Geriatrics Commons^™

Coping Tips For Caregivers

CenterPieces

Educate yourself about the disease your family member is facing and how it may affect his or her behavior, pain level or quality of life.

Find sources of help for caregiver tasks. Contact family, friends, neighbors, church/synagogue, workplace, Area Agency on Aging or other organizations.

Protect your personal time for something you enjoy or something you need to get done.

Helping Caregivers To Cope

CenterPieces

When Deb Lacktman promised her dying father that she would care for her mother, Margaret Rimato, after he passed, she wasn’t prepared for the challenges to come. Shortly after he passed, Margaret became increasingly forgetful and delusional. Deb attributed her mother’s memory loss to the stress of losing her husband. With time, however, Margaret’s condition worsened and she was diagnosed with Alzheimer’s disease.

As the primary caregiver of a parent with Alzheimer’s, Deb dealt with various complications beyond the memory loss. Her mother continually roamed the house in the middle of the night, for no apparent reason. It turned out …

Speaking With Barry Rovner, Md

CenterPieces

Q: What Alzheimer’s related studies are you involved in currently at the Farber Institute for Neurosciences?

Dr. Rovner: We are evaluating three exciting new disease-modifying drug treatments that may slow down the course of Alzheimer’s disease. I am also a Principal Investigator of Jefferson’s Center for Excellence in Neurodegenerative Diseases funded by the Pennsylvania Department of Health Tobacco Settlement grant. We are testing innovative screening methods to identify dementia in community-based agencies serving older adults, as well as testing in-home skills training services to delay nursing home placement and reduce stress for a racially diverse group of family caregivers. This …

Message From Dr. Laura Gitlin, Director Of Carah, Laura N. Gitlin

CenterPieces

Welcome to the second issue of CenterPieces, the newsletter of the Center for Applied Research on Aging and Health. We dedicate this issue to the topic of dementia and family caregiving, a critical public health issue. There are 26 million individuals with dementia worldwide, and approximately 5 million individuals with the diagnosis in the US. This number may exceed 16 million in 2050.

For the past 15 years, CARAH has been in the forefront of developing and testing innovative approaches to supporting families in their heroic care efforts and enhancing the quality of life of affected individuals. CARAH’s current research …

Blanche Dubois Geriatrics, Edward F. Ansello

Director's Editorials from Age in Action

While the numbers of older adults are growing and the leading edge of the Baby Boom is in its 60s, aging-related education, service, and practice are far from burgeoning. We look forward to continuing Virginia's Geriatric Training and Education program, which produces geriatrically or gerontologically trained physicians, nurses, pharmacists, therapists, recreators, and social workers.

My Passage To India, Edward F. Ansello

Director's Editorials from Age in Action

Different cultures select different "colors" from the curriculum palette in painting the experience of aging as they see it. Aging is a construct, experienced amid and influenced by the norms, limitations, expectations, and horizons around us.

Sold A Bill Of Goods, Edward F. Ansello

Director's Editorials from Age in Action

With regard to Boomers, elders, and all of us growing older, we have been sold a bill of goods in America. Rather than independence, assisted autonomy is a means to empowerment and inclusion. Additionally, as we grow older, we grow less like our age mates, and dissimilarity and heterogeneity increases.

Awaken The Sleeping Giant, Edward F. Ansello

Director's Editorials from Age in Action

In order to maintain our commitment to quality, we in the Aging Network need to invest in the future despite the monetary problems of the present. In Virginia, older Virginians are a remarkable resource for our future.

Virginia's Money Follows The Person Demonstration, Jason A. Rachel, Karen Lawson

Case Studies from Age in Action

Educational Objectives

1. Describe Virginia's Money Follows the Person Demonstration project, including the new services available to individuals through Virginia's Medicaid-funded home and community-based waiver program.

2. Explain how Virginia's Money Follows the Person Demonstration project, being administered by the Virginia Department of Medical Assistance Services (DMAS), would assist an individual in transitioning from a long-term care facility to the community.

3. Illustrate how someone might experience the MFP processes from pre-transition through post-transition.

The Older Inmate, Tara Livengood

Case Studies from Age in Action

Educational Objectives

1. Present a general overview of elderly inmates, including statistics, characteristics, crimes, mental and medical illnesses, and disabilities.

