Hospitalized Patients at Risk for Cognitive Decline
 |
| Cross Your Fingers, Cover Your Butt Yes Be Scared of Hospitals Dirk Anschutz |
We have reported on this issue before and the conclusion is the same – avoid the hospital at all costs.
In a study of 1,870 Chicagoans over the age of 65, researchers tested the participants’ cognitive functioning and long-term memory following a hospitalization. They found that overall cognitive function declined more than twice as fast after a first hospital stay. What’s more, on specific cognitive tests, the rate of decline after the first hospital stay was more than three times faster on a long-term memory test and 1.5 times faster on a complex attention test.
The National Institutes of Health and the National Institute on Aging supported the study. It was published in the March 21 issue of Neurology.
Two years ago we reported that researchers, found that hospitalized elderly have an increased risk of cognitive decline. 2,929 people, aged 65 and older, were studied over 13 years. All did not have dementia at the start of the study. During follow-up, 1,287 were hospitalized for a non-critical illness and 41 were hospitalized for a critical illness, while 1,601 of the participants were not hospitalized.
Among those hospitalized for one or more non-critical illnesses, there were 228 cases of dementia, and among those hospitalized with one or more critical illnesses, there were five cases of dementia. There were 146 cases of dementia reported among the participants who weren’t hospitalized.
Researchers concluded that patients hospitalized for a non-critical illness were 40 percent more likely to develop dementia than those who weren’t hospitalized.
Is it the hospitalization or the illness to begin with that causes this increase? The jury is out. With the increased risk of infections in a hospital, it must play a contributing factor.
Of course hospitals and nursing homes have a huge challenge in front of them to prevent hospitalizations.
So help them. Any way you look at it, this still gets back to basics. Most of what lands us in the hospital, not all but most, is directly related to our life choices.
Met Life Reverse Mortgage Study Scares Me!
 |
| Don’t Regret “Reverse” @Bruce Laurance |
The MetLife Mature Market Institute published a study of how aging homeowners use reverse mortgages. Reverse mortgages are available to homeowners age 62 or older. In the past, many older homeowners took out this loan as a way to enhance their quality of life. But now, people who consider these loans are more concerned about urgent financial needs, including lowering debt.
By refinancing borrowers:
- borrowers can defer making principal and interest payments on their existing home mortgage until they move out.
- must also meet all of their other reverse mortgage obligations including making timely property tax and homeowners insurance payments.
This strategy, however, can also increase financial risks if borrowers do not manage their spending or rapidly draw down their home equity.
Their study is based on responses to questions that U.S. Department of Housing and Urban Development (HUD) approved counselors must discuss with older homeowners as part of mandatory counseling for all reverse mortgage applicants. 21,240 of these counseling sessions and related data were analyzed for the study. Here are key results:
- Older homeowners are looking for solutions to help manage their often precarious financial situation, and that a reverse mortgage can play an important role.
åÊ - More reverse mortgage borrowers are applying at earlier ages. While the average age of borrowers is about 73 years old, the average age of home-owners who went through counseling between September and November 2010 was 71.5 years old.
åÊ - 46% are under age 70.
- One in five (21%) are leading edge Baby Boomers (age 62 to 64). In 1999, this was 6 percent.
- Most of these homeowners (67%) wanted to lower household debt.
- Only 27% were considering a reverse mortgage to enhance their lifestyle.
- About two-thirds (67%) of recent counseling clients have a conventional mortgage that will need to be repaid if they decide to take out a reverse mortgage.
- About one in four (27%) reported having both housing and non-housing debt. Borrowers with sizable existing debt may rapidly deplete home equity by accessing the equity to repay debt.
- For about one-third (32%) of counseling clients, their existing mortgage may exceed 50% of the value of their home. They may not have enough equity to qualify for a reverse mortgage, or may have to wait several years until they qualify for a loan to meet their financial goals.
Met Life concluded that older homeowners can use assistance and additional consumer education to ensure that they make wise decisions about the most appropriate use of their ÛÏnest eggÛ of home equity.
This is especially needed to:
- enable potential borrowers to compare the pros and cons of different loan options, features, and costs.
- foster understanding that in paying off an existing mortgage loan, they are not eliminating their housing obligation, but only deferring the repayment.
- encourage borrowers to involve other professionals, including, as appropriate, legal advisors, financial planning and tax advisors, and medical advisors.
The study suggests that as the Baby Boomer generation ages, reverse mortgages may be part of a growing trend to include home equity as a natural part of retirement planning and addressing income shortfalls in retirement.
And that to me is plain scary. Because however you slice it, you still have debt. It is not magic, free money here. Obviously, the idea is to age-in-place and should you do that successfully, when you die, your estate will have to pay the difference if there is a shortfall between what you received in your reverse mortgage money versus what the house is sold for. And ÛÏreversingÛ the situation, if the house covers the reverse mortgage, it will lower the estate for heirs. And that is without factoring whether you may need long-term care and that is a whole other discussion.
Proceed cautiously and get great counseling.åÊ
I would love to have a pro and a con argument for this. Any guest bloggers want to take me up?
MS Caregiver Burdens Greater than the General Family Caregiver
Multiple Sclerosis Caregivers 2012 is a report based on a survey conducted by the National Alliance for Caregiving with support from the National MS Society that reveals that the physical, mental and financial burdens on family caregivers of people with MS are significantly greater than the general family caregiving population.
- Half of MS patients experience ÛÏmental confusionÛ that negatively impacts caregivers in regards to their own mental health (43%) and overall financial situation (47%).åÊ
- In addition, 86% of family caregivers of people with MS indicated needing assistance in funding to pay for in-home care to help keep their loved one home and out of a long-term care facility.
- Half of MS caregivers see the day when long-term care facilities are required – and the top triggering event in the need for a long-term care facility is the need for 24 hour care.
- Most caregivers of people with MS use the internet to search for information about the disease and how to care for someone (94%).åÊ Less than half found the information helpful.åÊ
The type of care provided by family caregivers of people with MS is assisting with a wide variety of Activities of Daily Living (ADLs) – personal care, including bathing, dressing, feeding, and toileting- and Instrumental Activities of Daily Living (IADLs), such as housekeeping, transporting to the doctor, cooking, and handling finances.
The most-commonly felt emotion upon their care recipientÛªs diagnosis with MS was compassion, followed closely by fear and anxiety.åÊ Half of caregivers of people with MS stated that their personal relationship with their loved one has improved and three out of four caregivers indicated that becoming a caregiver to their loved one has made them closer.åÊ
The long life cycle of the disease suggests the total number of years one serves as a caregiver will be significantly longer than caregivers in general.
Already, MS Caregivers have been providing care for 9 years compared to less than 5 years for all other caregivers. The average age of all care recipients is 61, but the average age of MS care recipients is 50 and was diagnosed over 12 years ago. The mean duration of MS is 30 years, and it typically reduces life spans by 5-10 years.åÊ
ÛÏThe length of caring for someone with multiple sclerosis points to a real need for assistance for these individuals from family, friends, employers and social service programs. With more support for these family caregivers, more people living with this debilitating disease will be able to remain with their loved ones for a longer period of time,” said Gail Hunt, President & CEO of the National Alliance for Caregiving.
It is clear that caregiving is a burden to many and while MS caregivers have it worse, it is no picnic for others. With caregiving comes reward. But we also need to ban together as a society to provide relief!åÊ
