National effort to combat Alzheimer's disease begins; as research continues, there are preventive steps you can take

Country singer Glen Campbell, who has Alzheimer's disease,
stands with wife Kim during a national conference Tuesday.
Associated Press photo by Charles Dharapak.

With numbers expected to jump to 16 million Americans by 2050, research is being conducted in earnest to find a way to ward off Alzheimer's disease.

One plan of attack is testing therapies before people show symptoms of memory loss, since the disease starts attacking the brain at least 10 years before memory problems appear. An international study will see if an experimental drug can halt the disease in "people who appear healthy but are genetically destined to get a type of Alzheimer's that runs in the family," reports Lauran Neergaard for The Associated Press. In another study, researchers will see if a nasal spray that shoots insulin to the brain can help patients with early memory problems.

Part of the challenge in combatting the disease is researchers are still not sure what causes it. "The chief suspects are a sticky gunk called bata-amyloid, which makes up the disease's hallmark brain plaques, and tangles of a protein named tau that clogs up dying brain cells. One theory: "Amyloid may kick off the disease while tau speeds up the brain destruction," Neergaard reports.

Given the expected increase in the number of people with Alzheimer's, the Obama administration has adopted a national strategy to fight the disease, part of which is a website that is a "one-stop shop for families" to offer information about dementia and links to community resources. Today, there are 5.4 Americans with Alzheimer's or related dementias.

There are steps people can take to protect their brains from the disease, including intellectual and social stimulation to help build "cognitive reserve." Doing crossword puzzles, for example, can help. So can physical activity. "Any time your heart is healthier, your brain is healthier," said Dr. Elizabeth head of the University of Kentucky. Diet is another consideration, since foods that are heart healthy are brain healthy, including omega-3 fatty acids found in fish. (Read more)

455 deficiencies found in 72 Kentucky nursing homes in fourth quarter of 2011

State inspectors found 455 deficiencies in 72 Kentucky nursing homes in the fourth quarter of 2011, with one facility accounting for 25 of them alone: Kindred Transitional Care & Rehab-Fountain Circle in Winchester.

The information was released by Kentuckians for Nursing Home Reform, a nonprofit organization that advocates for nursing home residents and obtains the data regularly through open-records requests to the Kentucky Cabinet for Health and Family Services and distributes it statewide. The information is posted as part of Medicare's nursing-home comparison data.

According to the Centers for Medicare and Medicaid Services, the average number of deficiencies for a nursing home inspected in the U.S. is eight and the average in Kentucky is seven. Inspections assess a facility on the care of residents and how that care is administered; on how staff and residents interact; and on its environment. Certified nursing homes must meet more than 180 regulatory standards. The state Office of Inspector General website has more data, such as the results of inspections and the ownership of each facility.

Nursing homes with 10 or more deficiencies in the fourth quarter of 2011 were:

• Bridge Point Care and Rehabilitation Center, Florence (22)

• Pineville Community Hospital (17)

• North Hardin Health & Rehabilitation Center, Radcliff (15)

• Richmond Place Rehabilitation and Health Center, Lexington (13)

• Hart County Health Care Center, Horse Cave (13)

• Parkview Nursing and Rehabilitation Center, Pikeville (13)

• West Liberty Nursing & Rehabilitation Center (13)

• Redbanks, Henderson (12)

• Knox County Hospital, Barbourville (11)

• The Forum at Brookside, Louisville (11)

• Bradford Square Care and Rehabilitation Center, Frankfort (10)

• Florence Park Care Center (10)

• Boyd Nursing and Rehabilitation Center, Ashland (10)

• Corbin Health & Rehabilitation Center (10)

For more information about Kentuckians for Nursing Home Reform, click here.

Free seminar on guardianship to be offered Feb. 26 in Lexington

Kentuckians for Nursing Home Reform will provide the opportunity to learn from experts about guardianship Feb. 26. More than 23,000 Kentuckians live in nursing homes.

