Fight the flu

“A flu shot is your best protection against catching the flu,” says Randy Bergen, MD, pediatric infectious disease specialist at Kaiser Permanente. The flu virus changes often. The protection given by the flu vaccine only lasts for about a year, so you need to get a flu shot every year, preferably in the fall.

The Centers for Disease Control and Prevention recommends that children 6 months and older, and every adult, get vaccinated against the flu. Children and adults who have a chronic health condition or weakened immune system, adults 65 or older, or smokers who are between 19 and 64 should also get a pneumonia vaccine. When you come in for your flu shot, ask if you need a pneumonia vaccine.

Flu shots are safe and won’t give you the flu .

What to do if you get the flu

1.Don’t ask for antibiotics, which won’t help because the flu is caused by a virus.
2.Stay home to help avoid spreading the flu to others.
3.Wash your hands often and avoid touching your face.
4.Use home remedies or over-the-counter medications, but don’t give any cough or cold products to children 6 years old or younger.
Protect yourself and family

The flu is more serious than the common cold, so do everything you can to prevent it. A flu shot (or nasal spray) is your best defense. The vaccine is safe, won’t make you sick, and generally has few side effects.

The flu virus changes often, and the protection from the vaccine only lasts for about a year. That’s why you should get a flu shot every year, preferably in the fall.

Who should get a flu shot?
The CDC recommends everyone 6 months and older get a flu vaccination every year.

The flu shot helps prevent you from getting the flu and from spreading it to others. Even healthy people can develop serious complications or even die from the flu — so protect yourself and your loved ones by getting vaccinated.

Vaccination is especially important for:

*people 50 years and older
*children 6 months through 4 years old
*women who are or will be pregnant during flu season
*people with chronic medical conditions or weakened immune systems
*people who live in nursing homes and other long-term care centers
*health care workers
*people who live with or care for anyone at high risk for flu-related complications
*Complications of flu can include bacterial pneumonia, ear infections, sinus infections, dehydration, and worsening of chronic medical conditions, such as congestive heart failure, asthma, or diabetes.

Why kids should get a flu shot
Children can spread the flu easily to adults and other children. Getting vaccinated also helps protect infants (who cannot receive a flu shot), pregnant women, the elderly, and people with chronic conditions.

Make sure your children get all recommended vaccinations on time. Check your child’s immunization record.

Flu shots will be available beginning in early fall 2011.  They are available from your health care provider or at local CVS drug stores & local Safeway stores! Do you have a primary care physician to help you if & when you do get the flu? Dr. Thomas Yatteau is a wonderful physician here  in Sonoma County who offers Concierge medicine.

 Dont forget  or delay- Get your flu shot today!

ScienceDaily (Dec. 26, 2007) — Elderly nursing home residents receive relatively few cancer care services, including screening, surgical treatment, or hospice care, according to a study published online December 25 in the Journal of the National Cancer Institute

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Few studies have examined cancer treatment and care among elderly patients residing in nursing homes. Yet as theU.S.population ages, more people will move into nursing homes, many of whom will later be diagnosed with cancer. Cancer risk increases as people age.

Cathy Bradley, Ph.D., of theVirginiaCommonwealthUniversityMasseyCancerCenterinRichmondand colleagues assessed the cancer care received by elderly nursing home residents who were insured by Medicaid. Using data from the Michigan Tumor Registry and Medicare records, they identified 1,907 nursing home residents diagnosed with cancer. They analyzed the patient data by cancer stage at diagnosis, type of cancer, survival time, and whether the patient received surgery or hospice care, as well as other variables.

Sixty-two percent of the nursing home residents with cancer had late or unstaged disease when they were diagnosed, and almost half died within three months of diagnosis. Among patients with late stage cancer, only 28 percent received hospice care. Patients aged 71 to 75 were three times more likely to have surgery than patients aged 86 and older.

“An aging population, coupled with trends in cancer diagnosis and treatment, will shift more cancer care…to nursing homes and make investigations into the care of nursing home cancer patients particularly relevant. At present, nursing homes may be unequipped to recognize and care for their residents with cancer,” the authors write.

In an accompanying editorial, Noreen Aziz, M.D., Ph.D., and Keith Bellizzi, Ph.D., of the National Cancer Institute inBethesda,Md., describe the essential components of cancer care, which include treatment, follow-up care, and palliative care. They also discuss the importance of further studies on the cancer care needs of this unique population of elderly nursing home residents.

