MATURE MARKET HEADLINES 12/30/2000
Malnutrition Targeted in Nursing Homes
Nursing home. The mere mention of "that place" is enough to strict terror into the hearts of the nation's elderly. And, rightly so. It's the proverbial "last stop" on life's journey. In the minds of many elders, postponing "that stop" is tantamount to postponing death itself. Afterall, life-expectancy upon entrance to a nursing home is, on average, only six months.
Here's the point. Nursing homes are scary enough without the additional prospect of malnutrition. In the past, malnutrition may have been imposed by uncaring staff in questionable facilities. In other cases, malnutrition may have been self-induced by patients bent on attempting erosive suicide. In any case, something needs to be done because malnutrition is a major problem in nursing homes.
Over the last decade a number of methods for improving the nutrition of older persons in nursing homes have been published. However, these are often not used and persons with treatable causes of malnutrition often fail to get appropriate treatment.
Dr. John Morley, editor of the Journal of Gerontology: Medical Sciences states that “failure to recognize and treat malnutrition in older nursing home residents leads to pressure ulcers, hip fractures and a poor quality of life. Depression is also a major cause of weight loss in long-term care settings, accounting for up to 36 percent of residents who have weight loss.
For three years, the Council for Nutritional Clinical Strategies in Long Term Care has established a clinical guideline to manage malnutrition and involuntary weight loss among residents of long-term care facilities.
The guideline recommends a structured approach to the management of unintended weight loss, primarily because body weight is easily measured, but the evaluation of unintended weight loss is difficult.
The Council's guideline is published in the December 2000 issue of the Journal of Gerontology: Medical Sciences. The journal is a refereed publication of the Gerontological Society of America, the national organization of professionals in the field of aging.
The Clinical Guide for physicians, pharmacists, and dietitians focuses on differential diagnosis. Emphasis is made on reporting of medical conditions and decline in activities of daily living. The guideline also emphasizes the cognizance of delirium, depression and mood disorders in residents, and notes that reversal of delirium may result in resumption of appetite.
The study also noted that drugs have been found to be a cause of weight loss, and suggests that in consultation with pharmacist, all drugs potentially aggravating anorexia should be discontinued. Drugs that stimulate appetite are available and can lead to reversal of malnutrition.
The clinical guide is divided into two parts, one designed for nursing staff, dietary and dietitians and a second guide for physicians, pharmacists and dietitians. Dr. John Morley, editor of the Journal of Gerontology: Medical Sciences stated “This guideline offers health professionals a simple approach to improving the well being of older persons.”
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New Genetic Risk Factor for Alzheimer's
Three new, separate research studies suggest that a gene or genes on chromosome 10 may be risk factors for late onset Alzheimer's Disease (AD). The findings, reported in the current issue of Science, are important new evidence that more than one gene may play a role in development of AD later in life.
AD is a progressive, degenerative disorder, characterized by amyloid plaques and neurofibrillary tangles in the brain, resulting in loss of memory and, eventually, in loss of mental and physical function. Scientists involved in the trio of studies believe that this newly discovered genetic influence on late onset AD may possibly involve the processing of a protein that is important in the formation of the amyloid plaques associated with AD.
Prior to this current discovery of the gene on chromosome 10, researchers found evidence of an AD risk factor gene in the region of chromosome 12. However, for the past several years, a particular form of apolipoprotein E (APOE) gene on chromosome 19 was the only widely recognized genetic risk factor in late onset Alzheimer's disease.
There are two types of AD, early onset and late onset. In the early onset AD, symptoms first appear before age 60. Some early onset disease runs in families and involves inherited mutations that are believed to be the actual cause of the disease. So far, three early onset genes with AD-causing mutations have been identified. Early onset AD is rare, accounting for less than ten percent of cases.
Late onset AD, the most common form of the disease, develops in people 60 years and older. Late onset AD may run in families, but a gene may not be the absolute determinant. Instead, the role of genes in late onset AD may be to modify the risk of developing AD. In this case, the genes may be involved in the formation of plaques and tangles in the brain.
