Gilbert Guide Care

Gilbert Guide is a web resource designed to provide information about quality senior care. The site offers a  wide range of resources to help families and caregivers including:

A comprehensive provider database allowing readers to identify options in every state across the country. Quality assessment tools to conduct  and evaluation of providers
practical information on senior care basics, developing a care plan or other issues in elder care

Readers can also subscribe to "The Weekly Insider", which consists of advice and reviews on new issues or read the column "New Experts".

To explore Gilbert Guide, go to  http://www.gilbertguide.com/

Direct Care Jobs and Long-Term Care

PHI has released an issue brief called Direct-Care Jobs & Long-Term Care: Untapped Engine for Job Creation & Economic Growth that outlines how direct-care jobs are uniquely positioned to help repair and stabilize America’s economy.

The issue brief provides compelling facts and figures about the impact of the direct-care workforce that our nation’s leaders must take into consideration as they develop and implement strategies for economic recovery.

http://phinational.org/archives/phi-releases-issue-brief-on-job-creation/

The Institute for Safe Medical Practices

The Institute for Safe Medication Practices (ISMP), based in suburban Philadelphia, is the nation’s only 501c (3) nonprofit organization devoted entirely to medication error prevention and safe medication use.

ISMP represents over 30 years of experience in helping healthcare practitioners keep patients safe, and continues to lead efforts to improve the medication use process. The organization is known and respected worldwide as the premier resource for impartial, timely, and accurate medication safety information.

Publications available at the site include:

Error-Prone Abbreviation List (PDF; 73 KB)
High-Alert Medication List (PDF; 51 KB)
Confused Drug Name List (PDF; 101 KB)
“Do Not Crush” List (PDF; 52 KB)
Textbook and Publication Errata

The Caregiver: A Life with Alzheimer's

First published in 1999, this book by Aaron Alterrra, a pseudonym for E.S. Goldman, an award winning fiction writer who publishes frequently in the Atlantic, recounts the caregiver's experience.

From the point of view of both a husband and a writer, the book is an eloquent depiction of the early uncertainly and denial which takes place before diagnosis to the transition to the the disabilities and indignities often inflicted on the person with Alzheimer's.

Vancouver: UBC Press, 2007. ISBN: 978-0-7748-1538-3

Project 2020

Founded in 1964, the National Association of State Units on Aging (NASUA) is a non-profit association representing the nation's 56 officially designated state and territorial agencies on aging. The mission of the Association is to advance social, health, and economic policies responsive to the needs of a diverse aging population and to enhance the capacity of its membership to promote the rights, dignity and independence of, and expand opportunities and resources for, current and future generations of older persons, adults with disabilities and their families.

NASUA is the articulating force at the national level through which the state agencies on aging join together to promote social policy in the public and private sectors responsive to the challenges and opportunities of an aging America.

The National Association of State Units on Aging (NASUA) and the National Association of Area Agencies on Aging, conscious of the financial pressures facing states and the federal government, have developed a coordinated national long-term care strategy (Project 2020) that will generate
savings in Medicaid and Medicare at the federal and state levels while enabling older adults and individuals with disabilities to get the support they need to successfully age where they want to — in their own home and community.

The goal of 2020 is to provide the resources to implement consumer-centered and cost-effective long-termcare strategies authorized in the 2006 reauthorization of the Older Americans Act and to empower the Aging Services Network to implement these strategies through a three-pronged program encompassing person-centered access to information, evidence-based disease prevention and health promotion activities, and enhanced nursing home
diversion services.

http://www.nasua.org/issues/federal_policy/project_2020.html

Metlife Market Survey of Nursing Home and Assisted Living Costs, 2008

Released annually by Metlife Mature Market Institute, Medlife's center on aging and the 50+ market, in conjunction with Lifeplan.

MMI’s works to research, generate national partnerships, and educational materials to expand the knowledge and choices for those in, approaching, or caring for those in the mature market.

