age-friendly-chicago

In Case You Missed It: Aging Friendly City

We had a great Chicago Bridge educational event on Wednesday! Joyce Gallagher, the Executive Director of the City of Chicago Area Agency on Aging, provided some wonderful background into the Age Friendly movement and then delved deeper into the successes in Chicago. Four neighborhoods have instituted the Age Friendly model with a grass roots effort by neighborhood associations and volunteers, most notably in Englewood and Pilsen. Twenty-one total neighborhoods are on the docket to adopt the model. The Age Friendly initiative also involves every department in the city of Chicago, including the police, fire, HR, and others, and each offers their unique contributions. The City of Chicago and its Area Agency on Aging, with the passionate leadership of Joyce Gallagher, work with other urban governments to continue to bring unique solutions and continued the momentum to the Age Friendly initiative.

Thank you to the Kott Gerontology Institute for the awesome spread of food and drink!

The End Of Secrecy In Nursing Home Wrongdoing

Carolyn Rosenblatt , CONTRIBUTOR – Forbes.com

I write about healthy aging, and dealing with aging loved ones.

Opinions expressed by Forbes Contributors are their own.
After 25 years without changes in basic rules, the nursing home industry is finally being forced to reveal hidden wrongs that happen to residents.

Until now, consumers were required to sign arbitration agreements when they were admitted to a nursing home. Unbeknownst to the average person, these agreements required that if anything went wrong in a nursing home, the family could not have their day in court to seek justice. Instead these grievances could be dealt with only in arbitrations, hidden from the public. Results were never known outside those connected to the arbitration hearing itself. If a nursing home neglected its residents or allowed serious harm to come to them, no one else would find out how an arbitrator decided such a case. Private arbitration took the place of a public trial in open court.

That has finally changed along with a lot of other very important rules. For years consumer advocates, many of them lawyers representing the residents or their families, have fought for elimination of these one-sided forced arbitration agreements. The lawyers who could not file cases in court for serious harm to a resident, even murder of a resident while in a nursing home wanted families to be able to seek justice the way everyone else does: by a regular lawsuit and a jury. Now they can.

No one wants to go to a nursing home in the first place. But after surgery, serious illness or an accident or because someone needs around the clock care, nursing homes are a necessary part of the health care system. Ideally rehabilitation takes place there in what is supposed to be a more relaxed setting than a hospital. Some people must remain in nursing homes for the rest of their days, due to many factors. These should not be dangerous places, but some are.

We do not have separate nursing homes for elderly criminals who have served their time and now need full time skilled care. We do not have separate nursing homes for disruptive or aggressive residents who suffer from mental illness or dementia with behavior problems. Everyone can be under the same roof and many nursing homes have not provided enough trained staff to properly care for the most difficult residents there. New rules now say they must properly train and staff their facilities. They must protect vulnerable people from dangerous other residents who might harm someone if not carefully supervised by skilled staff. They must spend resources on getting enough workers and teaching them how to do the job properly.

 

The Federal entity, the Center For Medicare and Medicaid Services has issued these revised rules, much to the relief of advocates. The improved rules affect over 15,000 long term care homes that accept Medicare and Medicaid across the country. In reality, the worst nursing homes will not fully comply with the new rules, as they did not fully comply with the older versions of what was acceptable. But in order to receive payment from Medicare and Medicaid (most of the income in these homes), all homes will have to step up to better standards or they will lose money.

How does this affect the life of anyone with an aging parent or other loved one? It means that if your family member has to go to a nursing home, they are likely to be safer than before these rules came into being. Rules are not a guarantee of safety for anyone. But, no one placing a loved one in a nursing home can be forced into signing an agreement to arbitrate a grievance there. My hope is that you never have such a grievance. Learn some pointers on how to choose that nursing home. You might be under pressure with little time to pick one from a list of unfamiliar names. Take the time to visit a few, see them in person and get a sense of how they operate. You’ll learn at lot by an unannounced visit.

The best takeaway here is to watch over your loved one daily if you can, particularly in any nursing home.

Carolyn Rosenblatt, RN, Elder Law Attorney, Healthy aging and protecting our elders, AgingParents.com, AgingInvestor.com

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In Case You Missed It: Older Adults & Immigration

img_5418Last week the Chicago Bridge, in collaboration with Rush University and the Continuing Education Institute of Illinois, hosted a panel discussion on Older Adults & Immigration. The panel participants, Padraic Stanley, MSW of Rush University’s Heath & Aging Department, Yadira Montoya, MSPH of Rush University’s Alzheimer’s Disease Center and Adela Carlin, J.D. of the Legal Assistance Foundation, presented a wealth of information regarding the aging immigrant population in Chicago and across the nation, tips for the clinical practice and wonderful stories about the resiliency of undocumented immigrants who despite contributing to the American economy are often, if not always, locked out of essential services.

