SourceBook Guide To Retirement Living - ProAging Info Network :

ProAging on LinkedIn

Mon, 13 Jul 2009 15:29:00 -0400

Over 100 ProAging members are now using the LinkedIn platform to take advantage of an additional way to connect to content and network. To access the group, click http://www.linkedin.com/groupRegistration?gid=2012650.

Please note if you are not a member of LinkedIn you will need to sign up for a free account. Once on your can join the ProAging group which will serve as a great platform to find like minded professionals.

Questions? email steve@proaging.com

DC Metro Guide to Retirement Living SourceBook Deadline Approaching

Mon, 13 Jul 2009 15:26:00 -0400

Don’t miss being included in the Fall 2009 edition (Sept - Dec.)

Maryland: Barbara Snyder barbara@proaging.com or 800-394-9990 ext. 1503
DC and Virginia: Steve Gurney steve@proaging.com or 703-992-1118

FIRST GAY GROUP TO JOIN LEADERSHIP COUNCIL Of AGING ORGS

Mon, 13 Jul 2009 15:25:00 -0400

Statement from SAGE Executive Director, Michael Adams

New York, NY – The Leadership Council of Aging Organizations (LCAO) has invited th, Services and Advocacy for Gay, Lesbian, Bisexual, and Transgender Elders (SAGE) to join its membership. The LCAO, which consists of 56 member organizations nationwide, uses its coalition strength to develop effective policy for the nation’s diverse aging population. Millions of older Americans are served by the organizations that make up LCAO. In accepting the invitation, SAGE becomes the first member organization of the LCAO to represent LGBT older adults and their concerns.

Statement of Michael Adams, Executive Director, SAGE:

“SAGE is honored and excited to become the first LGBT agency to join the Leadership Council of Aging Organizations. SAGE knows how important LCAO is in helping shape this country’s public policy on aging. We also know how important it is that those policies start addressing the needs of LGBT older adults. SAGE is in a unique position to serve as a resource on LGBT aging issues for LCAO and its members. We are looking forward to working with the LCAO as a critically important national voice for all older adults and their families.”

About the Leadership Council of Aging Organizations (LCAO)
The Leadership Council of Aging Organizations (LCAO) is a coalition of national nonprofit organizations concerned with the well-being of America’s older population and committed to representing their interests in the policy-making arena. Recognizing that the strength of the coalition lies in the diversity of its membership, the purpose of the LCAO is to foster communication and resource sharing among its member organizations, to serve as a source of information about issues affecting older persons, to initiate joint advocacy strategies as appropriate, and to provide leadership and vision as America meets the challenges and opportunities presented by its aging society.
For more information, please visit http://www.lcao.org.

About SAGE (Services & Advocacy for GLBT Elders)
SAGE is the world’s oldest and largest non-profit agency dedicated to serving lesbian, gay, bisexual, and transgender older people. Since its inception, SAGE has pioneered programs and services for the aging LGBT community, provided technical assistance and training to expand opportunities for LGBT older people across the country, and provided a national voice on LGBT aging issues. In 2005 SAGE became the first official LGBT delegate at a White House Conference on Aging. In 2008, SAGE presented its Fourth National Conference on LGBT Aging, entitled "It’s About Time," sponsored by AARP. For more information, please visit www.sageusa.org

Vendor Opportunities for Howard County’s 50+EXPO

Mon, 13 Jul 2009 15:24:00 -0400

New Green Fair for Environmentally Friendly Exhibitors

ELLICOTT CITY, MD – Howard County’s 50+EXPO returns for its 11th consecutive year and is calling all vendors and exhibitors to participate in the premiere annual event for the 50-and-over population, their families, caregivers and friends. The 2009 50+EXPO will be held on Friday, October 16, from 9 a.m. to 4 p.m. at Wilde Lake High School, 5460 Trumpeter Road in Columbia.

