Business, economic development - the unofficial Chamber of Commerce

Q: My mother is always losing, hiding and hoarding things, I am losing my mind! What can I do to get her to stop?

A: This is a great question and I have a lot of material to work with.

My grand mother had made me the most beautiful doilies. One resident in my adult family home insisted that they were the ones she had made and took them when I wasn’t looking. I would put her in bed at night only to find my doilies hidden in her diaper.

After dinner one evening we discovered a client’s $3000.00 dollar pair of hearing aids wrapped up in a nice little napkin and stuffed in her drinking cup.

Some residents would go through others belongings, when I would suggest that they stop because the purse belonged to someone else, they would reply, “I know that” and would continue digging.

The weirdest experience I had was a resident who liked to clothes shop so much that she would go shopping in other peoples closets.

Invariably, just when you need something, it has disappeared, whether it’s your doilies, car keys, glasses, or hearing aids. Hiding, hoarding and losing things are very common things you have to deal with when you are caring for a person with Alzheimer’s.

To cut down on the prospect of losing very important things, here is a list of things to do to help you.

1. Simplify your surroundings. You would be amazed at how much easier it is to care for a person with Alzheimer’s if you aren’t surrounded by clutter. If you lose something, you will have less to sort through to find it.

2. Keep really important things in a locked and secure place.

3. Childproof your cabinets and doors that you don’t want your loved one rummaging through.

4. Don’t leave things lying around.

5. Keep your loved ones glasses, hearing aids, and teeth in a plastic container or tub when you put them to bed at night. That way you will always know where they are in the morning.

Here are a few other things to keep in mind.

1. People with Alzheimer’s like to put their teeth and hearing aids in their napkins at meal time. Always check napkins before throwing them into the trash.

2. Check their wastebaskets before you throw out the trash.

3. Check their pockets before doing the laundry-if they haven’t put something of value in them, I can almost guarantee that there is a Kleenex in them, a load of laundry washed with a Kleenex is the not very fun.

4. If a person with Alzheimer’s is a wanderer you will want to check the sides of their chairs frequently also.

While you may not be able to stop this behavior all together you might be able to control it a bit better with these tips.

Renee “Dutchy” Reeves is an Elder Care Consultant with over 10 years of working with the elderly and their families. Her online advice column, “Ask Dutchy” provides practical ideas and advice for assisting the elderly with Alzheimer’s disease, Dementia, Parkinson’s, disability, and those needing long term care.

Consider the power of a smile: It may happen in a flash, but the memory of it somehow lasts a lifetime. Shouldn’t an assessment of one’s front teeth, therefore, be where all modern makeovers begin?

Teeth are, after all, the true personality of a smile. So if we cover them due to imperfections, then no matter what we do to turn back the time with our skin, clothes, makeup and hair, we would still run a risk of getting lost in the crowd.

On the other hand, alongside the arrival of so many aesthetic treatments to combat aging, advancements in the field of cosmetic dentistry are credited for delivering astonishing, life-changing effects. According to LVI Global, the world-renowned school of advanced dental studies, a new and beautiful smile makeover can now be completed much more quickly than in the past, in perhaps just two or three visits. Even the most uneven smiles can be straightened without the need for unsightly, uncomfortable, and time-consuming metal braces.

Here is a sampling of what can be done:

Whitening of discolored or stained teeth
Straightening of crooked or overlapping teeth
Gaps closed
Chipped and worn teeth repaired
Missing teeth replaced
Lengthening, or shortening uneven teeth for a uniform appearance
Replacing unsightly metal fillings with natural or tooth-colored ones
Reduction or elimination of a “gummy” smile.

LVI Global has trained thousands of dentists around the world and many graduates are practicing in Canada. Please click here to learn more about cosmetic dentistry and see before and after pictures.

http://www.lvidocs.com

A co-worker of mine once had a troublesome cold a while back for weeks on end and because I had to add to my workload by splitting his share up with the rest in the office, I told him of a method to use as a cure for the common cold used by the Indians and some West Africans. (Okay, I’m not that insensitive-I told him this because I cared!)

This method is known in Sanskrit (the Indian Language) as Neti or “Nasal Irrigation).
It is the cleaning of the nasal portion of the respiratory system whose function is to allow air to come in contact with the circulating blood so exchange of the gases can happen.
If this sounds a little bit complex if you need a cure for your cold and are not trying to read all these facts, just believe this works as a cure for the common cold the way nothing else can. (well besides a fast…)

Neti (nasal irrigation) is unmatched in its ability to

-Clear the nostrils for freer breathing.

-Reduce excess mucus.