Fast Facts

  • 20% of Chicago’s population was born outside of the United States
  • 172,000 Older Adults in Illinois speak limited English
    • 40,000 Mexican heritage
    • 21,000 Polish heritage
    • 11,000 Puerto Rican heritage
    • 9,000 Chinese heritage
    • 91,000 Mix of other nationalities and cultures all at least with 1,000 or more older adults
  • Non-English speaking elderly are 2x more likely to live in poverty
  • There are roughly 511,000 undocumented immigrants in Chicago
  • Roughly $14 billion in taxes are filed by those who do not have Social Security numbers — this amount has been attributed to the contributions of undocumented immigrants through the use of a Individual Taxpayer Identification Number or ITIN
  • 50%-60% of those left uninsured after the passage of the Affordable Care Act are undocumented immigrants

Tips for Clinical Practice

  1.  Know when you need to know immigration status & when you do not. Is there is a funding source that requires this information?
  2. Ask what the client’s preferred language ?
  3. Why did the client move to the United States? Were they coming to meet family? For work? Fleeing violence? Knowing this can give you an idea of what background/perspective they may be coming from.
  4. If not familiar with a culture or nationality seek out experts that can connect you with resources or groups that may serve as a support for the client. Seek out historical information about that culture and their movement into the U.S.
  5. Find out how the client is surviving? Do they have family or community support ? What are their resiliency factors?

Resources

Coalition of Limited English Speaking Elderly (CLESE)

CLESE – Profile of Limited English Speaking Older Adults in Metro Chicago

Migration Policy U.S. Data Tools

Latinos in America – PBS Special 

National Hispanic Council on Aging – Status of Hispanic Older Adults: Recommendations from the Field

Internet Comes Through In A Big Way for 89-Year Old Popsicle Man 

Hunger Among Seniors In Cook County (PDF)

LEP Older Adults Metropolitan Chicago Report (PDF)

LEP Populations Over 65 By Township (PDF)

 

‘Extremis’: An Unforgiving Look At Death In America

By Daniel Gaitan (Life Matters Media)

“Everybody standing in this room is going to die one day, and it’s good to have a little bit of a say in how.”

 

Those are some of the first words from Dr. Jessica Nutik Zitter as she addresses her team in the new Netflix documentary Extremis. The film follows the palliative care physician as she attempts to provide care – and counseling  – to dying patients at the bustling Highland Hospital, in Oakland, Calif.

 

Read at lifemattersmedia.org

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Elderly with no nearby family to help them need safety net, experts say

The brother and sister, both unmarried, childless and in their 80s, had been fending for themselves in their Vernon Hills home: avoiding neighbors, ordering groceries, skipping doctors’ appointments.

“They lived in a home that was like something out of the reality show ‘Hoarders,'” says professional patient advocate Teri Dreher, who was called in by a local hospital after the brother fell down the stairs, fracturing some ribs.

“They had five to six years of newspapers and magazines, they were paranoid, they had neighbors who were trying to have them sign papers (giving up) control of their finances.”

Sometimes called elder orphans, seniors with no relatives available to help them manage aging and illness are a large and likely growing group, according to Dr. Maria Torroella Carney, chief of geriatrics and palliative medicine at Northwell Health in New Hyde Park, N.Y. Roughly 22 percent of adults over the age of 65 are elder orphans or are at risk of becoming elder orphans because they don’t have spouses, children, or siblings who live nearby, according to an analysis by Carney and three co-authors that was presented at the American Geriatrics Society’s 2015 annual meeting.

“We’re seeing these individuals, they’re right under our noses, we just are not necessarily alert to them,” Carney said.

“Maybe that’s where we can start improving things: We can have the awareness and try to bring in family members that are available to be more involved. Let’s educate patients that we see as physicians that might be elder orphans, while they have their independence, about how are you going to deal with living in the community for as long as possible?”

Almost 19 percent of women ages 40 to 44 are childless, as compared to about 10 percent in 1980, according to U.S. census data quoted in Carney’s presentation. And a third of Americans ages 45-63 are single, an increase of 50 percent since 1980.

That could leave more of us without ready access to family support as we age.

Cook County Public Guardian Robert Harris said an increasing number of elderly people with cognitive disabilities need guardians to handle their financial assets, and private agencies have been cropping up to fill the need. His office provides guardianship to 650 people with cognitive disabilities, most of them elderly.

Harris recommends drawing up a will, an advance directive and power of attorney documents while you’re still in good health, so that your wishes are clear and someone else can make decisions on your behalf, should that become necessary.

“If you don’t have children or relatives, you can name a really good friend, or you can set up a bank or some other institution as a fiduciary to take care of you,” he said.

