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AAA Warman Home Care’s E-Update is intended to bring to you timely and useful articles and information at the click of the mouse. It is sent monthly in an effort to keep you apprised of what is happening across the healthcare continuum of care effecting hospital, hospice and rehabilitation social workers and case managers, as well as Assisted Living, Independent Living and Skilled Nursing facility executives. Warman understands that time is limited and has undertaken to share with you important industry information without your having to search for it.
The elderly who suffer from dementia aren't able to say when something hurts or is sore. They may demonstrate their pain through behaviours like rocking or striking out, and we often dismiss these actions as symptoms of the dementia instead of pain, which is usually from a different problem. Arthritis, diabetic neuropathy, fractures, muscular contractures, bruises, abdominal pain and mouth ulcers are among the list of common ailments that go undetected. It is important for those who live or work with persons with dementia to know how to identify when an elderly person is experiencing pain - and receive treatment sooner rather than later.
The University of Alberta's Cary Brown, PhD, has a new tool to help. She has developed an online workshop and toolkit for caregivers, health-care providers, family members and friends of people with dementia.
The researcher from the Faculty of Rehabilitation Medicine created an evidence-based website with a narrated presentation on pain and dementia, a downloadable resource pack for family members, a downloadable pain log and a facilitator's toolkit with background material, a planning guide, promotional material and supplemental information for organizations who wish to put on a workshop.
The online workshop and toolkit are available at: http://www.painanddementia.ualberta.ca
SOURCE: University of Alberta, September 3, 2009
People who drink light to moderate amounts of alcohol in later life are less likely to develop dementia than people who abstain from alcohol consumption, a study from The Australian National University has found.
The meta-analysis analysed the outcomes of 15 research studies meeting rigorous scientific criteria exploring links between drinking and dementia, drawing on the results for more than 10,000 people worldwide.
"We looked at the results of studies that followed up with participants at intervals over two to eight years," said study leader Prof Kaarin Anstey from the Centre for Mental Health Research (CMHR) at ANU. "We then used statistical analysis to synthesise the results and to weight the studies according to their sample size.
"We found that light to moderate drinkers were 28 per cent less likely to develop Alzheimer's than non-drinkers, 25 per cent less likely to develop vascular dementia, and 26 per cent less likely to develop 'any dementia'."
Dr Anstey said that some of the research projects considered in the ANU synthesis study only reported whether participants were 'drinkers' or 'non-drinkers' without exploring the extent of people's drinking. In these studies drinkers had 44 per cent reduced risk of developing Alzheimer's and 47 per cent reduced risk of developing 'any dementia'.
The meta-analysis also found that the relationship between drinking and dementia was the same for men and women, with light to moderate drinkers showing decreased incidence of dementia regardless of sex.
"It should be noted that the studies we found on this topic nearly all focussed on older adults and their drinking habits," Prof Anstey said. "There is not yet enough scientific data published to draw conclusions about how early life alcohol consumption affects later dementia risk. We also did not analyse the type of alcohol beverages consumed as there are not enough studies that reported results separately for beer, wine etc."
Prof Anstey, who heads the Ageing Research Unit at the CMHR, said that it wasn't clear why light to moderate drinkers were less likely to develop dementia, but suggested that it could be to do with a protective effect of alcohol in reducing inflammation and heart disease, the benefits of social interactions associated with alcohol consumption, or Characteristics of individuals recruited into the studies.
The report is published in the American Journal of Geriatric Psychiatry and the research was also supported by the ANU Dementia Collaborative Research Centre.
SOURCE: The Australian National University, August 30, 2009
Natural doesn't always mean safe when it comes to herbal supplements, according to the August issue of Mayo Clinic Health Letter.
When used properly, many herbal supplements may be safe and possibly beneficial to health. However, a few supplements can cause life-threatening problems or dangerous interactions with medications.
Mayo Clinic Health Letter covers some of the known interactions between herbal supplements and medications:
St. John's wort: This supplement can greatly increase or decrease the potency of many medications and cause serious side effects. Patients who take antidepressants, anti-blood-clotting drugs, certain asthma drugs, immune-suppressing medications or steroids should probably avoid St. John's wort.
S-adenosylmethionine (SAM-e): This can cause serious side effects when taken with antidepressant medications that affect serotonin.
Garlic, ginseng, ginger and feverfew: Patients who take anti-clotting medications such as aspirin, warfarin (Coumadin) and clopidogrel (Plavix) should avoid these supplements. They may increase the risk of bleeding. Supplements chondroitin and glucosamine also may interfere with warfarin.
