. Symptoms that persist — like appetite loss, sleep problems, loss of interest in normal activities, thoughts of suicide and, in older people, confusion or agitation — are red flags that signal the need for a medical evaluation.
But my father is not depressed. He’s coping with one of the more difficult aspects of a long life. So I listen to the funeral reports and try not to respond by pointing out all the reasons he has to feel fortunate.
I try to remember to say things like: “Ah, that’s so sad. How long had you known this person? What was he like? Do you need help arranging a ride to the funeral home? I’m sorry, Dad. It must be hard. I bet you’ll miss him.”
Read “Words for Seniors Facing Loss” from The New York Times.
Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”
Tuesday, March 2, 2010
2009 Tax Information for Seniors and Their Families
The following is helpful information for seniors and their families for the 2009 tax season:
Tips for Seniors in Preparing their Taxes
Claiming the Credit for the Elderly or the Disabled
Common Errors Made by Taxpayers 65 and Older
Tips for Seniors in Preparing their Taxes
Claiming the Credit for the Elderly or the Disabled
Common Errors Made by Taxpayers 65 and Older
Tuesday, February 16, 2010
Life Settlements: The Legal Rights of Insurance Policy Owners by Chris Orestis, Life Care Funding Group
The right of a policy owner to engage in a Life Settlement was guaranteed when U.S. Supreme Court Justice Oliver Wendell Holmes ruled in 1911 that life insurance is personal property and the owner is protected by all the same inalienable rights that any owner of real estate, stocks or any other assets enjoy. By the end of the 20th Century, Viaticals emerged as an opportunity for AIDS patients to cash out of a life insurance policy while still alive to cover the high costs of care not covered by health insurance. The Life Settlement market became an offshoot of Viaticals and has been growing rapidly ever since, with $13 billion in transactions completed in 2008.
In a 2003 study conducted by Conning & Co, they estimated that 90 million senior citizens owned approximately $500 billion worth of life insurance in 2003, of which over $100 billion was owned by seniors eligible for Life Settlements. The Wharton Business School issued a study where they observed, “Life insurance policies are typically assignable, which means that a policyholder is free to transfer their ownership of the policy to another person. A policyholder’s right to assign their policy to someone other than the insurance carrier has existed for some time.” The study also went on to observe that a life settlement, “gives the policyholder the economic freedom to choose between a number of buyers and, in so doing, to receive the fair market price for their policy.”
The right of a policy owner to engage in a life settlement is guaranteed by the landmark Supreme Court decision, Grigbsy v. Russell. In Justice Holmes’ final opinion it was codified that life insurance possessed all the ordinary characteristics of property, and therefore represented an asset that a policy owner could transfer without limitation. This decision established a life insurance policy as transferable property that contains specific legal rights, including the right to:
• Name the policy beneficiary
• Change the beneficiary designation
• Assign the policy as collateral for a loan
• Borrow against the policy
• Sell the policy to another party
A number of insurance industry organizations such as the National Association of Insurance Commissioners (NAIC), National Council of Insurance Legislators (NCOIL), American Council of Life Insurers (ACLI), National Association of Insurance and Financial Advisors (NAIFA), American Association of Life Underwriters (AALU) and the Life Insurance Settlement Association (LISA) have also recognized the legal rights of a policy owner to liquidate a life insurance policy through a life settlement.
During a panel session at ReFocus 2008, jointly presented by the ACLI and the Society of Actuaries, industry CEO’s agreed on the need for Life Settlements. Stuart Reese, chairman, president and CEO of MassMutual Life Insurance Company said that if a policy is first purchased with protection in mind and is no longer needed after a period of time, then a contract holder does have property rights and “there is a legitimate Life Settlement business which is consistent with the purpose of insurance.”
“The Life Settlement industry provides an important and efficient function to the insurance marketplace-- and it is a practice established by the Supreme Court”, said Chris Orestis, President of Life Care Funding Group (www.lifecarefunding.com), “In light of the long standing Supreme Court ruling on the transferability of insurance as property; those holding a policy that they no longer need will always be able to maximize the value of that property through a life settlement transaction.”
