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Dementia rates falling in the U.S.

11/21/2016

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Dementia is a generic term for a range of neurological disorders affecting millions of Americans every year. As the disease is more common in older age and the aging population is expected to increase in most countries, dementia has been predicted to increase exponentially. However, new research reports a decline in the prevalence of dementia in the United States.

Dementia is an umbrella term used to describe a variety of conditions and symptoms that occur when nerve cells die or no longer function properly. The malfunctioning of these neurons leads to memory loss, impaired reasoning and cognition, and sometimes personality changes.

Patients are diagnosed with the disorder when such impairment becomes severe and interferes with a person's ability to carry out daily tasks. Alzheimer's disease is the most common form of dementia, accounting for 60-80 percent of cases.

Ultimately, Alzheimer's disease is fatal, ranking as the sixth leading cause of death in the U.S.

According to the Alzheimer's Association, 1 in 3 American seniors die with Alzheimer's or another form of dementia.

It is estimated that 5.2 million Americans aged 65 or over live with Alzheimer's, and the numbers are expected to escalate. As the so-called baby boom generation has started to reach age 65 and over, by 2050, the number of seniors with Alzheimer's disease is expected to triple to a staggering 13.8 million.

The rapidly expanding nature of dementia has earned its nickname as "The Silent Epidemic."

However, some recent studies have suggested that the risk of developing dementia may have declined in the past 25 years, particularly in high-income countries. New research seems to support this optimistic view.


Has the risk of developing dementia decreased over the years?

At least three European studies have suggested dementia risk may be decreasing in older adults, with authors hypothesizing that the change is due to changes in education, decline in vascular risk factors, and overall decrease in stroke incidence.

In the U.S., one study noted a 20 percent decrease in dementia per decade between 1977-2008, but only in adults with at least a high school education.

New research compares the prevalence of dementia in the U.S. in 2000 and 2012.

The new study was led by Dr. Kenneth M. Langa, Ph.D., of the University of Michigan in Ann Arbor. The results were published in the journal JAMA Internal Medicine.

Researchers used data from a large, nationally representative group of American adults who participated in the Health and Retirement Study (HRS). In total, the study looked at over 21,000 adults aged 65 and over. The HRS gathered data from 10,546 adults in 2000 and from 10,511 adults in 2012.

The HRS used cognitive measures and appropriate methods for classifying answers self-reported by the participants themselves or by a designated proxy.

Participants in the HRS had an average of 75 years in 2000 and 74.8 years in 2012. Of the cohort studied in 2000, 58.4 percent were female, compared with 56.3 percent in 2012.

The analysis used logistic regression to identify and account for socioeconomic and health variables.


Study finds significant fall in dementia in U.S.

The new study supports previous studies suggesting dementia rates may be dropping.

The analysis found that dementia prevalence among participants aged 65 and older decreased from 11.6 percent in 2000 to 8.8 percent in 2012.

This corresponds to an absolute decrease of 2.8 percent and a relative decrease of 24 percent.

Researchers also found an inverse association between time spent in education and the risk of developing dementia.
More years of education was correlated with a lower risk of dementia, with adults in the 2012 group having, on average, 1 more year of education, compared with adults in the 2000 group.

The average number of years spent in education increased from 11.8 years in 2000 to 12.7 years in 2012.

Education may have influenced the declining trend in dementia either by having a direct effect on the brain, improving brain power and cognitive function, or indirectly, through an association with positive health behavior, such as exercising or having a healthy diet.

Education may also be associated with more cognitively complex activities and better access to health care, the authors note.

The decrease in dementia prevalence occurred despite the increases in cardiovascular disease risk factors, such as hypertension, diabetes, and obesity. Researchers suggest improvements in treatments for cardiovascular risk factors may have had a positive effect on dementia risk.
 
