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| Home > Newsletters > Caregiving PolicyDigest > Volume XI, Number 8, May 9, 2011
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A Newsletter of FCA's National Center on Caregiving
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May 9, 2011 Volume X, Number 8
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IN THIS ISSUE
State Legislation, Policy & Reports - North Carolina: Establishes Adult Day Care And Respite Programs. More...
Federal Legislation, Policy & Reports - Department Of Veterans Affairs: Taking Applications For New Family Caregiver Program. More...
- Revised Medicaid Regulations: A Move Toward Person-Centered Care. More...
- Alzheimer's Redefined Offers Earlier Detection Criteria. More...
International News - Canada: Consequences Are Steep For Employed Caregivers. More...
- Spain: QoL For Caregivers. More...
Research Reports & Journal Articles - Study Links Cholesterol And Brain Inflammation To Alzheimer's Disease. More...
- Brain Shrinkage Aids In Early Detection For Alzheimer's Disease. More...
Conferences & Trainings - Conference 2011 National Aging and Law Institute November 10-12. More...
Funding, Media & Miscellaneous - When To Hang Up Your Keys: Aging Takes A Toll On Public Safety. More...
- Texas: Plan Finances In Advance Of Becoming A Caregiver. More...
- Medicare Revamped 'Ask Medicare' 2.0. More...
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North Carolina: Establishes Adult Day Care And Respite Programs.
A law (SB 512) to better regulate adult day care and respite programs was introduced on April 5th in North Carolina.The proposed legislation would require minimum standards around both programs, including staffing requirements, fire safety, program activities, and nutrition. For adult day care programs that advertise special care services for people with Alzheimer's disease, other dementias, mental health disabilities, or other special needs, the law would impose additional requirements. For example, the program will have to disclose to both consumers and the Department of Health and Human Services the program's overall philosophy, the process used for assessment and establishment of the care plan, staffing ratios, training that is dementia-specific, additional costs and fees, and how families are involved. Senators' Debbie Clary and Louis Pate are sponsors of the bill. Senator Clary was recognized by AARP for making home care a priority and improving the quality of life for elders in North Carolina. For more information, visit:
North Carolina General Assembly
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Department Of Veterans Affairs: Taking Applications For New Family Caregiver Program
The Department of Veterans Affairs announced the publishing of the interim final rule for implementing the Family Caregiver Program of the Caregivers and Veterans Omnibus Health Services Act 2010. The application process opens on May 9th for benefits to post-911 family caregivers of Veterans and Servicemembers. Benefits include receiving a stipend, mental health services, and for those not already covered access to healthcare insurance. Other benefits under the new program are comprehensive caregiver training and medical support. Respite relief and counseling services are also provided under the new program, ensuring that caregivers can protect their well-being throughout their caregiving role. "We at VA know that every day is a challenge for our most seriously injured Veterans and their Family Caregivers," said VA Secretary Eric K. Shinseki. "I know many Veterans and their Family Caregivers have been waiting anxiously for this day and I urge them to get their applications in as soon as possible so they can receive the additional support they have earned." The application enables the Veteran to designate a primary Family Caregiver and secondary Family Caregivers if needed. Caregiver Support Coordinators are stationed at every VA medical center and via phone at 1-877-222 VETS (8387) to assist Veterans and their Family Caregivers with the application process. For more information, visit:
U.S. Department of Veterans Affairs
Revised Medicaid Regulations: A Move Toward Person-Centered Care
The Centers for Medicare and Medicaid Services (CMS) is seeking comment on a proposed rule that would make it easier for states to provide community-based services in the Medicaid program by allowing states to target multiple groups in a single home-and-community based (HCBS) waiver. This proposed rule would revise the regulations implementing Medicaid home and community-based services (HCBS) waivers under section 1915(c) of the Social Security Act by providing states the option to combine into one demonstration three target groups-- the aged, disabled persons with developmental disabilities, and those with mental illness. Under current rules, states can only serve one group per waiver, which can create administrative difficulties, ultimately leading to delays for persons with disabilities to either remain in their homes or transition to community living situations. The proposed rule also outlines new options for "person-centered" care plans that allow individuals to design their own array of services and supports including personal care and respite services for caregivers. The goal is to integrate people into the social mainstream, offering them equal opportunities with a chance to make choices about their quality-of-life. The ruling in Olmstead v. L.C., (1999) held institutionalizing a person with a disability who can benefit from community living is discrimination. The proposed rule is open for 60 days and public comment is due by June 14, 2011. For more information or to provide comment on the proposed rules, visit:
edocket
Federal Register
Cornell University Law School
