Based on new biomarker tests that allow the diagnosis of Alzheimer’s disease some ten years before symptoms begin to appear, the National Institute of Health (NIH) is proposing to change the diagnostic criteria of Alzheimer’s disease, to permit diagnosis of the disease before a patient has started to exhibit the telltale signs of memory loss that are the hallmark of the disease. Scientists believe that the brain of patients who will go on to develop Alzheimer’s disease start to exhibit detectable changes in the brain (such as plaque or amyloid) some 10 years before the patient exhibits symptoms such as memory loss and confusion. Recent scientific advances, such as a PET scan of the brain developed by Dr. Daniel Skovronsky M.D. (recently reported on in The New York Times) allow scientists to detect these changes in the brain that are the precursors of Alzheimer’s disease. The NIH is proposing that doctors be able to diagnosis Alzheimer’s disease when these biomarker tests show the brain changes associated with Alzheimer, even if the person has not yet exhibited clinical symptoms. Within the next few years, it is expected that these tests will be available to the general public.

That means that you or your family members will be able to be tested before you have become impaired. Right now, the prospect of being tested when there is no cure seems like a scary one. But doctor’s ability to diagnose Alzheimer’s disease before a patient has started to exhibit memory loss carries with it the promise of being able to treat the disease and prevent it from progressing to the stage where memory loss is present. Scientists are optimistic for the first time that treatment will be available in the coming years to diagnose and treat Alzheimer’s disease before impairment sets in.

What the NIH is doing is important, to assure that patients receive early treatment for the disease. Insurance companies are not big on paying for preventive treatment, and by labeling certain persons as having Alzheimer’s, before memory loss appears, it will be easier for such persons to qualify for insurance coverage for whatever pre-memory loss treatment that becomes available.

To read the New York Times article (Promise Seen For Detection of Alzheimer's) about Dr. Skovronsky’s test for Alzheimer’s disease, click here.

To read the Times article ("Rules Seek to Expand Diagnosis of Alzheimer's) about the proposed change in diagnostic criteria for Alzheimer’s disease, click here.

Felicia Curran
www.ElderAdvocacyLaw.com
www.ElderAdvocacyBlog.com

Wonder what it is like to be an elderly resident of a nursing home and totally dependent on your care givers for help? A security videotape taken at a nursing home in Queens, New York, which forms the basis for a criminal elder abuse prosecution, can give you an idea. The nursing home care giver is shown to walk away as an elderly lady falls to the floor out of her wheelchair, after the care giver jerked the chair forward. In the process the lady breaks her hip. The care giver then walks away and leaves the elderly lady struggling on the floor. Click below to see the tape:




Why would a care giver walk away like that? As part of a cover up of her own involvement in the lady's fall. She hopes that someone else at the nursing home will "find her on the floor" and it will get reported as an "unwitnessed fall." The elderly victim herself will often be too impaired to speak for herself and tell what happened.

This scenario is repeated every day in nursing homes across the country, but this time it was caught on tape. Does the tape force this nursing home to take responsibility? You'd think, but instead the clip shows how the nursing home tries to use the "blame the victim" approach so typical in these cases. The nursing home lawyer (the guy in the suit) is quoted as saying that the elderly 85 year old lady -- who had dementia -- "caused her own fall." Is it also her fault that she can't get up from the floor or that she is old and frail?

Felicia Curran
www.ElderAdvocacyBlog.com
www.ElderAdvocacyLaw.com

The National Assocaition of Elder Law Attorneys (NAELA.org) has announced

"Next Tuesday, June 8, at 11:15 a.m. EDT, President Obama and Kathleen Sebelius, Secretary of Health and Human Services, will host a "tele-town hall" event with older adults in Wheaton, MD. The purpose of the event is to answer questions from older adults in person and by phone about how the Affordable Care Act will affect Medicare. NAELA is co-sponsoring the event along with other national organizations which represent older adults.

Individuals interested in viewing the town hall may do so through the White House website or at a regional viewing events. The town hall will also likely be broadcast on C-SPAN. Obama Administration officials will be present at some of the regional viewing events in order to answer questions from participants. The list of regional events includes some private events highlighted in yellow. The rest of the events on the list are open to the public and include the location and contact information for the person organizing the event.

Individuals interested in asking a question of President Obama or Secretary Sebelius can call in during Tuesday's town hall at 1-800-837-1935, pass code: 80272058."

Felicia Curran
www.ElderAdvocacyBlog.com
www.ElderAdvocacyLaw.com

If there was a contest for "Worst Place For (Gay)Elderly to Live," Sonoma County, California would have to be on the short list, based on what they did to two elderly gay gentlemen, Clay Greene and Harold Scull, pictured here in happier times. Clay Greene was living in his home in Sonoma County, with his partner of 20 years, Harold Scull. Harold, then 88 years old, fell and was hospitalized. What happened then is every elder person’s – and gay person’s – worse nightmare. The County sprung into action, removing Clay from his home, and sending Clay and Harold, against their will, to separate nursing homes.