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6 Simple Ways For Older People To Deal With Chronic Pain

11/18/2016

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Chronic pain is an unfortunate reality for many elderly people. As we age, our bodies become more fragile. Osteoarthritic, musculoskeletal, neuropathic, and chronic joint pain are all common and difficult to treat.
These issues make everyday activities incredibly challenging, often causing sufferers to withdraw into a sedentary lifestyle. While these issues cannot be completely cured, taking steps deal with chronic pain can slow the aging process and prevent these health issues from getting worse.
The guidelines below are six simple no-brainer steps that will help any senior citizen deal with chronic pain easily.
1. Maintaining an Active Lifestyle
Living a sedentary lifestyle is one of the primary causes of chronic pain. Our bodies need to stay in motion to keep fit. Simple tasks like getting up from a chair or walking around can become incredibly challenging, as our muscles can degrade to a point where they can no longer support our bodies.
So as soon as mobility starts to become an issue, or you discover that your body fat scale reading is getting higher than it should be, then it’s very important that you get as much daily activity you can.
2. Taking Medication
When prescribed by a doctor, medication can be incredibly effective at treating the symptoms of chronic pain. Anti-inflammatory drugs can treat the muscular issues that cause pain, and aspirin can treat the effects. If these medications are not powerful enough, many doctors prescribe opiate medications to improve the patient’s quality of life.
Unfortunately, opiates have many side effects. If used incorrectly, they can quickly turn into a drug problem. If the pain is reversible, opiates can be used to manage the symptoms while the sufferer receives treatment.
For long term treatment, it’s often recommended that patients take Palmitoylethanolamide. Also known as PEA, this drug is a naturally occurring substance that is responsible for a large number of biological functions. It’s proven itself to be a highly effective treatment for chronic pain, without any of the addictive qualities or negative side effects found with opiates.
3. TENS Therapy
Transcutaneous Electrical Nerve Stimulation, abbreviated as TENS, is a popular treatment for chronic pain caused by muscular issues. A TENS unit is a small electrical device with two electrodes. A low voltage current passes through the skin and into the muscle tissue, creating impulses that are detected by the central nervous system.
The current stimulates the nerves, reducing the pain to a manageable level. There are no side effects, making this a popular alternative to addictive medications.
4. Chiropractic Care & Massage Therapy
Inflammation and muscle tension can, over time, cause your joints to shift out of their natural positions. Over time, your bones and joints can shift. This permanently reduces mobility and increases pain levels. Chiropractors can manually reposition bones into their correct places, reducing the effects of chronic pain.
Massage therapists attack this problem from a different angle, forcing tense or imbalanced muscles to relax. In serious cases, these treatments are only temporarily effective. But regular appointments can drastically improve comfort levels.
5. Assisted Living
Chronic pain can get to a point where basic self-care is simply not possible. Nutrition and hygiene are essential to slowing the aging process. Elderly patients should have a live-in caretaker or relocate to a group home so that all of their basic needs are met.
When chronic pain results in mobility issues, maintaining a social life is an impossible task. Assisted living can address the physical problems, but a group home addresses the mental health consequences of an isolated lifestyle.
6. Reduce Stress
For people who suffer from chronic pain, stress can be a major problem. Our body reacts to stress with increased blood pressure and muscle tension. This amplifies the pain, creating a cycle that is hard to break. Fortunately, the treatment is easy. Simple things like spending time in the sun, visiting with loved ones, or even a phone call to a friend can reduce stress and provide the body with a chance to relax.
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You have options and keeping your loved one at home, where they want to be, might be the best one.

11/17/2016

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Caregiving runs through my veins. I’ve cared for my mom, my sister and my dad, all through the last days of their lives. I know the stress, the agony, the helplessness and the emptiness. And I know the value of peace of mind and support, knowing my family members are cared for.
 
With more than 40 million Americans preparing to care for an elder in the United States, I know I’m neither unique nor alone. The prospect of caring for an aging loved one can be daunting and caregiving can quickly become your most important role. Luckily, a helping hand exists in virtually every community across the country.
 
For me, caregiving is not only personal, it’s professional. As the President and CEO of Meals on Wheels America, caregiving is at the heart our mission. Our network of more than 5,000 community-based organizations across the country makes sure our aging or ailing loved ones and neighbors can live independently at home for as long as they choose. It’s not only a practical option - it saves families, the healthcare system and taxpayers a substantial amount of money.
 
And Meals on Wheels isn’t just about the nutritious meals that get hand-delivered each day. Millions of American families sleep better at night and can continue their daily routines and responsibilities because they know that Meals on Wheels is keeping a watchful eye over their loved ones. When other competing responsibilities make it impossible or difficult for us to be there, Meals on Wheels can make sure our parents, grandparents and others important in our lives are cared for, and that someone is there to raise a red flag if something doesn’t seem just right.
 
Meals on Wheels can also be an appropriate solution during care transitions - when a patient moves from one healthcare provider or setting to another. More than 2.5 million seniors are readmitted to the hospital within 30 days of being discharged, typically because the care they receive upon return is insufficient. Meals on Wheels can provide the nutritious meal and daily check-in from a caring volunteer that is critical to getting them back on their feet.
 
