Obama Considers New Best Practices for Nursing Homes

The federal government is considering a new rule that would improve the care and safety of the 1.5 million patients living in more than 15,000 long-term care facilities or nursing homes in the US.

The current requirements for Medicare and Medicaid participation have not been reviewed or updated since 1991. Since that time there has been extensive evidence-based research that has enhanced knowledge of resident safety and health outcomes.

“In light of these changes, we recognized the need to evaluate the regulations on a comprehensive basis, from both a structural and a content perspective,” according to the rule.

A proposed rule being considered by the Department of Health and Human Services would create best practices for nursing homes that participate in Medicare and Medicaid programs. The rule would require staff be properly trained on caring for patients with dementia and preventing elder abuse.

The rule also would require facilities improve their care planning and provide more food choices. Nursing homes would also be required to update infection prevention and control programs.

“These proposed changes are necessary to reflect the substantial advances that have been made over the past several years in the theory and practice of service delivery and safety,” HHS wrote in the rule. “These proposals are also an integral part of our efforts to achieve broad-based improvements both in the quality of health care furnished through federal programs, and in patient safety, while at the same time reducing procedural burdens on providers.”

President Barack Obama initiated the call for improved regulations at 2015 White Conference on Aging. The president is working to bring nursing facilities towards utilizing the current trends in medical technology.

In an excerpt from the deliverable, “The 2015 White House Conference on Aging is harnessing technology to bring today’s conversation to communities across the country. Hundreds of watch parties are happening across every state in America and are being hosted by organizations such as AARP, the National Association of Area Agencies on Aging, Service Employees International Union (SEIU), the Diverse Elders Coalition, Leadership Council of Aging Organizations members, and numerous cities and counties.”

Many nursing homes are already on this course, but the new regulations will ensure that these rules are followed across the board.

Tests and Treatments Older Americans Should Question

The American Geriatric Society (AGS) has released an updated list of recommendations that will raise awareness about treatments and tests that may lack efficacy and even cause potential harm. The list is part of the ABIM Foundation’s Choosing Wisely campaign. More than 70 societies have released recommendations of test and treatments that patients and providers should question.

The updated list from AGS reflects new research on conditions affecting older adults, such as agitation, certain types of cancer, delirium, dementia, diabetes, and insomnia. Based on new research and insights, these topics may warrant deeper discussions on the appropriate healthcare choices, according to AGS.

“Providing high-quality care to older adults means recognizing and responding to the specific, evolving challenges and opportunities that we all face as we age,” Wayne C. McCormick, MD, MPH, AGSF, president of the AGS, said in a statement. “Since 2012, the AGS and the ABIM Foundation have worked together through Choosing Wisely to synthesize pressing updates from the geriatrics field in a format that is easy to understand—and apply—in everyday practice.”

AGS has updated 7 specific tests, treatments, or procedures based on emerging expert opinion. For instance, lung cancer screening have been added to the list of oncological screenings that should not be recommended for older adults without first considering life expectancy and the risks associated with testing, overdiagnosis, and overtreatment. In addition, when recommending moderate blood-glucose control for older patients with diabetes, medications other than metformin should be avoided.

AGS continues to recommend avoiding antipsychotics as the first choice treatment for behavioral and psychological symptoms associated with dementia. This guidance has been expanded based on new data. The AGS panel of experts determined that antipsychotics provide “limited and inconsistent benefits” and include the risk of oversedation, worsening memory problems, and increased likelihood of falls, strokes, and mortality.

The Society also added new guidance:

Pursuing oral-assisted feeding for patients with advanced dementia instead of a “percutaneous” feeding tube threaded through the skin into the stomach
Not using antibiotics to treat patients who have bacteria in their urine (a condition known as bacteriuria) unless certain urinary tract symptoms are present
Conducting a treatment regimen review before prescribing medication

“As the older adult population in the US continues to grow, it’s so important that geriatrics care principles reflect the latest science, evidence, and advice supporting quality health and care,” said Paul Mulhausen, MD, MHS, FACP, AGSF, who chaired the AGS Choosing Wisely Workgroup responsible for the list. “We are grateful to the ABIM Foundation for this opportunity to share timely recommendations that will help patients avoid unnecessary tests and procedures and support overall well-being.”