“Optimal palliative care will often require multidisciplinary approaches and treatment plans made in accordance with the wishes of, and in partnership with, the patient and family, with a goal of decreasing morbidity and a focus on quality of life,” the editorialists write.

ScienceDaily (Jan. 10, 2011) — A large proportion of Medicare expenditures for nursing home residents with advanced dementia, a terminal illness, is spent on aggressive treatments that may be avoidable and of limited clinical benefit, according to a new study by the Institute for Aging Research, an affiliate of Harvard Medical School, published in the online version of the Archives of Internal Medicine on Jan. 10, 2011.

The study examined Medicare expenditures for 323 nursing home residents with advanced dementia in 22 facilities in the Greater Boston area as part of the Choices, Attitudes, and Strategies for Care of Advanced Dementia, or CASCADE, study. According to the findings, the largest proportion of Medicare expenditures was for hospitalizations (30.2%) and hospice (45.6%). Medicare expenditures rose by 65 percent in each of the last four quarters before death, primarily due to an increase in both acute care and hospice services. Acute care costs were lower among residents who had either a Do Not Hospitalize (DNH) order, lived on a special care dementia unit, or did not have a feeding tube.

“Our study demonstrates that a large proportion of Medicare expenditures in advanced dementia are attributable to acute and sub-acute services that may be avoidable and may not improve clinical outcomes,” says senior author Susan L. Mitchell, M.D., M.P.H., a senior scientist at the Institute for Aging Research.

An additional 10 percent of Medicare expenditures were for care in a rehabilitation facility after hospitalization. Dr. Mitchell calls the benefits of skilled nursing or rehabilitative care for these patients “questionable,” given that most of them are totally physically functionally and cognitively impaired.

Strategies that promote high-quality palliative care may shift expenditures away from aggressive treatments for dementia patients at the end of life and more toward a comfort care approach, say the researchers.

“The strong association between the lack of a DNH order and higher acute care expenditures supports the notion that advance care planning may be a key step toward preventing aggressive end-of-life care,” says Dr. Mitchell, an associate professor of medicine atHarvardMedicalSchool. Among cancer patients, advance planning lowers costs in the last week of life, and lower costs are associated with a higher quality of dying experience.

Both hospice and palliative care focus on quality of life or “comfort care,” including the active management of pain and other symptoms, as well as the psychological, social and spiritual issues often experienced at the end of life. Unlike hospice, however, palliative care services do not depend on life expectancy and may be used in conjunction with curative treatments.

Estimates peg 2010 total health-care expenditures for dementia at $172 billion, which will continue to rise as the number of people experiencing the end stages of this disease increases. Currently, more than 5 million Americans suffer from dementia, a number that is expected to increase to almost 13 million in the next 40 years. Total Medicare and Medicaid payments (nursing home care is generally paid for by Medicaid after individuals have exhausted their savings) for patients with dementia are roughly three times higher than they are for those without dementia.

Dr. Mitchell’s team looked at Medicare health services used by the nursing home residents over 18 months, culling data from hospital admissions, emergency department visits, primary care provider visits, and hospice enrollment. Roughly one-third of all Medicare costs for dementia were for hospitalizations, which Dr. Mitchell says are burdensome for many of these patients because, among other reasons, they involve a physical transfer and dementia patients often become even more confused and agitated in an unfamiliar environment. Previous studies by Dr. Mitchell and others have shown that most hospitalizations for patients with end-stage dementia are for conditions such as pneumonia that could be treated as effectively and at less cost in a nursing home setting.

Hospice payments accounted for close to half of all Medicare expenditures even though only 22 percent of the nursing home residents received hospice care. Hospice has been shown to benefit residents dying with dementia, but it is greatly underutilized with this population.

Dementia is a group of symptoms severe enough to interfere with daily functioning, including memory loss, difficulty communicating, personality changes, and an inability to reason. Alzheimer’s disease is the most common form of dementia.

A 2009 study by Dr. Mitchell in the New England Journal of Medicine was the first to rigorously describe the clinical course of advanced dementia and to label the disease a terminal illness similar to other incurable diseases, such as cancer.

October is National Breast Cancer Awareness Month

Breast cancer is the second most common cancer in American women behind skin cancer.  Seniors are at an increased risk to develop breast cancer, so take time during National Breast Cancer Awareness Month this October to learn more about this deadly disease.  Here are a few facts regarding seniors and breast cancer, provided by the National Breast Cancer Awareness Month website (www.nbcam.org).