Visit Life Care Funding Group for more information.
Monday, January 11, 2010
Healthy Older Adults With Subjective Memory Loss May Be At Increased Risk For Mild Cognitive Impairment And Dementia
Forgot where you put your car keys? Having trouble recalling your colleague's name? If so, this may be a symptom of subjective cognitive impairment (SCI), the earliest sign of cognitive decline marked by situations such as when a person recognizes they can't remember a name like they used to or where they recently placed important objects the way they used to. Studies have shown that SCI is experienced by between one-quarter and one-half of the population over the age of 65. A new study, published in the January 11, 2010, issue of the journal Alzheimer's & Dementia, finds that healthy older adults reporting SCI are 4.5 times more likely to progress to the more advanced memory-loss stages of mild cognitive impairment (MCI) or dementia than those free of SCI.
The long-term study completed by researchers at NYU Langone Medical Center tracked 213 adults with and without SCI over an average of seven years, with data collection taking nearly two decades. Further cognitive decline to MCI or dementia was observed in 54 percent of SCI persons, while only in 15 percent of persons free of SCI.
"This is the first study to use mild cognitive impairment as well as dementia as an outcome criterion to demonstrate the outcome of SCI as a possible forerunner of eventual Alzheimer's disease," said Barry Reisberg, MD, professor of psychiatry, director of the Fisher Alzheimer's Disease Program and director, Clinical Core, NYU Alzheimer's Disease Center at NYU Langone Medical Center. "The findings indicate that a significant percentage of people with early subjective symptoms may experience further cognitive decline, whereas few persons without these symptoms decline. If decline does occur in those without SCI symptoms, it takes considerably longer than for those with subjective cognitive symptoms."
According to the authors, scientists and physicians can now target the prevention of eventual Alzheimer's disease in the SCI stage, beginning more than 20 years before dementia becomes evident
"These intriguing results more fully describe the possible relationship between early signs of memory loss and development of more serious impairment. This is critical to know, as we look for ways to define who is at risk and for whom the earliest interventions might be successful," said Neil Buckholtz, PhD, National Institute on Aging (NIA) which supported the research. "These findings also underscore the importance of clinicians' asking about, and listening to, concerns regarding changes in cognition and memory among their aging patients."
Co-authors of Dr. Reisberg at the NYU Alzheimer's Disease Center include Melanie B. Shulman, MD, Carol Torossian, PsyD, and Wei Zhu, PhD.
Primary funding for this study was provided by the NIA, which is part of the National Institutes of Health. Additional funding was provided by Mr. Leonard Litwin and the Fisher Alzheimer's Research Foundation.
Article Date: 08 Jan 2010 Source: NYU Langone Medical Center
The long-term study completed by researchers at NYU Langone Medical Center tracked 213 adults with and without SCI over an average of seven years, with data collection taking nearly two decades. Further cognitive decline to MCI or dementia was observed in 54 percent of SCI persons, while only in 15 percent of persons free of SCI.
"This is the first study to use mild cognitive impairment as well as dementia as an outcome criterion to demonstrate the outcome of SCI as a possible forerunner of eventual Alzheimer's disease," said Barry Reisberg, MD, professor of psychiatry, director of the Fisher Alzheimer's Disease Program and director, Clinical Core, NYU Alzheimer's Disease Center at NYU Langone Medical Center. "The findings indicate that a significant percentage of people with early subjective symptoms may experience further cognitive decline, whereas few persons without these symptoms decline. If decline does occur in those without SCI symptoms, it takes considerably longer than for those with subjective cognitive symptoms."
According to the authors, scientists and physicians can now target the prevention of eventual Alzheimer's disease in the SCI stage, beginning more than 20 years before dementia becomes evident
"These intriguing results more fully describe the possible relationship between early signs of memory loss and development of more serious impairment. This is critical to know, as we look for ways to define who is at risk and for whom the earliest interventions might be successful," said Neil Buckholtz, PhD, National Institute on Aging (NIA) which supported the research. "These findings also underscore the importance of clinicians' asking about, and listening to, concerns regarding changes in cognition and memory among their aging patients."
