ElderWeb

A recent study evaluated the feasibility of providing telemedical wound care using a mobile telephones with integrated cameras as a way to reduce the cost of care and make it easier to work with patients at a distance. A team of doctors led by Dr. Ralph Peter Braun of the University Hospital of Geneva set up three physicians to evaluate 61 leg ulcers. One physician did a face-to-face consultation that was used to determine the quality of the remote evaluations, and the other two physicians worked from pictures taken with a cell phone camera and sent to them by email. The researchers found that results from the remote evaluations were nearly as reliable as the face-to-face evaluation. The physicians considered the camera image to be good 59% of the time, and very good 20% of the time, and said they felt comfortable making a diagnosis based on the pictures in 82% of the cases.

The article is available in the Archives of Dermatology at: http://archderm.ama-assn.org/cgi/content/short/141/2/254

Paro, a robot that looks like a baby harp seal and is covered in fur like a stuffed animal, is being used to provide therapy for some elderly Japanese nursing home residents. Paro has sensors to help it recognize its master's voice and hand gestures, and it coos and flaps at gentle touches and but squeals in anger if handled roughly. The developers state their purpose in creating Paro was to provide the benefits of animal therapy in environments where there are concerns about using live animals because of allergies, infection, scratching, and biting.

They state, "Almost everyone has touched or played with cats and dogs, so when they experience the robotic form of these animals, they can not help but compare the robot to the real creatures. If the robot does not respond in a familiar way or if it feels different from the real animal, people often become critical of the robot and lose the chance to experience its therapeutic qualities. We selected baby harp seals as the model for our robot because most people have not had any contact with such animals. When considering human-robot interaction, we envisioned a robot that could sit in a person's lap so that it could be held or stroked. That is how Paro came to be."

A March 10, 2005 article in the Washington Post said, "Researchers have been testing the robot's effect on the elderly at a nursing home in Tsukuba, about 40 miles northeast of Tokyo. During a recent visit by a reporter, the sad eyes of elderly residents lit up as the two resident robot seals were brought out. Tests have shown that the cute newcomers indeed reduce stress and depression among the elderly."

Read more about Paro at: http://www.aist.go.jp/aist_e/museum/science/6/6.html

Kyodo News reports that the ruling Liberal Democratic Party's tax policy-setting panel decided Wednesday to lift restrictions on tax breaks on equity investment trusts for people aged 65 or older. This is intended to encourage older people to shift their money away from bank and postal deposits and into equities.

Gabriele Doblhammer and James W. Vaupel of the Max Planck Institute for Demographic Research studied remaining life expectancy at age 50 of people in Denmark, Austria, and Australia, and found that in northern hemisphere countries, people born in the fall months of October-December had longer life expectancies than those born in the spring months of April-June. They found that the pattern was repeated in the southern hemisphere, where everything shifted by six months so that, again, those born in fall months had the longest life expectancies. The researchers reported that these findings are based on population data with more than a million observations. They also found a correlation between the month of birth and chronic diseases related to the cardiovascular, respiratory, and digestive systems, as well as for infectious diseases such as pneumonia and influenza. They speculate that these differences may be partly due to the fact that many years ago people were likely to eat much better in the summer than in the winter, thus mothers who gave birth to babies in the fall would have had better nutrition throughout most of their pregnancy than those who were pregnant during winter months. The report was published in the Proceedings of the National Academy of Science.

Researchers at the University of Verona studied the relationship between body mass and lung function in older men and found a strong relationship between body composition, fat distribution, and lung function in elderly men. Researchers concluded that a small reduction in body mass might lead to significant improvement in lung function. The study was published in the April issue of the American Journal of Clinical Nutrition.

The Associated Press reports that Taiwan's top economic planner, Chen Po-chih, chairman of the Council for Economic Planning and Development, said that women with low-paying jobs should stay home to care for their husbands' elderly parents. The government toughened regulations last year to allow only families with severely disabled relatives to hire foreign maids or caretakers. Chen told lawmakers that women with low-paying jobs should stay home to care for their in-laws. He said that the regulations should not be relaxed to spare them that duty.

A new gerontology page for The Netherlands (NL) was started up in January 2001. This initiative was taken to improve access to the field of gerontology in The Netherlands to stimulate and intensify international contacts for education, science and research in the domains of gerontology and geriatrics. (http://gerontologie.pagina.nl)

An article in the current issue of the Journal of Clinical Endocrinology & Metabolism suggests that insomnia in older people may be partly caused by a lack of exposure to light. Dr. Kazuo Mishima of Akita University School of Medicine in Akita City, Japan, led a study of nursing home residents with insomnia and found that exposing them to more light improved their sleeping patterns and also increased their production of the melatonin, a hormone believed to help regulate sleep. Some research suggests melatonin production declines with age, and that melatonin supplements may combat insomnia.

Mishima's team compared sleeping patterns and melatonin levels among 10 nursing home residents with insomnia, 10 healthy residents of the same home, and 10 healthy college students. The elderly insomniacs initially had poorer sleep patterns than either of the other groups, and showed the lowest melatonin levels. The researchers then exposed the patients to 4 hours of bright, artificial light at midday for 4 weeks--roughly equal to the normal light exposure of the young control group. The investigators found that the extra light sent the elderly patients' melatonin production to a level similar to that of the college students, and improved their sleep quality.

ABC News reports on a program used in China to help care for the elderly. Able-bodied older people help seniors who cannot care for themselves, and the time they spend doing so is put in a "Time Bank." When they need help themselves, they will be able to draw from that bank and get help from others. Families used to provide care for older relatives, but many young people leave home in search of work in other parts of the country, and China's national "one child" policy means that there are fewer younger family members available to provide care.