• The risk of developing breast cancer increases as a woman grows older, but the risk increases significantly for women age 60 and older.
• Breast cancer is not common in women younger than age 35, but it can occur.
• There is some evidence to suggest young African-American women are at greater risk for breast cancer than young Caucasian women.
• Medicare covers mammography screening every year for female Medicare .  Eligible women and their doctors may not know about this important benefit, so be sure to share this information with your female clients and their families. A series of publications regarding this benefit are available in English and Spanish.
• For more information about Medicare coverage, contact the Medicare toll-free hotline at (800) MEDICARE or the Medicare Web site, www.medicare.gov.

Join the effort to detect Alzheimer’s early

The Home Instead Senior Care^® network has joined the Alzheimer’s Early Detection Alliance (AEDA) in a nationwide effort to educate people about the warning signs of Alzheimer’s disease and the importance of early detection.  The AEDA is a group of corporations, nonprofits and government entities under the leadership of the Alzheimer’s Association dedicated to making a difference in the fight against Alzheimer’s disease.

There is no cure for Alzheimer’s disease and no way to prevent it. Early detection allows those living with the disease – and their families – time to plan for the future. The Alzheimer’s Association created the following list of warning signs for Alzheimer’s disease and related dementias. Every individual may experience one or more of these symptoms in varying degrees:

1. Memory changes that disrupt daily life
2. Challenges in planning or solving problems
3. Difficulty completing familiar tasks
4. Confusion with time or place
5. Trouble understanding visual images and spatial relationships
6. New problems with words in speaking or writing
7. Misplacing things and losing the ability to retrace steps
8. Decreased or poor judgment
9. Withdrawal from work or social activities
10. Changes in mood and personality

If you notice any of these signs in your senior clients, contact the client’s family members immediately.

To learn more about the 10 signs of Alzheimer’s disease, contact the Alzheimer’s Association at www.alz.org/10signs or 877-IS IT ALZ (877.474.8259).

The Elder Care Radio Show—July 2011
KSRO 1350 AM Fridays—12:30-1:00 p.m.KFRC 1550 AM & KNEW 910 AM Saturdays—8:30-9:00 a.m

I suspect I’m in the minority of people who are comfortable talking about death.  This month guests and I will discuss the subject in a gentle, educational way.  To dispel perceptions of “creepiness,” I invite you to e-mail a helpful tip or experience for me to share with other listeners at ElderCareShow@gmail.com.  I hope you will give yourself a 30-minute break each week to tune in to the live show or to a podcast.  Take good care,            Kira Reginato

Archives of The Elder Care Show are available on podcast at www.lifegcm.com.  Weekly downloads are also available at iTunes.com.

        July 1KSRO 1350                         July 2KFRC 1550                                   July 9KNEW 910

Patrick Arbore, Director of The Friendship Line

Institute on Aging, San Francisco

Patrick is one of my favorite guests.  He’ll discuss why we fear death, dislike talking about it, and what the fear of death can lead to:  depression, drinking in excess, and leaving our loved ones guessing at what our wishes might have been in the midst of their grief.  Let Patrick help you begin to become comfortable with the topic.

         July 8KSRO 1350                                July 9KFRC 1550                          July 16KNEW 910

Elvira Orozco, Funeral Director

Windsor-Healdsburg Mortuary, Windsor

 Do you realize that if you died tomorrow, your loved ones are responsible for completing extensive paperwork and carrying out your final wishes?  You can lighten the responsibility that falls to your family by becoming informed, making decisions, and even completing paperwork now.  Drawing on her 16 years in the mortuary business, Elvira will discuss options, services and costs.

           July 15KSRO 1350                           July 16KFRC 1550                        July 23KNEW 910

Ryan Lee, Author of “A Day in the Life of Death:  A Behind the Scenes Look at the Mortuary Business” 

Ryan is a graduate of the San Francisco College of Mortuary Science and, in addition to being a best-selling author, currently serves as a business consultant, writes for a number of national publications, and is a frequent lecturer.  He will talk about the funeral industry as a business and offer advice about being an informed consumer when dealing with funeral homes.                   July 22KSRO 1350           July 23KFRC 1550              July 30KNEW 910Kathy Curry, Manager, Fernwood Cemetery, Funeral Home and Crematory, Mill Valley Are you aware that the resources consumed to cremate one body are equivalent to the amount of energy one person uses in a month?  Kathy will explain the option of natural or “green” burial where there are no toxic embalming fluids, no vault, and only a biodegradable casket or burial shroud. Ryan Lee, Author of “A Day in the Life of Death:  A Behind the Scenes Look at the Mortuary Business”  During today’s program, Ryan will provide information about technology for funeral services including webcast funerals for those far away and digital biographies. We’ll have a special guest talk about selling real estate in probate.The Elder Care Radio Show thanks its sponsors:  Reliable Caregivers • SearchSeniorLiving.Com • Dr. Michael A. Fraga, Neuropsychologist • Arcadia Home Care and Staffing •Brookdale Senior Living • Golden Living Centers • Home Instead Senior Care • Institute on Aging • Jewish Home of San Francisco • Lifeline Personal Response and Support Services • Dr. Thomas Yatteau, Concierge Medicine