Co-authors of Dr. Reisberg at the NYU Alzheimer's Disease Center include Melanie B. Shulman, MD, Carol Torossian, PsyD, and Wei Zhu, PhD.
Primary funding for this study was provided by the NIA, which is part of the National Institutes of Health. Additional funding was provided by Mr. Leonard Litwin and the Fisher Alzheimer's Research Foundation.
Article Date: 08 Jan 2010 Source: NYU Langone Medical Center
Friday, January 8, 2010
Why Older Americans Will Have to Wait for Swine-Flu Shots by Betsy McKay
On a visit to his doctor last week for a blood-pressure check, Neil Johnson, a former mortgage lender, dutifully got his annual flu shot. Having suffered from flu in the past—"you ache, you cough...you have fever all over"—he wanted to make sure to get his shot early.
But Mr. Johnson, an 81-year-old resident of an assisted-living facility in Sandy Springs, Ga., will have to wait quite a while before he can roll up his sleeve for a vaccine against this season's best-known virus: the H1N1 swine flu. People age 65 and older are nearly last in line for that shot.
Older Americans are normally at the front of the queue for shots against the seasonal flu viruses that circulate every fall and winter, and public-health officials and doctors strongly urge them to get one each year. There's little wonder why: An estimated 36,000 people die in the U.S. every year from the seasonal flu, and 90% of them are 65 or older.
Perk of Age
But so far the new H1N1 flu is largely sparing the 60-plus demographic, instead hitting children and young adults the hardest. While it has spread like wildfire through secondary schools and colleges, and claimed more than 2,800 lives world-wide, few older people have even gotten sick.
That's because many people 60 and older were exposed to H1N1 viruses that circulated between 1918 and 1957. Those earlier viruses were similar to the new H1N1 virus, so the immunity that some people built up then is helping them now.
A study by scientists at the Centers for Disease Control and Prevention found that about one-third of adults age 60 and older had antibodies that protected them against the new H1N1 virus. By contrast, children had none.
The pattern is similar to one seen in the deadly 1918 pandemic, in which death rates were highest among young adults, according to infectious-disease experts. One possible reason is that older adults had been exposed to similar flu viruses in the 1800s.
Be Patient
With the risk of infection lower for older adults, federal health officials are allotting the swine-flue vaccine first to pregnant women, children and young adults, and anyone under 65 with asthma, diabetes or another medical condition that can increase their risk of complications from the flu. The CDC says older adults should be offered the vaccine only when there's enough medicine for all the other priority groups.
That's likely to take a few months. The federal government expects to receive and distribute 195 million doses of swine-flu vaccine by year-end. Officials estimate that 159 million people make up the top-priority groups—not including older adults—though not everyone in those groups is likely to opt for a shot. The new vaccine is free, and many insurance companies have said they will cover administration fees for the shot.
Budgie Amparo, senior vice president of quality and risk management for Emeritus Corp., which operates senior-living facilities, including the facility where Mr. Johnson lives, says it's working on getting swine-flu vaccine for its residents as quickly as it can through its regular supplier of seasonal-flu shots. "We've taken some proactive steps," Mr. Amparo says. "We were reassured that once it's available, we're going to get it."
Extra Precautions
In the meantime, nurses at Emeritus properties plan to spend more time educating residents about ways to protect themselves from the flu, such as washing their hands, Mr. Amparo says. They will also more actively monitor residents' health, to reduce their chances of complications should they get the flu. "We want to make sure we're managing their overall medical condition," helping residents get medications in a timely fashion, or helping those with respiratory conditions such as asthma see doctors quickly, he says.
One reason for the extra precautions: While older adults account for the fewest U.S. cases of swine flu, the proportion of those who have died is higher than for other age groups, according to CDC data. "Once you do get infected, your risk is higher," says Charlotte Yeh, chief medical officer for AARP Services Inc., part of the Washington-based advocacy group. Many older Americans have chronic conditions that affect their immune status, making it harder to fight off any flu, she says.