LifePlans, Inc. is a risk management and consulting firm, which provides data analysis and information to the long-term care insurance industry. The firm works with insurers, the federal government, industry groups, and other organizations to conduct research that helps these groups monitor their business, understand industry trends, perform effective advocacy, and modify their strategic direction.

http://www.metlife.com/FileAssets/MMI/MMIStudies2008NHALCosts.pdf

Vision Loss

From the Family Caregiver Alliance, this thorough fact sheet on vision and aging discusses the types of vision loss in aging and their treatment options, as well as strategies for living with vision loss, including rehabilitation strategies, home modifications, assistive devices, and traveling with vision impairment. The sheet also deals with emotional and financial issues that may arise with vision loss and provides further reading, and useful resources.

http://www.caregiver.org/caregiver/jsp/content_node.jsp?nodeid=2222

Valuing the Invaluable: The Economic Value of Family Caregiving, 2008 Update

This AARP Public Policy Institute Insight on the Issues by Ari Houser and Mary Jo Gibson presents recent data on the economic value of family caregiving at the national and state levels and summarizes findings about costs to caregivers and how caregiving helps contain health care and long-term care costs.

http://www.aarp.org/research/housing-mobility/caregiving/i13_caregiving.html

Ginkgo Evaluation of Memory Study

The dietary supplement Ginkgo biloba was found to be ineffective in reducing the development of dementia and Alzheimer's disease in older people, according to a study published in the "Journal of the American Medical Association"{1}. Researchers led by Stephen T. DeKosky, M.D., formerly of the University of Pittsburgh, vice president and dean of the School of Medicine at the University of Virginia in Charlottesville, conducted the trial known as the Ginkgo Evaluation of Memory (GEM) study at four clinical sites over the course of 8 years. GEM is the largest clinical trial ever to evaluate ginkgo's effect on the occurrence of dementia.

This research was co-funded by five components of the National Institutes of Health (NIH): National Center for Complementary and Alternative Medicine (NCCAM); National Institute on Aging (NIA); National Heart, Lung, and Blood Institute; National Institute of Neurological Disorders and Stroke, and the Office of Dietary Supplements.

"We have made enormous progress in understanding the basic mechanisms involved in Alzheimer's disease, and we continue to pursue a vigorous program to translate what we know into the development and testing of new potential therapies for this devastating disease," said Richard Hodes, M.D., director of the NIA. "However, it is disappointing that the dietary supplement tested in this study had no effect in preventing Alzheimer's disease."

GEM enrolled 3,069 participants age 75 or older with normal cognition or mild cognitive impairment. Those with dementia were excluded from participation. After extensive medical and neuropsychological screening, participants were randomly assigned to receive twice-daily doses of either 120 milligrams of ginkgo extract or an identical-appearing placebo. The 240 milligrams daily dose of ginkgo was selected based on current dosage recommendations and prior clinical studies indicating possible effectiveness at this dose. The products used in the study were supplied by Schwabe Pharmaceuticals, a German company.

"According to the 2007 National Health Interview Survey, ginkgo is one of the top 10 natural products used by Americans," said Richard L. Nahin, Ph.D., M.P.H., acting director of the Division of Extramural Research at NCCAM. "It is important to conduct studies and build the scientific evidence base regarding botanical supplements through rigorous research, such as the GEM trial."

The study was conducted primarily to determine if ginkgo would decrease the incidence of all types of dementia and, more specifically, reduce the incidence of Alzheimer's disease. Secondarily, the study evaluated ginkgo for its effects on overall cognitive decline, functional disability, incidence of cardiovascular disease and stroke, and total mortality. The primary endpoint was the diagnosis of dementia as determined by an expert panel of clinicians using standard criteria for diagnosis. The patients with a diagnosis of dementia underwent magnetic resonance imaging scans to determine their dementia type.

"The results of this study confirm the importance of randomized trials in the development of new therapies for dementia and Alzheimer's disease and in determining therapeutic benefit not only for conventional therapies but also complementary therapies like ginkgo," said Dr. DeKosky, principal investigator on the GEM study. "If older patients are considering using ginkgo for preventing dementia, I urge them to speak with their health care providers about the results of this study and work together to create the best treatment plan."

Study participants were followed for an average of approximately 6 years (maximum of just over 7 years). During the study, 523 participants were diagnosed with dementia, 246 in the placebo group and 277 in the ginkgo group. Thus, ginkgo showed no overall effect for reducing all types of dementia or Alzheimer's disease. In addition, in analyzing safety data, the GEM study did not find significant adverse effects from ginkgo, in particular there was no evidence for increased bleeding risk in persons taking ginkgo.