2. Describe Virginia’s only geriatric correctional facility.

3. Explain the practice of release planning, focusing especially on geriatric release.

Sleep And Sleep Disorders In Later Life, Robert D. Vorona

Case Studies from Age in Action

Educational Objectives

1. Describe basic changes in sleep that occur as we age.

2. Review several important sleep disorders common in later life

3. Discuss treatment modalities for these sleep disorders and potential benefits of therapy.

Activity Engagement For Persons With Dementia, Barbara Braddock, Ellen Phipps

Case Studies from Age in Action

Educational Objectives

1. Describe a successful approach to activity engagement for persons with dementia.

2. Review three cognitive interventions useful for activity engagement for persons with dementia.

3. Discuss applications of this approach using university students in home visits.

Administrators’ Perceptions Of Medication Management In Assisted Living Facilities: Results From Focus Groups, Priscilla T. Ryder, Melanie Joseph, Marnie Zuckermann, Ilene H. Zuckermann

Scholarship and Professional Work – COPHS

Objective: Assisted living (AL) residents are vulnerable to adverse events as a result of using numerous medications and frequently need assistance in administering medications. Very little is known, however, about the ways in which medications are managed within this level of care. Design: AL administrators from the metropolitan Baltimore, Maryland area were invited to participate in focus groups to explore issues involved in medication management.

Setting and Participants: Four administrators from smaller (15 beds or fewer) and six larger (more than 15 beds) certified AL facilities serving primarily older residents participated. Administrators must have served in their position at least …

Association Of Antipsychotic Use With Hospital Events And Mortality Among Medicare Beneficiaries Residing In Long-Term Care Facilities, Linda Simoni-Wastila, Priscilla T. Ryder, Jingjing Qian, Ilene H. Zuckermann, Thomas Shaffer, Lirong Zhao

Scholarship and Professional Work – COPHS

Objective—Antipsychotic (AP) utilization has grown significantly in long-term care (LTC) settings. Although a growing literature associates AP use with higher mortality in elderly with dementia, the association of APs with hospital events is unclear. The authors examine prevalence and trends in AP use by Medicare beneficiaries residing in LTC and the association of APs and other drug use variables with hospital events and mortality.

Design—Retrospective analysis using sequential multivariate Cox proportional hazards models.

Setting—Medicare Current Beneficiary Survey linked to Institutional Drug Administration and Minimum Data Set files.

Participants—A total of 2,363 LTC Medicare beneficiaries, 1999–2002. Measurements—Trends in LTC AP use …

Lymphomatoid Granulomatosis Masquerading As Interstitial Pneumonia In A 66-Year-Old Man: A Case Report And Review Of Literature, Ashima Makol, Kalyan Kosuri, Deimante Tamkus, Wanderley De M Calaca, Howard T. Chang

Wayne State University Associated BioMed Central Scholarship

Abstract

Lymphomatoid granulomatosis (LG) is a rare, Epstein-Barr virus (EBV)-associated systemic angiodestructive lymphoproliferative disorder that may progress to a diffuse large B cell lymphoma. Pulmonary involvement may mimic other more common lung pathologies including pneumonias. Therapeutic standards have not been established for LG, but rituximab, interferon-α2b (INF-α2b), and chemotherapy have shown to improve symptoms and long term prognosis.

We report a case of rapid respiratory deterioration in a 66-year-old man with clinical presentation, chest radiography, pulmonary function testing and high resolution computed tomography (HRCT) findings consistent with idiopathic interstitial pneumonia, but very poor response to antibiotics and low dose steroids. …

Congregate Mealsite Participants’ Self-Reported And Functional Health, Participation In Activities And Attitudes Toward Aging In Wisconsin, Amy Ramsey

Master's Theses and Doctoral Dissertations

The number of older Americans is increasing. Participation in activities is essential for maintaining health and functional independence, preventing or delaying chronic diseases and improving quality of life. Generally, as older adults age, prevalence of regular activity declines. Many older adults are not engaging in activities and are not receiving the health benefits that these offer.

