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Report warns of rising Alzheimer’s costs and their impact on families

The rising number of Alzheimer’s cases and their accompanying costs are taking a toll on caregivers and society at large. A new Alzheimer’s Association report published last March makes some worrying projections about the cost of the disease.

The population of elderly Americans with Alzheimer’s is expected to increase 29 percent from the current 5.5 million to 7.1 million by 2025. Without any headway on effective treatments by then, the number will likely skyrocket to 13.8 million people in 2050.

The report’s authors pointed out that family caregivers shoulder most of the responsibility when it comes to looking after Alzheimer’s patients. As a result, there is likely to be negative impact on their emotional, physical and financial wellbeing, the Alzheimer’s Association said in a statement.

Last year over 16 million people spent 18.4 billion hours providing unpaid care to Alzheimer’s patients. Families assume 70 percent of the lifetime cost of their care, which totaled $329,360 per patient in 2017.

The report warned of the “growing cost and impact of Alzheimer’s on the nation’s health care system.” Its authors emphasized that society would benefit greatly from the early diagnosis of Alzheimer’s disease as it would reduce long-term care costs.

The caregiving expenses for individuals with Alzheimer’s and other forms of dementia are estimated to be $277 billion this year, not including unpaid caregiving. The amount includes Medicaid and Medicare, along with out-of-pocket expenses mostly for nursing homes and private insurance.

“The need for reliable and creative approaches to pay for the devastating cost of home care and nursing home care is overwhelming,” said Michael Gilfix. Mr. Gilfix is an attorney and entrepreneur who has helped hundreds of families obtain quality care — without the loss of the family home and without financial destruction.

California faces growing concerns and lawsuits over nursing home evictions

California has been at the center of a renewed focus on patient dumping and unlawful nursing home evictions. Local and federal regulators are looking to enhance the enforcement of laws that protect nursing home residents.

A lawsuit was recently filed in Santa Clara County Superior Court against SavaSeniorCare, a national nursing home chain. Six of its California facilities were accused of illegally evicting nursing home residents. They allegedly refused to provide patients with advance written notices of discharge or inform them of their right to appeal the discharge.

The lawsuit claimed SavaSeniorCare favored profit over following longstanding rules designed to protect residents. Last year, the AARP Foundation filed a similar lawsuit against a Sacramento provider.

Nursing homes have a legal duty to provide 30 days’ notice before discharging a patient involuntarily. They must also notify the appropriate parties, give a specific reason for the eviction and offer the resident a chance to contest the decision. In addition, the nursing home is required to help arrange the individual’s transfer to their home or another long-term care facility.

Evictions have to meet a limited set of criteria in order to be justified. For example, a patient may be discharged because of their failure to pay, the facility’s closure or inability to meet the resident’s needs, or because the resident poses a risk to others’ safety. Many nursing homes misinterpret the reasons and engage in patient dumping for monetary gains.

Legislation that aims to deter the practice of patient dumping has been introduced in the California State Senate. The measure would ensure nursing homes discharge patients to their specified place of residence or to another licensed facility.

Unfortunately, far too many residents nationwide are unaware of their rights and are evicted without an appeal. As a result, they end up without permanent housing or the routine medical care they need upon discharge.

How robots could help ease the looming caregiving shortage

The United Nations estimates that the global population of elderly individuals will increase 56 percent by 2030. However, the number of professional caregivers is expected to fall short.

Researchers at Oklahoma State University believe that robots could be the key to meeting the growing demand for caregivers. Engineering professor Weihua Sheng and his team are developing robots that are able to provide companionship to elderly individuals and detect potential problems.

The first model is an interactive tabletop robot designed along the lines of home assistants like Alexa or Google. The robot’s capabilities include asking questions, logging vital statistics and having the ability to detect falls. After finding out where the fall occurred, the robot can then contact the person’s doctor. The second prototype is a mobile robot that is equipped to move through a single-story house.

Sheng said his project aims to improve the lives of elderly people and enable them to be more independent. “Because of the shortage of nurses and doctors and home health care providers . . . many older adults are not able to access those kinds of caregiver resources,” he said. “That’s why we need technology to help them.”

One of the main issues with robot caregiving is a lack of empathy and emotional connection with patients. Sheng and his team are planning to address that by conducting trials at a retirement community.

“We’re trying to improve the intelligence of the robots so they can recognize emotions and facial expressions, which can provide a context for the human-robot conversation,” said Sheng. He predicts similar robots will be available for sale in the next decade or so at a price point ranging from $1,000 to $2,000. Although robots are unlikely to take over the entirety of caregiving, they may help lighten the load on caregivers in the future.

Robot caregivers elicit mix of worry and enthusiasm among Americans

A Pew Research Center survey conducted last year offers some interesting insights into how people feel about robot caregivers and automation in general. Some Americans view robots as a possible solution to the anticipated shortage in caregivers for the nation’s aging population. However, many are concerned about the negative consequences of replacing human caregivers with technology.

One of the earliest caregiving robots ever created was PARO, a therapy robot in the form of a cuddly baby seal that helps patients who suffer from memory loss. Currently, researchers in Oklahoma State University and other institutions are developing robots that can not only serve as companions, but also perform household tasks, assess vital signs, lift people, seek assistance in emergencies and dispense medication.

Around 40 percent of survey respondents expressed interest in the idea of having a robot caregiver. They believe that such technology would help young people worry less about caring for elderly family members. In addition, robot caregivers would allow older adults more independence and enable them to remain in their own homes longer.

Among those interested in using robot caregivers, just over 20 percent feel they would provide better, more reliable care than paid human caregivers today. For example, a robot would not get tired nor let emotions or biases affect the quality of care provided. In addition, they can help ease the burden on family members who are often juggling other responsibilities.