Last year’s 50+EXPO drew a crowd of more than 6,000 attendees, with more than 140 commercial and non-profit vendors of services, products and services. New this year, the 50+EXPO will include a “Living Green” Fair, with a limited amount of spaces available for vendors of environmentally friendly products and services. In addition, the 2009 event boasts a health fair, health screenings, a speaker series, workshops, demonstrations, a benefit auction, live entertainment, and food. The Capitol Steps will headline the entertainment again this year, with two shows, at 11 a.m. and 1 p.m. in the Rouse Theatre.

The 50+EXPO offers a great marketing opportunity for vendors to reach Howard County’s older adults, the second-fastest growing population in Maryland. Two-thirds of Howard County residents age 60 and older report annual incomes in excess of $30,000. They are also well-educated: more than 95% hold a high school diploma and of those ages 60 to 64, 60% hold a college degree.

Fees for vendors vary and are based on exhibitor category and exhibit location. Vendor packets and information on sponsorship opportunities are available on the Office on Aging’s website, www.howardcountyaging.org (click on the 50+EXPO logo). To have a packet mailed to you, email dtugwell@howardcountymd.gov or call 410-313-5949. For more information, please contact Laurie Diener, event coordinator, at 410-313-7467.

Collaborative Publishes Unique Manual

Mon, 13 Jul 2009 15:20:00 -0400

FALLS CHURCH, Virginia - The Center for Excellence in Assisted Living (CEAL) and the Cecil G. Sheps Center for Health Services Research/University of North Carolina at Chapel Hill (UNC) are announcing publication of a first-of-its-kind manual to improving practices and informing policies in assisted living communities through the use of a collaborative method of research – community-based participatory research (CBPR). The manual can be downloaded from the CEAL website homepage at www.theceal.org.
     CEAL, a consortium of 11 national organizations representing provider and consumer interests in assisted living, partnered with UNC and formed the CEAL-UNC Collaborative to study medication administration in assisted living using the CBPR method and develop a manual to help others learn about this important applied research methodology.
     The two-year project (2006 – 2008) was funded by the U.S. Agency for Health Care Research and Quality. Community-based participatory research is a social science research method whereby researchers work as full partners with community members in the area being studied. This collaborative form of research has led to more comprehensive, nuanced and accurate findings that are more easily used and replicated by others in the study field. Until this study, the technique had rarely been used in the area of senior living or aging.
     “The information contained in the manual is especially important for assisted living and other long-term care professions to learn about as they can initiate CBPR projects on areas to better guide their practices.’’ said Dave Kyllo, Chair of CEAL.
    The manual explains the principles and methods of community-based participatory research with actual examples from the medication management research. Because community-based participatory research gives community members equal voice, power and decision-making in all aspects of the project, the results tend to be more relevant and on point and make it easier to incorporate evidence-based improvements and changes in practices and policies. Dr. Sheryl Zimmerman, a distinguished professor at UNC’s School of Social Work and Co-Director of the Aging Research Program at the Cecil G. Sheps Center for Health Services Research, was the principal investigator on the project.
     Assisted living communities provide assistance in the activities of daily life, such as dressing and bathing, to frail seniors in a residential setting. Assisted living communities care for approximately one million residents in the United States and aim to help elders age with dignity, independence and grace and maintain control over their lives in a setting of their own choice.
    CEAL, a non-profit collaborative, includes representatives from AARP, Alzheimer’s Association, American Assisted Living Nurses Association, American Association of Homes and Services for the Aging, American Seniors Housing Association, Assisted Living Federation of America, Consumer Consortium on Assisted Living, National Center for Assisted Living, NCB Capital Impact, Paralyzed Veterans of America and Pioneer Network.

The Challenge of Geriatric Pain

Mon, 13 Jul 2009 15:19:00 -0400

Steven A. King, MD, MS

Persistent pain is not an inevitable part of aging, but it is, unfortunately, fairly common among those aged 65 years and older. Between 25% and 50% of the general geriatric population and 45% to 80% of those in nursing homes have this problem.1

Pain is less likely to be adequately controlled in older persons than in younger adults, despite guidelines for the management of geriatric pain.1-3 Several factors appear to be involved in this unfortunate reality.