Depending on where your loved one is on the continuum of need, keeping them at home, where they want to be, can make sense with the right support. Just because mom or dad has hung up their car keys for good and can’t drive to the grocery store anymore doesn’t mean they’re incapable of caring for themselves. Malnutrition knows no economic bounds and Meals on Wheels is a simple, affordable solution.
 
No matter what care path is right for you and your loved one, reach out for the help and resources that are readily available in your community. That peace of mind can make all the difference.

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Do Exercise and Physical Activity Protect the Brain?

11/16/2016

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Exercise and other types of physical activity many benefits. Studies show that they are good for our hearts, waistlines, and ability to carry out everyday activities. Epidemiological studies and some intervention studies suggest that physical exercise may also play a role in reducing risk for Alzheimer’s disease and age-related cognitive decline. 
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Animal studies point to why this might be so. Exercise increases both the number of small blood vessels that supply blood to the brain and the number of connections between nerve cells in older rats and mice. In addition, researchers have found that exercise raises the level of a nerve growth factor (a protein key to brain health) in an area of the brain that is important to memory and learning.

Researchers have also shown that exercise can stimulate the human brain’s ability to maintain old network connections and make new ones that are vital to healthy cognition. In a year-long study, 65 older people exercised daily, doing either an aerobic exercise program of walking for 40 minutes or a nonaerobic program of stretching and toning exercises. At the end of the trial, the walking group showed improved connectivity in the part of the brain engaged in daydreaming, envisioning the future, and recalling the past. The walking group also improved on execu­tive function, the ability to plan and organize tasks such as cooking a meal.

Several other clinical trials are exploring further the effect of physical activity on the risk of Alzheimer’s and cognitive decline. Other NIA-supported research is examining whether exercise can delay the development of Alzheimer’s disease in people with MCI. Findings from these and other clinical trials will show more definitively whether exercise helps protect our brains from cognitive impairment.

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Most Elderly Smokers Don't Use Anti-Smoking Meds After Heart Attack

11/14/2016

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SUNDAY, Nov. 13, 2016 (HealthDay News) -- Many elderly smokers who've had a heart attack fail to fill prescriptions for medications designed to help them quit smoking, a new study finds.

"These findings come as no surprise for geriatricians and health care professionals who face on a daily basis the challenges of recognizing and managing the complexity of caring for older adults," said Dr. Gisele Wolf-Klein, who reviewed the new findings. She directs geriatric education at Northwell Health in Great Neck, N.Y.

She noted that elderly patients face many challenges, such as "multiple medical conditions, which often include depression and forgetfulness."

That can make it tough for them to initiate and stick with a quit-smoking regimen such as medications, lozenges or patches, Wolf-Klein said.

The new study was led by Dr. Neha Pagidipati of Duke University Medical Center in Durham, N.C. It was scheduled for presentation Sunday at the annual meeting of the American Heart Association, in New Orleans.

The study included nearly 2,400 heart attack survivors older than 65 who were either current or recent smokers and were treated at 377 U.S. hospitals. During their hospital stay, the patients were advised by health staff to quit smoking.

Nearly all of them received prescriptions for smoking-cessation medications before being discharged from the hospital.

But, the study found that only about one in 10 actually filled a prescription for the smoking-cessation medications bupropion (Wellbutrin) or varenicline (Chantix) within 90 days of leaving the hospital.

That rate barely budged over time: Only 13 percent filled a prescription within one year after leaving the hospital, the study found.

The older the patient, the less likely they were to fill the prescription, the researchers noted. And, men and minorities were less apt to try the anti-smoking aids than women or white patients.

Wolf-Klein agreed, but said there are reasons patients fail to take advantage of smoking-cessation aids.
 
"Older adults are particularly concerned with taking too many medications, both because of the increasing and often unsurmountable monthly costs of their prescribed drug regimen, and because of the difficulty of remembering when to take them," she pointed out.

Too often, patients are simply handed the medications without much explanation, she added. "Before 'buying into' the new market of smoking-cessation medication, older adults will need strong scientific data to persuade them -- and their caregivers -- of the longevity and quality of life benefits of giving up one of their last pleasurable habits," she said.

Dr. Satjit Bhusri is a cardiologist at Lenox Hill Hospital in New York City. He agreed that "we clearly have a long way to go in continued long-term counseling" for elderly heart patients who smoke.

