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The Kaiser Family Foundation released a new guide—Navigating
Medicare and Medicaid, 2005: A Resource Guide for People with Disabilities,
Their Families, and Their Advocates. The guide offers a basic
introduction to Medicare and Medicaid programs, including answers
to questions such as:
- How do people with disabilities apply for
under Medicare or Medicaid?
- What is Medicare's policy for covering durable
medical equipment?
- Where can people with disabilities turn if they
need help in applying for Medicaid?
- How do people with disabilities appeal Medicare
coverage decisions?
- Can a person with a disability who has
Medicare and/or Medicaid be employed and
still keep their coverage?
The guide is available online in both .pdf and HTML formats at
http://www.kff.org/medicare/7240.cfm
Youcan Toocan, a leading supplier of home health products
since 1994, is happy to announce an upgrade to their online store
for caregivers and patients. Some of the products now available
include:
- Caregiver aids, such as emergency response
telephones, personal alarm systems, fall monitors,
personal pagers and gait belts
- Mobility products, such as walkers, travels chairs,
canes and accessories
- Products to help around the house including reachers,
grip aids and writing devices
- Aids to assist with cooking and eating
- Health and exercise products
- Cushions
- Low vision and hearing products
- Bathroom and bedroom safety equipment
- Dressing and personal grooming aids
- Products to help get around the bedroom
- Incontinence supplies
Youcan Toocan prides itself on its staff of professional physical
and occupational therapists that can properly assess the needs of
the caregivers and provide them with assistance in providing their
loved ones with the best care possible. Visit, www.youcantoocan.com
to see daily specials, request a catalog, and learn how they may help.
The Department of Health and Human Services has launched a new website
that provides consumers with information on how well hospitals care
for adult patients. Hospital Compare
(http://www.hospitalcompare.hhs.gov)
uses voluntary, self-reported information from hospitals on three
major causes of morbidity and mortality--heart attack, heart failure,
and pneumonia--to show how often participating hospitals provide
the recommended care for adults with one of these three conditions.
Consumers can search for hospitals by name, state, county, city,
or zip code. To learn more visit, Hospital Compare
at
http://www.hospitalcompare.hhs.gov.
Jewish Association for Services for the Aged (JASA) is pleased to
announce its new program for immigrant caregivers who are caring
for elderly persons 60 years of age or older and living in any of
the New York City boroughs. For more information, please contact
JASA’s Help Center at (212) 273-5272.
Although progress has been made in understanding pain in infants
and children, the youngest patients do not always receive the pain
control they need, according the American Medical Association. The
most common type of pain in children is acute or short-term pain,
caused by injury, illness, or medical procedures. Long-term or chronic
pain, however, may affect as many as 20 percent of children, according
to the National Pain Foundation, and may predispose these children
to ongoing pain as adults. Pain can also disrupt treatment, slow
healing, and cause additional medical problems. To learn more, visit
http://www.wehealnewyork.com/whatsnew/releases/
Anesthesiology.htm
According to the National Institute of Neurological Disorders and
Stroke, Parkinson's disease (PD) belongs to a group of conditions
called motor system disorders. The four primary symptoms of PD are
trembling in hands, arms, legs, jaw, and face; stiffness of the
limbs and trunk; slowness of movement; and impaired balance and
coordination.
Currently, treatment has shifted to a therapy called Deep Brain
Stimulation (DBS). DBS has several advantages over prior therapies:
First, the effects are reversible so that, if stimulation causes
an unwanted side effect, the stimulator can be turned off and the
side effect will disappear. Second, stimulation is adjustable and
allows doctors to adjust stimulation gradually, finding the proper
level at which there is good therapeutic benefit with minimal or
no side effect. Therapy can be customized for each patient. Third,
stimulation parameters can be adjusted in response to changes in
the patient's physiology over time, enhancing the longevity of response.
Finally, sites within the brain that simply should not be destroyed
can be treated with DBS as opposed to prior treatment by ablation.
To learn more about this type of treatment, visit
http://www.ninds.nih.gov/disorders/deep_brain_stimulation
/deep_brain_stimulation.htm
and/or
http://www.nyneurosurgery.org/park_treat.htm
Colorectal cancer is a disease that results from the growth and
reproduction of abnormal cells in the lining of the colon or rectum.
It is the cancer cell's ability to multiply continuously, invade
normal tissue, and spread to other parts of the body (metastasize)
that identifies it as malignant and potentially life threatening.
To learn more, visit
http://www.wehealny.org/services/cancer/colorectal/index.asp
In a study of people with mild cognitive impairment, those who took
the drug donepezil were at reduced risk of progressing to a diagnosis
of Alzheimer's disease (AD) during the first year of the trial,
but by the end of the 3-year study there was no benefit from the
drug. Vitamin E was also tested in the study and was found to have
no effect at any time point in the study when compared with placebo.