In the older population, the treatment of pain can be fraught with multiple problems that are far less likely to occur in younger adults. Even trying to determine the presence or level of pain can be difficult. Pain is a subjective concern; clinicians usually depend on the patient to identify pain and its severity.

Many geriatric patients have impairments in communication because of health problems, such as strokes and dementia. Thus, commonly used instruments to assess pain—such as the Visual Analogue Scale and the Verbal Numeric Rating Scale—may have a limited role for these patients. Other instruments, most of which were originally developed for young children, have been used for older patients. These include the Faces Scale (in which patients rate their level of discomfort based on facial expressions that range from smiling to crying) and the Pain Thermometer (which uses the image of a thermometer and asks the patient to rate the pain according to the image).4,5 However, even simple scales require some ability to communicate if valid and useful information is to be obtained.

The difficulty in assessing pain in noncommunicative geriatric patients is probably the major reason this group is even less likely to receive adequate pain management than the rest of the geriatric cohort.2,6 Clinicians may fail to consider a patient’s impaired ability to communicate and may rely instead on self-report rather than observing the patient for signs that might indicate pain (such as grimacing or inability to sit or lie comfortably).

Unfortunately, even when physicians do recognize the presence of pain, their attempts to alleviate it may fail because they do not take into account the patient’s general health status. For example, analgesics are often prescribed for hospitalized patients on an as-needed (prn) basis. Obviously, patients who are unable to communicate cannot ask for medications to relieve their pain. Physicians may feel they have addressed the pain by prescribing prn analgesics without recognizing that it is unlikely that patients will ever receive these drugs.

Failure to control pain adequately can have pernicious effects. A study examining pain in older men found that it was associated with increased frailty—itself a predictor of additional health problems and death.7 The study also found that mood may be a more important factor in the association between pain and frailty than physical illnesses. This finding highlights the importance of a comprehensive physical and mental health evaluation of geriatric patients.

Another recent study suggested that changes in the brain may play a role in chronic pain in older adults. Buckalew and colleagues8 compared MRI scans of geriatric patients with chronic low back pain with those of individuals without such pain. They found significant reductions in gray matter in the posterior parietal cortex in the older persons with low back pain. Although this research is preliminary, it does offer a suggestion about why pain may develop after traumatic injuries to the brain or as a result of changes in the brain from other diseases.

Patients with Parkinson disease, for example, commonly experience pain. Althouth it is often attributed as secondary to other signs of this disorder (eg, tremor and akinesia), it appears to be caused by underlying changes that result in these other problems.9

Even when pain is identified, physiological changes that are associated with aging and comorbid illnesses may restrict treatment options. For example, tricyclic antidepressants are among the most effective analgesics for a number of painful conditions—most notably, neuropathic pain—often experienced by geriatric patients. However, because of their potential to cause cardiac toxicity and adverse GI and CNS effects, they are generally contraindicated for elderly patients.10

The use of commonly employed analgesics can make geriatric patients more vulnerable to other health problems. Spector and colleagues11 found that anticonvulsants—another effective treatment for neuropathic pain—opioids, and antidepressants all increase the risk of fractures among nursing home residents.

All these factors make it extremely challenging to manage pain in geriatric patients. But we should not confuse challenging with impossible.

Source: http://www.psychiatrictimes.com/display/article/10168/1426159

U.K. Considers Abolishing Mandatory Retirement Age of 65

Mon, 13 Jul 2009 15:14:00 -0400

July 13 (Bloomberg) – The U.K. government, aiming to help the country cope with an aging population, said it was considering whether to abolish rules allowing employers to force staff to retire when they reach age 65.

Pensions minister Angela Eagle said in an e-mailed statement that a review of the default retirement age, originally planned for 2011, will now take place next year. While the majority of Britons retire before they reach 65, about 1.3 million choose to work past that age. According to the government, more people would do so if their employers let them.

“It is time to look again at this,” Eagle said. “We want to give older people flexible retirement options. The government is responding to the changed economic landscape.”