"We need to enhance our smoking-cessation counseling outside of the hospital by providing additional assistance and education to our patients," Bhusri said. "The importance of not smoking after a heart attack is crucial to recovery and prevention of future heart attacks."

Experts note that studies presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.

More information
The American Cancer Society offers a guide to quit smoking.

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Bingo? Pass. Bring on Senior Speed-Dating and Wine-Tasting.

11/11/2016

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NOTHING about Mather’s-More Than a Cafe looks as if it’s aimed at people over 50. But the Chicago cafe, which could easily be mistaken for a large Starbucks, is much more than that, serving as a community hub, mostly for older people, with dozens of classes on topics like flower arranging, Egyptian history and digital safety.

In her six years as a member, Pat Knazze, 66, has taken line dancing and piano lessons and participated in over 50 seminars via Skype, including architecture classes that helped her qualify as a neighborhood docent.

As she ages, Ms. Knazze has also found another expected benefit: a caring group of neighbors who serve as a kind of substitute family.

“We’re social beings,” said Ms. Knazze, who is divorced. “And the cafe is a kind and loving group. I have multiple families that nurture me.” The Mather’s Cafe manager even attended Ms. Knazze’s mother’s funeral.

To appeal to baby boomers like Ms. Knazze, many community senior centers are getting up-to-date makeovers. There are about 11,500 senior centers in the United States, according to the National Council on Aging. They are increasingly offering everything from top-flight gyms to speed-dating sessions, wine tastings and Apple support groups.

Many are also shedding their names so that they can evolve beyond being seen as just places to play bingo. The senior center in Rochester, Minn., has become 125 Live, which just opened in a sleek, modernistic building with a teaching kitchen, big lap pool, pottery studio and a gym. Another in Minnesota is now Lakeville Heritage Center; it has yoga, Pilates and Zumba classes — and a motorcycle club.

“We have to move away from hot meals and bingo,” says Jim Firman, the chief executive of the National Council on Aging. “So there’s a lot of exciting innovation going on. The laggards will catch up or go away.”

Mather’s three Chicago cafes helped kick-start the transformation in 2000. They were inspired by Robert Putnam‘s best-selling book, “Bowling Alone: The Collapse and Revival of American Community.” He talked about how people’s health and happiness were declining along with a sense of community, said Mary Leary, chief executive of the Evanston, Ill.--based nonprofit Mather LifeWays.

“So the cafes were conceived as a way to connect with others,” said Ms. Leary. “And it all starts with a cup of coffee.” Indeed, a bottomless cup of coffee costs only 95 cents at Mather’s Cafe, which also offers breakfast and lunch.

Mather’s Cafes take a holistic approach to aging, she said. Classes, aimed at 50-plus adults, include wellness, lifelong learning, fitness and entertainment. There are also telephone topics programs, such as chair yoga or eating well, for people who can’t attend. Innovative classes are devoted to edgier subjects like sexual identity and virtual reality. Fees are donation-only.

“We see aging on a spectrum,” Ms. Leary said. “Let’s help people stay active so they can age in place and connect with others.”

To spread its message, Mather holds workshops for other organizations. So far, people from 138 cities have attended and more than 40 other cafes have popped up, Ms. Leary said.

Like Mather’s Cafes, many senior centers are usually funded privately or by communities, so fees are typically nominal.

More a luxury club than a senior center, The Summit in Grand Prairie, Tex., charges $55 a year for adult residents 65 and older. The sunny 60,000-square-foot building has perks like an infinity edge pool, underwater treadmill and a hot tub. There is also a 100-seat movie theater, banquet rooms with full kitchens and an outdoor cafe with a grill.

“This is really an active adult facility,” said Amanda Alms, general manager of The Summit. “The city wanted to create a facility that was unlike any other.” Members have benefited by becoming more fit, finding artistic niches and making lifelong friends, she said.

For Wilfred Sanchez, 69, The Summit has become his home away from home. A Vietnam veteran who was exposed to Agent Orange, Mr. Sanchez has post-traumatic stress disorder and nerve diseases. So he uses The Summit’s pool for exercises like running laps or the underwater treadmill.

“PTSD makes me not want to go anyplace,” said Mr. Sanchez, who is also a retired information technology instructor. “But I don’t let it stop me.” Mr. Sanchez and his wife also visit the center to go to the movies, eat lunch and socialize with other veterans. “I’m so thankful,” he said.

