Thursday, February 26, 2009

How to Prevent Falls - Senior Seminar

Aging in Place in Darien is sponsoring a special event. We're going to have an expert on fall prevention demonstrate what to do to stay steady. It's open to the public.

Safe Steps
Hands-On Ways to Prevent falls and Create a Safer Home Environment

Tuesday, March 17th, 2009

10:00 a.m. - 11:30 a.m.

Darien Town Hall Gym

2 Renshaw Road

Open to the public and free of charge!

Instructors from Nursing & Home Care, Inc. and Bayada Nurses will teach participants to assess and correct potential falling hazards in and around their own home. Participants will complete a Safe Steps Home Assessment and try balance exercises with the instructors.

Comfortable clothes and sturdy shoes are strongly encouraged!

Come for yourself, a friend, neighbor, or family member. This is important information everyone needs!

Enjoy refreshments and snacks and enter a FREE raffle for a

Sentina Rechargeable Smart-Light

R.S.V.P. Alyssa Israel, Aging in Place Coordinator, 202-2912

This program is sponsored by Aging in Place in Darien, Darien Social Services,

Nursing & Home Care and Bayada Nurses

Saturday, February 14, 2009

Sensors Help Seniors Stay Safe

The New York Times ran a fantastic article on February 13, 2009, about high tech sensors that help seniors stay safe at home. The sensors can tell if a senior has gotten out of bed, left the house, moved around in a normal pattern or taken their pills. It's helping seniors stay alive and stay at home. If something seems wrong, a center calls the senior. If the senior doesn't answer, then it calls neighbors, family and finally 911.

A permanent link to the article is below:


http://www.nytimes.com/2009/02/13/us/13senior.html?partner=permalink&exprod=permalink

Here is a copy of the article:

February 13, 2009

Sensors Help Keep the Elderly Safe, and at Home

Increasingly, many older people who live alone are not truly alone. They are being watched by a flurry of new technologies designed to enable them to live independently and avoid expensive trips to the emergency room or nursing homes.

Bertha Branch, 78, discovered the power of a system called eNeighbor when she fell to the floor of her Philadelphia apartment late one night without her emergency alert pendant and could not phone for help.

A wireless sensor under Ms. Branch’s bed detected that she had gotten up. Motion detectors in her bedroom and bathroom registered that she had not left the area in her usual pattern and relayed that information to a central monitoring system, prompting a call to her telephone to ask if she was all right. When she did not answer, that incited more calls — to a neighbor, to the building manager and finally to 911, which dispatched firefighters to break through her door. She had been on the floor less than an hour when they arrived.

Technologies like eNeighbor come with great promise of improved care at lower cost and the backing of large companies like Intel and General Electric.

But the devices, which can be expensive, remain largely unproven and are not usually covered by the government or private insurance plans. Doctors are not trained to treat patients using remote data and have no mechanism to be paid for doing so. And like all technologies, the devices — including motion sensors, pill compliance detectors and wireless devices that transmit data on blood pressure, weight, oxygen and glucose levels — may have unintended consequences, substituting electronic measurements for face-to-face contact with doctors, nurses and family members.

Ms. Branch, who has severe diabetes and heart disease, said she could not live on her own without the system, built by a Minnesota company called Healthsense.

“I lost a very close friend recently,” she said. “She was also diabetic and she fell during the night. She didn’t have the sensors. She went into a coma.”

Without the sensors, Ms. Branch said, “I would probably be dead.”

Stories like Ms. Branch’s show the potential of relatively simple devices to provide comfort and independence to an aging population that is quickly outgrowing the resources of doctors, nurses, hospitals and health care dollars available to it.

The cost for Ms. Branch’s basic system, supplied by a health care provider called New Courtland as part of a publicly financed program, is about $100 a month, far less than a nursing home, where the costs to taxpayers can exceed $200 a day. In the two years Mrs. Branch has had the system, she has fallen three times and been stuck once in the bathtub, each time unable to call for help without it.

“On an individual basis, we’ve demonstrated that they can be very effective,” said Brent Ridge, an assistant professor of geriatrics at Mount Sinai School of Medicine in New York. “But until they’re launched on a wide-scale basis, you just don’t know. Physicians might say, ‘I’m already overstretched, I don’t have time for all this data.’ ”

At a white ranch-style house in Middletown, N.J., Joseph Hayduk, 86, a retired Air Force lieutenant colonel, is greeted by a voice from a small box: “Good morning. It is now time to record your vital signs.” Mr. Hayduk has been using the device since 2006, after his second heart attack, through a program run by Meridian Health.

He stepped on a scale. “Are you experiencing more difficulty breathing today, compared to a usual day?” the voice asked. Mr. Hayduk pressed yes.

“That’s normal for me,” he said.