-Moisten the nasal canal; strengthen the eyes, because there is stimulation of the blood vessels of the nose and eyes via nasal irrigation.

Cure for the Common cold: Using Nasal irrigation (neti)

1. Using un-iodized TABLE SALT, add a level teaspoon of salt to 24 oz warm water.

2. Wash your neti pot (which is available in most health food stores).

3. Re- rinse internally and externally with drinking water.

4. Fill the pot (which holds about 8 oz) with the saline solution.

5. Now tilt your head so your right nostril is uppermost over a sink or large basin.

6. Pour the solution into the nostril and ensure to keep the mouth open to breathe.

7. After it all comes out, remain motionless for 30 seconds or so then blow the nose thoroughly and rinse out the mouth with drinking water.

Repeat steps 1-7 on the right nostril pouring through the left this time.

You can bend forward to ensure it all drips out or preferably perform 10-15 rounds of bellows breath (a breathing exercise that entails forcefully pulling the belly back towards the spine which pushes the stagnant air out of the lungs) to get all the solution out.

I found it pleasant and soothing after practicing it only once. Besides aiding as a cure for the common cold, it also ensures that blocked nasal passages as a result of irritants and pollutants are well loosened.

Furthermore it is said to have a marked cleansing effect on the sinuses and mind and helps to clean the anterior regions of the upper palate housing the olfactory organs. It even helps to cleanse to some degree the inner workings of the ear. Children using this product should be supervised by an able adult.

Cure for the Common Cold: Dietetic Suggestions

Moreover, to target the root cause of the common cold, now will be a good time to try one kind of a fast which could be

1. The use of Fresh Fruit juices.

2. The Broth of succulent and tasty steamed vegetables such as celery, cabbage etc

3. A mono-diet of a seasonal juicy fruit.

If like most people, you just cannot fast, well see to it that you abstain from all types of Animal Products, Breads, Grains and beans during this time. These substances have been known to either cause or aggravate the common cold along with other diseases and conditions including but not limited to the flu, asthma and diabetes.

This fact is based on research performed the renowned French Hygienist, Albert Mosseri and based on my personal experiences with curing my asthma, I definitely advocate his opinions. A good replacement for the less beneficial items listed above will be fresh fruits, roots and leafy vegetables for fuel.

So don’t be fooled into spending your money on drugs and nasal sprays as a cure for the common cold, it, like any other disease, can be alleviated by common-sense drugless healing alternatives, if only you know how.

With the steps above, you, like my co-worker, now know exactly how to cure you cold naturally for long-term success.

Foras Aje is an independent researcher and author of Fitness: Inside and out, a book on improving physical and mental health naturally. For more information on natural health and wellness visit http://www.bodyhealthsoul.com

Approaching the second half-century of my life brings me to a new appreciation of the ‘aged’ in our society. Mid-life does have it’s rewards; that being an opportunity to appreciate what has gone by, as well as looking ahead with hopeful anticipation to a world that will allow us to live an age-full life. Simply put; to live and age fully from mid-life to death, to value and honor the full circle of life with all it’s seasons, and the be fully present at each stage or age. There does not seem to be a lot of expectation in that, does there?

A past generation has taught us to respect our elders, but that too has become passé, as society’s trend on respect seems to be declining? Elders are “an older person with some authority..superior in rank.” They convey honor, wisdom and experience. Respect is a learned behavior. No matter how the body ages, the soul and mind are the same until the end. If youth are taught to respect their elders, they will also learn to respect authority through life, so maybe it’s time to get back to basics. Well explained in this quote “young and old typically have little but superficial contact with each other. We let appearances deceive us and dismiss what our elders have to teach us, even before we give them a chance to speak. Thus, we forfeit the wisdom accumulated through lifetimes.” It is difficult for youth to appreciate wisdom; it comes with life experience, it is not automatic.

I consider myself very blessed to have good memories of wonderful grandparents. Whether they knew it or not, they were teaching me, I was learning and absorbing. It was all the ‘little stuff’ that the books in school could not teach, it is all the knowledge I carry with me today that I could not find on the internet, and it is all that logic that comes simply through osmosis, having been in their presence.

