Consider an In-Patient Rehab Facility Before You Suffer a Fall

AS A SAVVY MEDICAL consumer, you may already know which hospital you’d go to in an emergency or which doctor you’d turn to for a particular procedure. But many people never plan where they’d go for a few weeks or months of in-patient rehabilitation to recuperate from a fall. That choice may not even occur to a family until Mom, Dad or a spouse winds up in the hospital. “The case manager comes in and says, ‘Look at these facilities and tell us where you want to go so we can start our paperwork.’ The family and patients are overwhelmed,” says Dr. Saket Saxena, a geriatrician at Cleveland Clinic.

But it may be time to give the scenario a little thought. This year 1 out of every 4 older adults will fall, according to the Centers for Disease Control and Prevention, and 20 percent of those people will suffer a serious injury, such as a broken hip or a head injury. While the best option is to go home after hospitalization for a fall, where you can rely on in-home or out-patient follow-up treatment, not everyone is well enough or has the support at home. It could help to know which rehab facility would be best for your family, should you ever need to stay in one.

Full story at US News

Worse Depression Trajectory in Old Age

Major depressive disorder (MDD) may be more persistent for older individuals, a longitudinal study found.

Within a cohort of 18- to 88-year-old patients, older age was tied to a worse 2-year course of depression across several variables, reported Roxanne Schaakxs, PhD, of the VU University Medical Center in Amsterdam, and colleagues in The Lancet Psychiatry.

Older patients were more likely to have a diagnosis of major depression after 2 years (OR 1.08, 95% CI 1.00-1.17) and to have chronic symptoms (OR 1.24, 95% CI 1.13-1.35). They were also less likely to achieve remission of symptoms (HR 0.91, 95% CI 0.87-0.96) and had less improvement in depression severity (regression coefficient 1.06, P<0.0001).

Patients age 70 and older had the “worst outcomes” over 2 years, Schaakxs’ group said, compared to patients age 18 to 29 years old.

Full story at Med Page Today

Opioids and Other Elder Justice Challenges

In nine days, we will join the world in commemorating World Elder Abuse Awareness Day (WEAAD). Elder abuse is, by definition, abuse that affects older adults, and yet every year on WEAAD I see people of all ages coming together to take a stand against elder abuse. This is because elder abuse doesn’t just affect the person being targeted. Friends, family members, and neighbors all feel the effects. It affects anyone who is, or hopes one day to be, an elder living in a community where they are treated fairly and equally. And ultimately, it affects all of us, because at elder abuse strikes at our core values, which are predicated on human dignity and the right of all people to live their lives without fear of harm.

Similarly, opioid addiction doesn’t just affect the person experiencing addiction. It affects everyone around them, and as we are seeing across the country, it can have devastating effects for the entire community.

And when these two issues overlap, the results can be heartbreaking.

Full story at acl.gov

Research Pertaining to People with Intellectual and Developmental Disabilities

ACL has issued several funding opportunities for data collection and longitudinal research pertaining to people with intellectual and developmental disabilities. Please see the short descriptions below and links for more details.

State of the States in Developmental Disabilities-On-going Data Collection and Information Dissemination — The purpose of this project is to maintain national longitudinal research on state fiscal efforts related to services and supports for people with intellectual and developmental disabilities. Activities include: analyzing developmental disabilities and financial and programmatic trends in each state;  collaborating with other ACL or other federal agencies data collection projects; developing products for public knowledge and use; and conducting evaluation to demonstrate the impact of the project. View more details and application instructions . Deadline for submissions is by midnight on July 25.

Full story at acl.gov

Dodging Dementia: More Of Us Get At Least A Dozen Good, Happy Years After 65

You’ve turned 65 and exited middle age. What are the chances you’ll develop cognitive impairment or dementia in the years ahead?

New research about “cognitive life expectancy” — how long older adults live with good versus declining brain health — shows that after age 65 men and women spend more than a dozen years in good cognitive health, on average. And, over the past decade, that time span has been expanding.