Lexington attorneys Carolyn Kenton and Robert McClelland will speak, along with Virgiel Clayton, director of the Division of Guardianship in the Department of Aging and Independent Living.

The seminar, which is free and open to the public, will begin at 2 p.m. Feb. 26 at the Tates Creek Branch of the Lexington Public Library. For more information, click here.

Nursing home ombudsman program at risk because of 'callous and apparenly clueless' move by feds, advocate writes

The Kentucky long-term care ombudsman program is at risk in Kentucky due to a change in federal policy. The Centers of Medicare and Medicaid Services is "quietly telling some state aging leaders that by Jan. 1 they will no longer be allowed to use civil monetary penalty funds to help pay for the nursing home ombudsman program in their states," Bernie Vonderheide, president and founder of Kentuckians for Nursing Home Reform, writes an op-ed piece in The Courier-Journal.

The civil penalties are assessed for violations in nursing homes. In Kentucky, the fund contains about $15 million. But if the move by CMS goes through, Kentucky "stands to lose more than a half million dollars a year from the CMP fund that has gone into supporting full-time ombudsmen in all of the 15 area development districts in the state," Vonderheide writes. "We are concerned about the callous and apparently clueless action by the federal Centers for Medicare and Medicaid Services. It is obvious that the Washington bureaucrats who make decisions like this have never been in a nursing home and are oblivious to the needs of the people."

Nursing-home ombudsmen investigate alleged abuse and neglect in facilities, and visit residents. "In the average nursing home, surveys show that more than half the residents never have a visitor — family member or friend — except for one, and that's the ombudman," Vonderheide writes. "We can't lose our nursing home residents' best friends — those angels of mercy, the ombudsmen." (Read more)

Jury tells nursing home to pay $1 million to former resident

A Fayette County jury has decided that Lexington's Cambridge Place Nursing Home will have to pay more than $1 million in damages to a former resident who fell and was found in an equipment storage room with broken bones in her face.

In January 2009, Irene Hendrix, who has Alzheimer's disease, was reportedly walking up and down a hall using a Merry Walker, which is a walker that has a seat. At some point, Hendrix, right, fell and was found with bleeding in her brain, a 4-centimeter cut on her forehead and the broken bones, the Lexington Herald-Leader's Valarie Honeycutt Spears reports. Hendrix's daughter and guardian filed a lawsuit against the facility later that year, alleging negligence.

After two hours of deliberation, the jury awarded Hendrix $1 million for physical pain, suffering and mental anguish. It also awarded Hendrix more than $27,000 for her medical bills. "A jury spoke today regarding the level of care they expect for their loved ones in nursing homes in Fayette County," plaintiff's lawyer Scott Owens said.

The Cabinet for Health and Family Services and the Office of the Kentucky Attorney General previously investigated Hendrix's case and a state adult-protection worker "determined that Hendrix was a victim of caretaker neglect and had been exposed to an extreme safety risk," Spears reports. "The protection worker told the attorney general's office that she thought Hendrix's injuries were the result of an accident." The attorney general's office closed the case in March 2009. (Read more)

Free conference on Alzheimer's in Louisville Sept. 17

A Washington-based geriatric researcher will join University of Louisville researchers and clinicians a free conference examining Alzheimer’s disease from 9 a.m. to 3 p.m., Saturday, Sept. 17, at the Crowne Plaza Louisville Airport Hotel, 830 Phillips Lane, near the state fairgrounds.

“The Journey: Alzheimer’s Disease and Caregiving” will provide information on the risk factors for Alzheimer’s disease, the reasons why certain populations are at greater risk for developing it, and current practices in caregiving. Admission, parking and lunch are free to participants at but pre-registration is required by Sept. 15 to info@alz.org or 1-800-272-3900.

Thomas Obisesan, M.D., chief of geriatrics at Howard University Hospital, will open the meeting. His research is focused on finding a cure for Alzheimer’s and "disentangling the overlap of cardiovascular disease with Alzheimer’s disease risk," a U of L release says. The conference is supported with grants from Eisai Co. Ltd. and the Signature Research Institute. It is co-sponsored by the university and the Greater Kentucky and Southern Indiana Chapter of the Alzheimer’s Association.