"With the aging of the baby boomers, the urgency to understand Alzheimer's disease increases every day," says National Institute on Aging Director, Richard J. Hodes, M.D. "These findings of genetic loci associated with the disease can help us further identify the risk factors and describe the biological mechanisms at work in AD, bringing new promise in the search for ways to diagnose, treat, or prevent this devastating illness." It is estimated that 4 million Americans currently suffer from AD.
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Secure Retirement Fosters Active Lifestyle
The January / February 2001 issue of Secure Retirement, a publication of the National Committee to Preserve Social Security and Medicare, offers great reading for seniors interested in maintaining an active lifestyle. Readers will find reviews of Congressional actions, updates on Medicare, health concerns, profiles of eldercare, volunteer opportunities, and social security tips.
The National Committee to Preserve Social Security and Medicare (NCPSSM) was founded in 1982 to serve as an advocate for the landmark federal programs of Social Security and Medicare and for all Americans who seek a healthy, productive and secure retirement. Headquartered just a few blocks from Capitol Hill in Washington, D.C., the NCPSSM represents the interests of the "twenty-something" generation, baby-boomers, and the nation's thirty-four million seniors.
Congressional topics include:
- A roundup of what the 106th Congress accomplished for seniors
- Progress on the Renewal of the Older Americans Act
Medicare and Health topics include:
- Medicare's new economic benefits
- Update on the fight for prescription drugs
Caregiver Profile topics include:
- Crisis of under-staffing in nursing homes
- Recent advances in prostate cancer treatment
A Special Section on Volunteering includes:
- How pet therapy breeds healthy living
- Esteem-building benefits of school volunteerism
The annual subscription to "Secure Retirement", the NCPSSM's magazine, is $3. For subscription details, contact the National Committee toll-free at: 1-800-966-1935.
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Retired Senior Volunteer Opportunities
"We don't just want to change the world…we're old enough to know how," is the theme of the new Public Service Announcement (PSA) launched by the National Senior Service Corps. As the largest generation of Americans turns age 55 and leaves the workforce in record numbers, the new PSA will challenge them to channel their skills into positive change in their communities.
The National Senior Service Corps hopes the PSA will help recruit thousands of new volunteers from among the almost 79 million Baby Boomers beginning to retire. "We have the largest, most active and fastest growing of seniors in our history. If we harness the energy of these seniors, we'll have a tremendous force for tackling some of society's most difficult problems, says Harris Wofford, Chief Executive Officer of the Corporation for National Service.
For more than thirty years, the Senior Corps has linked over 450,000 older Americans to volunteer opportunities in their communities. Its three main programs:
Foster Grandparent Program,
Retired Senior Volunteer Program
Senior Companion Program,
are a vehicle for interested older Americans to find challenging, rewarding, and significant service right in their own backyards.
Foster Grandparent Program Serving Children
Foster Grandparents devote their volunteer service to one population: children with special or exceptional needs. Across the country, Foster Grandparents are offering emotional support to child victims of abuse and neglect, tutoring children who lag behind in reading, mentoring troubled teenagers and young mothers, and caring for premature infants and children with physical disabilities and severe illnesses.
Retired and Senior Volunteer Program (RSVP) Serving the Community
RSVP offers maximum flexibility and choice to its volunteers. RSVP matches the personal interests and skills of older Americans with opportunities to help solve community problems. They tutor children in reading and math, help to build houses, help get children immunized, model parenting skills to teen parents, participate in neighborhood watch programs, plan community gardens, deliver meals, offer disaster relief to victims of natural disasters, and help community organizations operate more efficiently.
Senior Companion Program Serving Adults Needing Extra Assistance
Senior Companions reach out to adults, who need extra assistance to live independently in their own homes or communities. Senior Companions assist their adult clients with in basic but essential ways: they provide companionship and friendship to isolated frail seniors, assist with simple chores, provide transportation, and add richness to their clients' lives. Senior Companions serve frail older adults and their caregivers, adults with disabilities, and those with terminal illnesses.