Zika May Cause Brain Damage in Adults Too

Most of the concern surrounding the Zika virus has centered around pregnant women and the birth defects that develop in babies who were infected in the womb. However, adult brain cells are not completely safe.

In rare cases, it was known that Zika was linked to Guillain-Barré syndrome, which can result in paralysis and death. People experiencing Guillain-Barré tend to recover about 6 to 8 weeks after symptoms, such as tingling and muscle weakness that spreads throughout the body, begin. Now, new research has found evidence that adult brain cells critical to learning and member may be at risk, as well.

“Based on our findings, getting infected with Zika as an adult may not be as innocuous as people think,” Joseph Gleeson, MD, adjunct professor at Rockefeller, head of the Laboratory of Pediatric Brain Disease, Howard Hughes Medical Institute investigator, and co-author of the study, said in a statement.

A study published in Cell Stem Cell found that mice infected with the Zika virus showed neural progenitor cells were susceptible to the virus. Most adult neurons are resistant to the virus, but some replenish and are vital for learning and memory. The researchers found that the virus may have the same ability to infect adult neural progenitor cells as it does regarding fetal neural progenitor cells.

The results of the research, conducted only in mice, are only a first step, though. More research is needed to find the effect on an adult brain and to see if the mice model translates to humans. The researchers are also looking to find if the damage to adult brain cells can result in long-term damage.

“Zika can clearly enter the brain of adults and can wreak havoc,” Sujan Shresta, PhD, study co-author and a professor at the La Jolla Institute of Allergy and Immunology, said in a statement. “But it’s a complex disease—it’s catastrophic for early brain development, yet the majority of adults who are infected with Zika rarely show detectable symptoms. Its effect on the adult brain may be more subtle, and now we know what to look for.”

Coffee Benefits Among Colon Cancer Patients

Hot coffee on a plate — Photo: Creative Commons

Cancer Prevention Overview

HealthDay, a popular medical health digital magazine reported that the Gastrointestinal Cancer Center at the Dana-Farber Cancer Institute did a study of about 1,000 patients and found that “Those who drank coffee regularly had a better disease-free survival, meaning they had a lower rate of having their cancer recur or of dying.”

And another study published by the National Institute of Medicine reinforced the concept that drinking coffee is beneficial in helping to reduce the risk of other forms of cancer as well.

The Coffee Colon Factor

In addition, Dr. Charles Fuchs who helped lead the study said “But I do think it would be reasonable to conclude that it could be the caffeine in coffee that is affecting the colon cancer pathway. It’s just that for now we can’t say for sure. We need to confirm these findings in other patient populations.”

He added that patients who drank other caffeinated beverages like soda had “a poorer outcome,” and decaf coffee and tea did not produce the same benefits.

The Dana-Farber Cancer Institute stated, “Regular consumption of caffeinated coffee may help prevent the return of colon cancer after treatment and improve the chances of a cure.”

The New York Times reported that colon cancer patients who consumed higher volumes of coffee each day “had a far lower risk of dying or having their cancer return than those who did not drink coffee.”, referring to the same research. The study showed promise that “significant benefits” began with two or three daily cups of coffee, and patients who consumed four or more each day “had half the rate of recurrence or death than non-coffee drinkers.”

Additional reports stated that the scientists said until additional research is conducted, “people should not begin drinking coffee if they aren’t already java drinkers,” and those who do drink it should not increase their intake.

Psychological Care of Aging People

With aging, elderly people require a lot more attention and care. One of the most important areas of care is their psychological well being. It is not uncommon for senior citizens to be depressed, having mood disorders, feeling lonely or having other psychological problems. Additionally, they may be suffering from dementia. All these issues adversely affect their physical health. The whole process of mental and physical health deterioration ruins their healthy aging cycle, leaving them sad and unhappy. Things can me made much better for aging people by proper and attentive psychological care. Here is how we can go about it:

Understanding the Process of Aging

The process of aging is not easy. From complete independence, the person loses a lot of personal dependence and strength, and becomes reliant on others; sometimes even the most basic needs. The body does not work as fast as it used to, the senses depreciate, and the brain becomes weak. It is very difficult for the elderly to come to terms with all these changes, during which many are exposed to psychological issues. The ones taking care of aging people need to understand the process of aging. This will help them to look at their concerns and behavior from a much better and understandable perspective.