Carney said her 22 percent figure for elder orphans is only an estimate, based on the University of Michigan’s Health and Retirement Study. More work is needed, she said, both to ascertain the number of older Americans at risk, and to develop strategic plans for the hospitals, government health agencies and private nonprofits involved in their care.

Elder orphans are at higher risk for isolation, depression, not following up with doctors’ treatment recommendations and being readmitted after a hospitalization, Carney said.

She’d like to see interdisciplinary teams with medical professionals and social workers act as resources for doctors treating elder orphans; the teams could do comprehensive assessments and link patients with the services they need to stay independent.

As for the brother and sister in Vernon Hills, by the time Dreher, owner of North Shore Patient Advocates in Chicago, was sent in to do an assessment, both had diabetes and showed signs of early dementia. The sister’s ankles were swollen to three times their normal size, likely from congestive heart failure.

Neither sibling ever married or had children, but the brother had done well in the stock market, and had money to pay for good care.

“We had to call Catholic Charities and get a court-appointed guardian for them,” Dreher said.

“They ended up moving into a nice assisted living facility (and) they did quite well. Catholic Charities had volunteers go over and pick them up and take them to their doctors’ appointments and visit them and everything. Their nutrition improved, and they did much better.”

nschoenberg@chicagotribune.com

Twitter @nschoenberg

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Fewer Advanced Alzheimer’s Patients on Feeding Tubes

Practice dropped by half over past 15 years, study reports

By Kathleen Doheny from healthday.com
HealthDay Reporter

TUESDAY, Aug. 16, 2016 (HealthDay News) — The use of feeding tubes for nursing home patients with advanced dementia — a practice increasingly discouraged by some national organizations — is declining, a new study finds.

One Alzheimer’s expert who reviewed the new findings was heartened by the news.

“When we are looking at someone in the advanced stages of a terminal illness, a feeding tube doesn’t make a lot of sense for families,” said Beth Kallmyer, a social worker and the vice president for constituent services at the Alzheimer’s Association.

Between 2000 and 2014, the proportion of residents in U.S. nursing homes with advanced dementia and feeding tubes declined from 12 percent to 6 percent, said study leader Dr. Susan Mitchell. She’s a professor of medicine at Harvard Medical School and a senior scientist at Hebrew Senior Life Institute for Aging Research.

Although the study doesn’t delve into the exact cause of the decline, Mitchell said there are likely a number of reasons.

“The decline roughly parallels the emergence of research, and subsequent expert opinion and recommendations by national organizations, discouraging this practice,” she said.

As research has emerged discouraging the use of feeding tubes in advanced dementia patients, national organizations have developed recommendations that reflect that research. At the same time, doctors also began to more widely accept the idea of palliative care (keeping a person with a terminal illness as comfortable as possible), Mitchell said.

Read the rest at:

https://consumer.healthday.com/cognitive-health-information-26/alzheimer-s-news-20/fewer-advanced-alzheimer-s-patients-on-feeding-tubes-713915.html?utm_source=newsletter&utm_medium=email&utm_campaign=20160818&utm_term=713915

 

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Alzhiemer’s Patients Keep Spark Alive by Sharing Stories

By Jane E. Brody at the New York Times

Can you keep the love shining after your partner’s brain has begun to dim? Just ask Denise Tompkins of Naperville, Ill., married 36 years to John, now 69, who has Alzhiemer’s disease.

The Tompkinses participated in an unusual eight-week storytelling workshop at Northwestern University that is helping to keep the spark of love alive in couples coping with the challenges of encroaching dementia.

Each week participants are given a specific assignment to write a brief story about events in their lives that they then share with others in the group. The program culminates with a moving, often funny, 20-minute written story read alternately by the partners in each couple in the front of an audience.

Read the rest at:

 

 

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Alzheimer’s Disease: Period Pain Drug Cures Symptoms In Mice, New Research Shows

BY  @ International Business Times

The incurable Alzheimer’s disease may now have a cure. A new research by the University of Manchester shows that the most common form of dementia can be fully cured with an anti-inflammatory drug, commonly used for period pain.

Almost 7.5 million new cases of Alzheimer’s — a disease that causes acute problems with memory, thinking ability and behavior — diagnosed around the world every year. In the United States, about five million people currently suffer from the degenerative disease that has claimed one in three senior citizens with some form of dementia.

The team, led by Dr. David Brough, worked with mice to find that a common Non-Steroidal Anti Inflammatory Drug (NSAID) routinely used to relieve menstrual pain — mefenamic acid — completely reversed the inflammation of the brain and lost memory in the specimen.

Mefenamic acid is available as a generic drug and is sold under a variety of brand names.

 

Read the rest, and watch the video at:

http://www.ibtimes.com/alzheimers-disease-period-pain-drug-cures-symptoms-mice-new-research-shows-2401212