Although Clay and Harold had wills, powers of attorney, and medical directives, all naming each other as their responsible persons, the County even obtained court orders preventing Clay and Harold from seeing each other. The County sold their belongings at auction, and as reported by Scott James of the New York Times, removed the men’s cats from their home, right in front of Clay Green. Clay is still haunted by the scene. “When Clay M. Greene remembered the events of June 2008, he clenched his teeth, his hands tightened into fists and his body shook. They grabbed them by their necks and tossed them in a car,’ he said last week, recalling the fate of his beloved cats, Sassy and Tiger. He never saw them again.” Harold died in the nursing home, a few months later. With the assistance of a court-appointed attorney, Anne Dennis, of Santa Rosa, Clay was finally released from the nursing home

According to Kay Kendall of the Bilerico Project, all Clay has left from his life together with Harold is a photograph. The rest was destroyed by the County.

Clay Greene has decided to strike back against this despicable and egregious conduct, and is suing Sonoma County for violation of his civil rights – as an elder and as a gay man – in a lawsuit that will go to trial in July. Clay is from a generation that was forced to live their lives behind closed doors, so he does not use the term “gay” to describe himself, or the term “same sex partner” to describe his relationship with Harold. By standing up for himself, though, he will vindicate the rights of senior citizens in general and gay senior citizens in particular who live in fear that the same thing could happen to themselves.

To read the New York Times article about Clay Greene, click here. To read Kay Kendall’s article in Bilerico, click here.

You can learn more about the lawsuit, by visiting a Facebook page set up by Clay's supporters: www.facebook.com/JusticeForClay?v=app_2347471856

Felicia Curran
www.ElderAdvocacyLaw.com

If you have an elderly parent or grandparent you should take time now to familiarize yourself with the causes of aspiration and its signs and symptoms. When a patient aspirates, food, drink or even saliva that should be channeled from the mouth into the stomach instead gets channeled into the lungs, causing a pneumonia in the lungs. Aspiration is usually, but not always, a life threatening situation, compromising the person’s ability to breathe on their own.

When my Dad landed in the hospital in 2002, after having a fall at home and breaking his hip, I had heard of aspiration, but that was the furthest thing from my mind. After all, how could a broken bone lead to aspiration? My Dad was aging amazingly well – he was mentally and physically intact, sharp as a tact, with normal blood pressure and no health troubles other than a bad back. My main concern was that the hip surgery go well, which it did. Without a hitch in fact.

The night before he was to be discharged from the hospital, I visited him at night after work. We were looking forward to the next day, when he would be discharged to a rehab center for physical therapy, and after that, to go home. He had already eaten dinner when I arrived at 8 pm. He had told me that earlier that day he had become confused and thought that the furniture was flying around the hospital room, and realized that it must be the pain medication. I noticed that he was wheezing off and on -- something he had never done before. Dad said that the wheezing had started just before I arrived. I asked the nurse what that meant, and she said that he “might just have a little congestion.” I asked her to ask the doctor about it and get back to me. Other than the intermittent wheezing, Dad seemed fine, so I left at 11 pm without having heard back from the doctor.

The hospital called me at 2 a.m. and said that my Dad was transferred to the ICU. I rushed to the hospital and was told that he had aspiration pneumonia -– most likely caused by aspirating his dinner the night before. That’s what that wheezing meant. When I spoke to Dad’s doctor, he said that most likely the pain medication Dad was on for the hip fracture (the Oxycontin and Vicodin) interfered with his swallow mechanism, causing the food Dad ate at dinner to go down his windpipe instead of into his stomach.

My Dad never regained consciousness, and within 48 hours he was dead from complications of the aspiration.

There are many other unlikely causes of aspiration. For example, patients who became malnourished are at risk of aspirating. Safe swallowing depends on working swallowing muscles, and drastic weight loss diminishes the swallowing muscles’ ability to function properly. A malnourished elderly patient can be at risk for aspirating simply because their swallow muscle has atrophied due to malnutrition. Because malnutrition is so prevalent in nursing home residents (for many reasons, most of which are preventable), that's one reason why nursing home residents are vulnerable to aspirating in a nursing home.

The New York Times New Old Age Blog has just posted an article on swallowing disorders, When The Meal Won't Go Down. It is an excellent introduction to swallowing issues in the elderly and will refer you to other resources on the web, such as the American Speech-Language-Hearing Association website.

Felicia Curran
www.ElderAdvocacyLaw.com