The $2.2 million study will be conducted at Johns Hopkins University in Baltimore, Maryland as well as Sisley’s Scottsdale Research institute in Phoenix, Arizona. Since not all participants will begin at the same time, the study is expected to take up to two years to complete.
According to physician and study organizer Dr. Sue Sisley, the ideal candidate will have a disability rating from the Department of Veterans Affairs for combat-related PTSD, but otherwise be generally healthy with no other major medical issues. Veterans with traumatic brain injuries will be eligible to participate. There candidates should still have symptoms from PTSD despite having already been treated.
The study intends to use different methods of smoking and different types of marijuana to figure out which combination, if any, helps PTSD victims with their symptoms. After initial tests and assessments, participants will be given 1.8 grams (two joints worth) of marijuana a day. Participants will be told to smoke in response to their PTSD symptoms. There are no requirements on the amount smoked at a time or how many times a participant chooses to smoke as long as they don’t exceed the 1.8 grams.
Sisley recognizes that marijuana will not be a cure for PTSD, but believes that it will at least reduce the symptoms. If her hypothesis is proven true, officials with the California-based Multidisciplinary Association for Psychedelic Studies (MAPS) says they intend to seek use of marijuana as a federally approved, prescription drug.
If you are a combat veteran suffering from PTSD in the Baltimore area and would like to participate in the study, you can email your contact information to arizona@marijuanasites.org.
For the Phoenix area, contact 410-550-0050 to register your interest in participating.
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Family caregiving can improve mental health, study shows.
By Chris Berry
Family caregiving can be extremely stressful and potentially detrimental to the caregiver’s health, however, studies have revealed that people who care for a family member live longer than comparable people who aren’t caregiving.
(Related: Your Long-Term Care Insurance Company Can Fail)
Although scientists didn’t ask the caregivers what they attribute their healthier and possibly happier lives to, 3,503 people were surveyed to better convey the overall caregiving experience.
Among those surveyed, only 17 percent said they had high levels of caregiving strain, with the majority putting in less than 14 hours of care each week.
“The burden of caregiving certainly can be overwhelming and negative to health,” says David Roth, director of the Center on Aging and Health at Johns Hopkins University and lead author of the study. “But those are not necessarily the typical experience.”
(Related: Muskegon County’s Alternative Court for U.S. Combat Veterans)
Originally gathered for a multiyear study on stroke risk, the study data included people being care for with a wide range of health problems. With an average age of 64, the caregivers were more likely female of white or African-American descent.
Researchers found that family caregivers were 18 percent less likely to die than noncaregivers over six years.
Leah Eskinazi, director of operations for the Family Caregiver Alliance in San Francisco offered her theory on what made life better for the caregivers.
“There are people who find caregiving very rewarding,” Eskinazi told Shots. “They feel really good that they can give back to Mom, for example, because Mom was really there for them when they were growing up. Maybe they weren’t the best kid, but as they’ve aged they can have a more balanced healthier relationship and heal some of those wounds.”
Eskinazi added that importance of the type of care required. Caring for an individual with dementia takes a greater toll because the person is dealing with a long inevitable decline. “You’re caring for someone who can’t voice their preferences,” she says. “You’re making decisions for another person and for yourself, and that can last for a long time. It’s tough.”
(Related: Female Veterans Gather for a Day of Service and Sisterhood)
In contrast, caregiving for someone after a stroke can be extremely positive. “There’s a lot of energy going into helping that person recover,” Eskinazi says.
If the person receiving care has the ability to be grateful it makes a dramatic difference. “To have someone stick by you, or a group of people stick by you, that’s pretty cool,” Eskinazi says. “It gives you an opportunity to say thank you.”
Read more: http://wunc.org/post/family-caregiving-can-be-stressful-rewarding-and-life-affirming
Christopher J. Berry is a Michigan elder law attorney Dedicated to helping seniors, veterans and their families navigate the long-term care maze. To learn more visit http://www.theeldercarefirm.com/ or call 248.481.4000
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Assisted living facilities currently provide care for close to three quarters of a million seniors nationwide. a number that will surely rise as Baby Boomers continue to age.