Cognitive status was known for more than 93 percent of all participants at the end of the trial and 60 percent of active participants were taking their assigned study medication. There was no difference in adherence to taking medication between the ginkgo group and the placebo group.

"While this study revealed that ginkgo does not have an effect on reducing dementia in the study populationi it does provide us with important information about how to design and conduct large dementia prevention trials in older adults" said Dr. Jeff Williamson, a geriatrician and principal investigator of the GEM Clinical Coordinating Center at Wake Forest University. "Future analyses will provide us with additional information on ginkgo's possible effects on cardiovascular disease, cancer, depression and other age-related conditions. We are especially grateful to the more than 3,000 older adults who dedicated many hours to helping us answer the important questions addressed by GEMS."

The GEM results will prove useful in determining how many participants are needed in future trials to provide clinically significant measures on outcomes such as occurrence of dementia. Future analysis of this study may also identify subgroups of these participants who may be at greater risk for developing dementia.

Data analysis for the trial was overseen by the University of Washington, Seattle and the four GEM institutions that participated in this study were

* University of Pittsburgh
* Wake Forest University, Winston-Salem, N.C.
* Johns Hopkins University, Baltimore, Md.
* University of California, Davis

The National Center for Complementary and Alternative Medicine's mission is to explore complementary and alternative medical practices in the context of rigorous science, train CAM researchers, and disseminate authoritative information to the public and professionals. For additional information, call NCCAM's Clearinghouse toll free at 1-888-644-6226, or visit the NCCAM Web site at www.nccam.nih.gov.

The National Institutes of Health (NIH) -- The Nation's Medical Research Agency -- includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.


REFERENCE:
{1} DeKosky ST, Williamson JD, Fitzpatrick AL, et al. Ginkgo biloba for Prevention of Dementia. "Journal of the American Medical Association". 2008 300(19): 2253-2262.

Valuing the Invaluable: The Economic Value of Family Caregiving, 2008 Update

This research report from the AARP Public Policy Institute provides updates of state and national data on the economic value of family caregivers and their effects on the health and LTC systems.

Policy recommendations at both the federal and state levels are offered to prevent family caregivers from being overwhelmed by the demands placed upon them and to fund more services and supports for them.

http://www.aarp.org/research/housing-mobility/caregiving/i13_caregiving.html

Guideline for Alzheimer's Disease Management

Prepared by the California Workgroup on Guidelines for Alzheimer's Disease Management. There are two versions of the guidelines, designed primarily for primary care practitioners and clinicians working with people with Alzheimer's and their families.

The guidelines are hosted on the California Council of the Alzheimer’s Association website. This Association is affiliated with the national Alzheimer’s Association and is the vehicle for California’s five chapters to advance statewide public policy issues. The Council identifies and influences issues that demonstrate a direct, positive link to people living with Alzheimer’s disease and other dementia disorders and their families. Through the leadership of the California Council families drive policy decisions that impact persons with dementia, their families and caregivers.


http://www.caalz.org/Guidelines.htm

Well-being of Older People in Ageing Societies

Rising human longevity in recent times pose new challenges to policy-makers worldwide, particularly in maintaining the financial sustainability of old age pension systems.

Individuals planning for retirement also face critical challenges: they need to safeguard against risks of falling into poverty during an increasing longer duration of retirement.

This book provides new insights into how with ageing factors such as ill health and disability become ever more important in determining the personal well-being of older people, and these factors have financial implications not captured by an analysis of pension income alone.

Another important policy implication arising from this book is the extent to which people are exposed to income risks in their retirement. While individuals and governments already safeguard against such hazards, this research shows that these measures will need to be strengthened further in light of the increasingly longer time spent in the post-retirement phase of life and in view of greater reliance by retirees on diverse and potentially volatile sources of income.

http://www.euro.centre.org/detail.php?xml_id=1356

The Baby Boomer's Handbook on Helping Parent's Receive Care for Memory Problems

This book contains tips and information on helping parents or families seek care for memory problems and includes:

• a 15 point Dementia-Risk Inventory
• Q and A on talking to parents about dementia
• ten benefits for the parent in recognizing dementia early
• twelve warning signs of dementia
• ten commandments to dementia prevention

http://www.alzbrain.org/pdf/handouts/a%20bABY%20BOOMER's%20guide%20to%20dealing%20with%20memory%20problems%20in%20their%20parents.pdf

Age-Related Disease Study

The National Eye Institute (NEI), part of the National Institutes of Health (NIH), announces the release of more than 10 years of data collected during the Age-Related Eye Disease Study (AREDS), which looked at the progression of age-related macular degeneration and age-related cataract in 4,757 adults aged 55 to 80.