These findings, from the Memory Impairment Study, are the first
to suggest that any agent can delay the clinical diagnosis of AD
in people with mild cognitive impairment. The effects of the drug
measured in this study "did not provide support for a clear
recommendation for the use of donepezil" generally to forestall
the diagnosis of AD in people with mild cognitive impairment, the
researchers stated in their report, but they did note the potential
importance of the findings for some patients. The data, they said,
"could prompt a discussion" between clinicians and patients
on the possibility of donepezil therapy in certain cases.
The findings were reported online in the April 14, 2005 issue of
The New England Journal of Medicine by principal investigators
Ronald Petersen, Ph.D., MD, of the Mayo Clinic, Rochester, MN, Leon
Thal, MD, of the University of California, San Diego, and colleagues.
The research was funded in part by the National Institute on Aging
(NIA) and was conducted as part of the Alzheimer's Disease Cooperative
Study (ADCS), a nationwide clinical trials consortium supported
by the NIA, a component of the National Institutes of Health, U.S.
Department of Health and Human Services.
"While the delay in progressing to Alzheimer's disease had
a limited effect in this case, it comes at an early stage of memory
loss, a critically important time for patients and families hoping
that the disease can be held at bay," says Neil Buckholtz,
Ph.D., chief of the Dementias of Aging Branch at the NIA.
Additional important factors in the study were the success in diagnosing
mild cognitive impairment on a reliable basis in a multi-site study
and the findings that can be predictive of AD are the following:
- A condition whose characterization in the medical community
is relatively new, mild cognitive impairment is a transitional
state that occurs between the cognitive changes of normal aging
and the very early stage of AD. The amnestic subtype of mild cognitive
impairment, the focus of this research, involves memory problems
not severe enough to be classified as dementia. Previous studies
have shown that approximately eight in 10 people who meet criteria
for amnestic mild cognitive impairment progress to AD within 6
years of diagnosis and that people with the APOE-e4 gene progress
to AD more rapidly.
- Donepezil, a cholinesterase inhibitor, is currently prescribed
for mild to moderate stages of AD to improve memory and other
cognitive functions. Cholinesterase inhibitors work by delaying
the breakdown of the neurotransmitter acetylcholine in the brain.
Acetylcholine helps communication between the nerve cells and
is important for memory.
- In this trial, donepezil and the antioxidant vitamin E were
each compared to placebo to learn whether either treatment might
delay or prevent progression to AD among people with mild cognitive
impairment. Participants were randomized to three groups, one
taking 2000 International Units daily of vitamin E, the second
receiving 10 mg of donepezil daily, and the third on placebo.
All participants also took daily multivitamins. The average age
of the participants at baseline was 73 years.
- Among the 769 study participants enrolled at 69 sites in the
U.S. and Canada, 212 developed possible or probable AD within
the 3-year study period. The overall rate of progression from
mild cognitive impairment to AD for all three treatment groups
combined was 16 percent per year. The study found that the group
on donepezil's risk of progression to a diagnosis of AD was reduced
by 58 percent one year into the study, 36 percent at 2 years,
but there was no risk reduction at the end of the full 3 years
of the study.
The trial received primary support from the NIA, with additional
funding provided by Pfizer, Inc., and Eisai, Inc. Pfizer and Eisai
also contributed the donepezil study medication, and vitamin E was
provided by DSM Nutritional Products, Inc.
The report will appear in the June 9, 2005, print version of The
New England Journal of Medicine.
For more information on participation in an AD clinical trial, visit
http://www.clinicaltrials.gov/
(search for Alzheimer's disease trials),
or the Alzheimer's Disease Education and Referral (ADEAR) Center website
at http://www.alzheimers.org.
ADEAR may also be contacted toll free
at 1-800-438-4380. The ADEAR Center is sponsored by the NIA to provide
information to the public and health professionals about AD and age-related
cognitive change and may be contacted at the website and phone number
above for a variety of publications and fact sheets, as well as information
on clinical trials.
In light of the media focus on the Terry Schiavo case, caregiving.com
has added a series of articles about the feeding tube decision on
their website. Go to www.caregiving.com,
and click on "Feeding
Tube Decision" to view the articles. Please feel free to share
with your family caregivers, co-workers, and staff.
This website (www.respectingchoices.org)
is dedicated to the teams,
instructors, and facilitators across the U.S., Australia, and Canada
who are working hard to implement the Respecting Choices® model
of Advance Care Planning.
Five Wishes
The Five Wishes document helps you express how you want
to be treated if you are seriously ill and unable to speak for yourself.
