Scientists are looking at every possible cause of Alzheimer’s Disease; some of the theories come across as sound and make sense and others….just don’t.

ST. LOUIS- Scientists who set out to explore changes in the brain as Alzheimer’s disease progresses got a surprise: a possible link between daydreaming and the degenerative brain disease that robs memory, language and thought.

A new Washington University study shows the part of the brain used to daydream is the same where Alzheimer’s disease develops — in some people — later in life. It suggests the normal brain activity of daydreaming fuels the sequence of events leading to Alzheimer’s.

“The implication, albeit a speculative one, is that those activity patterns in young adults are the foothold onto which Alzheimer’s disease forms,” said lead researcher Randy Buckner, associate professor of psychology. He said they may lead to a life-long cascade that ends in Alzheimer’s disease in some people.

“It suggests a new hypothesis and opens an avenue in exploration,” Buckner said. “By no means is it definitive.”

The study appears in this week’s The Journal of Neuroscience.

Researchers at Washington University and the University of Pittsburgh used five imaging techniques to map the brains of 764 people. The subjects fell into three groups — people in their 20s, and older people with either early-stage dementia, or Alzheimer’s disease.

When they compared images, they found that parts of the brain involved in musing, daydreaming or recalling pleasant memories in young people were where evidence of Alzheimer’s disease appears.

Read the rest of this article—>

I never heard of such a thing, but appearently it’s happened twice this year. This nursing home better get that driveway up graded and fast.

HARRISBURG, Pa. - A nursing home resident died five days after his wheelchair rolled down a steep driveway outside the facility, the second such death at the home this year.

Paul Miller, 80, died Monday after suffering internal injuries when was he thrown from a wheelchair outside the Villa Teresa skilled nursing facility in Lower Paxton Township on Aug. 17.

Surveillance video from the facility shows Miller waiting in the lobby for a van to take him to dialysis treatment when a volunteer opens the door for him to go outside; the video did not record what happens next, officials said.

“He said he was going 70 miles an hour,” said Miller’s daughter-in-law, Joyce Miller, of Lower Paxton Township.

“We feel it was negligence (on the part of the nursing home) for him to be out there by himself, that he could get out the door,” Miller said.

The volunteer who opened the door for Miller was dismissed, Villa Teresa officials said. The home is conducting an internal investigation of the incident, said Janice Dubrosky, the facility’s interim administrator.

Earlier this year, another Villa Teresa resident died after a similar accident.

Sylvia Rodkey, 85, was injured in March when her wheelchair sailed down the driveway; she died five days later and the Dauphin County Coroner’s office ruled her death an accident. Authorities said Rodkey may have wheeled herself outside when a visitor held the door open.

After the first accident, the nursing home installed posts outside the front door to prevent a wheelchair from passing through. But Joyce Miller said at least one of the posts had been removed when her father-in-law rolled down the driveway.

Villa Teresa has been operating without a regular license for more than a year, according to the state Health Department, which licenses nursing homes. Its license has been downgraded several times since an initial May 2004 inspection; it has until Nov. 19 to correct a list of deficiencies or it will be downgraded to “provisional 4″ status, the final step before it would lose its license, Health Department spokesman Richard McGarvey said.

The state is investigating Miller’s death, McGarvey said.

I suspect this would be true in any nursing home in the country that recieves federal funding.

BURLINGTON, Vt. Vermont’s medical marijuana law is not recognized in nursing homes.

Shane Higgins, who has multiple sclerosis and is resident of the Starr Farm Nursing Center in Burlington, found that out this spring.

He is on the state’s medical marijuana registry, which theoretically allows him to legally possess and consume marijuana. But his place of residence poses a problem.

When the staff found a marijuana cigarette in Higgins’ room, they called police.

Starr Farm Nursing Center administrators say they can’t allow marijuana on the premises because the federal government doesn’t recognize Vermont’s medical marijuana law and the nursing home receives federal funding.