Be Considerate

The challenges that aging brings forth require a lot of patience from the care taker’s side. While taking care of an elderly, be considerate of their needs and the changes that they are going through. They would be going through decline in their sensory abilities, so keep that in mind while communicating with them and attending to them. Speak a bit louder, but politely. Hand them things carefully. Help them with eating, drinking and dressing if they need assistance with that.

Do Not Imply Yourself

They have lived a life on their own, and having to be told what to do may not be taken so well in aging. Leave some authoritative space for the elderly to make choices and decisions. Let them feel that they are still in power, they can decide. This will help them retain dignity and self respect and take aging process positively. Do not try to impose your decisions on them; instead ask them in a manner that they automatically make the right call.

Make Them Feel Included

The main reason why people are prone to psychological problems like depression, mood disorders, hallucinations, etc., is because they don’t feel included in their social surroundings. They are often ignored in conversations even if they were present in the same room. This leads to a lot of self doubt and speculation. They feel lonely and unwanted. So make them feel a part of family. Include them in conversations and seek their opinion just like you normally would ask any other person. Don’t discredit their input.

Aging is a challenging course. But with help from caretakers, it can be made easy for the people who are going through the process. It only requires consideration and empathy.

Daily Nut Consumption Helps Reduce Risk of Disease

Could eating nuts every day improve your health and reduce your risk of developing certain diseases? A Dutch study from Maastricht University published in the International Journal of Epidemiology found a positive correlation. In a 10-year study of more than 120,000 men and women between the ages of 55 and 69 years, people who ate at least 10 grams of nuts or peanuts a day had a 23% lower chance of death.

Specifically, there was a decrease of 45% of neurodegenerative disease, of 39% for respiratory disease, and of 30% for diabetes.

“Peanuts showed at least as strong inverse associations as tree nuts, but peanut butter did not,” Piet A. van den Brandt, PhD, and Leo J. Schouten, MD, PhD, wrote. “Meta-analyses showed consistent risk reductions for cancer and respiratory mortality.”

However, a recent study in Nutrition Reviews determined that current evidence of the nut consumption’s disease-prevention role remains inconsistent. Researchers reviewed 36 epidemiological studies and clinical trials that reported an association between nut consumption and type 2 diabetes or specific cancers.

Overall, they determined that nut consumption may play a role in reducing the risk of developing colorectal cancer, endometrial cancer, and pancreatic cancer. However, there was no association found with type 2 diabetes or other types of cancers, including breast cancer, gastric cancer, leukemia, ovarian cancer, and prostate cancer.

“Additional studies are needed to more accurately assess the relationship between nut consumption and the prevention of individual types of cancer, given the scarcity of available data,” the authors said.

However, what is known is that many nuts do supply a great deal of nutrients that our bodies require each day. According to GoodFood, there are varying benefits of nuts, depending upon the type of nut you are eating.

As far as peanuts are concerned, whfoods.org states “Peanuts are rich in monounsaturated fats, the type of fat that is emphasized in the heart-healthy Mediterranean diet. Studies of diets with a special emphasis on peanuts have shown that this little legume is a big ally for a healthy heart. In one such randomized, double-blind, cross-over study involving 22 subjects, a high monounsaturated diet that emphasized peanuts and peanut butter decreased cardiovascular disease risk by an estimated 21% compared to the average American diet.”

