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Spooky Statistics – Lack of Healthcare Staff to Meet Aging Demands

Spooky Statistics –

Lack of Healthcare Staff to

Meet Aging Demands

Do not read any further if you are wearing rose colored glasses.

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WARNING! DISTURBING CONTENT!!!

Do not read any further if you are wearing rose colored glasses.

by Certified Dementia Consultant

This is insider information taken from the leading academic journal in the United States called “Generations”. It is produced by the foremost academic and professional organization in America, The American Society on Aging. All content in their journal is researched and documented by the highest credentialed researchers in Aging topics. For more information on “Generations” and the American Society on Aging go to: www.generationsjournal.org and www.asaging.org. All information in quotation marks is directly from the Spring 2016 issue of Generations. (Volume 40 number 1)

Question: How many doctors specialize in diseases of the aging (and therefore know something about dementia)?

Answer: “There have been only 7,000 actively certified geriatricians for more than 10 years.”  That’s for 46 million Americans over the age of 65 (as of 2015), never mind older adults with dementia. Geriatricians are doctors specifically trained in diseases in older adults. Not many- huh? Only “about 300 new geriatricians” are trained in medical schools each year. Not many- huh? Worse, “more than 40% “of fellowships for training geriatricians went unfilled for the last 3 years. And some current geriatricians are letting their certifications lapse.

Question: What does that mean? How does that affect me?

Answer: These are the specialists, along with neurologists, for elders with dementia (most people with dementia are elderly).  Clearly there are not enough experts for the number of people who need their expertise. And there are less in the pipeline coming up, rather than more. Why? Geriatricians pay is lower than most other doctors, and loans to go to medical school can be well over $100,000! And of course the anti-aging bias we have here in America. Look at old wrinkled bodies? Ugh- I don’t think so!

So, what are you left with? Your regular family doctor, of course, or the local clinic, or the emergency room. In other words, the general healthcare system.

Question: How much training do general healthcare system doctors get in older adult issues including dementia?

Answer: “Less than 3% of medical students choose geriatric electives, meaning most medical professionals will enter the field without any exposure to serving elders.” Also there is currently a “lack of faculty, lack of funding, lack of time in [an] already busy curricula (courses that have to be taken) and the lack of recognition of the importance of geriatric training.” In the past, in most medical schools there weren’t even courses in geriatrics at all, so if your doctor had been practicing for a while, chances are huge that they have no training in geriatrics (or dementia). And currently, there is no requirement to have any training in geriatric conditions to keep up their medical doctor certification, except in California, and that is limited to doctors who have over 25% of their patients are elderly.

Question: What does that mean? How does that affect me?

Answer:

Answer: Chances are high that your family doctor and the doctors in the hospitals don’t have the knowledge that you think they do in relation to your elderly family member (especially one with a dementia). That means that you have to ask them how much actual training they have had over the years to know if you have to question their knowledge/advice for your loved one. Taking their knowledge/advice for gospel could be detrimental to your loved one’s health, if in fact they don’t know the intricacies of good care of elderly people. It can lead to medical mistakes, as they are now known. Things like misdiagnosis’s, nondiagnosis’s, the wrong medications prescribed, medications that react badly with the other medications given, too much medication, not enough medications, surgery advised when not needed, and no surgery prescribed when some is needed. The list of errors can go on and on.

Question: If my doctor doesn’t have the training what can I do?

Answer: Ask them to include a course in geriatric medicine for their next certification for their medical license.

Question: What about other health care personnel who deal with my loved one?

Answer: OK, let’s go through some professions.

  • Nurse Practitioners and Registered Nurses: In 2014 out of 3.1 million nurses there were “7,874 nurses trained in gerontological nursing”.
  • Social Workers: There is no formal gerontology certification for social workers, but there is a specialization in aging category.” In 2010 of 19,673 students, 1,318 graduated with a Masters in this category. Less than 4% of social workers have been trained to work with elders, yet 75% report they regularly work with this population”.
  • There were “2,158 pharmacists in the USA that were certified geriatric pharmacists”. They know the interactions and side effects of drugs that older adults take.
  • “As of 2015 out of 18,071 physical therapists in the USA, 1936 were certified in physical therapy specifically for older adults”.
  • In 2015 there were “18 occupational therapists certified in geriatric occupational therapy in the USA”.

As you can see, there is a severe shortage of all types of healthcare professionals trained in providing all types of healthcare to older adults, not to mention the subset of them with a dementia. You could call it a crisis, if you wish. And as more and more people enter the age group of elderly every day, it is reasonable to assume that it is going to get a lot worse before it gets better.

Question: What can I do to try and make things better?

Answer:  Get loud and demand action of the right people. Who are the right people? Believe it or not, its Politicians! Generations says (and I agree), that there is “no political will” to do anything to address this crisis. Heck, the crisis isn’t even on anybody’s radar, no matter what political party you are talking about. Yes, you may hear about the Affordable Care Act, but guess what? The Affordable Care Act doesn’t even address the issue of next to no knowledge how to properly care for the elderly or how to get professionals interested in caring for the elderly, or in training others to care for the elderly.