I’m including the entire article here, about Adult Day Care and Medicare coverage. This would be a really good thing.

U.S. Medicare to take close look at adult day care

The Medicare insurance program for the elderly and disabled soon will try out a possibly cheaper way to help people recover from health problems outside of the hospital — adult day care.

Some experts say extra services at most day-care centers — activities, socializing and on-site nurses — could also help patients recover faster and prevent costly complications that Medicare would have to pay for later.

“We’re able to pick up on the subtle changes” in patients, said Patty McCabe, a registered nurse who has worked at Holy Cross Hospital’s adult day-care center near Washington for nearly 23 years.

There are already about 3,400 adult day-care facilities across the United States, and more than 60 percent provide some health services, according to a Wake Forest University study.

Medicare currently does not cover day care for adults, though it does cover visiting nurses and medically necessary care in nursing homes.

Those who need help arranging meals, taking medicine or need other supervision can pay for day care out of their own pocket or will sometimes be covered under Medicaid, the insurance program for the poor.

Under the three-year Medicare test program, scheduled to start early next year, centers could see more demand as the population ages — especially if the U.S. Congress makes it permanent.

Medicare, which serves 43 million Americans, wants to see if treating more patients at fewer locations is more efficient — saving the government and home health-care companies money.

‘BIG IMPACT’

“Adult day care programs (and) assistant programs like that clearly have a big impact,” Medicare chief Mark McClellan said. “It seems like it would make sense to coordinate those services with acute health care.”

Under the trial, up to 15,000 elderly recovering from any ailment that requires a nurse home visit could go to a day care center instead.

That would keep some patients out of hospitals and nursing homes, two “costly settings where the outcome is not necessarily better,” Pacific Growth Equities analyst Balaji Gandhi said.

Home health agencies coordinate visiting nurse services and would receive the Medicare payments to use for their own day care center, if they own any, or to contract with an outside one.

Providers include Apria Healthcare Group Inc., NeighborCare Inc., Amedisys Inc., and Matria Healthcare Inc., among others.

Todd Lyles, head of administration for Almost Family Inc., said his home health agency lobbied Congress for the demonstration because visiting nurses “are not as efficient as they could be,” seeing only up to five or six patients a day.

“The model is very similar to the physician model that disappeared years ago. Doctors used to make a lot of house calls. But doctors don’t make house calls today because it’s not an efficient use of their time,” he said.

MANY ADULT DAY-CARE FACILITIES HAVE NURSE ON STAFF

Many adult day-care facilities already recognize the need for some medical care and have a nurse on staff.

Even more are adding medical services, said Linda Velgouse, who heads home and community-based services for the American Association of Homes and Services for the Aging. “They are doing many of the things home health care agencies are doing,” she said.

At the very least, advocates said the Medicare trial could introduce daytime care to those who may have never considered it. It could also reduce stress and improve the health of patients’ caregivers, many of whom are also Medicare beneficiaries.

The Visiting Nurse Associations of America are more skeptical. Bob Wardwell, vice president of regulatory and public affairs, said seeing more patients at one place may not actually save any money and that it may increase home health companies’ liability.

“It adds a wrinkle if we (home health firms) are paying for things we have no reasonable control over,” he said

I’m surprised this is even making news. Of course poor quality care will result in deaths and disease. Sometimes I wonder who funds these studies.

MONDAY, Aug. 15 (HealthDay News) — Older patients in declining health who receive fewer recommended tests or treatments for the conditions they suffer from are at greater risk of dying after three years than their peers who get higher quality care, a new study finds.

The researchers say their study is the first to show that broad-based “process of care” measures can be used to predict patient survival among vulnerable elderly individuals.

Put simply, when doctors provide care that’s consistent with recommended guidelines — whether it’s assessing the functional status of a dementia patient, checking the blood sugar of someone with diabetes, or administering a pneumococcal vaccine to ward off pneumonia — patients do markedly better.