Mr. Firman of the National Council on Aging says his goal is to transform the typical senior center into more of a longevity hub.

“There’s an evolution going on and a revolution as baby boomers age,” Mr. Firman said. “So we’re developing richer programming. We’re given the gift of longevity, so we have to spend it wisely.”

Many people are overwhelmed by the challenges of living longer, Mr. Firman said. “Health is complicated,” he said. “Finances are complicated. And there’s no playbook.”

The Senior Center in Charlottesville, Va., now includes a lifelong learning program on how to design a good life. The center also offers lots of ways to socialize, including singles gatherings, travel partner matches and three bands that members can join. There are also fitness classes, hiking programs and pickleball.

Peter Thompson, the center’s executive director, lamented the word “senior” in the name, though. “It’s a barrier,” Mr. Thompson said. “People don’t want to acknowledge that that’s them.”

The goal, he added, is creating centers that help people feel ageless. So a new center including features like a mind-body studio aimed at active adults is being planned.

Hansie Haier, 65, goes to the senior center often to socialize. She takes line dancing, yoga and tai chi. Ms. Haier, who is single, also teaches a weekly writing group there.

“The center helped me find my purpose,” said Ms. Haier, a retired psychiatric nurse who now writes short stories. “I’m constantly learning new ways of living. A good center helps keep the brain functioning. That’s really important.”

Isolation is a potential risk for millions of aging adults, said Shannon Guzman, a senior policy research analyst at the AARP Public Policy Institute. But new forms of social engagement are emerging in the digital world. Selfhelp Community Services’ Virtual Senior Center in New York helps homebound older adults keep in touch via computer: They can attend group museum tours, Shakespeare discussions or even take laughter yoga.

“We’re building an online community,” said David Dring, executive director of Selfhelp Innovations. “Seniors can create these cyberclassrooms.” They can also create ongoing virtual friendships.
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Ms. Knazze says she feels deeply fulfilled and cared for at Mather’s Cafe. “Now,” she said, “I want to share that with others.”
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How Knowing When to Call in Professional Help is Key

11/10/2016

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Even though we would like to think we can, it’s impossible to handle all of life’s nuisances on our own. In fact, many of history’s most successful people attributed their successes to knowing when to seek the help of others. This goes for all areas of life whether it be business, education or dealing with a problem. For me, dealing with a major problem is where I finally learned this significant life lesson.
Trying to always handle things myself, I came to a road block when a huge problem arose within my family. After recently putting my grandmother in a nursing home, she made us aware that things really weren’t going so well. She was complaining to us that the food seemed to be making her sick. My family and I shrugged her complaints off for a while and just thought she was being dramatic and trying to get taken out of the home. However, as time went on, we realized that she was right. She looked worse than ever, seemed a lot thinner and didn’t have much energy. The staff started to give her more medications to help her stomach which ended up having a whole host of negative side effects.
Eventually, we decided to experiment by cooking meals and delivering them to her on our visits. Within a week of eating our food, she started to feel and look about a thousand times better than she had before. We even started speaking to some of the other nursing home residents who complained of stomach issues as well. Once we had figured out that it was the food making her sick, we really didn’t know what else to do.
Realizing that we needed the help of a professional, we did our research and stumbled upon a group of lawyers who specialized in nursing home and elder abuse. Giving them a quick call to explain our situation, they took immediate action and guided us through the process to get my grandmother out of there and told us how to take legal action against the nursing home. It didn’t take long before we had my grandmother in a shiny new facility with delicious and health giving food that we could afford to pay for with the settlement that we got from the case.
This whole situation was a huge lesson for me and my family in knowing when to call in professional help. We couldn’t have done it on our own and had the same fantastic results. And, for all of you out there with a loved one in a nursing home or some other elder care facility, make sure to watch out for signs that something could be going wrong. You can check out some of the warning signs that nursing home abuse is going on here to help you better evaluate if you should take action.
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So, how else should you determine if you should call in professional help in any situation?

• There are legal implications involved
• The task involves a physical aspect that you are not capable of
• There is prior education needed that you do not have
• There is a natural skill required that you don’t possess 
• You don’t completely understand all of the implications 
• You need to make a decision that will drastically affect your life or someone else’s life

If you want what’s best for you and those closest to you, don’t try to do it all. Sometimes, calling in a professional is the best way to find success. 