Researchers around the world can apply for access to this complete set of medical history records and clinical trial results as well as select genetic information to gain a better understanding of two complicated vision conditions that affect aging adults.

The public, open-access AREDS data can be viewed on the dbGaP website at http://www.ncbi.nlm.nih.gov/projects/gap/cgi-bin/study.cgi?study_id=phs000001.v2.p1.

Researchers can find a link to the application for controlled access to individual-level data on the same site.

Source: National Eye Institute (NEI)

Finding Rosa: A Mother with Alzheimer's, a Daughter in Search of the Past

A moving account of one woman’s journey into the realm of her mother’s dementia.When her mother, Rosa, begins to show signs of Alzheimer’s, Caterina Edwards embarks on a complex journey—all at once geographical, intellectual, and emotional—that turns out to be a journey in search of the past and of home. As Rosa loses her memory and her sense of herself, Edwards travels to Istria, now part of Croatia, to get at the truth of her mother’s past.

For ordering information, go to the following link:

http://www.dmpibooks.com/book/9781553653899

Aging and Caring at the Intersection of Work and Home Life

This book looks at the boundaries of care by looking at private and public help, professional and personal help and paid and unpaid caregivers. It captures and conceptualizes the complexity of the intersection of work and home life as it relates to the provision of assistance and support to older relatives in a variety of "care work" contexts.

Readers of this volume will gain a deeper understanding of issues of care provision amongst "networks" of careers and helpers, and of the particular dynamics of care when it is episodic or framed by constrains of space and time as a result of geography.

Source: Gerontologyarena.com

Consumer Direction of Personal Assistance Services in Medicaid: A Review of Four State Programs

With a shift towards providing long-term services and supports in the community, policy interest in Medicaid consumer direction of personal assistance services (CD-PAS) has grown. Although overall enrollment in these programs is small, 42 states offered consumer direction in Medicaid in 2006. These programs allow Medicaid beneficiaries control over hiring, scheduling, training and paying of personal care attendants. The Kaiser Family Foundation’s Commission on Medicaid and the Uninsured has produced two new reports examining Medicaid’s role in providing CD-PAS in four states: California, Colorado, New York and Virginia.

http://www.kff.org/medicaid/kcmu032408pkg.cfm

Oseltamivir, Amantadine and Zanamivir for the Prophylaxis of Influenza

This technology appraisal contains a series of documents providing guidance to the NHS on the use of oseltamivir, amantadine and zanamivir for the prophylaxis of influenza.

This guidance is produced by the National Institute for Health and Clinical Excellence (NICE). Technology appraisals produced by NICE have been developed by a team of experts aiming to produce guidance for both the NHS and patients on medicines, medical equipment and clinical procedures based on evidence of clinical and cost effectiveness.

Made available in September 2008, this appraisal includes practice guidelines, a patient-oriented leaflet, and background information.

http://www.nice.org.uk/guidance/index.jsp?action=byID&o=12060

Estrogen and progestogen use in postmenopausal women: July 2008 position statement of The North American Menopause Society.

This links to a summary of the recently updated guideline from the North American Menopause Society.

http://www.guideline.gov/summary/summary.aspx?doc_id=12713&nbr=6584&ss=6&xl=999

Alzheimer's Disease: Unraveling the Mystery

he National Institute on Aging today released a new edition of Alzheimer's Disease: Unraveling the Mystery, an illustrated, 80-page book written for people with Alzheimer's disease (AD), their families, health care professionals, students, and others with an interest in the disease.

This update to the 2003 edition of Unraveling the Mystery helps readers understand AD, its impact on individuals and society, and research advances to prevent or diminish the effects of the disease. The new edition:

• describes the basics of the healthy brain;
  
• focuses on changes that occur in a brain affected by AD;
  
• highlights findings from recent NIA-funded research into the causes of AD, new developments in diagnosis, and the search for new treatments; and
  
• addresses issues of concern to AD caregivers and families.