“Are your ankles more swollen than usual?” the machine asked. In patients with chronic heart failure, swelling or weight gain can indicate that they are retaining fluid. Mr. Hayduk pressed no. After a blood pressure reading, the device signaled that it had relayed the information to Meridian Health.

There, a nurse calls all 18 patients in the program daily, starting with the ones whose data call for urgent attention. One morning, Mr. Hayduk left the house before the nurse’s call. As he sat on his neighbor’s porch, he watched a police car pull up to his house to check on him.

Mr. Hayduk chuckled at the memory, but said that the system had allowed him to stay in his home of 37 years.

“This system’s invaluable to me, not only physically, but psychologically,” he said. “I don’t want to be in assisted living. That’s for people in wheelchairs and walkers.”

Philip Marshall, 85, another Meridian Health patient, uses a system tied to his cellphone to help him remember his medications. Mr. Marshall has high blood pressure and macular degeneration, and takes 10 pills a day. He cannot see a clock or work the buttons on most phones, so he uses a Jitterbug, a phone with big buttons and limited functions.

Drug compliance is one of the biggest problems for the elderly, especially those with memory loss. Until Mr. Marshall got Meridian’s Jitterbug system, his daughter Melanie, 55, said she had to leave work several times a month to help him with his drugs. “I’m answering the phone in meetings,” she said. “He’d forget whether he took a pill or whether he was supposed to take a pill.”

The system, which costs $20 a month, calls him after he is scheduled to take a pill and asks if he has taken it; if not, it asks him why not and sends automated alerts to his daughters.

“I worry a lot,” Mr. Marshall said. “All my life. So this gives me peace of mind.”

He added that knowing that a call was coming had helped him remember to take his medications before the phone rang.

This is the ultimate goal of personal health monitoring — that people who know they are being watched may modify their behavior to better their health. Jeffrey Kaye, director of the aging and Alzheimer’s and memory assessment clinics at Oregon Health and Science University, said one of the most useful health technologies was a cheap pedometer, because carrying one motivated people to walk more.

But Stuti Dang, who directs dementia care for the Miami Veterans Affairs Healthcare System and uses monitoring systems to track the vital signs of 400 patients, said one unforeseen consequence of the system was that “it somehow absolves their kin of the responsibility.”

“The daughter doesn’t have to call every day because she knows if something was wrong with her father, she would receive an alert,” Dr. Dang said, adding: “It’s good for the patient, but there needs to be personal responsibility. As a provider, I don’t want to be responsible for my patient 24 hours a day.”

Raymond Carroll, 59, a retired school administrator, said he went online every day to check on his mother, Viola Carroll, 85, who lives in a building in Queens run by Selfhelp, a nonprofit organization that assists Holocaust survivors. Mr. Carroll checks the temperature of her apartment and calls if it is too hot. Since a system of motion detectors called Quiet Care was installed three years ago, on a grant from Selfhelp, he said he probably called more often but visited less.

Marvin Joss, whose mother, Ray, 89, is also in a Selfhelp building, said the system had helped improve their conversations. “In the past, I tried to spend more time on, ‘How are you feeling?’ ” Mr. Joss said. “I still ask those questions, but now it’s more to an idea of having a conversation, not trying to listen for clues about whether she’s O.K. ”

The future of these technologies, and the terabytes they gather, can involve unprecedented information about the whereabouts and well-being of older people. In a program with Intel, Dr. Kaye is combing motion data for patterns that indicate the onset of dementia, years before the decline shows up on cognitive tests.

But until there is more research — and reimbursement — the technologies’ ultimate impact remains unknown.

“It’s not that we need new technologies,” Dr. Kaye said. “We need to use what we have more creatively. It’s all cool — but is it going to be helpful?”

Friday, February 06, 2009

Don't Be Stubborn

You've heard of penny wise and pound foolish? Well, this person deserves a posthumous Darwin Award. The man had $600,000 saved up and refused to pay his electricity bills. His electricity was restricted, and he froze to death. (see AP article pasted below)

The Town of Darien has a fuel bank that enables seniors with little income or cash flow to get fuel oil to heat their homes at reduced rates. People donate to the fund. (see Town of Darien Social Services -- www.darienct.gov.) I believe our local utilities can help people out, too. The 93-year-old man who froze obviously didn't need money, he just was stubborn about paying bills.

I knew another adult in her 70s who didn't pay the utility or the fuel oil or the telephone company and had all three shut off. She had money, too. Go figure....

The moral of the story is -- don't be stubborn about paying bills.

link to story: http://news.yahoo.com/s/ap/20090205/ap_on_re_us/frozen_indoors

BAY CITY, Mich. – An attorney says a 93-year-old Michigan man who froze to death after a power company restricted electricity to his home over roughly $1,000 in unpaid bills left an estimated $600,000 to a hospital.