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8 Expert Tips for When Aging Parents Won’t Listen

11/9/2016

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Our parents always told us to listen to them, but what happens when they refuse to listen to us? Adult children are finding that Father doesn’t always know best when it comes to his driving, diet, housing, caregiving, health, medication or other important issues. Learn more about what to do when your parents aren’t listening to you.

Mom Won’t Take Your Advice: Now What?

Recent research out of Penn State University, the New Jersey Institute for Successful Aging and the Rowan University School of Osteopathic Medicine, found that 77% of grown children think their parents are stubbornabout taking their advice or getting help with daily problems.

Mary Heitger-Marek, a 46-year-old program analyst from Annapolis, Maryland, could write the book on parental stubbornness. In 2004, her parents were living in a condo in Florida with steep stairs and ongoing health problems. She begged them to move near her to a housing community with support. Instead, they bought a home in Florida with a yard and a pool. They also acquired a dog. Several falls (some from walking the dog) and multiple surgeries ensued. They refused to hire help for either themselves or their house.

Two years ago, they moved to independent living near Heitger-Marek, again refusing a professional caregiver. Last October, her dad died; since then, her mother has been hospitalized four times. Now she’s in rehab but plans to move in with Heitger-Marek. She’s still vowing not to have outside help.

“My parents’ life decisions have greatly impacted me and I am very resentful,” says Heitger-Marek. “I love my mother, but I am at my wit’s end. I can’t even begin to tell you how many times my husband and I have suggested options to improve my parents’ quality of life and they have turned us down. I feel like we could open a senior care business because of all the programs, aid and other things we have looked into for them.

What to Do When Your Parents Refuse Help
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We asked experts for their advice on what to do in situations like this – and unlike some parents, we did, in fact, listen! (Though, some of this advice may not apply to a loved one with dementia.)
Experts recommend:
1.    Trying to understand the motivation behind their behavior. Suzanne Modigliani, a Boston-based geriatric care manager with a social work background, says to ask yourself: Are they acting this way out of habit, to assert independence, or because they’re depressed or confused? What are they afraid of?
2.    Decide how important the matter is. Is it a safety issue or something that is just irritating but inconsequential? As the saying goes, pick your battles.
3.    Blame it on the kids (that would be you) or the grandkids. If Mom isn’t willing to change her behavior for herself, would she do it for a loved one? Robert Kane, M.D., author of “The Good Caregiver,” Director of the Center on Aging at the University of Minnesota and a professor in its School of Public Health, says his mother quit smoking after his sister argued the second hand smoke was a risk to the grandchildren. Another approach is to say to your parent, “You don’t want me to worry, right? This (fill in the blank) will give me enormous peace of mind. Please do it for me!”
4.    Think ahead. Is there a milestone they want to be around for, such as a wedding, graduation or anniversary? Then bring it up!
5.    Find an outside outlet for your feelings. If you’re angry or resentful that Dad’s not with the program, vent to, confide in, or strategize with, a geriatric care manager, geriatrician, therapist, friend, sibling or online support group rather than your parents.
6.    Treat them like the adults they are. Dr. Kane warns about infantilizing parents. “Dealing with a stubborn parent is not the same as dealing with a stubborn child. Older people should be autonomous.”
7.    Accept the situation. You may want your mantra to be “It is what it is.” Said another way, “you can take a horse to water, but you can’t make them drink.” As Modigliani points out, “they are adults with the right to make decision – even poor ones.”
8.    Don’t beat yourself up. Roseann Vanella, 50, of Marlton, New Jersey, happens to be a family mediator. But even with her professional training, she has been unable to reason with her parents. Her father, 84, has dementia and her mother, 75, has a rare blood disorder. Still, her mother insisted on taking her husband to Sicily on vacation. Vanella told her, “I can’t stop you so at least get medical jet insurance.” She said she would. Soon after arriving in Italy, her mother’s disease kicked up, she needed a blood transfusion and to come home. She admitted she never purchased insurance. Vanella and her brother were on the next plane. “After that I said, ‘she’s never going to take him to Europe,’ but she did,” says Vanella. “I told her how bad it was for my dad since his dementia had progressed.” Again, Vanella had to go to Italy and bring them back. “The hardest part is knowing something could have been averted but wasn’t,” she notes. “My advice is not to hit your head against the wall too hard. There isn’t a lot we can do sometimes but stand by, watch closely and be able to jump in when needed.”
Have you or your family had an experience before where your parents didn’t listen? What did you do to resolve the matter? Share your story with us in the comments below.
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The Importance of the Senior Vote

11/8/2016

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The role of seniors in every election is important, the senior vote holds power.