Planned merger of Louisville hospitals grows more controversial; C-J devotes considerable space to it and Beshear steps in

UPDATE, July 27, 3:43 p.m.: Gov. Steve Beshear issued a statement saying "It is clear there are growing concerns within the community about issues related to the hospital’s future level of access to medical services, and those concerns need to be fully vetted before the Commonwealth takes the legal steps required to approve this merger," such as changes in leases of public property and agreements on operation of the hospital. Just as important as the legal issues, Beshear said, is "the public policy of how the University of Louisville Hospital will continue to honor its mission as a public teaching hospital that provides access and care to citizens, especially those who are indigent." The governor said his administration "will hold a series of conversations with the principals in the proposed merger and other interested parties," starting with a meeting among four of his cabinet secretaries, Mayor Greg Fischer, state Auditor Crit Luallen and Attorney General Jack Conway.

The merger that would put a Catholic health group in charge of the University of Louisville's hospital is growing ever more controversial, as demonstrated by today's edition of The Courier-Journal. The top story was about U of L President Jim Ramsey's uncertain response to a request by state legislators to answer questions of a legislative committee, accompanied online by a photograph of a somewhat sheepish-looking Ramsey, left. UPDATE, July 28: Ramsey says he will appear before the panel Aug. 17.

The paper's editorial page was mainly about the issue. The top editorial was headlined "Ramsey's silence," and it referred to the second 'editorial' on the page, actually a recitation of email correspondence between Ramsey and one of his Fern Creek High School classmates and her husband, who oppose the merger and questioned Ramsey's charcterization of an earlier C-J editorial as "not based on complete and factual information."

Next to that piece was a letter from the lawmakers: Rep. Tom Burch, chairman of the House Health and Welfare Committee and a Catholic who opposes the merger because of its implications for reproductive and end-of-life procedures; and Reps. Mary Lou Marzian and Joni Jenkins of Louisville. It was illustrated by a photo of Ramsey looking thoughtful. Above it was a letter, illustrated by a photo of Pope Benedict XVI, from Eugenia K. Potter, former executive director of the Kentucky Commission on Women, headined "Is it dogma or discrimination?" Conservative commentator Martin Cothran has a contrary view on his blog.

UPDATE, July 27, 8 a.m.: The C-J editorial page is again mainly about the issue, with an editorial urging the state auditor, governor and attorney general "to thoroughly scour and bring transparency to the negotiations with Catholic Health Initiatives;" an article by former University Hospital nurse Beverly Glasscock saying that the hospital wouldn't be able to perform emergcy abortions needed to save a woman's life; and a letter from former university trustee Bill Stone defending Ramsey from what he calls an "over the top" attack by the paper's editorial board.

Louisville hospital merger could thwart some patients' final wishes

More concerns are being raised about the merger that would put a Catholic hospital group in charge of the University of Louisville's hospital. First, it was the prospect that women getting Caesarean sections would not be able to get their tubes tied at the same time. Now, "A growing chorus of protest from local residents, doctors and others has erupted over the fact that Catholic doctrine could override patients' end-of-life wishes," Laura Ungar and Patrick Howington report for The Courier-Journal.

"While many wealthier patients could simply choose a different hospital, indigent patients have little choice but University Hospital for treatment, including end-of-life care," the reporters note. "That has left some worried about how end-of-life decisions will be affected if living wills and decisions to remove a feeding tube, for example, will not be honored if they are 'contrary to Catholic teaching'."

Denver-based Catholic Health Initiatives told the newspaper that advance directives such as living wills would be honored “in the vast majority of cases” but “There may be the rare situation, such as a patient in a persistent vegetative state who is not in the dying process, when what the patient is requesting through his or her advance directive is not consistent with the moral teaching of the Church. In those few cases, a Catholic health care facility would not be able to comply, and with the family's guidance, the patient would be transferred to another facility, or to their home under hospice and family care.” (Read more)