Conversely, nearly 60 percent of adults said they would not want robot caregivers for themselves or loved ones. The main reason for this appeared to be a lack of trust and compassion. While some people believe that the human touch can never be replicated by technology, others are worried about robots making mistakes in caring for their family members. Some survey respondents liked the idea of having a human remotely monitor the robot, such as via video surveillance.

Key differences between nursing homes and assisted living facilities

Choosing the right type of senior care for yourself or an aging loved one can be a difficult task due to the many options available. Among the best-known types of residential senior care are assisted living centers and nursing homes. Understanding the basic differences between them and whether they fulfill one’s requirements can help the decision-making process.

An assisted living facility allows one to live rather independently and offers special housing and day-to-day support services for its residents. Onsite staff members provide assistance with bathing, grooming, housekeeping and other daily living. Residents are given meals and have the option to participate in scheduled activities. Very basic health care, such as medication management, may also be offered.

A nursing home is also known as a skilled nursing facility. Seniors in nursing homes receive assistance with day-to-day activities. They are also monitored and cared for by around-the-clock nursing staff. Nursing home residents often have disabilities or chronic medical conditions that require full-time medical care.

Family members dealing with minor age-related issues and who wish to maintain their independence might find that an assisted living community is a good fit. However, elderly individuals who require daily medical support may prefer a nursing home.

Of course, there are many other issues to think about when choosing a living situation for an elderly loved one. Besides varying levels of medical services offered to residents, there are also differences in how seniors and families can pay for their care and the cost of living in such facilities. To learn more about long-term care planning, contact the knowledgeable attorneys at Gilfix & La Poll Associates.

Practical tips for choosing an assisted living facility or nursing home

Last August, the largest assisted living complex in California was sued for poor care of its senior residents. The lawsuit alleged poor worker training, elderly abuse and mistreatment. Residents of the facility claimed they were left unattended, with little access to clean clothing and nutritious food.

Unsurprisingly, such findings raise concerns about how loved ones will be cared for at an assisted living facility or nursing home. Knowing what to look for and being able to identify potential red flags can help families make an informed decision about which facility best meets their needs.

Visiting facilities at different times of the day, such as during meal times or activities, can help one get a better idea of how they function. Check to see whether all areas are clean, safe and comfortable.

The National Center for Assisted Living recommends speaking with administrators, staff and residents. You can learn a lot about a facility by the people who live and work there. Do the residents seem happy?

Observe how staff interact with current residents and whether they appear genuinely friendly and caring. To feel confident that you or your loved one will be well taken care of, make sure to ask questions about staffing levels. Factors to consider are the daytime and nighttime ratios of staff members to residents, as well as how emergencies are handled.

There are countless other considerations. Bringing a checklist during an assisted living facility or nursing home visit can help ensure all your questions are addressed. Additionally, make sure to check whether the facility is in compliance with local and state licensing requirements. Have any complaints been filed against it? It is possible to check a state-licensed assisted living home’s performance record on the Department of Social Services website.

How assistive technology can help individuals with disabilities

People with disabilities can benefit greatly from assistive technology (AT). There are a number of different options available, depending on the individual’s specific needs. Assistive technology can improve accessibility in the home or workplace, and help make daily activities easier.

Last year, California State University, Northridge held its annual CSUN Assistive Technology Conference dedicated to exploring innovative new assistive technologies. The event aimed to provide people with disabilities an opportunity to have direct input on the creation and modification of assistive technologies such as interactive software, smartphone apps and wheelchairs.

Sandy Plotin, managing director of CSUN’s Center on Disabilities, said, “Our conference brings together thousands of people from around the world . . . all committed to driving innovation in assistive technology to promote inclusiveness for people with disabilities.”

There are many companies that are developing ways to take assistive technology to the next level. Next year, IBM and Local Motors are hoping to launch a self-driving, electric shuttle bus. Dubbed “Olli,” the bus will use a combination of smartphone apps, artificial intelligence and augmented reality to transport people with a range of physical and mental disabilities around neighborhoods.

Susan Henderson, executive director of the Disability Rights Education and Defense Fund, said the bus offers a way to address the limitations of current transportation systems. Under the Americans with Disabilities Act, only certain subway and train stations are required to be accessible. As a result, individuals with walkers or wheelchairs often have to travel several stops out of their way to reach a destination.

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.

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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Nursing shortage leaves families struggling to find at-home care

Families across California approved for at-home nursing care are having difficulty getting the help they desperately need. Health care advocates are pointing to a larger nationwide nursing shortage as one of the reasons demands are not being met.

The American Association of Nurses has noted a lack of younger nurses to replace older nurses who are retiring. A licensed vocational nurse (LVN) is among the most sought-after home care nurses. Licensed vocation nurses are responsible for providing basic nursing care under the guidance of a doctor or registered nurse.

The at-home nursing shortage is attributed in part to low Medi-Cal reimbursement rates which make it challenging to hire nurses with the desired skills. Nurses say they are already dealing with low pay and poor working conditions — problems that are only exacerbated by the nationwide nursing shortage. According to an ABC 10 News report, health care providers are struggling to recruit and retain nurses willing to work for considerably less than potential earnings in the private sector.

Assembly member Brian Maienschein proposed legislation that would partly raise Medi-Cal reimbursement rates. He said the bill would improve care and quality of life for children.

“It’s important to note that any change to Medi-Cal reimbursement rates, including Home Health Agency (HHA) services, are a part of the state budget process and must also receive approval from the Centers for Medicare and Medicaid Services,” a California Department of Health Care Services spokesperson said in a statement.

The department said it is developing a process to help families find nurses to fulfill the hours authorized for HHA services. They said a number of factors must be considered such as payment levels for HHA services as well as the geographic availability of care providers.

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