To find out more about making a difference in your area, e-mail your questions to: nsscjoin@cns.gov
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Talented Older Persons in Schools (TOPS)
Illinois Department on Aging's Director Margo E. Schreiber has announced four schools and an agency serving seniors are receiving grants to start a Talented Older Persons in Schools (TOPS) program. The program encourages senior volunteers to tutor and mentor kindergarten through sixth grade students.
The following schools will each receive a $5,000 seed grant: Lake Elementary School in Granite City; Egyptian Community Unit in Tamms; and Ford Heights School District, Ford Heights. In addition, Community Resources and Information Services (CRIS), an agency serving Danville area seniors, will work with the Danville School District to institute TOPS. CRIS will receive $24,000 and the Danville School District will receive $5,000, which will allow an after-school child care program in CRIS' senior center in Danville.
"The sites were carefully chosen using criteria which considered truancy rates, reading scores and service to low-income students," said Schreiber. "We are grateful that the Illinois State Board of Education helped in the selection, which was difficult considering we received more than twenty applications."
Schreiber said in addition to tutoring and mentoring, an added feature of TOPS is that it encourages seniors to monitor classrooms, hallways, cafeterias, playgrounds and bus stops to promote school safety.
"We are very excited about the TOPS initiative," Schreiber said. "It will allow seniors to serve as role models for youth and to give a little more attention and assistance to those who may be falling behind in school work. I think the seniors will also enjoy sharing their knowledge and time because they recognize how impressionable the children are and the need to reinforce their potential."
Open houses at each site are planned for early next year. For more information, contact the Illinois Department on Aging at: 1-800-252-8966
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Boomer Athletes Vision Correction Options
Claire Mosby, a senior citizen with age-related vision difficulties, took aerobics classes for years. And for years, her bifocal glasses bounced around on her nose. However, when she began teaching classes last year, she decided she needed to see her much younger students better. She needed some mid-range and better distant vision. Mosby bought her first pair of bifocal contact lenses last year when she was 82 years young.
Active baby boomers, many of whom are shifting from team sports to individual sports, still have vision demands which may differ from their everyday activities. "Statistically, the baby boomer generation is becoming presbyopic in greater numbers than any other population. This is an active population with significant disposable income, so many boomers can afford multiple options," says Charlotte A. Tlachac, Professor at the University of California, Berkeley School of Optometry.
Presbyopia is a condition in which the crystalline lens of the eye loses its flexibility. "The result is progressive difficulty in focusing on close objects. Presbyopia is not preventable, it's simply part of the aging process. For many graying athletes this can be an adjustment process," adds Dr. Tlachac.
Most athletes under these circumstances have to accept a certain compromise in vision. "However, depending on the sport, bifocal glasses can make intermediate range hand-eye coordination difficult. In addition, glasses in general can be uncomfortable and, in some cases, impractical," says Dr. Tlachac. "Fortunately, in the past five years, contact lens treatment options have increased significantly."
For bifocal contact lenses wearers, there are a variety of design options in soft lenses, gas permeable lenses and specialty designs for astigmatism. "Vision correction is a part of one's sporting equipment. As performance goes, it's as important as wearing the right clothing, using the right clubs or wearing the right running shoes. It's another way to enhance the game," says Dr. Tlachac.
For more extreme athletes, this equation often includes a variety of factors. John J. Gardner, O.D., F.A.A.O., an optometrist in private practice is also a marathoner. Several years ago, when Gardner ran a marathon on the side of Mt. Everest, vision correction included UV protection for increased ultraviolet exposure, dry air (altitude hydration), hygiene considerations, and replacement lenses.
"Each sport has different vision requirements. And now, all athletes have a variety of options," said Dr. Gardner. "No matter what the sport, from ballroom dancing to tennis, your optometrist can recommend the best vision equipment for the best results. And, you don't have to be ranked number one in the country
to be an athlete. If you participate in a sport, you are an athlete."
The American Optometric Association, founded in 1898, represents more than 33,000 doctors of optometry, optometry students and paraoptometric assistants and technicians in more than 6,600 communities across the country and in foreign countries.
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