Interesting theory…

FRIDAY, July 22 (HealthDay News) — One of the hallmarks of Alzheimer’s disease, an accumulation of plaque deposits in brain tissues, may trigger the disorder in a way experts have not considered before.

Two sets of researchers now believe that plaque formed by the accumulation of beta-amyloid proteins might cause Alzheimer’s disease by clogging cerebral blood vessels, as opposed to the brain itself.

The findings appear in the August issue of The American Journal of Pathology.

These plaque blockages led to neuroinflammation in two sets of mice, along with blood vessel damage and blood-brain barrier damage, the researchers report.

Scientists have long known that these plaques are a sign of Alzheimer’s disease, but doctors have not agreed so far on whether — or how — they contribute to dementia.

The research was conducted by scientists at Stony Brook University in New York and at the Flanders Interuniversity Institute for Biotechnology at the University of Antwerp in Belgium.

I have seen this therapy being used and it works. It’s gross to think about, and even more yucky to work around, but it works.

Barbara Enser wasn’t very comfortable at first with the idea of using maggots to clean the wound on her right foot. But if it meant saving it from amputation, she was willing to give it a try.

The 57-year-old Bay City woman was diagnosed with diabetes 40 years ago and subsequently lost her left leg to the disease. She also suffers from neuropathy, meaning she has no feeling in her foot or leg, and ulcers or wounds can develop from constantly putting pressure on the foot.

“I’m just hoping this works because I think this is the last straw for saving the foot,” Enser told The Bay City Times before a recent treatment. “I don’t like creepy, crawly things. I won’t even kill a creepy, crawly thing.”

Enser went through a number of other procedures to stem the infection that is spreading through her foot. She had the wound cleaned with a scalpel and has been on antibiotics.

But after those failed, she turned to Dr. Gerald L. Dowling, head of the podiatry section of the Orthopedics Department at Bay Regional Medical Center. He first treated Enser with maggots on July 6.

For the procedure, the maggots — about 2 millimeters each in size — are placed on the wound, then surrounded by an adhesive foam, clear tape, and a gauze bandage.

By July 8, the maggots had swelled to twice their normal size and eaten away part of the infection. When Dowling removed the bandages two days later, Enser’s foot was looking better. Healthy, pink skin was replacing the dead tissue, and the swelling was down in her foot and ankle.

The maggots do more than just clean a wound. They also dissolve the infected tissue, kill bacteria and leave an enzyme behind that stimulates healing. They will only eat the infected tissue, leaving healthy tissue alone.

“In general, maggots have the capacity to distinguish viable and dead tissue on a cell-by-cell basis,” said Dr. Steven M. Holland, chief of the laboratory of clinical infectious diseases at the National Institute of Allergy and Infectious Diseases.

As much good as the first treatment did, Dowling decided to go with one more treatment. And when the bandages from the second procedure were removed 72 hours later, Dowling deemed the procedure a success.

Once the bandages were taken off, the maggots were removed using tweezers and the area was rinsed with a saline solution. Dowling then cut away leftover dead skin.

Wow.

A convicted sex offender living at a Cherokee nursing home is accused of sexually abusing elderly women at the home.

Country Side Estates nursing home faces a $3,500 fine from the Iowa Department of Inspections and Appeals for allegedly failing to protect residents from sexual abuse and failing to notify the families of the alleged victims.

According to state inspection reports, a male resident had a history of sexual aggression and a past conviction for sexually assaulting a minor.

Officials at the home allegedly knew of a sexual relationship between the man and one female resident who has been diagnosed with “severely impaired decision-making skills.” The woman was deemed competent to consent to sexual relations by her psychiatrist.

Separate from that relationship, the man repeatedly pursued two other women at the home, according to state inspectors.

Workers at the home documented numerous instances in which the man kissed or fondled female residents. Country Side Estates is home to 31 people, 17 of whom are at risk for abuse due to poor cognitive skills.

The home’s administrator, Gart Parry, did not return calls to his office Tuesday and Wednesday. Country Side Estates is owned and managed by American Healthcare Associates.

The federal government has informed another nursing home it cannot renew it’s licence…therefore forcing the facility to close down. Sounds like it may be a good thing.

SANTA CRUZ — Citing a litany of suspected problems, including failure to report patient abuse claims and medication errors, the state has effectively ordered Capitola Care Center to shut and given its operators four months to move residents of the skilled-care nursing facility.

A letter issued Monday by the Department of Health Services said the facility’s provisional license would expire the next day and not be renewed.

The center was issued the provisional license about 17 months ago when new owners took over the facility, previously known as Brommer Manor.

Regulators detail 26 alleged problems at the home, which has 99 beds. It serves mostly seniors but is also home to younger adults and some residents who require mental health services.

The findings came from an unannounced “survey” conducted there June 21-30. Regulators investigated 14 complaints and found three serious “deficiencies” believed to pose a danger to residents.

