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Can a smell test help identify dementia risk?

Dementia is a devastating, life-altering illness that leads to memory loss and decline of mental abilities over time. What makes dementia even more challenging to deal with is its difficulty to diagnose. However, researchers are now hopeful that a simple smell test could soon have the potential to identify individuals at high risk of the disease.

University of Chicago scientists studied almost 3,000 adults between the ages of 57 and 85 with normal brain function. They were asked to complete a smell test that involved sniffing five different scents: fish, leather, orange, peppermint and rose. The participants were interviewed again five years later to find out if they had been diagnosed with dementia.

All the people who were unable to detect any odors had dementia, as well as 80 percent of those who had only identified one or two smells. Overall, participants who were unable to identify a minimum of four smells had twice the likelihood of having dementia in five years.

The results point to a possible link between a decline in sense of smell and a dementia diagnosis. Surgery professor and lead study author Jayant M. Pinto said, “These results indicate that the sense of smell is closely connected with brain function and health.” He explained that losing one’s ability to smell strongly indicates “significant damage” to the brain.

Pinto and his team said their findings may help lead to the development of a quick, inexpensive test that could identify individuals who are at high risk of dementia. However, more research needs to be done until the test can be used in a clinical setting for screening and diagnostic purposes.

According to the Alzheimer’s Association, currently no single test exists that can accurately detect Alzheimer’s, which is a common form of dementia. MRI scans, currently a common test for Alzheimer’s, are not affordable for every patient as they cost thousands of dollars.

Advising Clients About Hospitalization and Operations

Recently, in the Trust and Estate Magazine, Myra Gilfix wrote a featured article titled “Advising Clients About Hospitalization and Operations.” In this article, Gilfix discusses how families can be advocates for themselves and for senior family members. In the article Gilfix stresses that a patient advocate is a crucial part of elder care.

Elder law attorneys help clients make decisions about end-of-life care through living wills or advance healthcare directives. Elder law lawyers can help their clients express their wishes regarding artificial life-prolonging care, artificially administered food and water, and comfort care if they can no longer make their own decisions in an event of an illness. Gilfix strongly encourages family members to talk to friends, other family members and medical providers about their wishes and feelings regarding end-of-life care.

Patient advocates or proxies, are those named in documents describing the medical care decisions or advance directives. The proxy can even be effective if the client is not debilitated or absent. Noted geriatrician, Dr. Mark Lachs, says, “. . . I firmly believe that there is no health-care venue where laypeople — patients, families, concerned friends and neighbors — can have a greater impact on improving outcomes of care.”

Elder care lawyers are positioned to offer information and help when a loved family member may be hospitalized. While not offering legal advice, an elder care attorney is able to encourage a client to name who they feel is the foremost person(s) to help them while they are in hospital. “Sometimes,” says Gilfix, “it takes a village.” Family, friends, a church group or even a professional advocate are the best support system and resource for seniors facing hospitalization. Patient advocates are in the unique position to help with communications with doctors and nurses, keep track of numerous medical staff, make sure a patient is comfortable and is recovering.

Elder law lawyers can easily add patient advocate to their existing role of assisting seniors, making attorneys more proactive in offering practical, fact-based advice and information for all family members.

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Recognizing signs of elder abuse through a forensic lens

Elder abuse in nursing homes can take many forms. While some signs of elder abuse such as physical injuries may be obvious, others may be harder to detect. Some elderly patients may be suffering verbal abuse or financial exploitation, which are harder to recognize.

Advocates for elder safety have long been looking for new ways to both identify and prevent nursing home neglect. A recent clinical study encourages health care professionals to adopt a “forensic lens” approach “inspired by law enforcement to better identify and address cases of elder abuse.” The technique can help first responders, doctors and others not trained in law enforcement to determine whether neglect could have occurred.

Researchers from the USC Leonard Davis School of Gerontology examined two cases of suspected elder abuse in caregiving situations. On the surface, both cases appeared to be similar. However, it was only after viewing them through a forensic lens methodology that they could decide whether mistreatment had actually taken place.