It is unique among all other living will and health agent forms
because it addresses all of a person's needs: medical, personal,
emotional, and spiritual. Five Wishes also encourages discussing
your wishes with your family and physician.
Five Wishes lets your family and doctors know:
- Who you want to make healthcare decisions for you when you can't
make them.
- The kind of medical treatment you want—or don't want.
- How comfortable you want to be.
- How you want people to treat you.
- What you want your loved ones to know.
To learn more or order Five Wishes, visit Aging with Dignity at,
http://www.agingwithdignity.org/order.html
Advance directives are statements made by patients that describe
the treatments that should or should not be given in the event a
medical situation arises that requires a decision about therapy,
and patients are unable to speak for themselves. Patients can be
sure that their wishes are followed by executing advance directives.
While laws vary in each state, most recognize at least one of two
advance directives:
- Health Care Proxy
- A Living Will
To learn more about advance directives, visit
http://www.netofcare.org/content/goals_care/default.asp
My father
is a veteran. Is he eligible for any services? If so, which ones?
There are various service-connected
and non-service connected benefits for honorably discharged veterans.
Those who suffered injuries or diseases during the time in the military
may receive what is called Veterans’ Administration (VA) compensation
or pensions, vocational rehabilitation, and VA life insurance program.
There are also benefits for eligible surviving spouse, parents,
and children of the veteran, such as Dependency and Indemnity Compensation
and Spina Bifida Allowance. Benefits can also include non-service
connected disability pension, VA burial allowance, and VA guaranteed
loans. There are health insurance benefits and medical centers for
veterans’ healthcare needs. These benefits are determined
by income, number of dependents (children), severity of disability,
and whether the disability is service related. Caregivers should
not overlook checking on possible veterans’ benefits.
The federal Department of Veterans Affairs (VA) website, www.va.gov,
describes all these benefits, answers commonly asked questions,
lists locations for offices and facilities, and provides online
applications for benefits. Eldercare attorneys are also likely to
be able to assist in gaining veterans’ benefits for which
you qualify.
Below are internet links for more information:
Department of Veterans Affairs
Local office:
245 West Houston Street
New York, NY 10014-4805
(800) 827-1000
(212) 807-7229
www.va.gov
Veterans of Foreign Wars (VFW) Department Service Officer,
VA Regional Office
245 W. Houston Street, #207
New York, NY 10014-4805
(212) 807-3164
http://www.bearsystems.com/vfw/vfw.html
Black Vets for Social Justice
665 Willoughby Avenue
Brooklyn, NY 11206
(718) 852-6004
www.bvsj.org
VA NY Harbor Healthcare System, Network 3
423 E. 23rd Street
New York, NY 10010
(212) 686-7500, Ext. 6838
http://www1.va.gov/visns/visn03/
How do
I access equipment for a loved one who cannot walk?
Many simple pieces of equipment
that can make a difference in your loved one’s life are available,
some even at your local pharmacy. Speak with your healthcare provider
if you need a wheelchair, walker, shower seats, etc. Aside from
equipment, other changes to aid your loved one should include adding
a ramp to get in and out of the home and widening the bathroom doorways.
The following resource list may be helpful:
NYS Office of Advocate for Person’s with Disabilities
1 Empire State Plaza, #1001
Albany, NY 12223-1150
(800) 522-4369
www.advoc4disabled.state.ny.us
Met Council on Jewish Poverty, Metro Pair Program
80 Maiden Lane, 21st Floor
New York, NY 10038
(212) 453-9500
www.metcouncil.org
How can I find more information
about organizations that are working to improve services for older
adults?
There are many organizations
that are committed to improving services. Some of these are listed
below:
American Association of Retired Persons (AARP)
New York State Office
780 Third Avenue, 33rd Floor
New York, NY 10017
(212) 758-1411
TTY: (212) 644-3486
www.aarp.org
Friends and Relatives of Institutionalized Aged (FRIA)
11 John Street, Suite 601
New York, NY 10038
(212) 732-4455
www.fria.org
Gray Panthers
165 W. 86th Street
New York, NY 10024
(212) 799-7572
http://www.graypanthers.org/
Medicare Rights Center
1460 Broadway, 11th Floor
New York, NY 10036
(212) 869-3850
www.medicarerights.org
NYC Long-Term Care Ombudsman Program
11 Park Place, Suite 1111
New York, NY 10007
(212) 962-2720 or 1-800-342-9871
Nursing Home Community Coalition of New York State
11 John Street, Suite 601
New York, NY 10038
(212) 385-0355
www.nhccnys.org
Public Advocate for the City of New York
1 Centre Street
New York, NY 10007
(212) 669-7670
www.pubadvocate.nyc.gov
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