Following is a table from the USDA National Nutrient database that depicts the nutritional value of peanuts (per 100g):

Principle	Nutrient Value	Percentage of RDA
Energy	567 Kcal	29%
Carbohydrates	16.13 g	12%
Protein	25.80 g	46%
Total Fat	49.24 g	165%
Cholesterol	0 mg	0%
Dietary Fiber	8.5 g	22%
Vitamins
Folates	240 µg	60%
Niacin	12.066 mg	75%
Pantothenic acid	1.767 mg	35%
Pyridoxine	0.348 mg	27%
Riboflavin	0.135 mg	10%
Thiamin	0.640 mg	53%
Vitamin A	0 IU	0%
Vitamin C	0	0%
Vitamin E	8.33 mg	55.5%
Electrolytes
Sodium	18 mg	1%
Potassium	705 mg	15%
Minerals
Calcium	92 mg	9%
Copper	1.144 mg	127%
Iron	4.58 mg	57%
Magnesium	168 mg	42%
Manganese	1.934 mg	84%
Phosphorus	76 mg	54%
Selenium	7.2 µg	13%
Zinc	3.27 mg	30%
Phyto-nutrients
Carotene-alpha	0 µg	—
Crypto-xanthin-beta	0 µg	—
Lutein-zeaxanthin	0 µg	—

Four Common Childhood Illnesses and How to Treat Them

Ricard Canals 'Sick Child' — Ricard Canals 1876 – 1931 Barcelona ‘Sick Child’

You have just welcomed your new born into the world and you do everything possible to keep your child safe. Unfortunately, babies and newborns are bound to catch something, no matter how hard we try to protect them. The idea of course is to protect them from the viruses that lurk out there as much as we can. Here are some common diseases and illnesses faced by children and how to properly treat them.

Gastroenteritis

This is a very common type of illness among children. Even though you may not be familiar with its name, in layman terms, it is a tummy ache. Additionally, it can lead to diarrhea and abdominal pain if things are not handled correctly. This type of disease normally comes as a result of the variety of viruses inside the stomach of children. If your child faces this problem, it is suggested that he/she drink water;* however, not very much, as it sickens the child. In this case, it is ideal to give them a tablespoon of electrolyte solution, gradually increasing the amount with every serving. You can also give them fruits to cure this illness.

Influenza

Flu can really make your child weak as it gives chills to the body, makes the throat sore, causes a headache and may also result in diarrhea. Children often suffer from Influenza during winter times but your child always comes back to their normal routine if you schedule annual flu vaccines to cure it. You can administer it as a shot as well as spray if your child is over 2 years old. Doctors recommend visiting them in case children are facing symptoms of Influenza, just to be on the safe side.

Roseola

Normally, the symptoms of Roseola among children are really minor and it might be difficult for you to understand if they are under the weather. This illness usually comes with coughing, congestion, high fever and itchy rashes on the chest. In addition, Roseola remains for at least a week. If you see things going out of hand, you should always visit your doctor. In the meantime, you can give your child ibuprofen to relieve them of the pain temporarily.

Hand Foot Mouth Disease

We see children putting their hands and feet in their mouth routinely. They usually do this because they have a habit of taking things in mouth, unintentionally acquiring germs by doing so. As children, they do not know this, but this can cause serious problems in their mouth, which can be in form of sore. Those sores in their mouth come along with red blisters and usually last for a week or so. These sores can be really painful for the children but like other diseases, can be cured by acetaminophen or children’s ibuprofen. You can also give your child ice pops in this case but avoid giving them acidic juices as they can be harmful.

Time to Visit the Doctor

Nowadays, even the smallest diseases among children can become serious; so, you need to be really attentive and careful when it comes to your child’s health.

If your child is facing any of the diseases listed above, you must not wait; you should immediately make an appointment for your nearest pediatrician and start following the recommended instructions and prescription given by the physician.

*Disclaimer. This article is for information purposes only. Any information provided here should be confirmed by a qualified medical professional at all times.

The Links Between Smoking and Cancer

Smoking and Cancer Risks — *Smoking can affect many parts of the body*

In the 20th century, tobacco was responsible for an estimated 100 million deaths in the world. According to the World Health Organization (WHO), if people do not stop smoking, then it is likely that billions more will die in the future.