With every winter comes elections, the time when American citizens discuss policies, personalities and preferences most often, and seniors are no exception. The role of seniors in every election is important, their collective participation holds power. First, in a close election, every vote counts.  Second, despite significant ideological diversity within the senior population, seniors are able to come together and defend their interests by contacting their elected officials, donating money, and yes, voting. With demographics in their favor, there is every reason to believe that seniors will continue to make their voices heard, and play an active role in shaping the policies that directly affect them and our great nation.

The first thing to keep in mind is that retired people are especially vulnerable to any changes in policy made by elected officials. Social Security constitutes the majority of a senior household’s income for 53% of married couples and 74% of unmarried persons, according to the Social Security Administration. Medicare is practically the only health care option for the 50% of beneficiaries with an annual income below $22,000, according to the Kaiser Foundation. When a person’s health and livelihood are so heavily dependent on government assistance, voting becomes much more than a mere exercise in civic duty; it can make a very tangible difference in one’s quality of life. The more salient point of this discussion, in my opinion, is the importance of civic participation. A recent book by Andrea Louise Campbell (How policies make citizens: Senior political activism and the American welfare state, 2003) makes the case that the political activity of senior citizens is a great model of a healthy democracy. Using Social Security as a central issue, Campbell shows how voting and policy outcomes become a mutually reinforcing cycle among elders. Through campaign donations, letter writing, and voting, senior citizens have been able to defeat numerous efforts to cut Social Security and Medicare benefits. Beneficial policy outcomes then serve as proof that the democratic process really is responsive, thus reinforcing the importance of political activity. In this way, senior citizens have been able to defend their hard-earned and well-deserved benefits from some very powerful corporate lobbies over the years.

The overall political activity of senior citizens has been increasing since the 1971 White House Conference on Aging and the creation of Social Security. As the proportion of older Americans that relied on Social Security as their main source of income increased, so did that age group’s participation in the political process. In her book, How Policies Make Citizens: Senior Political Activism and the American Welfare State, Andrea Louise Campbell concluded “Absent Social Security, senior citizens are a disparate group of people whose common characteristic, age, has little political meaning. Once governmental benefits are conferred on the basis of age, the group has political relevance and is ripe for mobilization by policy entrepreneurs, interest groups, and political parties.” Older voters are therefore unique in that they are a very diverse group that, nevertheless, has been willing to unite, when necessary, to defend its common interests.

Long considered the “third rail” in American politics, some may still believe that Social Security and Medicare are untouchable. Yet in our current political climate, with a rapidly increasing number of retirees and a soaring national debt, there are more and more calls on seniors to sacrifice for the common good and accept cuts in benefits. Rational people may, of course, have differences of opinion on this matter. Yet, in a healthy democracy, public policy should be determined by votes rather than special interest money, and seniors must understand the power they wield collectively through their political participation.

When a certain demographic participates at a higher rate than any other, it tends to carry relatively more political clout. This does not mean that all seniors vote the same way and thus decide elections. People do not suddenly abandon their lifelong political philosophies and vote in lockstep just because they have reached a certain advanced age. The senior vote is quite diverse, and statistics from past elections actually confirm that voting preferences among the elderly do not differ significantly from those of the general population. The lesson for the rest of us is that democracy can work. When politicians know that their actual bosses (their constituents) are paying attention, keeping them accountable, and exercising their patriotic right to vote, they will listen. If we only spent less time watching American Idol, and spent more time learning about the issues that matter most to us as a nation, we would have a government that actually works for and responds to “We, the people.” In this, as in so many other things, we would be wise to follow the example of our elders.

This article was written by Kryspin Turczynski for Alameda Senior Magazine, reprinted with permission.
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2016 Voter Guide: Why your vote counts when it comes to health care

11/7/2016

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With 17 statewide initiatives, the November 2016 ballot includes the largest number of measures since 2000, when 20 measures qualified. Among these initiatives are a handful that could have a significant impact on patient access to care and the state of health care in California.

Vote with California’s doctors to increase patient access to care and improve health care in the Golden State! Below is a summary of the propositions as they relate to health care, as well as the California Medical Association's official positions on the measures.