By contrast, cognitive challenges arise in a more compressed time frame in later life, with mild cognitive impairment (problems with memory, decision-making or thinking skills) lasting about four years, on average, and dementia (Alzheimer’s disease or other related conditions) occurring over 1½ to two years.

Full story at Kaiser Health News

Unseen face of the opioid epidemic: drug abuse among the elderly grows

The face of the nation’s opioid epidemic increasingly is gray and wrinkled.

But that face often is overlooked in a crisis that frequently focuses on the young.

Consider this: While opioid abuse declined in younger groups between 2002 and 2014, even sharply among those 18 to 25 years old, the epidemic almost doubled among Americans over age 50, according to the Substance Abuse and Mental Health Services Administration.

Because of information like that, the Senate Special Committee on Aging convened a hearing Wednesday on opioid misuse by the elderly.

Full story at The Washington Post

Link between IBD and Parkinson’s might allow doctors to slow down condition

Doctors may be able to modify or slow down the progress of the neurological condition Parkinson’s disease in the future by spotting signs of it in patients with inflammatory bowel disease (IBD), suggest a study published in the journal Gut.

Danish researchers found patients with IBD appeared to have a 22% greater risk of developing Parkinson’s disease in a study that monitored participants for almost 40 years.

IBD, Crohn’s disease and ulcerative colitis are chronic conditions with onset in young adulthood.

It has already been suggested in previous studies that inflammation plays a role in the development of Parkinson’s disease and multiple system atrophy.

Full story at Science Daily

Link between tuberculosis and Parkinson’s disease discovered

The mechanism our immune cells use to clear bacterial infections like tuberculosis (TB) might also be implicated in Parkinson’s disease, according to a new collaborative study led by the Francis Crick Institute, Newcastle University and GSK.

The findings, which will be published in The EMBO Journal, provide a possible explanation of the cause of Parkinson’s disease and suggest that drugs designed to treat Parkinson’s might work for TB too.

Parkinson’s protein

The most common genetic mutation in Parkinson’s disease patients is in a gene called LRRK2, which makes the LRRK2 protein overactive.

Full story at Science Daily

What to Look for in a Geriatric Care Manager

WHEN OLDER ADULTS CAN no longer care for themselves, it’s usually up to their family members to take over the responsibility. But it’s hard to know where to begin managing the care of someone who has chronic health conditions, requires frequent doctor visits and needs assistance at home – which may be in another town. “Families are often overwhelmed and ask, ‘What do we do? How do we handle this?’” says Nancy Avitabile, president of the board of directors of the Aging Life Care Association.

Avitabile is an aging life care manager (also known as a geriatric care manager), a type of elder care professional trained to jump into these challenging situations and offer solutions, guidance and hands-on management.

“It’s not uncommon for adult children to involve a geriatric care manager when things are getting complicated with a new diagnosis or a change in function or cognition, especially when the family lives far away and they need guidance on which options are available,” says Dr. Christine Ritchie, a geriatrician, palliative care physician and professor at the University of California—San Francisco School of Medicine.

Full story at US News

CMS Seeking Comment on Durable Medical Equipment Interim Final Rule

CMS is seeking comments on an interim final rule that increases payments to suppliers for some DME and enteral nutrition in areas of the country that are not subject to the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DEMPOS) Competitive Bidding Process (CBP). These include rural areas, and Alaska, Hawaii and the territories. From June 1 through December 31, 2018, payments will return to the blended rates that were in effect in 2016.

The change is in response to stakeholder concerns about significant financial challenges created by the current rates for suppliers, as well as concerns that the number of suppliers in certain areas continues to decline. It is projected to result in a $70 million dollar Medicare cost-sharing increase to beneficiaries. This increase may be covered by supplemental insurance programs like Medigap, and for dual eligible beneficiaries, Medicaid pays the cost sharing. However, beneficiaries who do not have supplemental insurance or who are not dual eligible will have increased cost sharing.

Full story at acl.gov