“Better quality meant better outcome,” said Dr. Paul G. Shekelle, a consultant in health sciences at RAND Health and one of the study co-authors.

The report appears in the Aug. 16 issue of the Annals of Internal Medicine.

Among patients who received more recommended care, 18 percent died after three years compared with 28 percent of those who received less care, the study found.

“We were expecting to see a relationship,” said Shekelle, who is also a physician at the Greater Los Angeles VA Healthcare System, “but we were surprised at the strength of it.”

Dr. Harlan M. Krumholz, a professor of medicine, epidemiology and public health at the Yale University School of Medicine, said, “The reason an article like this is important is because, at a time when we’re spending more and more money on health care and being drawn to fancier innovations, studies like this tell us we’re not even doing the basics.”

The new results come from an ongoing project called Assessing the Care of Vulnerable Elders (ACOVE), a collaborate initiative of Rand Health and Pfizer Inc. Earlier findings showed that older patients at risk of declining health receive only a portion of recommended care and receive recommended medications only half of the time.

Read the rest of this article—>

Is it always about the money? Once they get the raises, the extra healthcare benefits, the shortened shifts are they content with their jobs? I don’t think so. No job is perfect and I think unions take advantage of this.

MILWAUKEE - Employees of seven Extendicare Nursing Homes authorized their union’s bargaining committee to call a strike on Tuesday after more than three months of negotiations.

The 500 workers are members of Service Employees International Union Local 150 and work as certified nursing assistants, housekeepers, dietary aides and laundry workers. They are seeking better health insurance, higher wages, eight-hour shifts and continuity of care for residents, the union said.

The bargaining group plans to hold more negotiations on Wednesday at the union’s Milwaukee headquarters before notifying the employer of its intention to strike if a resolution cannot be reached. Negotiations began on April 27.

The employees that voted to strike work at Sheboygan Progressive and Meadowview Manor, Mayville Nursing and Rehab, All About Life in Fond du Lac, Beloit Health and Rehab, Monroe Manor and The Willows of Sun Prairie.

A message left with an Extendicare spokesman was not immediately returned.

This probably should happen. It’s always been an option, and I have yet to see too many nursing homes not get hit by some nasty bug every fall and winter. When the residents get it, often the staff get it after too.

U.S. nursing homes must vaccinate all their patients against the flu and pneumonia starting this fall or risk being kicked out of the Medicare and Medicaid programs under a new plan made public on Friday.

The proposal, which has not yet been finalized, would ensure that the most vulnerable elderly receive their flu shots but could raise questions about how many doses will remain as Americans head into the 2005-2006 flu season with only two U.S.-approved vaccine makers.

Influenza kills about 36,000 Americans and hospitalizes 200,000 each year. People 65 and older are among the most vulnerable to the flu, especially those in the close quarters of nursing homes where germs can spread more easily.

“Vaccines against these diseases are effective in preventing hospitalizations and death,” Mark McClellan, head of the agency that runs the U.S. insurance programs for the elderly, disabled or poor, said in a statement. “However, many at-risk people are not getting the vaccines they need.”

There are between 1.6 million and 2 million residents in approximately 18,000 nursing homes, according to various U.S. government estimates.

In order to keep receiving Medicare and Medicaid payments, nursing homes would have to vaccinate each patient unless he or she or their family refused “for medical reasons,” it said.

If the Centers for Disease Control and Prevention (CDC) declares another shortage, states could have the option not to cite the violation.

Last year, officials said elderly patients should have first access to flu shots after one of two U.S. flu vaccine makers — Chiron Corp. — lost its license and could not deliver 48 million doses, which were half the anticipated supply. Despite initial confusion and long lines, the season ended with a surplus of unused vaccines.

U.S. health officials have said Chiron is making progress in fixing its problems, but it is not clear if the firm will be able to rejoin Sanofi-Aventis unit Sanofi-Pasteur on the U.S. market this year.