                 July 29KSRO 1350                     July 30KFRC 1550                 Aug 6KNEW 910

Ryan Lee, Author of “A Day in the Life of Death:  A Behind the Scenes Look at the Mortuary Business” 

During today’s program, Ryan will provide information about technology for funeral services including webcast funerals for those far away and digital biographies. We’ll have a special guest talk about selling real estate in probate.

The Elder Care Radio Show thanks its sponsors:  Reliable Caregivers • SearchSeniorLiving.Com • Dr. Michael A. Fraga, Neuropsychologist • Arcadia Home Care and Staffing •Brookdale Senior Living • Golden Living Centers • Home Instead Senior Care • Institute on Aging • Jewish Home of San Francisco • Lifeline Personal Response and Support Services • Dr. Thomas Yatteau, Concierge Medicine 

Be Inspired!         Be Intentional!      Be the change YOU want to see in the World!

My mom was Dignosed  in 1983 and with  treatment including a radical mastectomy I can say today, She IS  a 28 year SURVIVOR!!!!  She is an example of amazing strength!  She taught me so much just witnessing her battle with the treatment & the drainage tubes & rebuilding of her physical streagth and altered Body Image. Rebuilding her life, the one the doctors said she would most deffiantly loose on the opperating table & to make arrangments for her two  young children prior to suregery.  I must say her spritual streagth through, the worst of it, Nerver waivered!

My Mom IS a true Pink Ribbon Warrior! For my Mom  & my own Daughter Kerrry,  for your mom & your daughters, yours siter, your best friend …. I walk, I donate, I sponsor.  I want to see Breast cancer be only used in the past tence,  like an old dusty box found in the corner of a garage in a very old house. One day….but today, I WALK!

This disease affects so many,  yet we are so far from cure &  vaccination…. I have a client who just lost her sister to BC and that follows the death 3 yrs ago of their mother to the disease.     :-(    Unfortunatly this isnt a ramdom story, it is all to common. 

Walk! Walk to find a cure my friend!  Be inspired! Be intentional & Be the change we want to see in our World! One day this,  like so many other illness ( Alzheimer’s my other passion) will be only spoken on used in the past tense. Our children will tell their children of the great illnesses of our time which took so many lives. One day….But  today, WE WALK!

 Kerry, Julie Ann & Trudy~ photo above

Walk, Run, Join a team, or  Support one, Be inspired, Be intentional, Be the change you wish to see in the world! 

 Take Action. Take control. Make a change!

Join us at the San Francsico Avon Breast Cancer Walk on July 9th and 10th, stay hydrated & wear ur favorite sneakers!

~Julie Ann 

About the Avon Walk San Francisco

From the bustling downtown to the raw beauty of Marin, the Avon Walk San Francisco experience will embrace the very aspects of charm and diversity that make this city one of the world’s favorites. This Avon Walk weekend July 9 -10, 2011 will have you traveling across the Golden Gate Bridge and alongside the Sausalito waterfront. The legendary roller coaster hills are only a small price to pay as we walk together to address the unusually high occurrence of breast cancer in the City by the Bay.

IN IT for a purpose

We’ll walk up to 39.3 miles between Saturday and Sunday -all so that women and men can get the medical care they need regardless of their ability to pay, and leading research teams can receive vital support in their ongoing search for a cure.  For more specific details regarding the mileage per day, please see their  event page at :

http://www.avonwalk.org/san-francisco/

Are you drinking your favorite coffee drink right now? If you’re and female, you’re actually lowering your risk of stroke! Yes I said lowering your risk of having a stroke according to study of nearly 35,000 women published Thursday in Stroke: Journal of the American Heart Association.

This study followed women between the ages of 49 to 83 for an average of 10 years, and found that those who drank more than one cup of coffee a day had a 22% to 25% lowered risk of stroke, compared with women who drank less.  And if that wasn’t enough, drinking little or no coffee was actually associated with a slight increase in stroke risk. Who knew!