Moreover, the seasonal-flu vaccine may not offer full protection this year against a long-circulating virus that traditionally is linked with more hospitalizations and deaths among older adults than other strains. A new variant of the H3N2 seasonal flu virus has been identified on several continents that differs from the H3N2 strain covered by this year's vaccine. So far it's in the minority of H3N2 circulating viruses, and it's unclear how widely it will circulate in the U.S. this flu season, particularly given the current dominance of the swine-flu virus. But officials at the CDC and the World Health Organization say they're keeping a close eye on it.
Doctors can't quickly determine what strain of flu a patient has. "If you come in with all the signs of flu, we can't tell you which flu you have," Dr. Yeh says. "The critical thing is that if you have fever, aches, congestion, cough, dizziness, that is something you should talk with your doctor about." A doctor may prescribe an antiviral such as Tamiflu, which can't cure the flu but can shorten its duration and severity if started early.
Read Why Older Americans Will Have to Wait for Swine-Flu Shots for more information.
By Betsy McKay is deputy chief of The Wall Street Journal's Atlanta bureau.
But Mr. Johnson, an 81-year-old resident of an assisted-living facility in Sandy Springs, Ga., will have to wait quite a while before he can roll up his sleeve for a vaccine against this season's best-known virus: the H1N1 swine flu. People age 65 and older are nearly last in line for that shot.
Older Americans are normally at the front of the queue for shots against the seasonal flu viruses that circulate every fall and winter, and public-health officials and doctors strongly urge them to get one each year. There's little wonder why: An estimated 36,000 people die in the U.S. every year from the seasonal flu, and 90% of them are 65 or older.
Perk of Age
But so far the new H1N1 flu is largely sparing the 60-plus demographic, instead hitting children and young adults the hardest. While it has spread like wildfire through secondary schools and colleges, and claimed more than 2,800 lives world-wide, few older people have even gotten sick.
That's because many people 60 and older were exposed to H1N1 viruses that circulated between 1918 and 1957. Those earlier viruses were similar to the new H1N1 virus, so the immunity that some people built up then is helping them now.
A study by scientists at the Centers for Disease Control and Prevention found that about one-third of adults age 60 and older had antibodies that protected them against the new H1N1 virus. By contrast, children had none.
The pattern is similar to one seen in the deadly 1918 pandemic, in which death rates were highest among young adults, according to infectious-disease experts. One possible reason is that older adults had been exposed to similar flu viruses in the 1800s.
Be Patient
With the risk of infection lower for older adults, federal health officials are allotting the swine-flue vaccine first to pregnant women, children and young adults, and anyone under 65 with asthma, diabetes or another medical condition that can increase their risk of complications from the flu. The CDC says older adults should be offered the vaccine only when there's enough medicine for all the other priority groups.
That's likely to take a few months. The federal government expects to receive and distribute 195 million doses of swine-flu vaccine by year-end. Officials estimate that 159 million people make up the top-priority groups—not including older adults—though not everyone in those groups is likely to opt for a shot. The new vaccine is free, and many insurance companies have said they will cover administration fees for the shot.
Budgie Amparo, senior vice president of quality and risk management for Emeritus Corp., which operates senior-living facilities, including the facility where Mr. Johnson lives, says it's working on getting swine-flu vaccine for its residents as quickly as it can through its regular supplier of seasonal-flu shots. "We've taken some proactive steps," Mr. Amparo says. "We were reassured that once it's available, we're going to get it."
Extra Precautions
In the meantime, nurses at Emeritus properties plan to spend more time educating residents about ways to protect themselves from the flu, such as washing their hands, Mr. Amparo says. They will also more actively monitor residents' health, to reduce their chances of complications should they get the flu. "We want to make sure we're managing their overall medical condition," helping residents get medications in a timely fashion, or helping those with respiratory conditions such as asthma see doctors quickly, he says.
One reason for the extra precautions: While older adults account for the fewest U.S. cases of swine flu, the proportion of those who have died is higher than for other age groups, according to CDC data. "Once you do get infected, your risk is higher," says Charlotte Yeh, chief medical officer for AARP Services Inc., part of the Washington-based advocacy group. Many older Americans have chronic conditions that affect their immune status, making it harder to fight off any flu, she says.
