DiversityNursing Blog

GILLIAN MOHNEY

On her 50th birthday, Sandy Oltz sat on the film set of “Still Alice” and listened to actress Julianne Moore speak a line that Oltz, an early onset Alzheimer’s patient, had struggled to write.

“Please do not think I am suffering. I am not suffering,” Moore said as the character of Alice Howland. “I am struggling, struggling to be a part of things, to stay connected to who I once was.”

Playing a woman with early onset Alzheimer's disease, Moore was giving a speech to a fake meeting of the Alzheimer's Association. It's a position that Oltz has been in many times before.

Oltz, a self-described “type-A” person and former nurse, was diagnosed with early onset Alzheimer’s disease at age 47, when she was raising two teenage sons and juggling a high-pressure job.

“There is some family history, but I never really thought that it would be me,” said Oltz of her early diagnosis. "We tried menopause, we tried brain tumor, we thought stroke, seizure. It took about a year to come to Alzheimer’s.”

Months before the “Still Alice” film shoot in New York, Oltz partnered with the cast and crew of the film through the Alzheimer’s Association. She gave tips from her own life about how to cope with Alzheimer's, such as using a highlight to mark text she's reading. The work seems to have paid off with Moore winning a Golden Globe and an Oscar for her role.

"[Moore] would just ask questions like, ‘What does it feel like to have Alzheimer's,'" said Oltz. "I would say, 'Well, it’s like all these words [are here] and you can’t find the right one.'"

After living with the disease for three years, Oltz said she's mostly learned to accept her limitations, but she still worries that her disease will have an impact on how her sons view her.

"I worry ... they’re never going to know how smart I really was," she said. "They see their mom as kind of funny because I have to be."

Oltz said the film was important so that people can understand that it does not just affect the elderly.

“There’s a stigma that they’re grandmas and grandpas, and their life has been lived and they’re done,” she said of stereotypes about Alzheimer patients. “I pray [the film] breaks the stigma.”

Early onset Alzheimer’s disease affects 200,000 people in the U.S., according to the Alzheimer Association. The film “Still Alice” will be released in limited locations this Friday.

Source: http://abcnews.go.com

By Sanjay Gupta

So, in no particular order, here's my take on the nine big health stories to watch for, and the questions they will likely raise, in 2015.

Doctor shortage. There aren't nearly enough of us to care for the U.S. population. By some estimates, the country is already short of tens of thousands of doctors, a problem that will only get worse as the demand for care increases with our aging population. That could mean longer wait times for you when you need to make an appointment. But that also means policy makers will have to consider questions like: Is there a way to increase the number of residency training slots? Are there other health care professionals who can reasonably fill in the gaps? Will the nation's quality of care go down? How can the country avoid a situation where only the wealthy will be able to afford quality care? 

Hospital errors and infections. Hospital mistakes and infections are still one of the leading causes of preventable death (indeed, some studies suggest "hospital-acquired conditions" kill more people than car accidents or diabetes). 

True, a recent study showed the rate did get better this year, saving tens of thousands of lives. But what else can hospitals do to prevent these mistakes and infections? Can technology like e-prescriptions and electronic health records prevent problems that most often occur: the mistakes caregivers make with a patient's drugs? 

Antibiotic resistance. It has been called public health's "ticking time bomb."The World Health Organization calls antibiotic resistant infections one of the biggest threats to global health today. Each year, at least 2 million peoplebecome infected with bacteria that are resistant to antibiotics, and at least 23,000 people die each year. Most of these deaths happen in health care settings and in nursing homes. How can we respond? Well, research teams around the world have already started searching for the next generation of infection-fighting drugs. But it remains to be seen if time will run out, sending us back to the beginning: a time before antibiotics, where even a cut that becomes infected could kill you. 

More do-it-yourself health care: apps and technology. Technology has made do-it-yourself patient care much easier. This goes beyond just a patient's ability to look up their symptoms online. There are apps to help with autism, apps that can simulate a check-up, apps that can monitor conditions. Wearables can motivate you to walk more or sleep more or check a diabetic's glucose level. But how does all this helping yourself make your health care better? How much is too much? And what does this mean for your privacy? After all, the health care industry accounted for 43% of all major data breaches in 2013. Meanwhile, although 93% of health care data requires protection by law, some surveys suggest only 57% of it is "somewhat protected." What could this mean for your privacy and personal information if security doesn't get better? 