Good news for you  Female Java Junkies!

Read more: http://healthland.time.com/2011/03/10/study-drinking-coffee-may-lower-womens-risk-of-stroke/#ixzz1GRSim26h

In a medical news release issued Dec. 23, 2009 by Michael Purdy, a new study has affirmed that patients with cancer are less likely to develop Alzheimer’s disease, and patients with Alzheimer’s disease are less likely to get cancer.

“There were still people who had both Alzheimer’s and cancer, but it was significantly less common than we would expect,” says lead author Catherine M. Roe, Ph.D., research instructor in neurology at Washington University School of Medicine in St. Louis. “If there truly is an inverse association, it gives us one more way of finding out what’s going wrong in both cancer and Alzheimer’s, and that could lead us to new ways to treat either condition.”

The study appears online Dec. 23 in the journal Neurology.  You can also view a detailed video with Dr. Roe available on the Washington University of St. Louis Video News Release site.

Hints of a disconnect between cancers and neurological disorders have been building for years. The effect was first noticed in patients with Parkinson’s disease, who get cancer less often; later studies have suggested that multiple sclerosis sufferers may have fewer tumors, and that Down syndrome patients who live to middle age or older have reduced incidence of cancer.

Six years ago, Maria Behrens, M.D., then a postdoctoral fellow at Washington University’s Alzheimer’s Disease Research Center (ADRC), noticed that few nursing home patients in her native Chile seemed to have cancer. Roe, Behrens and their colleagues conducted a study using data from research volunteers at the ADRC and found that people with Alzheimer’s disease were slower to develop cancer in the future.

For the new study, scientists followed 3,020 people aged 65 and older enrolled in the Cardiovascular Health Study, a National Heart, Lung, and Blood Institute Study that gathered extensive health data on its participants. ADRC researchers monitored the subjects for an average of five years to see if they developed dementia and for an average of eight years to see if they were hospitalized for cancer. As the study began, 164 patients already had Alzheimer’s, and 522 patients had been diagnosed with cancer.

During the study, 478 people developed dementia, and 376 developed invasive cancer. Those who had Alzheimer’s disease at the start of the study were 69 percent less likely to be hospitalized for cancer treatment than those who did not have Alzheimer’s when the study began. Caucasian people who had cancer as the study began had 43 percent less risk of developing Alzheimer’s disease. The latter finding, however, was not apparent in minority groups.

To make sure that doctors or caregivers treating Alzheimer’s patients weren’t just too overwhelmed to notice the start of cancer, researchers also monitored cancer incidence in patients with vascular dementia. Scientists think this condition is caused by lack of blood to the brain.

“If the decreased chance of cancer diagnosis was simply due to the fact that physicians don’t notice cancer in people with dementia, the decrease should have shown up for both the Alzheimer’s patients and those with vascular dementia,” Roe says. “But the drop in cancer risk was only seen in those with Alzheimer’s.”

Could Alzheimer’s be killing patients before they can be diagnosed with cancer? Roe says epidemiologists have analytical techniques to adjust for such deaths. She also notes that patients with vascular dementia tended to die sooner than patients with Alzheimer’s, yet they still had a higher risk of cancer than patients with Alzheimer’s.

Roe cautions that the study was based on cancer hospitalization data, meaning that cases of benign, inoperable or otherwise untreated cancers could not be considered. She and her colleagues plan to study a larger patient population to see if Alzheimer’s disease changes risks of specific types of tumors, and if certain types of cancers have larger or smaller effects on Alzheimer’s risk.

As you may know, the caregivers of Home Instead Senior Care of Sonoma County have cared for many seniors with Alzheimer’s, ensuring that they’re comforted each and every day.  We help them to live life as independently as possible as the disease progresses.  If you have any questions about caring for a elderly loved one, simple give us a call at 707.586.1516 and we’ll be happy to schedule an immediate appointment to discuss your home care needs.

Roe CM, Fitzpatrick AL, Xiong C, Sieh W, Kuller L, Miller JP, Williams MM, Kopan R, Behrens MI, Morris JC. Cancer linked to Alzheimer’s disease but not vascular dementia. Neurology, Dec. 23, 2009.

Funding from the National Institutes of Health, the National Heart, Lung, and Blood Institute, the National Institute of Neurological Disorders and Stroke, the National Institute on Aging, the Washington University Alzheimer’s Disease Research Center and the National Center for Research Resources supported this research.

Washington University School of Medicine’s 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked third in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.