People with Dementia Live Better When Empowered to Manage Their Condition
People with Dementia Live Better When Empowered to Manage Their Condition
Researchers found that attending weekly Û÷self-managementÛª group sessions which encouraged socialization, discussion, problem solving and goal setting fostered independence and promoted social support among people with dementia. The groups, led by trained facilitators, were focused on providing people with a better understanding of their dementia and ways to cope with it. Participants were supported in their ability to manage their own symptoms, treatment and lifestyle changes with information and expert help. They were then encouraged to share ideas and strategies for dealing with their condition and were encouraged to record notes and reminders in a handbook. ÛÏDeveloping dementia can be a scary and isolating experience. We developed a group program to help people with dementia manage their condition and find ways of dealing with the changes in their lifestyle. We found early evidence that empowering people to manage their own symptoms and bringing them together helped them feel more confident about managing everyday life with dementia,Û said lead researcher Dr Catherine Quinn, Senior Research Fellow in The Centre for Research in Ageing and Cognitive Health (REACH).
Group Recommends Screening For Depression For All Adults
Group Recommends Screening For Depression For All Adults
The U.S. Preventive Services Task Force (USPSTF) is recommending screening for depression in the general adult population, including pregnant and postpartum women, and that screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up.
The report appeared in JAMA. Depression is among the leading causes of disability in persons 15 years and older. It affects individuals, families, businesses, and society and is common in patients seeking care in the primary care setting, and also common in postpartum and pregnant women.
The U.S. Preventive Services Task Force (USPSTF) reviewed the evidence in the medical literature on the benefits and harms of screening for depression in adult populations. The USPSTF is an independent, volunteer panel of experts that makes recommendations about the effectiveness of specific preventive care services such as screenings, counseling services, and preventive medications. The USPSTF found convincing evidence that screening improves the accurate identification of adult patients with depression in primary care settings, including pregnant and postpartum women, and found adequate evidence that programs combining depression screening with adequate support systems in place improve clinical outcomes.
Effective treatment of depression in adults generally includes antidepressants or specific psychotherapy approaches, alone or in combination. Given the potential harms to the fetus and newborn child from certain pharmacologic agents, clinicians are encouraged to consider evidence-based counseling interventions when managing depression in pregnant or breastfeeding women. Hmmm. Behavioral health is a big issue in the country and one whole argument in the gun control debate centers on behavioral health. This is a slippery slope however. Do we need to scare an entire population? And given the anti-depressants are already the #1 prescribed medication in the country, are we just encouraging more unnecessary drug use that big pharma benefits?
The Benefits of Social Media for Seniors
The Benefits of Social Media for Seniors
Earlier Hospice Enrollment Would Improve Quality of End-Of-Life Care
Earlier Hospice Enrollment Would Improve Quality of End-Of-Life Care Among family members of older patients who died of advanced-stage cancer, earlier hospice enrollment, avoidance of intensive care unit (ICU) admissions within 30 days of death, and death occurring outside the hospital were associated with perceptions of better end-of-life care, according to a study in JAMA. Patients with advanced-stage cancer receive aggressive medical care at the end of life. Few studies have examined whether these aggressive end-of-life care measures reflect patients’ preferences or bereaved family members’ perceptions and expectations of the quality of end-of-life care. Alexi A. Wright, M.D., M.P.H., of the Dana-Farber Cancer Institute, Harvard Medical School, Boston, and colleagues assessed the relationship between aggressive end-of-life care and family member-reported quality ratings of end-of-life care. Of 1,146 patients with cancer (median age, 76 years; 56 percent male), bereaved family members reported excellent end-of-life care for 51 percent. Family members reported excellent end-of-life care more often for patients who received hospice care for longer than 3 days than those who did not receive hospice care or received 3 or fewer days. In contrast, family members of patients admitted to an ICU within 30 days of death reported excellent end-of-life care less often as did family members of patients who died in the hospital. The authors suggest that multifaceted approaches might result in more preference-sensitive care for patients and overall improved quality of end-of-life care. In another JAMA study looked at the intensity of end-of-life treatment and the likelihood of dying in a hospital between physicians and the general population. In one study, Joel S. Weissman, Ph.D., of Brigham and Women’s Hospital, Boston, and colleagues examined whether physicians receive higher or lower intensity end-of-life treatments compared with nonphysicians. Physicians were less likely to die in a hospital compared with the general population (28 percent vs 32 percent), less likely to have surgery (25 percent vs 27 percent), and less likely to be admitted to the ICU (26 percent vs 28 percent). ÛÏThe possible reasons physicians received less intense end-of-life care than others could be knowledge of its burdens and futility as well as the benefits and the financial resources to pay for other treatment options, such as palliative care or skilled nursing required for death at home,Û the authors write. Would seem more physicians need to practice what they preach and have patients emulate what their end of life wishes entail.
Higher Doses Vitamin D Associated with Increased Risk of Falls in 70+
Higher Doses Vitamin D Associated with Increased Risk of Falls in 70+ Higher monthly doses of vitamin D were associated had no benefit on low extremity function but did increase the risk of falls in patients 70 or older, according to an article published by JAMA Internal Medicine. Lower extremity function that is impaired is a major risk factor for falls, injuries and a loss of autonomy. Vitamin D supplementation has been proposed as a possible preventive strategy to delay decline. Heike A. Bischoff-Ferrari, M.D., Dr.P.H., of the University Hospital Zurich, Switzerland, and coauthors conducted a one-year, randomized clinical trial that include 200 men and women 70 or older with a prior fall. The authors report:
- Of the 200 participants, 58 percent were vitamin D deficient at the start
- Of the 200 participants, 60.5 percent (121 of 200) fell during the 12-month treatment period
Compared with a monthly standard-of-care dose of 24,000 IU of vitamin D3, two monthly higher doses of vitamin D conferred no benefit on the prevention of functional decline and increased falls in seniors 70 years and older. The study concludes that high monthly doses may not be warranted in seniors with a prior fall.