“The ‘forensic lens’ is intended to help investigators evaluate the entire clinical, social and legal scenario when determining the cause of elder mistreatment,” commented Marti DeLiema, the study’s lead author. “Physicians and other health care providers can be trained for what to look for; just as a detective looks for clues in a crime scene, physicians can look for clues in a patient’s body and behavior.”

The two cases used in-home observations, detailed documentation of the patients’ conditions and non-accusatory caregiver interviews to determine whether intentional elder neglect had taken place. DeLiema admitted that careful investigation is likely to be challenging for busy health care professionals who are pressed for time. However, a growing number of hospitals are adopting policies to improve patient documentation which can serve as key evidence in elder abuse cases.

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Lawsuit highlights dangers of nursing home abuse and neglect

Nursing homes and senior care facilities exist to meet the needs of families that are no longer able to care for their elderly loved ones. While nursing homes provide a necessary service, they also raise concerns about elder abuse and the quality of care given to patients.

A care facility in Napa, California, was recently sued for elder abuse and neglect after the death of one of its elderly patients. Jeanne Roney, 91, died nine days after she was diagnosed with scabies. She had been admitted into Golden Living Center in 2011 after having a stroke.

Her daughter, Tammy Cook, claimed the facility’s negligence caused her mother’s death. According to the lawsuit, Roney suffered several falls, dehydration, malnutrition and multiple urinary tract infections while living there. Her condition was so poor that Queen of the Valley Hospital complained to the California Department of Public Health about the case.

Cook argued that Golden Living Center was understaffed, employed underqualified individuals and did not provide enough training in an effort to save money. Nursing homes are required to hire staff who are properly trained to provide assistance with daily activities and medication to the patients who rely on them.

There are a number of telltale signs of elder abuse. Unusual and excessive injuries may be red flags that an elderly individual is suffering neglect and not being cared for properly. Many times elder abuse slips through the cracks and goes unnoticed. If you suspect abuse, it is important to speak up and report it immediately for your loved one’s sake.

The attorneys at Gilfix and La Poll are skilled at helping families handle issues related to elder care and elder abuse.

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Mark Gilfix Article on Technology Innovation and Long Term Care in The Elder Law Report

Mark Gilfix has been keeping a close eye on innovation in the long term care space, and recently attended the Aging 2.0 “Optimize” Summit in San Francisco. He wrote an article sharing his insights with the The Elder Law Report, one of the top national publications for attorneys in the field. While at the Summit, he discovered many innovative and new start-up companies that were poised to assist seniors now and in the future. With technology moving as fast as it is, many of the offerings at Aging 2.0 “Optimize” are the next generation of assisted living concepts designed specifically for seniors.

One company that stood out at the Summit was Akili Interactive Labs – Cognitive Enhancement Video Games – developers of several video games focusing on cognitive enhancement with the ability to help heal the minds of those who face cognitive decline. The possibility also exists that these carefully crafted games may slow or halt memory decline for those with mild dementia.

Dr. Adam Gazzaley, a prominent neuroscientist from the University of San Francisco, demonstrated how the games could assist in helping those in their 80s to be as proficient and efficient as those in their 20s. This would be a powerhouse tool for the users and their families.

Some other companies that stood out to Gilfix:

Rendever – Virtual Reality in Elder Care – offers those who receive care and those who provide it with the ability to partake in cognitive stimulation that allows them to go anywhere – such as back to visit their childhood home or travel to a favorite place or country. Studies have shown that virtual trips greatly enhance the overall well-being of the participant. Software like this has the potential to be a game changer in improving the lives of geographically and socially isolated clients.

Silvernest – Vetted Roommate Matching Service for Seniors may also be revolutionary for older adults who have space in their home, would like to make extra income and wish to have a roommate or a companion. Silvernest offers a safer approach than advertising on the open market. The company does background checks, helps facilitate monthly payments and uses a special algorithm to help find suitable matches. A roommate or a companion could well help a senior renter improve the quality of their life.

Other Notable Innovations in Development

In the home-sensor field:

  • Stack Care – light-bulbs containing radar-based sensor technology capable of tracking falls and other changes in a senior’s daily activities
  • Echo Care Technologies – non-wearable system capable of detecting falls and other issues
  • UnaliWear – classic-style watch with the ability to respond to voice commands, track movements and provide other assistance as necessary

To read more about other new innovations download the full article here.

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