Cleaning (as if someone else might have to)

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Nancy Lundebjerg resizedNancy E. Lundebjerg, MPA
Chief Executive Officer
American Geriatrics Society

It started with the shoes in the corner of the bedroom—and it continued through three closets, two dressers, a huge chest in my living room, a small filing cabinet, the front hall closet, and even the desk in my office at work. Some might call this spring cleaning but, for me, it’s more episodic and usually sparked by something like being annoyed enough by the pile of shoes in the corner to find them a home.

As always happens during one of these all too rare bouts of purging, I think about the family cleaning events I’ve been part of as parents, aunts, and grandparents moved on. I was having dinner with a few friends last week and we were swapping our caregiver cleaning stories. I found that my late father’s desire to hold on to his power tools was matched by my friend’s father’s desire to bring them all with him to his new assisted living facility. I somehow ended up with a drill, hammer, and a ruler from my dad. The hammer is spattered with paint and the head may be a little loose but I think of my dad every time I use it and could not imagine purchasing a shiny new one. The ruler is an artifact in my curio cabinet – along with the rotary phone from my parent’s bedroom. They’re Items with no current purpose…and they make me smile.

I also spent several years as my aunt’s primary caregiver. Moving her out of her apartment was easier but still no less daunting. I had reached the point where I couldn’t maintain her at home given her advanced dementia, and so I undertook the hunt for a quality nursing home that she could afford and that would take her (Sidenote: “Would take her” is a thing…and a thing for an entirely different blog post!). Having found one, there came the task of cleaning out her apartment. My sister, niece, and I found that she had a closet filled with lightbulbs ordered from some charity (beware the telemarketer and your older loved one). There were bricks in that closet—from where and for what we still do not know. She also had a cedar chest (made by my grandfather) filled with old ConEd bills.

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Hospitalized Older Adults Released to Skilled Nursing Facilities May Not Get Counseling to Help Make Informed Choices

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JAGS graphicJournal of the American Geriatrics Society Research Summary

More than 20 percent of all hospitalized older adults who use Medicare will be admitted to a skilled nursing facility following a stay in the hospital (also known as “post-acute care”). However, these men and women may be given too little information when it comes to choosing a post-acute care facility: sometimes they may receive just a list of addresses for local facilities. What’s more, hospitalized older adults typically don’t plan for care at a skilled nursing facility ahead of time. This can lead to making important decisions too quickly or during a time of particular stress.

We don’t have much information about how people select skilled nursing facilities or what information they’re given to make informed choices. So a team of researchers recently studied how hospitalized older adults make decisions about choosing a facility, who helps them decide, what they think about the process, and what they consider as they make decisions. The researchers published their study in the Journal of the American Geriatrics Society.

They interviewed 98 older adults who had just been admitted to a skilled nursing facility. In 90 interviews in five cities across the country, the researchers spoke only to the older adult. A family member participated in the other eight interviews. Continue reading →

Older Adults Who Take More than Five Medications Walk Slower than Those Who Take Fewer Medications

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JAGS graphicJournal of the American Geriatrics Society Research Summary

“Polypharmacy” is the term used when someone takes many (usually five or more) different medications. Experts suggest that, for most older adults, taking that many medications may not be medically necessary. Taking multiple medications also can be linked to problems such as falls, frailty, disability, and even death. Polypharmacy also is a problem for older adults due to side effects or interactions resulting from the use of different medications. Older adults may have difficulties taking the medications properly, and the medications may interfere with a person’s ability to function well.

The ability to walk well is a sign of independence and good health for older adults, for example, and it may be affected by the use of multiple medications. Although healthcare providers know that some treatments can slow or hamper an older person’s ability to walk, little is known about the effects of polypharmacy on walking while performing other tasks, like talking. In a new study, researchers examined how polypharmacy affected walking while talking. They published their study in the Journal of the American Geriatrics Society.

The researchers examined information from 482 people age 65 and older who were enrolled in the “Central Control of Mobility in Aging” study. That study’s main purpose was to determine how changes to the brain and our central nervous system occur during aging, and how they might impact an older person’s ability to walk. Continue reading →

New Study: Proton Pump Inhibitors Do Not Contribute to Dementia or Alzheimer’s Disease

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JAGS graphicJournal of the American Geriatrics Society Research Summary

Proton pump inhibitors (PPIs) are medications used to treat digestive problems such as ulcers and reflux disease by reducing the body’s production of the acid that helps us digest food. Ulcers are sores that develop on the lining of our digestive system; when they develop in the upper part of the small intestine they are called “duodenal ulcers.” Reflux disease is a condition in which stomach acid or other fluids in the digestive system irritate our food pipe, also known as the esophagus.

Recently, safety questions about these medications have been raised in several studies. These studies suggested that PPIs increased the risk for dementia and Alzheimer’s disease in people 75-years-old or older. Noting that the prescription of PPIs is on the rise among middle-aged and older adults, a team of researchers designed a new study to examine PPIs and the risk of dementia, mild cognitive impairment, and Alzheimer’s disease. They published their study in the Journal of the American Geriatrics Society. The researchers also examined whether people with mild cognitive impairment who took PPIs were at higher risk for developing dementia or Alzheimer’s disease. Continue reading →

Difficulties Diagnosing Delirium in Older Adults After Surgery

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JAGS graphicJournal of the American Geriatrics Society Research Summary

Delirium is a medical term for “sudden confusion.” It is an abrupt, rapid change in mental function and can cause a wide variety of shifts in behavior ranging from aggression or agitation to feeling sleepy and inactive (or even a combination of several behaviors). When delirium occurs after an older person has had surgery, it’s called “post-operative delirium.”

Experts still don’t always agree on delirium symptoms or diagnoses, even when they are assessing the same symptoms in the same people. A team of researchers from the Netherlands designed a study to look at the accuracy of delirium diagnoses in older adults after surgeries. Their study was published in the Journal of the American Geriatrics Society.

In the study, researchers examined 167 older adults from one to three days after surgery. The researchers used a standard delirium rating scale and recorded the tests on video. Afterwards, the videos were shown to two independent delirium experts. If the experts didn’t agree on a diagnosis, the researchers asked a third expert to review the video. A third expert was called in for 21 percent of the evaluations. Continue reading →