It seems as long as our citizens allow the politicians to define the problem as an “individual family” problem, and not a reason to come up with any answers for the problem, then no headway can be made in getting the resources it would take to increase knowledgeable health care for the elderly. It’s got to become the politician’s problem too.

How to do that? What about starting with a phone call, a text or an email to your local state and federal congressman and senator? Or maybe to your preferred political party candidate? It could be as simple as, “What will you do to address the lack of knowledgeable health care out there for our elderly? I want to know, and I vote.”

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Carole Larkin  MA, CMC, CAEd, DCP, QDCS, EICS is an expert in Alzheimer’s and related Dementias care. She has a Master’s of Applied Gerontology from the University of North Texas, is a Certified Alzheimer’s Educator, is a Dementia Care Practitioner, is a Qualified Dementia Care Specialist, and an Excellence in Care Specialist at the Alzheimer’s Foundation of America, as well as a Certified Trainer/Facilitator of the groundbreaking dementia care training tool, the Virtual Dementia Tour Experience She is a Certified Geriatric Care Manager who specializes in helping families with Alzheimer’s and related dementias issues. She consults with families telephonically nationwide on problems related to the Dementias. Her company, ThirdAge Services LLC, is located in Dallas, TX, and her website is www.thirdageservices.com.

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Alzheimer’s or Pseudobulbar Affect

By Carole Larkin

I wish I knew about this when my mother was alive. I might have been able to help her. She would suddenly burst into tears for no apparent reason. I’d say, “What’s wrong? What are you sad about? Are you depressed?” She’d say, “Honey, nothing is wrong. I’m not sad about anything. I don’t know why I’m crying, and I can’t stop it.” I’d naturally attribute it to her Alzheimer’s disease. But I was wrong. Now I know that it was really PBA (Pseudobulbar Affect).

PBA is a SEPARATE neurologic disease or condition where the circuitry between the Frontotemporal Cortex (where our emotions reside) and the Cerebellum (which is involved with the control of our emotions) and the circuitry between our Motor Cortex (where the initiation of movement starts) and the brain stem (where control of movement resides). It generally happens along side of other neurologic diseases or events such as Alzheimer’s or other dementias, Stroke, Traumatic Brain Injury, Multiple Sclerosis or ALS (Lou Gehrig’s disease). Its symptoms are sudden, unpredictable short bouts of laughing or crying that are NOT able to be controlled and are NOT reflective of the person’s true feelings at the time. It is estimated that 2 million people have this condition.

What can you DO about it? Well, there is an FDA approved medicine for it called Nuedexta. It is supposed to lessen the number of events or stop them completely in 80% of the people they have tested. That is good news! Also recommended is to distract the person with something else, maybe a funny story or two or a funny video, if it’s the crying aspect of the disease showing.  If it’s the laughing part of the disease showing, removing the person to a quiet place and playing some soothing music, or showing them a calming video, of nature or underwater scenes. You can give them a shoulder and neck rub to relax the muscles that tense up when people are very emotional. It also helps the person focus on the sensation of the rubbing or kneading and may serve as a distraction for them. Sometimes coaching them thru deep breathing exercises may help them get over the bout.

How do they feel about it? In one word, EMBARRASSED. Wouldn’t you? What can you do to help them emotionally?  Tell them it’s part of a disease. It’s not their fault. You understand it’s something they can’t help. It’s something that will stop on its own shortly. (Because it will stop shortly. Most bouts last only a few minutes.) You love them and you are proud of them, even if this happens occasionally. They aren’t alone in this happening, 2 million others suffer with it too.

What lessons did I learn from discovering this affect exists?

When someone is crying for a short time on a periodic basis, it doesn’t ALWAYS mean that they are depressed. Don’t automatically ask for an antidepressant or to increase the dose if they are already on an anti-depressant. (The less meds the better).

Ask them if they are sad, don’t assume they are. I know that many people with dementia have depression, just don’t assume it always exists.

Listen to what they say when they answer the question why are they crying? If they say, “I don’t know.” Believe them. Very often by the time people  reach early midstage in the diseases, they do tell you the absolute truth, as they see it, feel it and think it. Whether it matches our reality is our problem, not theirs. They are not lying to us. They are telling us the way it is to them.

Ask your doctor about these bouts of laughing or crying. Tell him about this article and use the letters PBA when you are explaining what happens. Your family doctor may not know about the existence of PBA (Pseudobulbar Affect). He can research it, and prescribe the drug, if it’s appropriate for your loved one. Side effects and tolerance must be taken into account in that decision, of course.

It’s too late for me, but it may not be for you.

Carole Larkin

Carole Larkin is a Geriatric Care Manager with ThirdAge Services. 

Carole is doing some amazing work in the area of dementia and has nominated for the “Dementia Professional of the year.”   By clicking on the logo below you will be taken to a page which will give you more information on Carole, as well as a link to the nomination page.    

Phone  214-649-139

thirdageservices@gmail.com

www.thirdageservices.com

 

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