This cross-sectional study used a self-administered survey to examine whether there is an association between attitudes toward aging, self-reported and functional health, and participation in activities among older adults aged 55 and older who attend congregate mealsites in Wisconsin. It was hypothesized that older …

Llmhs Elderly Services Outreach Program: Lincoln, Lyon & Murray Human Services, Jamie Olson

All Graduate Theses, Dissertations, and Other Capstone Projects

Right now there is a lack of professional and community knowledge regarding the services LLMHS provides to those over age 65. Thus, there are elderly who are in need of help who are not getting connected to a county long term care social worker. The elderly may need help to simply get connected to resources, have questions answered, correct misconceptions about long term care, get recommendations, or assistance paying for home and community based services. There are also many providers and professionals with questions about what LLMHS does and does not do as well as what the assistance programs can …

White Paper: Walking Speed: The Sixth Vital Sign, Stacy Fritz, Michelle M. Lusardi

All PTHMS Faculty Publications

Walking speed is "almost the perfect measure." This review summarizes the strong psychometric properties of walking speed and robust evidence for using this clinical measurement. Walking speed is easily measurable, clinically interpretable, and a potentially modifiable risk factor. For these reasons, using WS as the sixth vital sign is both pragmatic and essential.

In Step With Our Parents: 3-Part Educational Series, Kate Boisen-Macdonald

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this project is to educate adult children caring for their parents, so they can identify as caregivers so they can better cope with, identify with, and/or navigate the role of care giving, and be aware of the resources available to them.

Knowledge Of Pain Management In Older Adults As A Content Area For Continuing Professional Education For Licensed Nurses, Wanda Cleveland Dubuisson

Dissertations

The research of the last 30 years has revealed the inadequacy of pain management in the older adult. Although evidenced-based clinical practice guidelines exist to direct the management of pain in the older adult, health care providers are either unaware or lack the proper understanding of the guidelines. This study investigated the differences in knowledge of pain management in older adults when examining licensed acute care nurses and extended care nurses. It sampled 118 acute care nurses working in two hospitals in Mississippi and 78 extended care nurses working in six extended care facilities (ECF) in Mississippi.

Based upon the …

Intracerebral Hemorrhage For The Palliative Care Provider: What You Need To Know., B Brent Simmons, Susan M Parks

Department of Family & Community Medicine Faculty Papers

Intracerebral hemorrhage (ICH) makes up 10%-30% of all strokes. Palliative care providers are often asked to get involved with ICH cases to aid with development of short-term and long-term goals. Prognosis can be calculated using the ICH score (based on Glasgow Coma Score score, ICH volume, presence of intraventricular hemorrhage, age, and location of origin) or the Essen score (based on age, NIH Stroke Scale [NIHSS], and level of consciousness). Do-not-resuscitate (DNR) status is important to discuss with families. Expert consensus states DNR is appropriate if the patient has two of the following: severe stroke, life-threatening brain damage, or significant …

Focus On Rna Isolation: Obtaining Rna For Microrna (Mirna) Expression Profiling Analyses Of Neural Tissue, Wang-Xia Wang, Bernard R. Wilfred, Donald A. Baldwin, R. Benjamin Isett, Na Ren, Arnold J. Stromberg, Peter T. Nelson

Sanders-Brown Center on Aging Faculty Publications

MicroRNAs (miRNAs) are present in all known plant and animal tissues and appear to be somewhat concentrated in the mammalian nervous system. Many different miRNA expression profiling platforms have been described. However, relatively little research has been published to establish the importance of 'upstream' variables in RNA isolation for neural miRNA expression profiling. We tested whether apparent changes in miRNA expression profiles may be associated with tissue processing, RNA isolation techniques, or different cell types in the sample. RNA isolation was performed on a single brain sample using eight different RNA isolation methods, and results were correlated using a conventional …

Focal Cerebral Ischemia In The Tnfalpha-Transgenic Rat, L. Creed Pettigrew, Mark S. Kindy, Stephen W. Scheff, Joe E. Springer, Richard J. Kryscio, Yizhao Li, David S. Grass

Sanders-Brown Center on Aging Faculty Publications

BACKGROUND: To determine if chronic elevation of the inflammatory cytokine, tumor necrosis factor-alpha (TNFalpha), will affect infarct volume or cortical perfusion after focal cerebral ischemia.