back to topAlzheimer's Redefined Offers Earlier Detection Criteria New medical guidelines were released last week to reflect current evidence that Alzheimer's disease attacks the brain years before the symptoms of dementia. The guidelines, updated for the first time in 27 years, were released by the National Institute on Aging and the Alzheimer's Association. The guidelines divide Alzheimer's into three phases: (1) when dementia has developed, (2) when mild problems emerge, yet, daily functions are still performed, and (3) when no symptoms are present but changes are occurring in the brain. One of the most important additions to the guidelines is the inclusion of methods like brain scans and tests of cerebral spinal fluid, physiological indicators that indicate if someone is likely to develop dementia. William Thies, the chief medical and scientific officer for the Alzheimer's Association explained that the goal of the guidelines is "extending the range of our ability to investigate this disease and eventually find the treatment that is going to be so necessary to avoid the epidemic of Alzheimer's disease that we see facing us over the next 40 years." The guidelines improve diagnosis criteria and distinguish Alzheimer's from vascular, frontotemporal, and Lewy body dementias. A bill introduced last month in Congress aims to make Alzheimer's diagnosis a billable expense under Medicare. Representative Edward J. Markey, Democrat of Massachusetts and a sponsor of the bill said, "Oftentimes family members notice the symptoms in their loved ones, but it's only years later that they get diagnosed or understand what resources are available." For more information, visit: The New York Times National Institute on Aging Alzheimer's Association ________________________________________________________________________ |
Canada: Consequences Are Steep For Employed Caregivers
Caregivers suffer harm to finances and careers when faced with work-family conflicts according to a recent study by social scientist at the University of Guelph's Centre for Families. About 2.3 million unpaid caregivers provide care to a family member or friend, said Donna Lero, a professor in Guelph's Department of Family Relations and Applied Nutrition. "While caregiving is a positive experience for most, people often have to miss work or reduce work hours and forgo job opportunities to provide care." There's a separate loss to "employers in lost productivity, absenteeism, and recruitment and training of hiring new employees" said Fast, a Professor in Alberta's Department of Human Ecology. "It represents an enormous loss of productivity to employers and to the economy-- the equivalent of 157,000 full-time employees annually," said Fast. For more information, visit:
Toronto Sun
Spain: QoL For Caregivers
A comparative study of the demands of caregiving analyzes two sub-groups, those who master and overcome the difficult tasks associated with caring, and those who find themselves impaired due to caregiving responsibilities. The authors analyzed the relationship between the functionality of the family and the quality of life (QoL) of caregivers of dependent relatives. The study included 153 caregivers from two different hospital settings in the city of Salamanca (Spain). Caregiver variables were demographic characteristics, care recipient profile, and family functionality perceived by the caregiver. To study the influence of the family function questionnaire on quality of life, researchers applied the Canonical Correspondence Analysis (CCA). Researchers found the strongest relationship is between the caregiver's quality of life (as measured by their physical and mental well-being) and family functionality. The authors conclude: "Providing support for caregivers or relieving the situations of work overload and stress that they are suffering may not be enough. These results indicate that it is important to ensure that when caregivers receive support, they actually perceive it like that, expressing their improvement at both the physical and emotional level." For more information, visit:
BioMed Central
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Study Links Cholesterol And Brain Inflammation To Alzheimer's Disease
Gene variant study shows increased risks for the elderly for Alzheimer's disease. In the largest genome-wide association study (GWAS) ever conducted in Alzheimer's research, investigators studied the DNA samples of over 50,000 study participants then analyzed shared data sets searching for gene similarities. For years, researchers suspected people with high cholesterol and people who had suffered strokes or head injuries were a higher-risk population for Alzheimer's disease. Scientists from the U.S. and Europe gathered their results to show a connection to cholesterol and inflammation in the transport of molecules inside cells. This latest discovery doubles the number of genes scientists can examine for a way to delay the disease on-set. Dr. Richard Mayeux, Chair of Neurology at Columbia University Medical Center said the findings would "open up the field." An estimated 5.4 million Americans have Alzheimer's disease, and most are over 65, costing $183 billion annually. The two studies published in the Journal Nature Genetics provide new clues to its disease biology, said Dr. Nelson B. Freimer, Director of the Center for Behavioral Genetics at the University of California, Los Angeles. This gene discovery by itself is not as influencing as the 1995 discovery of the APOE gene that showed an individual had a 400% chance of having the disease if they inherited a single copy from a parent and higher if by both parents. Results won't apply as did previous APOE gene research that also determined if an individual was more likely to develop the disease. But give scientists a clearer understanding of what additional risks exist for those who are more likely for Alzheimer's from more data regarding inflammation, movement of proteins within cells, and lipid transport, for tracking the disease process with the goal of finding ways to treat or delay the process. Significantly, ten genes are associated with Alzheimer's and these new genes confirm the involvement of high cholesterol. For more information, visit:
The New York Times
National Institute of Health Brain Shrinkage Aids In Early Detection For Alzheimer's Disease
A new study published in the journal Neurology finds that brain shrinkage occurs in healthy brains a decade before a diagnosis. The study followed two groups of healthy people in their 70's for an average of nine years. During the study, 50 participants remained cognitively normal while 15 developed the disease. Participants who had the highest amount of shrinkage in areas of the cerebral cortex were three times more likely to develop the disease. "The Magnetic Resonance Imaging (MRI) measurements could be very important indicators to help identify who may be at risk of developing Alzheimer's disease" said Leyla de Toledo-Morrell of Rush University Medical Center in Chicago, who worked on the study. For more information, visit:
Reuters
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Conference: 2011 National Aging and Law Institute November 10-12
The National Aging and Law Institute conference will offer sessions on the future of Social Security, the impact of Health Care Reform on Medicare and Medicaid, debt collection and issues of older consumers, the AoA and the Older American's Act programs and more. The conference is hosted by NAELA and co-sponsored by the National Aging and Law Conference (NALC). For more information, or to register, visit:
National Academy of Elder Law Attorneys, Inc
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When To Hang Up Your Keys: Aging Takes A Toll On Public Safety
Not until a car accident did Suzanne Blotner in her 70's give up her driving privilege. Luckily, no one was injured, but the experience served as a wake up call to the risks she imposed on herself and others. There were signs before the accident said her husband Hal, "I had concerns about her getting lost. Places she had been previously she had trouble finding." "Aging itself takes a toll," said Neuropsychologist Carey Gleason with the William S. Middleton Memorial Veterans Hospital in Madison and the Wisconsin Alzheimer's Disease Research Center. "Reaction times slow and vision is affected," said Gleason, and "judgment impaired." Laurie Jacobs, a physician specializing in Geriatrics at the Albert Einstein College of Medicine in New York City said, "trying to determine when to hang up the keys is not a straightforward issue." The Journal Sentinel reports vehicle accidents increase with age particularly between ages 75 to 79 years. Of fatal crashes per 100 million miles traveled, it was higher for drivers 80+. Drivers 85+ were the most likely in 2009 to be involved in fatal crashes For more information, visit:
Journal Sentinel Online
The American Occupational Therapy Association, Inc
Texas: Plan Finances In Advance Of Becoming A Caregiver
A recent article in the Youngstown News highlights the financial burdens placed on caregivers, especially those who are forced to stop working in order to provide care for a loved one. Sandra Timmerman, Director of MetLife Mature Market Institute, said caregivers spend more than $5,500 per year in out-of-pocket expenses and long distance caregivers spend $8,700 per year paying for such items as their transportation, food and supplies. Brain Fant, a Dallas elder-law attorney, said "What usually happens is people wait until they absolutely are forced into being a caregiver before they even consider what preparation would be helpful." There are, with numbers rising due to longer life expectancies, 65.7 million or 29% of the adult U.S. population caregiving. Not only should caregiving be a financial consideration but an assessment of how to plan around career and retirement. Timmerman (MetLife) advises caregivers to look hard before leaving a job to be a caregiver. Workers who do so risk losing their "lifetime wealth, wages, employer's matching programs," and some leave before they are "vested." For more information, visit:
Youngstown News
Medicare Revamped 'Ask Medicare' 2.0 A recent blog posting on the New Old Age (New York Times) highlights the importance of having a Website that is easily navigable and easy to read. The authors explain that Medicare.gov receives up to 160,000 page views per month, while Ask Medicare, a section devoted to family caregivers, was not visited as expected. In response, CMS re-designed the site to make it more user-friendly. The improved site offers caregivers basic information on eligibility and coverage, directions on filing claims, updates on common diseases and conditions, links to other agencies and organizations, and has downloadable fact sheets. For more information, visit:
The New York Times, The New Old Age
Ask Medicare
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To find caregiver support services in your state, visit FCA's Family Care Navigator http://caregiver.org/caregiver/jsp/fcn_content_node.jsp?nodeid=2083
?2011 Family Caregiver Alliance. All rights reserved.
The National Center on Caregiving at Family Caregiver Alliance works to advance the development of high-quality and cost-effective policies and programs for caregivers in every state in the country. The National Center is a central source of information and technical assistance on family caregiving for policymakers, health and service providers, program developers, funders, media and families. For questions or further information about the National Center on Caregiving, contact Policy_Digest@caregiver.org or visit the Family Caregiver Alliance website at www.caregiver.org.
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Caregiving PolicyDigest is a publication of the National Center on Caregiving at Family Caregiver Alliance, 180 Montgomery Street, Suite 900, San Francisco, CA 94104.
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