Despite the growth over the past number of years, no federal regulation has been put in place, while supervision remains spotty, varying from state to state. And all indications suggest that the industry likes things just the way they are.
(Related: Seven Questions To Ask When Searching for Assisted Living)
“Assisted living is the rock we don’t want to look under,” said Catherine Hawes, a professor at Texas A&M University’s Health Science Center who conducted a national study of the system.
Consumer advocates say that at best, families are having trouble finding a safe, quality home for their loved one. At worst, loved ones are neglected in poor conditions that could even result in death.
As a reaction to nursing homes, assisted living started in 1980s a reaction to nursing homes, which were more geared toward hospitalizations, and as a means to provide seniors with additional choice and independence.
Over time, assisted living has evolved to house seniors who require specialized care, like dementia or Alzheimer’s patients. Constantine Lyketsos, a geriatric psychiatrist and researcher at Johns Hopkins University, told FRONTLINE that is a study of residents in assisted living in Maryland, two-thirds had dementia.
As a result, more people have greater needs, and more specialized attention — and, some senior advocates contend, more advanced regulations to guarantee the safety and quality of care of residents.
(Related: Obamacare and Long-Term Care Insurance)
Without federal regulations, states are able to determine their own standards to the point of creating their own definition of what constitutes an assisted-living facility. A number of states employ the hands-off approach as a result of lacking time and resources, or because they didn’t foresee the shift in residents.
“The largest problem was that assisted living was melding into nursing home care,” Dean Lerner, the former head regulator of assisted living in Iowa, told FRONTLINE. “Who’s taking care of these people, and what are the laws that require them to be kept safe?”
Most states enforce their own regulations through random surveys of facilities. Regulators log violations during these surveys that can result in fines or potentially losing their license.
Common when self-regulating, a number of states are failing to collect what consumer advocates say are key data point, like how many times residents fall, if mistakes were made in giving out medication, or other points that are easily acquired for nursing homes.
Even in the instances where information exists that consumers are looking for, accessing said information is a horse of another color. Certain states will make the information online or even issue “report cards” on facilities, but not all states offer such a courtesy.
Industry advocates feel that evaluating an assisted-living facility with data fails to capture the complete experience of residents.
“While regulation is important, it is not necessarily a panacea,” Mark Parkinson, president and CEO of the American Health Care Association, an industry trade group, told FRONTLINE. “Regulation that is done smartly, that promotes person-centered care, that promotes quality outcomes is great. But regulation that creates regimens, institutional-type settings and really takes away from some of the benefits of assisted living would be a negative thing.”
State affiliates operate on behalf of the industry to keep restrictions in check. “It’s easier for lobbyists in the industry to fight regulation on a state-by-state basis” because typically, state legislators lack the knowledge or expertise that the industry utilizes in the debate, said John Bowblis, an economist at Miami University’s Farmer School of Business.
In 2008, Lerner, the former head regulator for health facilities in the state, tried to increase the penalties for elder abuse and have those convicted of the offense placed on a registry barring them from working at a facility for a period of time.
(Related: Nursing Home Use By Medicaid Senior Plummeting)
The health-care industry vehemently fought the law, accusing Lerner of “criminalizing” those who work in their facilities. The law that eventually passed set higher standards for showing abuse, requiring the state to show gross misconduct opposed to negligence.
“All in all it was a good thing to have gotten it passed, even in a semi-watered down fashion,” he said.
Most states lack the resources to hold facilities accountable. Take California as an example, where they only visit facilities every five years. In the instances when they do find a violation, citations are so weak that they make little impact. In California, FRONTLINE found five deaths in recent years in Emeritus facilities for which the company was found negligent by the state. The standard fine? $150.