Alleged problems include failures to assess and care for residents with serious health problems, and mistakes in giving medication.

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This didn’t take long. And I’m surprised at how such a value has been placed upon a life. I don’t like lawsuits.
I think they do more harm than good.

The daughter of a woman who died last month after sunbathing outside in 90-plus-degree heat at Heartland of Waterville has filed a civil lawsuit against the nursing home and its parent company, HCR Manor Care.

Noelle Tillman alleges that the nursing home was negligent in caring for her mother, Patricia Matney, who was a resident of the facility at 8885 Browning Drive for four years.

Ms. Matney, 49, who had multiple sclerosis and could not move on her own, died June 26 after she had been lying outside for several hours on a concrete patio. The Lucas County Coroner’s Office said she died from hyperthermia, and her body temperature was recorded at 109 degrees.

The lawsuit, filed Friday in Lucas County Common Pleas Court, also named unspecified defendants who were employees at the nursing home and alleges they were responsible for Ms. Matney’s care.

The complaint seeks compensatory and punitive damages in excess of $13 million. But Michael Leizerman, a Toledo attorney who filed the lawsuit on behalf of the family, said yesterday that a jury would be asked for a higher figure, in part, to send a message that changes are needed in the care of nursing home residents.

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A new device?? Weighted back packs. For fall prevention.

Elderly women with curved spines may be able to improve their balance and lower their risk of falls by using a weighted support device for their backs and participating in an exercise program, according to new study findings.

The women studied had osteoporosis-related curvature of the spine, or kyphotic posture, which causes strain on the spinal cord, can cause back pain, and may increase the risk of falls. Previous studies have shown that the use of a weighted backpack can increase a person’s perception of his or her spinal positioning.

In the current study, Dr. Mehrsheed Sinaki, of the Mayo Clinic College of Medicine in Rochester, Minnesota, and colleagues investigated whether such a device may also reduce the risk of falls among at risk elderly women.

“Most studies of falls address the effects of sedatives, weakness of the lower extremity muscles and neuromuscular diseases,” Sinaki said in a Mayo Clinic statement. “What we wanted to see in this study was the effects of intervention to shift the center of gravity, and improve back strength and gait.”

During the first stage of the study, the researchers found that the 12 women with curved spines were more likely to fall, had less muscle strength and had worse balance than did a comparison group of 13 healthy women, they report in this month’s issue of the journal Mayo Clinic Proceedings.

The researchers then assigned the study participants with curved spines to a four-week program in which they performed exercises to improve their balance, while wearing a fitted harness with a suspended weight, to help them better center their own weight over their legs. The weight on their backs was to counter the frontal weight of their torso. The women were instructed to wear the harness, essentially a weighted backpack, for 30 minutes in the morning and 30 minutes in the afternoon.

At the end of the four weeks, the researchers write, “the positive results of this intervention were surprising to us.”

The women showed improvement in their balance as well as their height, the report indicates. Their risk of falling decreased, their back strength improved, and they reported experiencing less back pain than they had at the start of the study.

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When I worked at the Alzheimer’s facility I got to see Hospice up close and personal. People who were at the very end stages of the disease got services, but it took a lot of education for the families in order to get it. Many families could not take their loved one home, so they stayed within the facility and Hospice took over their care. Nurses, aides, priests and others would come in several times a day. It was a neat thing to see.

TUESDAY, July 12 (HealthDay News) — Giving straightforward information to elderly people facing death in nursing homes makes them more likely to enter hospices, where they can receive better care in the last days of their life, a new study finds.

“Over the last 10, 20, 30 years we have tried all sorts of high-tech and expensive interventions to improve end-of-life care,” said Dr. David Casarett, director of the palliative care clinic at the Philadelphia Veterans Affairs Medical Center, who led the study. “But if you just get people talking, you get more people into the hospice sooner, and people who have these conversations are more satisfied with the end-of-life care they receive.”

The study started with Casarett and his colleagues interviewing nursing home residents or the people who made medical decisions for them, to help identify those who would benefit from entering hospices — facilities specializing in end-of-life care.

Of the 205 nursing home residents who were so selected, 107 were given an informational visit describing hospice care, and 98 received usual care, according to a report in the July 13 issue of the Journal of the American Medical Association.

One of every five people who got the informational visit entered a hospice within the next 30 days, compared to only one person among those who received usual care.

Eventually, 25 percent of those getting hospice information entered hospices, compared to 6 percent of those who did not.

The people who entered hospices had fewer acute care hospital admissions and spent fewer days in the hospital, the researchers noted. Most important, family members of those who entered hospices rated the quality of end-of-life care higher — 4.1 on a scale of five, compared to 2.5 for those remaining in nursing homes, the study found.

It’s true that many people nearing the end of life may not want to have these discussions for a variety of reasons, Casarett said. On the other hand, “many people want to have these discussions but don’t know how,” he said.

