Pittsburgh Healthcare Report

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Redefining Aging

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A puppy or kitten playing clumsily with a toy is certainly categorized as cute. Babies, with their contagious smiles and giggling squeals, are adorable. But when it comes to talking about older adults, please refrain from talking about how ‘cute’ or ‘adorable’ they are.

And, do not refer to them as ‘sweetie’ or ‘honey.’ Terms of endearment can carry different meanings and lead to judgments or assumptions at any age. One of the most damaging behaviors of ageism is to begin treating older adults like children, and words are often part of the problem.

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Modern Technology is an Activity of Daily Living at Providence Point

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Providence Point is a robust retirement and LifeCare community welcoming residents 62 and older. Residents have access to a revolving calendar of classes, programs and events. The popularity of classes for iPad, iPod and iPhone tutorials are proof that technology is everyday routine and a must for living at Providence Point. The number of visitors to the new website, that features a Google 360◦ virtual tour, has also risen dramatically.

The website was recently relaunched and includes floor plans for Hamilton Tower, and a video ‘fly-over,” an architectural rendering of the planned expansion of 70 spacious one- and two-bedroom residential living apartments. Using technology to gain information is no longer out of the hands of the older generation. Tech-savvy seniors participate in the community’s social media regularly and were thrilled to experience the tour of their community with Google VR glasses.

The virtual tour allows visitors the option to tour the grandeur at Providence Point from the comforts of home, something our tech-savvy residents are sharing with friends to best demonstrate the attributes of living at Providence Point. [Read more…]

The Haze Around Medical Marijuana in Pennsylvania

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By Thomas Handerhan

Marijuana has been extensively covered in the news recently, both nationally, as well as here in Pennsylvania. Currently, nine states (Washington, Oregon, California, Nevada, Colorado, Alaska, Maine, Vermont and Massachusetts) have legalized the recreational use of marijuana for adults 21 years of age and older.

Sales of medical marijuana in the U.S. were estimated to be around $3 billion in 2017 and are expected to rise.1 States like Pennsylvania (and 28 others, as of current date) have legalized the use of marijuana for medical reasons, with different guidelines in each jurisdiction. February 15th, 2018, marked the opening of the Commonwealth’s first medical marijuana dispensary. In an effort to ease public confusion, it is important to understand the legalities around these dispensaries and the patient process of receiving medical marijuana. Notably, this article is not a discussion of the pros/cons of marijuana.

The first question that comes to many people’s minds is, “Is medical marijuana really legal?”. The answer is a bit nuanced. In Pennsylvania, the Medical Marijuana Program (Act 16 of 2016) was signed into law in on April 17th, 2016, but from the federal perspective, marijuana is still technically illegal, with prohibition stemming back approximately 80 years. Therefore, in the Commonwealth, patients possessing and using medical marijuana, as well as the prescribing doctor, grower and dispensers run the risk of federal civil and criminal penalties. [Read more…]

Measles, Mumps, Rubella—Oh My!

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By Erin Hayden

In 2014-15, a record 885 cases of measles were reported, including outbreaks at Disneyland, exposure precipitated by international travel and cases concentrated within isolated pockets of unvaccinated communities.1-2 Although the number of measles cases has since reduced, risk is still present. In February 2018, Allegheny County saw a confirmed case of the measles in a fully vaccinated person. At current time, no other cases have been confirmed, but the 7 to 21-day incubation period for the virus delays detection of signs and symptoms. Mumps have also resulted in several outbreaks recently, including one in 2014 that hit the National Hockey League (NHL) and another outbreak in Arkansas in 2016-17 that affected over 3000 individuals.3 Outbreaks of these diseases result from a combination of factors, including lack of vaccination among groups, but also the longevity of the antibodies and immune response formed in individuals that are vaccinated.

MMR stands for measles, mumps and rubella, and commonly refers to the vaccine product used to prevent these diseases. These are three separate viral illnesses that are serious and spread easily through personal contact and airborne transmission. Measles is an airborne disease characterized by high fever and rash, while rubella is a form of measles with similar symptoms as well as the potential to cause birth defects/miscarriage in pregnant women. Mumps presents with painful/swollen glands and lymph nodes, as well as widespread body pain, fatigue and fever. Complications of mumps can include deafness and meningitis. In the United States, these diseases could be completely eradicated due to the availability of the highly effective MMR vaccine. [Read more…]

A Spike in Blood Pressure: Guidelines

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By Briana Schreckengost

While many people tend to put it off, it is recommended to schedule a yearly appointment with a physician to get a check up on your health. Illnesses that make us feel poorly, like the common cold, influenza, or an earache often send us to the doctor, but it is just as important to be evaluated when we are feeling healthy too.