Proposition 52: State Fees on Hospitals. Federal Medi-Cal Matching Funds. Initiative Statutory and Constitutional Amendment
CMA Position: Support


Since 2009, California has partnered with hospitals to secure $2 billion per year in federal matching funds for Medi-Cal. This alliance ensures vital access to health care for nearly 7 million California children, providing essential health services such as medical check-ups, immunizations, important prescriptions, dental and vision care. Several years ago, California diverted some of the funds from the hospital fee program to the state's general fund. The initiative will add language to the Constitution to prevent diversion by requiring voter approval of changes to the hospital fee program.

Proposition 53: California Voter Approval Requirement for Revenue Bonds Above $2 Billion Initiative
CMA Position: Oppose 


Prop. 53 would "require voter approval for projects larger than $2 billion that are financed through 'revenue bonds,'" a type of bond that is "repaid through tolls or fees paid by users" rather than from the state's general fund.  It takes away local control and creates an atmosphere of uncertainty around projects, which could result in higher costs and a loss of investment money in urban projects. Because of this uncertainty, it could impact medical care by curtailing the ability of state and local government to finance projects to build or rebuild major infrastructure. It also fails to contain an exemption for emergencies, in cases of an earthquake or flood, the state and local governments may need to wait as long as two years in order to get voter approval to begin rebuilding.

Proposition 55: California Extension of the Proposition 30 Income Tax Increase Initiative
CMA Position: Support 


It extends the temporary personal income tax increases enacted in 2012 on earnings over $250,000 by 12 years, with revenues allocated to K-12 schools, California Community Colleges, and health care. The measure would increase state revenues—$4 billion to $9 billion annually from 2019-2030. It would also provide almost $2 billion in funds to improve access to health care for low-income children and their families.

Proposition 56: California Healthcare, Research and Prevention Tobacco Tax Act of 2016
CMA Position: Support


CMA is a proponent of this initiative that is supported by a broad alliance of physicians, health care advocates, educators and others – would raise California’s tobacco tax, which is currently among the lowest in the country, to $2.87 a pack. The majority of the money from the initiative’s user fee on cigarettes and other tobacco products, including e-cigarettes containing nicotine, will be used for existing health programs and research into cures for cancer and other illnesses caused by smoking and tobacco products.

Proposition 58: California Non-English Languages Allowed in Public Education Act
CMA Position: Support
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The measure would repeal most of the 1998 Proposition 227, the "English in Public Schools" Initiative, thus effectively allowing non-English languages to be used in public educational instruction and bring back bilingual education. Research shows that bilingual education, when it is well-designed and implemented, can be at least as good, and often better at helping immigrant and other non-English speaking students gain academic proficiency. Forty percent of the California population is Latino, but only four percent of them are physicians. CMA supports this measure in the hopes bilingual education would encourage young people with language skills and cultural competency to chose health care as a vocation and improve care to Californians.

Proposition 61: Drug Price Standards Initiative
CMA Position: Oppose


The initiative would require state health programs to pay no more for prescription drugs than the discounted rate that the Veterans Association pays. The measure is a deceptive proposition that will increase drug prices, reduce access to medicines, while increasing red tape and taxpayer costs. The Legislative Analyst’s Office found that Medi-Cal fee-for-service, with 3 million people could be hit with higher, not lower, costs. Similarly, CalPERS, which provides retirement and health care benefits to California state government workers, raised red flags, citing, “decreased access to certain drugs for CalPERS members” and “increased administrative costs” under Prop. 61.

Proposition 63: “Safety for All” 
CMA Position: Support


Prop. 63 would prohibit the possession of large-capacity ammunition magazines and require most individuals to pass a background check, as well as obtain authorization from the California Department of Justice to purchase ammunition. CMA’s Board of Trustees, which is composed of physicians elected by their peers, endorsed the measure during its July meeting. In 1994, CMA declared the high volume of guns in California a major public health problem, and the decision to endorse Prop. 63 builds on CMA’s long history of protecting public health and promoting healthy California communities.

Proposition 64: California Marijuana Legalization Initiative
CMA Position: Support


Proposition 64 would allow adults aged 21 years old or older to possess and use cannabis for recreational purposes. The measure would create two new taxes, one levied on cultivation and the other on retail price. Revenue from the taxes would be spent on drug research, treatment, and enforcement, health and safety grants addressing cannabis, youth programs, and preventing environmental damage resulting from illegal marijuana production. CMA has adopted official policy recommending legalization and regulation of cannabis. The decision was based on a CMA white paper that concludes physicians should have access to better research, which is not possible under current drug policy.
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For more information on these initiatives, see www.cmanet.org/2016-ballot-measures.

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