Previous studies have shown that “a lot of people are thinking about hospices as something that can help them and are waiting for their physicians to start these discussions,” he said.

Doctors and nurses often do have such conversations with patients, “but what we are not doing is having these conversations in a systematic way,” Casarett. “I hope that this study will help change that.”

According to background information for the article, “At least one in four Americans dies in a nursing home, and considerable evidence indicates that nursing home residents do not receive optimal end-of-life care.” Approximately 25 percent of residents with daily cancer pain receive no pain medications, and residents are often transferred to an acute care setting to receive aggressive treatment in the last weeks of life. Families often express dissatisfaction with the end-of-life care their relative receives in nursing homes.

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I have heard of this company and it sounds like a great alternative to nursing home placement. Anything to keep the elderly home is worth looking into.

Cathy Smith started thinking about nursing homes after her 76-year-old mother, Dolly, suffered a heart attack.

Then she heard about Home Instead Senior Care, a business that sends caregivers to older people’s homes to help with nonmedical tasks or just to provide company.

The Smiths became clients of a growing senior care industry that promises to become even more lucrative as the older population increases.

Experts say the potential market is almost limitless. Propelling the growth are 36 million Americans over 65 and an additional 76 million boomers who’ll turn 65 by 2030.

Surveys show that eight of 10 seniors would prefer to “age in place,” remaining in their homes as long as possible and relying on aides when necessary.

“My parents’ caregiver has become part of our family,” Ms. Smith said.

The woman visits the Smiths twice each week, doing whatever has to be done. That may mean driving Ms. Smith’s mother to the mall or reminding her to take her medicine.

Philip Fritz, the Home Instead franchise owner in Dallas who placed the caregiver in the Smiths’ home, said most of his calls come from adult children such as Ms. Smith.

“Many are juggling the demands of two households and can’t take care of their elders by themselves anymore,” he said.

Biggest of the bunch
Mr. Fritz and his wife, Libbie, started their business with a couple of clients four years ago. Today they have 75 caregivers who serve 80 families throughout the Dallas area.

National franchising companies have emerged as the largest providers in a business once populated only by individuals. Home Instead is the biggest, with 600 franchises that employ 29,000 caregivers and serve 50,000 clients annually in 47 states and five foreign countries.

The Omaha-based business adds 50 franchises a year.

Founder and president Paul Hogan said the inspiration for his company came when his grandmother moved in with his mother because she was too weak to live alone.

“Our vision was to provide many of the same services my family had provided for Grandma Eleanor,” he said.

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The feds are closing down this nursing home, as it should!

The Wisconsin Department of Health & Family Services said Friday plans to close Havenwood Nursing & Rehabilitation Center in Milwaukee by this fall.

The move comes after the agency assumed operation of the center under a May 13 court order. The state agency took control of Havenwood, 3333 W. Highland Blvd., under a receivership after a state and federal investigation found “dire conditions” at the center.

Allegations of widespread neglect and abuse, along with possible Medicaid fraud and complaints by employees about paychecks bouncing, brought a group of state and federal authorities together in a criminal investigation of Havenwood, DHFS said in May.

On April 27, the facility’s owners, Leo Feigenbaum and Karen Mueller-Mason, stepped down as operators.

The Department of Health & Family Services said it does not operate nursing homes on a long-term basis. As receiver, it contracted with Pathway Health Services Inc., Brookfield, to oversee the day-to-day operation of the center.

DHFS secretary Helene Nelson said the situation at Havenwood has been “stabilized” and that it is time for a “more permanent solution.”

The agency, in consultation with Pathways and other Milwaukee providers, plans to find high quality, safe and stable placements for each Havenwood resident, in either another nursing home or other appropriate community setting.

The Department of Health & Family Services is also making the nursing home available for purchase by a qualified operator.

Investigations continue into the actions of Havenwood’s former administrators.

Interesting study and results…

Scientists in Hong Kong have shed new light on why cell repair is less efficient in older people after a breakthrough discovery on premature aging, a rare genetic disease that affects one in four million babies.

Premature aging, or Hutchison-Gilford Progeria Syndrome (progeria), is obvious in the appearance of a child before it is a year old. Although their mental faculties are normal, they stop growing, lose body fat and suffer from wrinkled skin and hair loss.

Like old people, they suffer stiff joints and a buildup of plaque in arteries which can lead to heart disease and stroke. Most die of cardiovascular diseases before they are 20.

In 2003, a team of scientists in the United States found that progeria was caused by mutation in a protein called Lamin A, which lines the nucleus in human cells.

A team at the University of Hong Kong, led by Zhou Zhongjun, took the research a step further in 2004 and found that mutated Lamin A actually disrupted the repair process in cells, thus resulting in accelerated aging.

The study was published in the July issue of the Nature Medicine journal.

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