Having a yearly assessment completed helps detect early signs and symptoms of common chronic problems, such as cardiovascular disease.  For instance, hypertension, or high blood pressure, affects approximately one third of American adults and is the primary reason for over 40 million doctor visits each year.1 Based on new updates to blood pressure guidelines by the American Heart Association (AHA) and the American College of Cardiology (ACC), many adults may be facing a new diagnosis of hypertension. [Read more…]

Finding a Cure for Alzheimer’s Disease

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By Kelly Mazzei

New funding for Alzheimer’s disease research might be just the gift needed to move closer to a cure. In November 2017, Bill Gates, cofounder of Microsoft, pledged $100 million dollars to Alzheimer’s disease research.

This contribution was prompted by Gates’ personal family history of the disease as well as his interest in the financial burden it places on families, the healthcare system and society as a whole.1  Alzheimer’s is currently the 6th leading cause of death in the United States, with 1 in 10 individuals anticipated to develop the disease at some point in their life.2 The social and financial burden of Alzheimer’s, along with the prevalence of the disease, has increased in recent years due to an aging population. The yearly cost burden has been estimated by the American Alzheimer’s Association to be around $259 billion.2

Taking both the emotional and financial aspects into account, Bill Gates has expressed a desire to have this donation go towards new and innovative approaches to solve the disease. His goals include enabling researchers to gain a better understanding of how Alzheimer’s disease progresses, improving screening and detection methods, fast tracking the clinical trial timeline, and ensuring that the data collected from trials is compiled into a common and more accessible form.1

Current FDA approved treatments for Alzheimer’s disease include cholinesterase inhibitors (Aricept, Exelon) which increase acetylcholine in the brain to improve symptoms, and NMDA receptor antagonists (Namenda) which slow the deleterious effects of glutamate in the memory centers of the brain.3 These existing treatments merely slow the progression of the disease, and fail to provide a cure. [Read more…]

Disneyland: The Sickest Place on Earth?

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Disneyland’s official tagline is the “happiest place on Earth.” It’s the place referenced by every Super Bowl champion, a cultural landmark known across the world, and ultimately, a place for families to go for entertainment and fun. It is considered a place of magic for many, but unfortunately in October 2017, it also became a place of sickness when multiple cases of Legionnaires’ disease became associated with the park. 

Legionnaires’ disease is a type of pneumonia not typically spread from person to person but rather through breathing in small droplets of water which contain the bacterium Legionella. This bacterium is able to multiply rapidly in water systems that have not been cleaned properly or on a regular basis. The most common water systems affected by this bacterium are mist machines, cooling machines, pools, and fountains.1 Since the water systems for these machines/objects are complex, it can be hard to correctly and completely clean every aspect of them, causing Legionella to grow and spread in an easier fashion.1,2

The pneumonia caused by Legionnaires’ disease generally appears two to ten days after exposure and will typically present with headache, muscle pains, chills, and a fever over 104°F. A few days after these symptoms appear, the disease may progress, causing symptoms such as cough, chest pain, trouble breathing, nausea/vomiting, and mental status changes. Not all individuals are at equal risk for development of the disease.1,3  Those with highest risk include smokers, people who have a weakened immune system, those with a pre-existing lung condition (such as asthma or chronic obstructive pulmonary disease [COPD]), or who are aged 50 years or older.1 If the disease is left untreated, it can lead to potentially dangerous and life-threatening complications such as respiratory failure, septic shock, or acute kidney failure.1,3 Treatment typically consists of antibiotics as no vaccine is available. However, the most important aspect of the disease is that is it preventable through proper maintenance of the complex water systems, which serve as the growth medium for the bacteria [Read more…]

How Medical Apps Maintain Your Health and Mind?

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By Ray Parker

The medical apps have an imperative role in a play in decreasing emergency room visits and hospitalizations throughout the healthcare continuum. This is done by enhancing care coordination and communication among doctors, nurses, specialists and others.

According to a research, the re-admission rates at a hospital have been decreased by 92% whereas the emergency room visits reduced by 87% with greater communication and the utilization of mobile health applications.