The book also includes a glossary, a comprehensive list of organizations offering more information, and a list of recommended reading.

To view, download, or order copies of Alzheimer's Disease: Unraveling the Mystery, go to: www.nia.nih.gov/Alzheimers/Publications/Unraveling, or call NIA's Alzheimer's Disease Education and Referral (ADEAR) Center at 1-800-438-4380.

Mental Stimulation and Lifelong Learning Activities

Elderhostel has issued a research report on "Mental Stimulation and Lifelong Learning Activities
in the 55+ Population" available at:

http://news.aarp.org/UM/T.asp?A910.52852.7112.7.2978658

A Personal Guide to Living with Progressive Memory Loss

Memory loss can create problems in every aspect of a person's life. The challenge of communicating thoughts and feelings can be made even harder by other people's negative perceptions of dementia.

This book provides practical guidance for coping with progressive memory loss, and includes examples of real people who have faced similar challenges. These stories highlight both good and bad ways to deal with the problems that arise, and are also useful for describing the experiences of memory loss to friends and family. The authors suggest ways of maintaining physical and mental health by staying active and engaged in society. They also offer techniques for improving communication, preserving self-esteem and overcoming the stigma associated with memory loss.

A Personal Guide to Living with Progressive Memory Loss offers inspiration and advice for anyone in the early stages of dementia. It also provides useful insight for family and friends who wish to offer support for a loved one affected by progressive memory loss.


Paperback, ISBN: 978-1-84310-863-4. Published by Jessica Kingsley, 2007.

NIH Senior Heath: Parkinson's Disease

This information resource on Parkinson's Disease is produced and made available on the Web by NIH Senior Health. The resource considers the causes, symptoms, diagnosis, and available treatment for Parkinson's Disease. Resources available include quizzes after each section, FAQs, and links to other resources included in the MedlinePlus service. This resource was last reviewed in September 2008.


http://nihseniorhealth.gov/parkinsonsdisease/toc.html

End of Life Care in Nursing Homes: 2004 National Nursing Home Survey

From the Centers for Disease Control and Prevention this document reports on end of life care for residents in nursing homes.

Data are from the resident component of the 2004 National Nursing Home Survey (NNHS), 2004.

NNHS is a nationally representative, cross-sectional probability sample survey of all current residents in nursing homes in the United States with three or more beds and either certified by Medicare or Medicaid or licensed by the state. All information is derived from interviews with nursing home staff.

http://www.cdc.gov/nchs/data/nhsr/nhsr009.pdf

A First Look at Americans and the Mortgage Crisis

Homeowners age 50 and over have been significantly affected by the mortgage crisis, according to this first-ever analysis of data on the mortgage crisis by age. More than 684,000 homeowners age 50 and over were delinquent, were in foreclosure, or lost their homes during the six months ending December 2007. Older African Americans and Hispanics had higher foreclosure rates than whites of all ages. The study also finds that older Americans appear particularly vulnerable to home price declines and to subprime loans. This Insight on the Issues, by Alison Shelton of AARP's Public Policy Institute, points out that losing a home is a loss from which many older Americans may not be able to recover. (6 pages)

http://www.aarp.org/research/credit-debt/mortgages/i9_mortgage.html

Seniors and Drug Prices in Canada and the United States

The Fraser Institute’s third report comparing Canada-US price differences for the prescription drugs that are most important to Canadian seniors (aged 60 and older).

This year’s report analyzes prices for the drugs most commonly prescribed to Canadian seniors in 2007, and compares Canadian and American prices for brand name and generic prescription drugs separately.

Full Document

NEW! Practical Tools and Resources for Caregivers and Professionals

In order to prepare current and future professionals in these fields, the AARP Foundation, in collaboration with the American Journal of Nursing, the Council on Social Work Education, Family Caregiver Alliance (FCA), and Rutgers Institute for Health Policy, received funding from the John A. Hartford Foundation and the Jacob and Valeria Langeloth Foundation for an interdisciplinary project on family caregiving of older adults.

The project brings together experts from the field of aging to advance the support of informal caregiving by identifying and further developing best practices in nursing and social work to help families care for older adults. The project lays the groundwork for producing a cadre of nurses and social workers who embrace a patient- and family-centered care perspective.

http://caregiver.org/caregiver/jsp/content_node.jsp?nodeid=2224