GlaxoSmithKline is seeking approval to sell its version of the vaccine in the United States but no decision had been announced. MedImmune Inc. makes a nasal spray vaccine.

Medicare officials said they came up with the nursing home rule after hearing from the CDC and two industry groups — the American Association of Homes and Services for the Aging and the American Health Care Association.

Only 65 percent of nursing home residents received flu shots, according to one 1999 survey. Officials said they want to raise that figure to 90 percent.

To help encourage more shots, Medicare officials in January said they would pay $18 for each vaccination on top of the cost of the actual dose, up from $8. Medicaid reimbursements vary state-to-state.

Nursing homes must also give pneumonia vaccine to patients who have never had it, officials said. Only 38 percent of elderly patients had received them, the 1999 survey found.

Medicare’s statement, dated August 11 and posted online on Friday, also said the homes should give flu shots to their workers.

The proposed rule is open for public comments for 15 days. Medicare spokeswoman Mary Kahn said she expected the final rule to be implemented soon after.

I have been to this site often and failed to put a link to it over on the side. I’m doing that now-this site has good info and news articles.

A sample:

Aug. 5, 2005 – An acid that kills nerve cells in the brain, quinolinic acid, was found in all the brains of dementia patients tested in a recent study released today, which the Australian researchers say suggests the toxin plays an important role in the progression of Alzheimer’s disease (AD), the most common form of dementia.

They say their finding is significant because it may provide evidence that could lead drug developers who are working on drugs for other conditions to investigate their use for Alzheimer’s patients to halt progression of the disease.

Current drug are only minimally effective treatments for the condition, which is increasing with the aging population.

“We found that all of the brains of dementia patients showed quinolinic acid neurotoxicity,” said Professor Bruce Brew, Director of Neurology at St Vincent’s Hospital and Professor of Medicine at the University of New South Wales (UNSW). “This acid kills nerve cells in the brain, leading to brain dysfunction and ultimately death.”

Read the rest of this article—>

More from Louisiana.

Louisiana is not enforcing federal regulations for nursing homes. Now a group has been set up to find out how to change that.

Department of Health and Hospitals Secretary Fred Cerise says about 20 people both in and out of state government, will compare Louisiana’s regulatory system to those of other states.

The latest statistics show Louisiana nursing homes are far less likely to be fined for violations than nursing homes in other Southern states, even though the state’s homes often rank at or near the bottom on key national quality indicators.

Unlike the vast majority of states, where health departments leave the job of punishing problem homes up to the federal government, Louisiana regulators typically impose their own penalties for violations.

Since 1999, at least 33 nursing home deaths have been linked to poor care. The average fine for nursing homes that caused or contributed to a resident’s death was $1,970, well below the state’s legal maximum of $10,000.

Nine deaths drew no fines or sanctions even though inspectors said the homes contributed to the fatal outcomes through significant mistakes in caring for the residents.

This sounds bizzare. Why would they question the roomate? I am going to keep track of this story as it unfolds. It will be interesting to see who killed the roomate.

A 74-year-old roommate of a slain nursing home resident is “shaken up” after being questioned by Cicero Police, her son-in-law said Tuesday.

Police interviewed the woman about the death of Mary Chrzaszcz, found dead with a plastic bag wrapped around her head Saturday afternoon at the 249-bed Alden Town Manor Rehabilitation & Health Care Center in Cicero.

Detectives told the roommate she was spotted “walking around with a plastic bag,” the son-in-law said. He also said police told her “We’ve got you on tape.”

The man doubted the existence of a security tape and said his mother-in-law was at a bingo game at the time of the murder. She’s in a wheelchair and in the early stages of Alzheimer’s disease, he said.

The man said police also visited his home several times and checked his wife’s arms for defensive wounds. He said his wife had not been to Alden Town Manor in weeks. Police also took a photo of a family friend living upstairs, the son-in-law said.

Read the rest of this article—>