When they do find a violation, often the citations are so weak they don’t seem to make much of an impact. In California, for example, FRONTLINE and ProPublica found five deaths in recent years in Emeritus facilities for which the company was found negligent by the state. The typical fine? $150.
“The residents in these facilities are citizens of the state, and they’re physically and often cognitively vulnerable,” Hawes, the consumer advocate, said. “It’s the state’s responsibility to ensure that things are safe and the quality is adequate. The argument ought to be why isn’t the state adequately funding this process? Why isn’t the legislature providing the funds that are needed?”
The Assisted Living Federation of American, known as ALFA, says it supports “meaningful and appropriate oversight” of senior living in each state. A list of standards and policies that it supports is listed on the website, including background checks on employees and trained staff members.
With that said, ALFA is adamant that federal oversight isn’t necessary and lobbies in Washington D.C. to ensure that doesn’t happen. They maintain national branch with a political-action committee and sponsor annual fly-ins for members to meet with members of Congress to advocate for bills.
(Related: Long-Term-Care Insurance Dilemma)
“We’ve become a very powerful organization in just a few years, because our board of directors, our staff have realized the importance of advocacy towards achieving the kinds of things we want done,” said Richard Grimes, ALFA’s president and chief executive, in a promotional video posted online.
A major industry priority is legislation to allow seniors to sell their life-insurance policies to a third party to pay for assisted-living care. Texas and Kentucky have already passed such laws. Maine, Florida and Louisiana are considering it.
The Centers for Medicare and Medicaid Services, known as CMS, intends to establish a definition of assisted-living facilities, in what would result in the first federal effort to get involved in assisted-living standards.
While it isn’t expected to impose regulations like staffing quotas or training requirements, it would establish guidelines to distinguish these facilities from nursing homes, like the ability of residents to make private phones calls or receive visitors at any hour. A time frame for these guidelines has yet to be set.
Along with other industry advocates ALFA argues that the free market, more than state regulators, will keep the industry regulated. If residents or their families don’t like a facility, they can take their money elsewhere.
(Related: Health Insurance Scams On The Rise)
“The answer is [to] be an advocate for your mom or dad, go in to the facility, talk to the people that are actually going to take care of them, and then talk to other folks who have their moms or dads or grandparents and find out what it’s really like,” Parkinson said. “That’s the way that you find out what facilities are all about.”
Christopher J. Berry is an elder law lawyer in Michigan Dedicated to helping seniors, veterans and their families navigate the long-term care maze. To learn more visit http://www.theeldercarefirm.com/ or call 248.481.4000
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It can be extremely difficult to find reliable data on assisted living. Federal and state statistics are not easy to discover and it’s often easier to search for hotel reviews in Mexico than it is to locate rating and reviews for a local assisted living facility.
So where should you begin to look if you are considering sending a loved one to assisted living? After questioning a number of experts, this is what they had to say.
1. What Are Your Needs?
First off, it is imperative to understand what level of care you require and how that may change with age. This is especially true in the case of seniors with dementia. A 2009 study by Johns Hopkins University found that 46 percent of assisted living residents suffered from at least three chronic conditions, yet only 54.5 percent of facilities surveyed in the study had a registered nurse or a licensed practical nurse on staff. As the survey authors note, “Some residents with multiple, complex medical conditions present a challenge that some [assisted living facilities] may not be prepared to manage.”
In some cases nursing homes may be the better solution for seniors.
“So many people have heard their mother say, ‘Promise me you’ll never send me to a nursing home.’ And a lot of people make a mistake in choosing assisted living because it looks nice rather than what the person really needs,” says Catherine Hawes, director of the Program on Aging and Long-Term Care Policy at Texas A&M University.
(Related: Alzheimer’s Disease Improved by Exercise, University of Maryland Study Shows)
2. Have You Made A Visit?
If you have decided on assisted living, visit prospective facilities a number of times. Experts recommend visiting at different times of the day — mealtimes are a great place to begin.
Don’t be content with a tour of the building from the director, they say. Take the time to speak with residents and staff for a sense of the facility’s culture and environment. Question the available services and what staffing is like throughout the day and at night. To gain insight into the reliability of their services, ask about turnover as well.