METHODS: Transgenic (TNFalpha-Tg) rats overexpressing the murine TNFalpha gene in brain were prepared by injection of mouse DNA into rat oocytes. Brain levels of TNFalpha mRNA and protein were measured and compared between TNFalpha-Tg and non-transgenic (non-Tg) littermates. Mean infarct volume was calculated 24 hours or 7 days after one hour of reversible middle cerebral artery occlusion (MCAO). Cortical perfusion was monitored by laser-Doppler flowmetry (LDF) during MCAO. Cortical vascular density was quantified by stereology. …

Living With Alzheimer’S Disease: A Study Of Adult Day Health Services In Massachusetts, Nina M. Silverstein, Cathy M. Wong, Kristen E. Brueck

Gerontology Institute Publications

The role of adult day health care (ADHC) is gaining increased attention as the nation prepares for the large cohort of baby boomers entering their later years. Many boomers are aging with physical and cognitive impairments, including Alzheimer's disease and related dementias. Projections indicate that Massachusetts, along with the nation as a whole, is experiencing an increasing rate of older persons as baby boomers enter late-life. The Commonwealth can expect that persons with Alzheimer's disease and their care partners will need community-based services that are specifically designed for adults with cognitive impairments. However, a report by the Robert Wood Johnson …

Response Of Endothelial Cells To Stressors: The Impact Of Aging And Diabetes, Katie Mclellan

Loma Linda University Electronic Theses, Dissertations & Projects

Preliminary research indicates there is some impairment of the endothelial cells to respond to single stressors such as local heat, shear stress, and global heat in older people and people who have diabetes. The response of the skin blood flow to local heat is an indicator of the endothelial cells ability to cope with stress. In addition, factors such as thicker subcutaneous fat and skin moisture may impair the skin’s ability to dissipate heat. For older people and people with diabetes, this endothelial dysfunction may cause an even more diminished response to multiple stressors. However, no studies have examined the …

A New Age In Dementia Care: Turning Evidence Into Practice

Center for Applied Research on Aging and Health Conferences

A New Age in Dementia Care: Turning Evidence into Practice Come celebrate the opening of the new Living Laboratory for Elder Care.

September 17, 2008 7:30 am - 4:30 pm Thomas Jefferson University, Dorrance H. Hamilton Building 1001 Locust St., Philadelphia, PA 19107

Speakers Include:
Christine Arenson, MD Associate Professor Director, Division of Geriatric Medicine Department of Family and Community Medicine Jefferson Medical College Director, Eastern-Pennsylvania Delaware Geriatric Education Center Co-Director Jefferson InterProfessional Education Center Thomas Jefferson University

Louis D. Burgio, PhD Harold R. Johnson Endowed Chair in Gerontology, Professor of Social Work Research Professor, Institute of Gerontology School …

The Aging Services Network: Accomplishments And Challenges In Serving A Growing Elderly Population, Carol O'Shaughnessy

National Health Policy Forum

In 1965, Congress enacted the Older Americans Act, establishing a federal agency and state agencies to address the social services needs of the aging population. The mission of the Older Americans Act is broad: to help older people maintain maximum independence in their homes and communities and to promote a continuum of care for the vulnerable elderly. In successive amendments, the Act created area agencies on aging and a host of service programs. The “aging services network,” broadly described, refers to the agencies, programs, and activities that are sponsored by the Older Americans Act. The Act’s funding for services is …

The Expression Of Microrna Mir-107 Decreases Early In Alzheimer's Disease And May Accelerate Disease Progression Through Regulation Of Β-Site Amyloid Precursor Protein-Cleaving Enzyme 1, Wang-Xia Wang, Bernard W. Rajeev, Arnold J. Stromberg, Na Ren, Guiliang Tang, Qingwei Huang, Isidore Rigoutsos, Peter T. Nelson

Sanders-Brown Center on Aging Faculty Publications

MicroRNAs (miRNAs) are small regulatory RNAs that participate in posttranscriptional gene regulation in a sequence-specific manner. However, little is understood about the role(s) of miRNAs in Alzheimer's disease (AD). We used miRNA expression microarrays on RNA extracted from human brain tissue from the University of Kentucky Alzheimer's Disease Center Brain Bank with near-optimal clinicopathological correlation. Cases were separated into four groups: elderly nondemented with negligible AD-type pathology, nondemented with incipient AD pathology, mild cognitive impairment (MCI) with moderate AD pathology, and AD. Among the AD-related miRNA expression changes, miR-107 was exceptional because miR-107 levels decreased significantly even in patients with …

It's About The People, Edward F. Ansello

Director's Editorials from Age in Action

The Virginia Center on Aging celebrates 30 years and the people who have made accomplishments possible.

Geriatric Training And Education (Gte) Projects, Edward F. Ansello

Director's Editorials from Age in Action

The Geriatric Training and Education (GTE) initiative is supporting 15 different projects in the current fiscal year that are affecting Virginians in each region, from certified nursing assistants to family caregivers of relatives with dementia to long-term care staff helping elders at the end of life.