The utilization of mobile communication tools has led increased patient engagement. This means more people are focused on enhancing their wellness and health. This includes continuing exercise routines, sticking to a health doctor-recommended diet, following their medication timetable along with follow-up appointments. [Read more…]

5 Ways to Plan for An Unexpected Medical Emergency

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By Ryan McEniff

Although the Scout motto has been used by millions of Scouts since 1907, it can be applied to how you can be better prepared in dealing with any potential emergency that your mother might experience like an injury, car accident, or something else. Being prepared will help you to help make the best decisions possible when Mom can’t make decisions on her own.

This article summarizes different precautionary measures: a health care proxy, trust, will, power of attorney, and the Five Wishes program that can help you put into place, so when an emergency strikes, your family is prepared.

Healthcare Proxy – a legal document whereby an individual appoints someone (an agent) to make healthcare decisions when they’re incapable of making them. If they’re capable, the proxy does not take effect; however, when the individual is declared incompetent by a physician, then the proxy becomes active. The agent, also called the Healthcare Power of Attorney, is someone to be trusted by the individual. Healthcare proxies vary from state-to-state, but share common guidelines:

  • Name and address of the agent/alternate agent
  • Duration of the proxy
  • Special instructions based on the individual’s desires (if none are listed, the agent can have flexibility with feeding tubes, dialysis, blood transfusion, etc.)
  • Instructions on tissue/organ/body donation
  • Two adult witnesses
  • A lawyer who might help draft the document

After the proxy is signed, copies are given to health care providers, the agent(s), and a close relative(s).

Will – a legal document giving instructions for distributing assets after you die. It allows you to select an executor to manage your assets, pay your debts, and handle any other administrative duties. You can name a guardian to raise your minor children if you should pass away and choose a property guardian to oversee assets you leave your children. A will is not expensive to set up and will prevent assets from going into probate, which takes months to resolve.

Trust – a legal relationship in which one person, the trustee, holds property (money, real estate, stocks, bonds, collections, business interests, personal possessions and automobiles, etc.) for the benefit of another, the beneficiary. Trusts are more expensive to set up and manage than wills, but upon the individual’s death, there is a shorter, less costly probate process. Trusts are private and are not made public like wills.

Power of Attorney (POA) – a written authorization by an individual to have an agent act for them in private affairs, business, or some other legal manner. Some jurisdictions require that POAs are notarized or witnessed.

The agent (i.e., the attorney-in-fact, stakeholder, trustee, or fiduciary) takes custody of the individual’s funds and pays all necessary bills. The POA is effective after the individual loses mental capacity. Many institutions, such as hospitals, nursing homes, banks, and the IRS, require a POA to be in writing and often need a copy for their records.

There are different types of POA: a special/limited POA is limited to a specific act; a general POA allows the agent to make all decisions related to personal/business; a temporary POA has a limited time period. The POA is ineffective if the individual dies or becomes “incapacitated”, unless the individual states in the original POA that it continues. This type of POA is called “power of attorney with durable provisions” or “enduring power of attorney”.

Five Wishes Program – a legal document that lets you plan in advance how you want to be cared for if you should become incapable of caring for yourself. It is sometimes referred to as an “advance directive”.  It lists directions to your doctor and family on how you want to be treated. It does not meet legal requirements in every state and varies as to the need for signage, witnessing, and notarizing. The document outlines:

  • Wish #1: Lets you choose the person you want to make decisions for you when you can’t make them yourself
  • Wish #2: A living will that places in writing the kind of medical treatment you want and don’t want if you become seriously ill and can’t communicate
  • Wishes #3 and #4: – Lets you describe how you want to be treated: pain management, personal grooming, bathing instructions, whether to be told about options for hospice, preference for being at home, desiring someone to pray by your bedside, etc.
  • Wish #5: Gives you a chance to tell how you want to be remembered: funeral, memorial plans

In conclusion, there are several precautionary measures that when put in place can help ease the strain if your mother should experience a potential emergency. “Being prepared” goes a long way in turning a potentially more difficult situation into something more manageable.  It allows your mother’s wishes to be fulfilled while eliminating the stress of making important decisions especially when there are multiple family members involved.

The author, Ryan McEniff, is a senior care expert and the owner of Minute Women Home Care, a home health care agency located in Lexington, MA.

What Should You Consider When Choosing a Nursing Home?

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By Robert F. Daley

Making the decision to put yourself, or a spouse, or a parent, or even an incapacitated adult child into a nursing or personal care home can be a tremendously difficult ordeal on its own. But once you’ve made that decision, another difficult one looms: choosing the nursing home itself.

Understand your options
The first step in selecting the proper care for your loved one is understanding your options. We often find that many people do not know the differences between various care models, making the selection process even more overwhelming. Educating yourself on these differences can make your decision much easier.

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