Marvin Schur's attorney, Cathy Reder, told the Detroit Free Press the World War II veteran bequeathed his entire fortune to Bay Medical Center.

Schur's frozen body was found Jan. 17, four days after Bay City Electric Light & Power installed a device on his electric meter that cuts power after a predetermined level is reached.

State regulators on Wednesday issued emergency rules designed to protect more people against electricity or heat shutoffs in the winter.

Wednesday, February 04, 2009

How to Name a Senior Service

I'm part of a Google Group that discusses the organizations that are starting up all over the country which were inspired by the Beacon Hill Village model. Recently, I got into a discussion about what to name such organizations. Do you offend people with names like Old, Village, Aging, Senior, Elderly, etc.? I posted a response in the group, and I post it here, too.

I've been dealing with this issue since 1975. Even in the mid-1970s, adults over 65 did not want to be called "older" or "senior" or "elderly". Yet, this same group wants perks for their age, like free checking accounts or discount movies. I know this because I was doing market research on "elderly" bank customers as a class project when I was at Wharton in Philadelphia. I've come to the conclusion that you truly can't please all the people all the time. If someone really needs the services, they won't care what the service is called. Plus people love to complain.

Norwalk Community College (Norwalk, CT) runs a special set of courses for people over 60. It's called Lifetime Learners Institute. It's popular and vibrant. They say up front that it's for people 60+. Stating an age may be the easiest way to communicate who your target audience is. My father-in-law used to be proud of belonging to the "Old Guard." "Adult" could connote "sex" as in adult videos. Any word you choose could have something wrong with it.

I'm on the board of Aging in Place in Darien. We discussed our name a lot and finally decided to just go with our descriptive title. Our town has a Senior Center and a Senior Men's Group that are popular. People who are offended by the names are missing out on great programs. Eventually, they hear of the true value via word of mouth.

Wyn Lydecker
Founding member of Aging in Place in Darien

Tuesday, February 03, 2009

Osteoporosis Drugs Can Harm Your Jaw

From the University of Southern California Chronicle:

http://www.usc.edu/uscnews/stories/16118

Data Links Drugs to Jaw Necrosis Risk

01/05/09
USC School of Dentistry study is among the first to acknowledge correlation between the common medications and jawbone death.
By Beth Dunham
Principal investigator Parish Sedghizadeh

Photo/Philip Channing
Even short-term use of common oral osteoporosis drugs may leave the jaw vulnerable to devastating necrosis, according to a USC School of Dentistry study appearing in the Jan. 1 Journal of the American Dental Association.

This is the first large institutional study in the United States to investigate the relationship between oral bisphosphonate use and jaw bone death, said principal investigator Parish Sedghizadeh, assistant professor of clinical dentistry at the USC School of Dentistry.

After controlling for referral bias, nine of 208 healthy School of Dentistry patients who take or have taken Fosamax for any length of time were diagnosed with osteonecrosis of the jaw (ONJ). The study’s results are in contrast to drug makers’ prior assertions that bisphosphonate-related ONJ risk is only noticeable with intravenous use of the drugs, not oral usage, Sedghizadeh said.

“We’ve been told that the risk with oral bisphosphonates is negligible, but four percent is not negligible,” he said.

Most doctors who have prescribed bisphosphonates have not told patients about any oral health risks associated with the use of the drugs, despite even short-term usage posing a risk due to the drug’s tenacious 10-year half-life in bone tissue.

Lydia Macwilliams of Los Angeles said no one told her about the risk posed by her three years of Fosamax usage until she became a patient of Sedghizadeh at the School of Dentistry.

“I was surprised,” she said. “My doctor who prescribed the Fosamax didn’t tell me about any possible problems with my teeth.”

Macwilliams was especially at risk for complications because she was to have three teeth extracted. The infection is a biofilm bacterial process, meaning that the bacteria infecting the mouth and jaw tissues reside within a slimy matrix that protects the bacteria from many conventional antibiotic treatments, and bisphosphonate use may make the infection more aggressive in adhering to the jaw, Sedghizadeh said. The danger is especially pronounced with procedures that directly expose the jaw bone, such as tooth extractions and other oral surgery.

After her extractions, two of the three extraction sites had difficulty healing due to infection, Macwilliams said. Luckily, with treatment as well as the rigorous oral hygiene regimen that USC dentists developed especially for patients with a history of bisphosphonate usage, the remaining sites slowly but fully healed.

“It took about a year to heal,” she said, “but it’s doing just fine now.”

Sedghizadeh hopes to have other researchers confirm his findings and thus encourage more doctors and dentists to talk with patients about the oral health risks associated with the widely used drugs. The results confirm the suspicions of many in the oral health field, he said.

“Here at the School of Dentistry, we’re getting two or three new patients a week that have bisphosphonate-related ONJ,” he said, “and I know we’re not the only ones seeing it.”