Moreover, the seasonal-flu vaccine may not offer full protection this year against a long-circulating virus that traditionally is linked with more hospitalizations and deaths among older adults than other strains. A new variant of the H3N2 seasonal flu virus has been identified on several continents that differs from the H3N2 strain covered by this year's vaccine. So far it's in the minority of H3N2 circulating viruses, and it's unclear how widely it will circulate in the U.S. this flu season, particularly given the current dominance of the swine-flu virus. But officials at the CDC and the World Health Organization say they're keeping a close eye on it.
Doctors can't quickly determine what strain of flu a patient has. "If you come in with all the signs of flu, we can't tell you which flu you have," Dr. Yeh says. "The critical thing is that if you have fever, aches, congestion, cough, dizziness, that is something you should talk with your doctor about." A doctor may prescribe an antiviral such as Tamiflu, which can't cure the flu but can shorten its duration and severity if started early.
Read Why Older Americans Will Have to Wait for Swine-Flu Shots for more information.
By Betsy McKay is deputy chief of The Wall Street Journal's Atlanta bureau.
Wednesday, January 6, 2010
Irrevocable Trusts and the Reverse Mortgage Opportunity
Irrevocable trusts can now be used for reverse mortgages, according to Paul N. Lovegrove Esq., President of Attorney Trust Review.
While traditionally reverse mortgages have not been permissible if the home is in an irrevocable trust, Lovegrove says there is no basis for the policy, adding that there is, “Nothing in the HECM guidelines that says you can’t use an irrevocable trust.”
Although lenders cant sell a reverse mortgage with an irrevocable trust to Fannie Mae, the recent growth of Ginnie Mae’s HMBS program has provided an opportunity for HECMs.
Lovegrove, an attorney who has been closing reverse loans for thirteen years and performs trust reviews for many lenders, including MetLife, proposes drawing up an agreement to the irrevocable trust that is agreed upon by all parties as a way to comply with the guideline.
An irrevocable trust may also not qualify for a reverse mortgage if one of the current beneficiaries does not meet HECM guidelines, amongst other things. All current beneficiaries of a trust must be HECM eligible for a HECM to be done on the home.
In addition, irrevocable trusts can pose a problem when the trust does not allow invasion of the principle by the settler. However, a lump sum distribution deposited into a bank account controlled by the estate can help solve this issue.
Lovegrove thinks that banks are not doing reverse mortgages on irrevocable trusts because they “never thought they could.” But Lovegrove adds, “By saying we can’t do it that’s closing out a lot of potential business that’s out there.”
By Reva Minkoff, Reverse Mortgage Daily, January 06, 2010
While traditionally reverse mortgages have not been permissible if the home is in an irrevocable trust, Lovegrove says there is no basis for the policy, adding that there is, “Nothing in the HECM guidelines that says you can’t use an irrevocable trust.”
Although lenders cant sell a reverse mortgage with an irrevocable trust to Fannie Mae, the recent growth of Ginnie Mae’s HMBS program has provided an opportunity for HECMs.
Lovegrove, an attorney who has been closing reverse loans for thirteen years and performs trust reviews for many lenders, including MetLife, proposes drawing up an agreement to the irrevocable trust that is agreed upon by all parties as a way to comply with the guideline.
An irrevocable trust may also not qualify for a reverse mortgage if one of the current beneficiaries does not meet HECM guidelines, amongst other things. All current beneficiaries of a trust must be HECM eligible for a HECM to be done on the home.
In addition, irrevocable trusts can pose a problem when the trust does not allow invasion of the principle by the settler. However, a lump sum distribution deposited into a bank account controlled by the estate can help solve this issue.
Lovegrove thinks that banks are not doing reverse mortgages on irrevocable trusts because they “never thought they could.” But Lovegrove adds, “By saying we can’t do it that’s closing out a lot of potential business that’s out there.”
By Reva Minkoff, Reverse Mortgage Daily, January 06, 2010
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