Ginkgo: Ginkgo may increase the risk of bleeding in patients taking anti-clotting medications. Ginkgo can counteract the blood pressure-lowering benefits of thiazide diuretic drugs. It also can interfere with anti-seizure medications.
Kava: Kava is a sedative herb and is associated with serious liver problems, even when taken for a short time. Many medications, such as cholesterol-lowering drugs, pose a risk of liver damage. Taking kava may increase the risk of liver problems even more.
It's always best to keep health care providers informed about supplement use, especially when starting a new medication or preparing for a medical procedure. Some supplements need to be discontinued two to three weeks before certain surgical procedures, because they affect blood clotting, response to sedation and blood pressure control.
SOURCE: Mayo Clinic, August 14, 2009
Amid reports that the 2009 H1N1 influenza virus could infect half of the U.S. population and the low rates of flu immunization among healthcare workers, the Association for Professionals in Infection Control and Epidemiology (APIC) urges healthcare institutions to require annual flu vaccines for all employees with direct patient contact.
Immunization is a primary way to prevent the flu, yet the Centers for Disease Control and Prevention (CDC) estimates that only about 40 percent of healthcare personnel receive yearly flu shots.
"Immunization will be especially critical for healthcare personnel during the 2009-2010 flu season because we will have more than one virus circulating," said APIC 2009 President Christine J. Nutty, RN, MSN, CIC. "All healthcare workers, including those who are pregnant, need to be immunized against seasonal influenza and 2009 H1N1 virus when vaccines become available. This is vitally important to healthcare worker and patient safety."
APIC further recommends that healthcare facilities obtain informed statements acknowledging the risk to patients from employees who decline the vaccine for reasons other than medical.
"Employees who are not vaccinated can transmit both seasonal flu and H1N1 virus to vulnerable patients in healthcare institutions," said Nutty. "Current rates of healthcare worker immunizations are appallingly low and must not be tolerated. It's time for hospitals to require flu shots - and hold employees accountable for declining the vaccine."
APIC states that healthcare facilities should implement a comprehensive strategy incorporating all of the guidelines for influenza vaccination of healthcare personnel from the CDC's Healthcare Infection Control Practices Advisory Committee (HICPAC) and the Advisory Committee on Immunization Practices (ACIP). APIC's recommendations are published in the APIC position paper, "Influenza Immunization of Healthcare Personnel."
"The rapid spread of H1N1 reminds us of what happens when a population has no immunity and underscores the importance of immunization to prevent influenza," said Linda R. Greene, RN, MPS, CIC, lead author of APIC's position paper and Director of Infection Prevention and Control at Rochester General Health System. "We want to be certain that healthcare personnel are protected against both seasonal flu and the 2009 H1N1 virus. Otherwise, facilities could face a double problem of increased illness and absenteeism among staff coupled with overcrowded emergency departments."
Influenza is a highly contagious disease that can spread before symptoms appear. If a healthcare worker contracts the flu, they may spread influenza infection to patients and other workers before realizing they are sick. The CDC estimates that seasonal influenza results in 226,000 hospitalizations and 36,000 deaths annually in the U.S.
APIC recommendations for influenza immunization apply to healthcare personnel in acute care hospitals, nursing homes, skilled nursing facilities, physician's offices, urgent care centers, outpatient settings and home health settings. All employees with direct patient contact should be immunized annually including physicians, nurses, therapists, dieticians, religious workers, environmental services and kitchen staff.
SOURCE: Association For Professionals In Infection Control And Epidemiology, September 3, 2009
Nightly bouts of interrupted, oxygen-deprived sleep from a collapsed airway in the upper neck raises the chances of dying in middle-aged to elderly people by as much as 46 percent in the most severe cases, according to a landmark study on sleep apnea by lung experts at Johns Hopkins and six other U.S. medical centers.
Even in people with moderate forms of the sleeping disorder, with anywhere from 15 to 30 episodes of interrupted breathing during each hour of supposed rest, risk of death jumps 17 percent.
The ongoing study is believed to be the largest ever conducted into sleep and related illnesses, with the latest report taking more than a decade to complete. The study involves some 6,441 men and women between ages 40 and 70, with mild to severe forms of sleep apnea or none at all. Many are self-described snorers; snoring is a key symptom of sleep apnea.