In 2005, Adair Turner produced a report for the government on pensions arguing that Britons would have to work longer and save more to enjoy the same standard of living in retirement as their parents. The following year, the government said it favored raising the age at which state pension was paid from 65 to 68 by 2046.

Source: http://www.bloomberg.com/apps/news?pid=20601085&sid=a2NbFkFZCAQM

Iowa's largest assisted living center changing its status to avoid state oversight

Mon, 13 Jul 2009 15:13:00 -0400

By Associated Press
11:31 AM CDT, July 13, 2009

DES MOINES, Iowa (AP) — Iowa regulators are expressing concern over plans by Iowa’s largest assisted living center to change its status to avoid future government oversight and regulation.

The Dubuque Retirement Community houses 116 seniors. The home’s owner, Assisted Living Concepts, is giving up a state license to operate as an assisted living center and wants to operate the building as an apartment complex.

Although residents of the home who are dependent and need medical assistance will be able to stay in the building and pay for 24-hour health care, state health inspectors won’t be visiting the home and checking on the quality of care being delivered.

Assisted Living Concepts CEO Laurie Bebo says residents are happy about the change. However, Iowa Department of Inspections and Appeals spokesman David Werning says there is concern Assisted Living Concepts is doing an end run around state regulations.

___

Information from: The Des Moines Register, http://www.desmoinesregister.com

Moderate Drinking Might Guard Against Alzheimer's

Mon, 13 Jul 2009 15:11:00 -0400

But only among those who are not cognitively impaired, study finds
By Alan Mozes, HealthDay Reporter

MONDAY, July 13 (HealthDay News) – Older adults with no history of dementia could cut their odds of Alzheimer’s and other cognitive decline by regular moderate drinking, new research suggests.

Defining "moderate" as having one to two drinks a day, the study authors observed that drinking in this range was associated with a nearly 40 percent drop in dementia risk, compared with non-drinkers.

However, those with a history of even moderate brain health issues did not appear to benefit from any amount of alcohol consumption, and appeared to face a significantly greater risk for dementia in the face of a heavy drinking habit.

"We found that for cognitively normal older adults, the lowest risk of dementia was for those who drank an average of one to two alcoholic drinks per day," said study author Dr. Kaycee M. Sink, an assistant professor of medicine with the department of internal medicine in the Gerontology and Geriatric Medicine section at Wake Forest University School of Medicine in Winston-Salem, N.C. "However, for older adults who started the study with mild cognitive impairment, alcohol use was not protective."

Sink and her colleagues were slated to present their findings Monday at the Alzheimer’s Association annual meeting, in Vienna.

The findings are based on work with 3,069 dementia-free adults over the age of 75 who were living in their community.

Nearly all were white, and all underwent initial testing to identify those who already had a mild form of cognitive impairment. Over the six-year study, participants also reported their drinking behavior, and were divided into abstinent, light (one to seven drinks a week), moderate (eight to 14 drinks a week), and heavy (more than 14 drinks a week) alcohol-consumption groups.

Sink and her team found that 482 of the participants had mild cognitive impairment when the study launched, and by the end of the study 523 new cases of dementia were diagnosed.

After accounting for other illnesses, depression, activity levels and cognitive health, the authors concluded that moderate alcohol intake conferred a 37 percent drop in the risk for dementia for those whose cognitive health was normal when the study began.

"Based on this study, we cannot recommend that older adults who don’t drink start drinking alcohol," Sink cautioned. "But it is reasonable to say that if you are already a light to moderate drinker, you may be at a lower risk of developing Alzheimer’s disease or other dementias. However, if you already have memory or thinking problems, drinking alcohol may accelerate memory decline."

Dr. Laurel Coleman, a geriatric physician at Maine Medical Center in Portland, said the findings were "in line with what I would expect."

"It’s very believable because it’s very consistent with other studies around this issue and heart disease prevention work," she noted. "And moderate alcohol use has been shown to be protective against heart disease, so it makes sense to me that it might also be protective for brain health."