Food deserts. While not everyone agrees with the term food desert, the USDA still estimates 23.5 million people live in these urban neighborhoods and rural towns with limited access to fresh, affordable, healthy food. Without grocery stores in these areas, residents often have to rely on fast food and convenience stores that don't stock fresh produce. It takes a real toll on their health. Families who live in these areas struggle more with obesity and chronic conditions, and they even die sooner than people who live in neighborhoods with easy access to healthy food. More farmers markets are now accepting food stamps and many nonprofits have stepped in to try to bring community gardens and healthy food trucks to these areas, but so far it's not enough. Will cities offer incentives to grocery store chains to relocate to these neighborhoods?  How else can this system be helped? 

Caregivers for the aging population. We are heading into a kind of caregiver crisis. The number of people 65 years and older is expected to rise 101%between 2000 and 2030, yet the number of family members who can provide care for these older adults is only expected to rise 25%. This raises a series of related questions, not least who is going to step up to fill the gaps? Will cities that don't traditionally have strong public transportation systems add to their routes? Will developers create more mixed-use buildings to make shopping and socializing easier to access? Could the government create a kind of caregiver corps that could check in on the isolated elderly? Who will pay for this expensive kind of safety net? 

The cost of Alzheimer's. Currently about 5.2 million Americans have Alzheimer's. That number is expected to double every 20 years. With a cure some way off, what can be done to ease the emotional and financial burden on families and communities affected by the disease? The Alzheimer's Association predicts that by 2050, U.S. costs for care will total $1.2 trillion, making it the most expensive condition in the nation. How will we be able to afford the costs of caring for this population? What can the country do to achieve the goal the White House set for preventing and effectively treating Alzheimer's by 2025?

Marijuana. With the growing acceptance of weed, we can expect that more laws will change to allow medical and recreational use of marijuana. How will the rest of the laws in this country adjust? For instance, Washington state is coming up with a Breathalyzer-type device to check if drivers are high. But it will be interesting to see how readily available these devices are going to be. Will legalization improve the scientific understanding of the long-term consequences of the drug? What other uses could this drug have to help those who may need pain relief most?

Missing work-life balance. Americans spend more time on the job than most other developed countries. We don't get as much vacation, we don't take what vacation we have, and we are prone to working nights and weekends. This stress has a negative impact on Americans' health. What are companies doing to help? What technology can change this phenomenon? Will millennials who say work-life balance is a bigger priority than other generations rub off on the rest of us? What can we personally do to find a better balance? 

We may not be able to answer all these questions in 2015, but we sure will try. And the health team and I look forward to exploring these issues with you in the coming New Year.

Source: www.cnn.com

Mary Lou doesn't know that she's being tracked.

The 77-year-old is in the middle stages of Alzheimer's and though she lives on her own, her family keeps close tabs on her. If she leaves her Washington D.C. home between 9 p.m. and 6 a.m., a silent sensor on her front door texts her daughter an alert.

There is a sensor on each of Mary Lou's two key chains that detects when she goes outside her condo's grounds. A motion sensor in the kitchen helps monitor her eating habits, and another in the bedroom notes when she wakes up in the morning and catches any sleeping issues. There is even a flood sensor in the laundry room.

All the sensors are made by SmartThings and relay the information back to a small wireless hub. Her two daughters, who act as her caretakers, can monitor it all on a smartphone app and set up special notifications.

"It's kept her to the point where we haven't even had to have in-home care yet. Our goal is to keep her in her home for as long as possible," said her daughter Cathy Johnson.

Caregivers like Johnson are increasingly turning to smart-home technology and wearable devices to monitor family members with Alzheimer's and dementia, helping them live independently longer. One of the first things Alzheimer's patients lose is the ability to learn new things. It makes getting their bearings and adjusting to a new residence especially difficult. But living alone can pose its own dangers, such as leaving a stove on, wandering off or forgetting to take medication.

"Often, decisions about care are made when safety becomes an issue" said said Beth Kallmyer, vice president of constituent services for the Alzheimer's Association. Tools like these sensors "can allow people to feel more comfortable" and ease the transition.

Finding the right system

SmartThings is a DIY home automation system that connects sensors and smart devices with a wireless hub. In addition to sensors like those in Mary Lou's home, the system can loop in smart thermostats, smart plugs, door locks and surveillance cameras.

SmartThings is highly customizable and works easily with third-party sensors, which makes it appealing to people like Cathy Johnson. It also doesn't require a monthly fee, unlike many other systems. (Samsung recently purchased the company for $200 million.)

The elder care tech industry is still young, but Laurie Orlov, an industry analyst, predicts it could be a $20 billion business by 2020. This means that both startups and big-name brands are getting in on the action.