We have all been hearing for generations that smoking is dangerous to your health and can cause cancer. With so much research done on the direct links between cancer and smoking, the reasons to stop smoking are clearer than ever before. Smoking is killing countless people all over the world. Let’s read more about smoking and cancer in detail below.

Which Body Part is Affected Most by Smoking?

When we smoke, chemicals in the cigarette enter the bloodstream, directly affecting the whole body. This is the main reason why smoking is dangerous to health as it affects almost all the body parts. Also, it causes fourteen types of cancers, lung diseases, and heart diseases. Unfortunately, people do know about it but still continue to smoke, due to the addictive nicotine which is present in it.

How is Cancer Caused by Smoking?

*A DNA adduct (at center) of benzo[a]pyrene, the major mutagen in tobacco smoke*

Cancer is caused when smoking damages our DNA and genes that guard us against this disease. Cigarettes contain several chemicals such as polonium 210, nitrosamines, benzo (a) pyrene and benzene that damage our DNA. There is also acrolein is an organic compound in cigarette smoke. It’s a toxic compound and associations have been made between acrolein and the development of lung cancers. It is a known DNA mutagen, and this, in turn, could lead to carcinogenic effects. Acrolein has also been linked to heart disease.

How Much Time Does It Take for Smoking to Cause Cancer?

The time duration which it takes for smoking to cause cancer is not defined. Usually, it can take decades or even years for smoking to affect your DNA. Fortunately, our bodies are designed in a way that they can deal with these damages, but when dangerous chemicals come into the body because of smoking on a continuous basis, it becomes difficult for the body to deal with them. Our body can fight against these elements for a time, but will not be able to keep them away indefinitely, especially if an individual is addicted to smoking. Ultimately, there will be a time when it these toxins will completely damage the internal organs.

Which Cancer is Caused by Smoking?

Smoking can directly affect the lungs in the body and research reports that lung cancer has one of the least survival rates among all cancers and consequently, many have died because of this serious illness.

While smoking affects the lungs, there are many more types of cancers that are associated with smoking. It can cause damage and create tumors in such organs as the bladder, larynx, mouth, pharynx, oesophagus, liver, kidney, pancreas, bowel, ovary, sinuses, cervix, nose, leukemia and breast cancer. It can actually destroy the whole body, once someone has acquired any of the cancers out there.

However, there is good news, as the best way to prevent such deaths is to give up smoking altogether. There are many cancer prevention organizations available. One popular service is preventcancer.org. Here you can learn the details of prevention methods for each of the cancers that can affect your body, as well as volunteering and donating to the cause.

Five Common Symptoms of Diabetes

Do you know that approximately 24 million people in the United States are a victim of diabetes? It is a serious and lifelong condition that can take some people towards certain death. Given that diabetes is a very dangerous disease, many people may not be aware of the symptoms; therefore, we are providing some symptoms that are commonly associated with diabetic patients.

Strong Hunger

When you are suffering from diabetes, your cells do not get energy. Due to this, insulin is not at all present in your body or it is not in its proper working condition. Since your body is drained of energy, your body reacts to finding more energy, generally in form of food. Ultimately, it causes intense hunger. This is the reason why we see so many diabetic patients getting hungry and eating promptly.

Obesity

This point is associated with the previous one. When you eat too much, it causes weight gain and a person becomes obese. In addition to that, obesity is mostly found among people who are suffering from type 2 diabetes. This is commonly seen in them because patients having type 2 diabetes suffer from insulin resistance. So, if such patients want to control obesity, exercising would be one consideration.

Frequent Urination

If you feel that you go to the bathroom more often than you should, consider consulting your doctor. Going to the bathroom frequently is not a normal condition. When your body has an excessive amount of glucose in your body, then you urinate more often. Additionally, when you urinate abnormally, you will also have to compensate for that lost liquid. For that, you will surely require drinking more water to keep yourself hydrated.

Dry Mouth

Your body would be using more than the normal amount of fluids causing the frequent urination mentioned above, so you must work to keep yourself hydrated. If you don’t or even if you do, you could get dehydrated (not a good thing) and your mouth will feel dry. Dry mouth also leads to faster tooth decay and possibly bad breath.