Though anecdotal reports and medical record searches have long hinted at the connection between sleep problems and death, especially from heart disease, the latest study is the first to define death from sleep apnea by monitoring a large number of people with or without the sleeping condition, including a high proportion of snorers, to see who dies and who does not. Some 1,047 deaths occurred among study participants since the clinical investigation began. It is estimated that 24 percent of American men and 9 percent of women have irregular breathing patterns during sleep, with four in five unaware that they have a problem.
As part of the so-called Sleep Heart Health Study, researchers at Johns Hopkins Bayview Medical Center monitored study participants' sleep patterns at home for at least one full night's sleep, which averaged about seven hours. More than 50 study technicians were needed to handle the nearly 10,000 detailed recordings of participants' breathing patterns, heart rhythms and brain activity made to date. About half of all participants had moderate to severe sleep apnea. They were then tracked through annual clinic visits to gauge any sickness or death from high blood pressure, heart disease or stroke.
Reporting it the Public Library of Science, Medicine online Aug. 18, researchers found that as little as 11 minutes a night " just 2 percent of an average night's sleep of seven hours " spent in severe sleep apnea and subsequent oxygen deprivation, in which blood oxygen levels drop below 90 percent, doubled the death rate in men.
Women in the study who died and had severe sleep apnea were too few for researchers to draw a similar conclusion at this stage in the study, but researchers suspect that further research will bear the same results.
"Our study results really raise concern about the potentially harmful effects of sleep apnea," says pulmonologist and study site principal investigator Naresh Punjabi, M.D., Ph.D., an associate professor at the Johns Hopkins University School of Medicine. He adds that low blood oxygen levels during sleep are "a particularly worrisome sign," citing the factor as the single biggest predictor of death in people with sleeping disorders.
"Such an increased risk of death warrants screening for sleep apnea as part of routine health care, in which all physicians should inquire about patients' sleeping habits, including symptoms of feeling tired or drowsy during the daytime, poor nighttime sleep quality, recurrent awakenings from sleep, and reports from your bed partner that you snore loudly or intermittently stop breathing during the night," says Punjabi.
He says that given how widespread sleep apnea is, acquiring this information is relatively easy and essential for medical scientists to identify which, if any, particular treatments work at curing the illness by ultimately lowering the number of chronic medical conditions and premature deaths caused by it.
Key among such treatments is use of overnight sleeping aids, such as the CPAP (continuous positive airway pressure) device. The device, which resembles a typical oxygen mask, is worn over the nose and connected by a thin tube to a machine that forces air into the nasal passages, preventing the airways from collapsing.
"Our goal is to achieve normal breathing patterns during sleep and maintain blood oxygen levels as close to normal as possible," says Punjabi, who points out that the medical standard is to always maintain blood oxygen levels in the range of 95 percent or above.
Punjabi says the study team's next steps are to separate causes of death due to sleep apnea, in particular, defining the added risk from heart disease or stroke.
Funding support for the study was provided by the National Heart, Lung and Blood Institute, a member of the National Institutes of Health.
Besides Punjabi, other Johns Hopkins researchers involved in the study were Brian Caffo, Ph.D.; Philip Smith, M.D.; Moyses Szkio, M.D., Ph.D.; and Melissa Minotti. Johns Hopkins was also the data coordinating center for the Sleep Heart Health Study, with additional research assistance provided by Marie Diener-West, Ph.D.; John Dodge; Michele Donithan, M.H.S.; Charlene Levine, B.S.; Curtis Meinhart, Ph.D.; Nancy Min, M.H.S., M.P.H., Ph.D.; Michael Smith, B.S.; Andrea Tibbs, B.S.; James Tonascia, Ph.D.; Linda Roberts, M.H.S.; and Jill Meinert.
Other study co-investigators involved in writing the report were James Goodwin and Eyal Shahar at the University of Arizona, Daniel Gottlieb and George O'Connor at Boston University, Anne Newman and David Unruh at the University of Pittsburgh, David Rapaport at New York University, Susan Redline at Case Western Reserve University, Helaine Resnick at the American Association of Homes and Services for the Aging, and David Samet at the University of Southern California.
SOURCE: Johns Hopkins Medicine, August 18, 2009
AAA Warman Home Care is a family-owned Residential Service Agency which has been providing in-home health care services to thousands of clients for the past twenty years. Warman specializes in providing the highest quality of private duty, non-medical care and companionship for the elderly, those recuperating after hospitalization / rehabilitation, the terminally ill, disabled, alone or at-risk. It is our goal to assist our clients in living the most independent, healthy and comfortable lives in the privacy of their own homes.
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