Lowe's, Home Depot, Best Buy, AT&T and Staples all have their own connected home systems and sell starter kits that you can expand by purchasing sensors à la carte.

Systems Lively and BeClose offer senior-specific accessories such as bed, toilet and pillbox sensors. GrandCare offers connected blood pressure, weight and glucose monitoring devices.

Wearable devices can also track health and behaviors, and built-in accelerometers can pick up on physical changes or tell when a wearer has fallen. Tempo is a wristband for seniors that picks up on lapses in routine or changes in gait that might indicate mental or physical deterioration. The device is due out this winter.

"Pet doors, water heaters, you name it we've either got it connected right now or we're in the process of connecting it," said Kevin Meagher, the vice president and general manager of Lowe's smart-home system, IRIS.

Watching without invading privacy

With any device that collects data, privacy can become an issue.

"We want to respect people's autonomy, respect their desire for how they want their care to go. One of the reasons we think people should get diagnosed early is so they can be a part of the conversation," said Kallmyer.

Phil D'Eramo chose to tell his parents about the Lively system he set up in their senior housing. He uses sensors to make sure they take their pills and tracks how many times his father goes to the bathroom at night, information that gets passed on to his doctor. His father, who has Alzheimer's, said it makes him feel more comfortable to know his son is monitoring him.

It helps that Lively includes a social element that appeals to seniors. Caregivers can upload photos, texts and notes to the Lively app from their phones, and once a month Lively will print out and mail the messages and photos to the seniors in a bright orange envelope.

"I compare it to the analog version of Facebook for seniors," said D'Eramo. "It helps them be connected to the digital social world."

The future of memory care

Connected home and wearable technology isn't enough to replace professional care or personal attention from family members. However, it can extend the amount of time a person is able to live independently, and the technology is constantly improving.

"We're just touching the surface of the technology," said D'Eramo. "I think in the future, the Lively base unit could interact with the person, almost like an electronic caregiver."

Source: http://www.cnn.com

By CNN Staff

(CNN) -- In the future, a test of your sense of smell may help doctors predict your risk of developing Alzheimer's disease, according to new research presented at the Alzheimer's Association International Conference in Copenhagen, Denmark, this week.

In two separate studies, scientists found that people who were unable to identify certain odors were more likely to experience cognitive impairment. The researchers believe that brain cells crucial to a person's sense of smell are killed in the early stages of dementia.

Researchers say this information could help doctors create a smell test to detect Alzheimer's earlier. Early detection means early intervention and treatment to slow the progression of the disease. Doctors today can only diagnose Alzheimer's disease once it has caused significant brain damage.

"In the face of the growing worldwide Alzheimer's disease epidemic, there is a pressing need for simple, less invasive diagnostic tests that will identify the risk of Alzheimer's much earlier in the disease process," Heather Snyder, director of medical and scientific operations for the Alzheimer's Association, said in a statement.

More than 35 million people worldwide live with dementia today, according to a new report. By 2050, that number is expected tomore than triple to 115 million.

Source: cnn.com

By Melissa McGlensey

Melvyn Amrine, of Little Rock, Ark., may not remember the details of his life since his Alzheimer's diagnosis, but he recently proved that his love for his wife transcends memory.

Melvyn was diagnosed with Alzheimer's disease three years ago and since then it hasn't been easy for his wife, Doris, CBS News reported. Melvyn at times doesn't remember details like whether he proposed to his wife, or vice versa. However a recent holiday prompted Melvyn to remember the most important thing.

On the day before Mother's Day, Melvyn went missing. Considering he normally requires assistance to do any walking, his family was alarmed and notified the police.

When police found Melvyn, he was 2 miles from his house and he was resolute in his goal, according to Fox 16. He was going to the store to buy flowers for his wife for Mother's Day, just like he had done every year since they had their first child.

Sgt. Brian Grigsby and Officer Troy Dillard were touched by Melvyn's determination, and decided to help the elderly man complete his mission by taking him to a store and even paying for the flowers.

"We had to get those flowers," Grigsby told CBS News. "We had to get them. I didn't have a choice."

Melvyn's flowers made a very sweet surprise for his wife of 60 years, Doris, as well as a reminder to the rest of us that love knows no obstacles.

"When I saw him waking up with those flowers in hand, it just about broke my heart because I thought 'Oh he went there to get me flowers because he loves me,'" Doris told Fox 16.

She added to CBS News: "It's special, because even though the mind doesn't remember everything, the heart remembers."

Source: Huffingtonpost.com