Unclear Vision

When you suffer from diabetes, blurry or unclear vision is also one of the common symptoms that you might face. Research predicts that retinal disorders are normal in case of diabetes. This is normally caused because the tissue is being pulled out from your eye lenses, thus affecting your ability to focus. If you take actions beforehand, then it can be treated properly and can save you from prolonged vision issues.

Bruises Take Time to Heal

When a person is free from diseases, their bruises and cuts cure timely. However, the injuries of those suffering from diabetes usually take longer to heal and cure than that of other healthy humans. This again happens because of the excessive amount of glucose in your body which undermines the ability to cure the marks.

If you are facing any or all of these issues, it is time to visit your doctor. Normally, diabetes is detected by carrying out a urine test followed by a blood test to see whether or not excess glucose is present in your body. Most people live normal lifespans with the proper treatment and medication. If you feel you might be contracting this disease, you should go for a checkup so you can be properly diagnosed and if the results are positive, you can get the appropriate treatment.

How Can You Determine If You Have Heart Disease

What if you have a heart problem and you are not aware of it? Well, it can happen. All of us are not aware of what is happening inside our body and hence, we live a peaceful life.

All heart problems do not come with clear symptoms; though, some common things may occur in your body if you have heart problems. To confirm or deny that you have a heart problem, you must always get regular checkups from your doctor and if you are facing any of the issues listed below, then you must contact your physician immediately or go to the nearest emergency room, especially if you are over 40*.

Chest Pains

Chest problems are one of the common signs faced by people suffering from heart disease. Chest problems often occur when you are either having a heart attack, feel some sort of pressure, feel pain or tightness in the heart, or have a blocked artery. Everyone cannot define this situation, attributing it to other reasons of their own. This kind of feeling is not normal and lasts more than a few minutes. Chest problems can occur either when you are doing some physical activity or you are at rest.

If you are feeling pain, pressure, or discomfort in the center of your chest or your arms, back, jaw, neck, or stomach, go to the nearest emergency room or call 9/11 for assistance. Do not ignore these symptoms.

Shortness of Breath

Shortness of breath is another way your body is alerting that it could be a sign of heart trouble as a response to extra stress on your heart. Fatigue and shortness of breath are more common in women and may begin months before a heart attack

Nausea

You may think that nausea is common and can occur due to an upset stomach. Well, it is possible that you can have an upset stomach for countless reasons, such as eating something that you do not normally eat or something else along those lines. Even though it may have nothing to do with your heart, these are really serious matters and you need to be careful about them. Sources report that people often feel nauseous when they have heart diseases. If you vomit often, then you need to consider this matter and inform your doctor about it.

Snoring

Is your significant partner irritated because of your snores? Although it is normal for some people to snore while they are sleeping, when you snore more loudly than usual, then that can be a symbol of sleep apnea. This actually puts in extra stress and pressure on your heart. If you think that this is becoming a common occurrence, then you need to consult your doctor.

Arm Ache

Doctors consider that when you feel pain in your left arm, you might have heart issues. Normally, this pain starts from your chest and spreads outwards, but sources report that people who have arm pains have had minor heart attacks in the past. Nowadays, even the smallest and normal pains in your body require attention; so, you must get them checked instantly if you are facing them.

Weariness and Exhaustion

Do you often feel weary, tired, and exhausted? Then, it is time to set up an appointment with your doctor. Things that never made you tired or exhausted and now affect you can be a clear symptom of a heart disease. If women face this, they should take it seriously and ask their doctor to prescribe them medicines to cure it.

In Summary:

You may experience any of the following that precedes a heart attack:

- mild pain or discomfort in your chest that may come and go
- pain in your shoulders, neck, and jaw
- sweating
- nausea or vomiting
- lightheadedness or fainting
- breathlessness
- Anxiety or confusion

Please see our heart disease infographic for more information.

Now that you know the symptoms of heart disease, we are sure that you will be able to determine the cause and act in time before things get worse.

*This article is for information purposes only. It is highly recommended to seek the advice of an experienced medical professional or your physician regarding any concerns or abnormalities you may be experiencing.