And for residents with dementia, it’s important to understand how the facility manages their care and safety: what type of programming is available? Are the doors locked at night for residents who wander?
Checklists for visiting an assisted living facility are available from several organizations, including the AARP, the Alzheimer’s Association, California Advocates for Nursing Home Reform, the Assisted Living Consumer Alliance and the Long Term Care Community Coalition, among others.
(Related: If you have Alzheimer’s or Dementia, there’s a Group waiting for You)
3. For-Profit or Non-Profit?
This designation may influence how resources are allocated for care. Close to 82 percent of residential care facilities are privates, for-profit facilities, with close to four in 10 belonging to a national chain. Such for-profit chains often have “requirements for a return on revenue that mean that they’re always pressing for higher occupancy and for constraining variable costs, and the variable costs are staffing and food, and to some degree, activities.”
From 2006 to 2011, for example, profit margins at privately owned assisted living facilities went from 3.5 percent to 6.4 percent, according to research from Sageworks, a financial information company. Those gains corresponded with drop in payrolls from 45 percent of sales in 2004 to 38 percent in 2012.
That’s not to say you ought to dismiss for-profits and focus exclusively on non-profits because there are good and bad facilities in each category.
4. Cost
Since assisted living is not covered by Medicare, it can be expensive. in 2012 the average monthly base rate in an assisted living facility rose to $3,550, according to a survey by MetLife. Rates can reach up $9,000 a month in some states.
Also, be weary of charges for additional services. Some facilities will charge a resident extra for meal delivery, while others tack on fees for services such as transportation to and from the facility, or laundry and housekeeping.
(Related: Obamacare and Long-Term Care Insurance)
5. What’s in the Admissions Agreement?
Experts advise you to take your time and the admission agreement carefully. On occasion the fine print will reveal language requiring 30 days notice to stop billing for service, even if the resident has died, says Patricia McGinnis, executive director of California Advocates for Nursing Home Reform.
Negotiated risk agreements are another red flag. These clauses are often offered as a way for residents to make preferred choices about their care, even if they prevent risks. McGinnis warns, if something goes wrong, “You have signed away your right to sue.”
The same problem can be realized through liability waivers, which are common in admission agreements.
“To me, that is a sign that the facility may not have either the ability or the commitment to meeting your needs,” says Nina Kohn, a professor of law specializing in elder law at Syracuse University. ”If you’re confronted with a contract with that kind of liability waiver, I think it’s reasonable to say, ‘I’m going to cross out that provision.’ See how the facility responds.”
Consult with an elder law attorney if any portion of the admission agreement is unclear. The American Bar Association also provides a checklist for choosing an assisted living facility.
6. Where is the Facility?
While it’s convenient to find a residence that’s close to friends and family, experts caution against allowing that to be your deciding factor.
“It is really important to have a place that’s easy to visit, but it’s more important to find a facility that’s really good,” says Hawes of Texas A&M. “Don’t choose a facility that’s five minutes closer to you, or 10 minutes closer to you just because of that. Make sure that you’re getting the best facility for what your loved one needs, and be realistic about what they need.”
7. What Does the Ombudsman Say?
Experts recommend contacting the long-term care ombudsmen for your local area for additional checklists or information on any citations against a facility. Additionally, they will answer any other questions you may have
Karen Love, president of the Center for Excellence in Assisted Living, says to look out for any medication administration violations. She also suggests asking “Have they been cited for not having staff trained, if it’s a state requirement, and have they gotten dinged for not having enough staff, again if that is a state requirement?”
The National Long-Term Care Ombudsman Resource Center provides a map on its website with contact information for ombudsmen in all 50 states.
Christopher J. Berry is a Michigan elder law attorney Dedicated to helping seniors, veterans and their families navigate the long-term care maze. To learn more visit http://www.theeldercarefirm.com/ or call 248.481.4000
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