80% of injuries in people over 50 years of age occur in the home. In response to this statistic, Brazilian doctors held a competition that called for people to design a "Casa Segura" (Safe Home), suitable for an elderly person. The winning design included features like removing carpets and rugs, using anti-slip flooring, round-edged tables, installing seats in the shower, designing baths that do not have curved bases, and using hand rails in precarious areas such as stairways.

The competition was organized by the Brazilian Orthopaedic and Traumatology Society. It was part of the XXXII Brazilian Congress in Orthopaedics and Traumatology in Rio De Janero. The organization hopes that the campaign will raise awareness of the measures that can be taken to make a house safer for the older person.

Housing for Older People in Europe (HOPE), a network of seniors housing organizations, has issued a conference findings report on the state of seniors housing in Europe. Some of the things they noted include the fact that the population is extremely diverse, and that no one service option fits everyone's needs and expectations. Some people want to be surrounded by people in an active location, others want more solitude. Some want to be around people their own age, others do not want to be ghetto-ized. Some want ownership, others prefer to rent. They found that people wanted a place to "retire and live" rather than an "old people's home to go and die."

DaneAge survey results from 1987 and 1997 were compared, reflecting a trend away from living as cheaply as possible toward a preference for a central location along with access to "nature" and green areas. The DaneAge survey also found a desire by many people for shared accommodations, as a way to provide for needs they might have in the future if they were incapacitated.

Another theme that emerged from various questionnaires was the importance of autonomy -- having control over the little things in life. They found that older people do not want to give up their right to take risks, and do not want to be over-protected. They want to be able to control their own destinies.

Interestingly, one observation was that many people are far more concerned about getting help with practical needs like getting a roof fixed than finding care assistance, and they put a high value on features like an on-site handyman to help out. Many older people saw freedom from home maintenance as a compelling reason to move to a retirement home.

A HOPE questionnaire found that most older people expected that the government would provide financing for their care needs, and don't mind paying more taxes if they are used this way.

The report also notes that more and more large provider chains are emerging in Europe, which is changing the face of the industry. Some people who resonded to the questionnaire express concern about that trend, and a fear that these "super providers" will dominate the future, and damage the ability of non-profit providers to survive.

An empty refrigerator in the home of an older person may be a precursor to a hospital admission. The refrigerator contents in the homes of 132 elderly Swiss residents were scrutinized during routine medical home visits following hospitalization. Researchers found that about 10% of the refrigerators were empty and 31% of the people with empty refrigerators landed in the hospital within four weeks. By comparison, only 8% of people with full refrigerators ended up in the hospital. Dr. Francois R. Herrmann, project manager in the geriatrics department at Geneva University Hospital in Switzerland, co-authored the study published in August 12 issue of The Lancet.

The doctors deemed the refrigerator contents either adequate, inadequate if food had expired or was rotten, or empty if fewer than three items were found. They also recorded how many pieces of meat, liters of milk and amounts of butter, vegetables and eggs were inside. A dietitian reviewed the results. The average age of the subjects was 81, 74% were women, and 69% lived alone.

Researchers pointed out that an empty refrigerator might be due to a number of things. The person might be clinically frail, or the empty appliance could be a sign that the person cannot handle daily activity, lacks the strength to shop, or doesn't have an external network to turn to for help. Herrmann says the study has obvious limitations. The doctors did not look at what food might be in cupboards in the houses, nor did they examine whether the refrigerator contents were related to the health status of the residents. The study also did not take into account the diseases for which people had been treated while hospitalized.

Danish scientists reported at the World Alzheimer Congress 2000 that failing memory may be a symptom of a treatable and reversible condition and not always a sign of Alzheimer?s disease. Gunhild Waldemar, M.D., and her colleagues examined 785 patients with memory problems, and found that only 43% were diagnosed with Alzheimer?s disease or some other form of dementia. 6% of those they examined had Alzheimers, but their memory problems were a result not of Alzheimers disease but of some treatable and reversable medical condition. Overall, they found that 35% of the patients they saw had a potentially treatable concomitant condition that could influence cognitive function, most commonly depression, high blood pressure and thyroid disease. Researchers concluded that it is important for patients with memory problems to have them properly assessed and treated, and not to assume that they indicate a diagnosis of Alzheimers.

The International Longevity Center-USA (ILC-USA) has published research reports about the development of mandatory national long term care insurance programs in Japan and German. These reports describe the types of long term care problems these countries were facing, and the evolution the national long term care insurance programs that were developed to deal with these problems.

A number of interesting and unexpected problems emerged during the process. For instance, Germany created a long term care insurance program which was to be partially funded by employers. To get the support of employers needed for the passage of the program, one national holiday had to be eliminated so that employers could redirect the money they had been spending on holiday pay to the new long term care benefit for their employees.

Japan is developing a satellite-based global positioning system and a cellular phone network which could be used to track the whereabouts of older people with dementia who have wandered off. Local governments in Tokyo and Japan's Kikuchi City plan to test the device, developed by a group led by trading house Mitsui & Co "We are definitely expecting a market to develop for the system,'' a Mitsui spokesman said.

There are about 13,500 patients in Israel's nursing homes, and about 2/3 of them are receiving government subsidization. The Israeli Institute for Advanced Strategic and Political Studies estimates that $200 million of taxpayer money could be saved by privatizing the nursing home system. They also believe that privatization would eliminate waiting times for admission, and the savings would allow individuals to purchase private geriatric insurance.