Greg M. Cole, associate director of the Alzheimer’s Disease Research Center at the UCLA David Geffen School of Medicine in Los Angeles, agreed.

He noted that while the apparent protective effect of moderate alcohol consumption seemed surprisingly high, "the fact that you would see a related risk reduction is not so surprising."

Cole added, "Alzheimer’s has a strong overlap with cardiovascular disease. And you have had a number of studies that have associated reduced cardiovascular disease risk with a rise in HDL levels – so-called ‘good’ cholesterol’ – that can come with consuming small amounts of alcohol. And it has been thought that this could potentially impact in a positive way on the risk for vascular dementia and Alzheimer’s. So there is a solid rationale for this finding."

The Alzheimer’s-cardiovascular health connection are, in fact, the subject of another study also being presented at the meeting.

In this case, a team from the University of Connecticut found that nearly two-thirds of 690 adults polled incorrectly thought there is no association between Alzheimer’s and either obesity or high blood pressure, two significant risk factors for heart health complications. In light of this and other misconceptions highlighted by the survey, the study authors called for a stronger effort to promote improved "dementia literacy."

In addition, a third study at the meeting reveals that having post-traumatic stress disorder (PTSD) increased the risk of developing dementia.

The University of California San Francisco researchers came to this conclusion after examining records from 2001 through 2007 provided by the U.S. Department of Veterans Affairs National Patient Care Database, concerning more than 181,000 U.S. veterans. The upshot: during the seven-year study, those with PTSD went on to develop dementia at a rate of nearly 11 percent, while those with no history of PTSD developed dementia at a rate of nearly 7 percent.

Source: http://health.msn.com/health-topics/addiction/articlepage.aspx?cp-documentid=100241812

National Geriatric Home Health Care Quality Program Offers New Tools and Discussion Forums Through an Expanded Web Site

Fri, 03 Jul 2009 11:42:00 -0400

June 30 expansion of CHAMP Program web site includes new online community features, best practices, resources, and tools

New York, NY (PRWEB) July 1, 2009 - To improve the quality of home care services for older persons, the Center for Home Care Policy & Research is expanding its CHAMP Program web site (http://www.champ-program.org) with new online community features, best practice information, and a redesigned look-and-feel to further its establishment of a national Community of Practice for geriatric home care excellence. The initiative is based on the nation’s first evidence-based recommendations specific to geriatric homecare - the Framework.

CHAMP (Collaboration for Homecare Advances in Management and Practice) has been improving geriatric home care nationally for the past 3 years via educational programs in medication and pain management for frontline homecare nurse managers. Now, these efforts will be leveraged with the Framework recommendations into a "Community of Practice," the first online national forum to motivate and support quality improvement efforts by home care organizations and other stakeholders.

The Community of Practice includes new online social networking features such as discussion forums and blogs. The community forums will provide a central place for nurse managers, staff and home care senior leaders to discuss success stories, strategies, and experiences within the home care field of work. The community blogs will feature "Ask the Expert" columns, where site users can ask questions and receive periodic advice from experts across a variety of home care topics, such as medication management and improvement methods.

The expanded web site will also include new best practice information, resources, and tools that are specific to geriatric home care and based on the Framework recommendations. Home health organizations, accrediting agencies, national and state professional associations, Quality Improvement Organizations, consumer groups, and other stakeholders in the delivery of home health services will be invited to participate.

The CHAMP Program’s expansion has been made possible with generous support from the Atlantic Philanthropies and The John A. Hartford Foundation and builds on their previous funding to the Center to improve geriatric home care quality nationwide.

The Center for Home Care Policy & Research conducts scientifically rigorous research to promote the delivery of high quality, cost-effective care in the home and community, and support informed decision making by policy makers, payers, managers, practitioners, and consumers of home and community-based services. The Center is part of the Visiting Nurse Service of New York, the largest nonprofit homecare agency in the U.S., ensuring the Center’s research is applicable to real-world homecare settings.