One memory that stands out in my mind is the ‘smoking’ lesson, with grandma (bless her heart)! She was a smoker, of course wanting to be sure her grandchildren did NOT smoke. There was no chitchat about risks and health hazards. She sat me on the kitchen table, lit a cigarette, and taught me to inhale. I guess if I was to be a smoker like she was, I need to be taught the ‘right’ way. Ending the lesson did not come with puffing, inhaling, choking, gagging, coughing, it was when I started turning green! Could that have had an affect on my decision to not smoke? Who knows, but where else in this world can you find wit like that? Maybe that is what our world is lacking; wit, common sense and acceptance. Acceptance that the wrinkles, gray hair, will come, the eyes will get tired, the hearing will fail, the bones will shrink, the joints may hurt, the appetite will diminish and the memory may lapse but that’s normal, it’s ok, or is it? Add to that, the worry about becoming a burden to society, or the loneliness and financial stress?

I often wonder what special messages were never shared by those gone before us. Maybe it would it go something like this: “we gave you love, in hopes that you would pass it on; we gave you wisdom and life skills, one day we may need reminding; we were patient while made mistakes, please have patience in accepting ours; we tolerated the changing times, so now please tolerate changes in us; we taught you to walk, so you could help us when our legs may fail; we taught you to read so that you could be our eyes when our vision may fail; we fed you foods you liked, allowed you to let us know when you were hungry, so please don’t force us to eat if we are not hungry; we cared for you when you were ill, and gave you medications only as required; so please medicate us only as required; we taught you when bedtime was but bent the rules now and again, so please bend rules for us now and again; we encouraged you to participate, be active and socialize, so please allow us that right as long as we can breath and move; we shared with you the days of old, so that those memories can carry on, in case our memory fades; we taught you to drive so that when our keys are taken away, you will give us a ride; we taught you to manage your money, so we can trust you to manage ours when we can no longer do so; we taught you right from wrong, so please remember the difference when you deal with us; we taught you about God so that you will always have somewhere to turn, so please pray for us when we no longer can; if we repeat the same story over and over, just remember how many times you made us read the same book to you at bedtime; we taught you about morals and values, so you could be an inspiration to others; we respected you, not only because you are our children, but because you are human, please remember to respect everyone you meet; on the day you see us weak and tired, try to bear with us and understand; when you see the wrinkles, remember the love, wit and wisdom behind them; remember how we let go when you needed to fly on your own? Please know that when God calls us home, you too can let go! This is the Circle of Life, please live yours fully.”

Thank you and God Bless each elder, here and gone, whom have added life to mine.

“I am a Carer”. There you go, “straight off the bat” as they say, I write this article (the first in a series) in my role as a Primary Carer first and author second. At present I am the primary carer for my elderly mother who is suffering from the advance stages of Alzheimer’s disease. It is desperately cruel disease (most are, I know) in that it robs people (by and large) of their dignity and their independence at a stage in life when they need it most.

In the United Kingdom, the Alzheimer’s Society claimed in a recent survey that over 750,000 people suffered from Alzheimer’s and related dementia problems. In the United States it is calculated that an estimated 4.5 million people suffer from Alzheimer’s and that this figure has doubled since 1980.

Further alarming statistics highlight the fact that it is possible that in the US alone, the number of people suffering from Alzheimer’s could more than double to between 11.5 and 13 million sufferers by 2050.

Alzheimer’s disease is what is described as a progressive disorder of the brain that gradually destroys a persons’ memory, ability to learn, reason, make judgements, communicate and carry out daily activities. As the disease progresses, sufferers may also experience changes in their personality and display such behavioural changes ranging from anxiety, agitation or suspicion right up to and / or including delusions and hallucinations

Although there is currently no cure for Alzheimer’s, new treatments are on the horizon as a result of accelerating insight into the biology of the disease. Research has also shown that effective care and support can improve quality of life for individuals and their caregivers over the course of the disease from diagnosis to the end of life.

Considering the long term implications for Alzheimer’s sufferers, the hidden sociological impact will in reality be born on the shoulders of those who will be caring for the sufferers for it is indeed a bittersweet irony that those who care for the sufferers in reality suffer more than the sufferers do themselves.

This fact in itself has been largely responsible for another survey finding recently and that was the fact that Americans are equally afraid of caring for someone who has Alzheimer’s as much as they are of developing the disease themselves. Approximately 1 in 2 American adults are more apprehensive of caring for partner or loved one who has developed Alzheimer’s. Just less than 1 in 5 American adults have indicated that they are more afraid of getting the disease themselves (17%).

The real problem from a carer’s perspective is that no two people experience Alzheimer’s disease in the same way. As a result, there’s no one approach to care giving. Your care giving responsibilities can range from making financial decisions, managing changes in behaviour, to helping a loved one get dressed in the morning.

Handling these duties is hard work. But by learning care giving skills, you can make sure that your loved one feels supported and is living a full life. You can also ensure that you are taking steps to preserve your own well-being.

Caring for someone who has Alzheimer’s disease or another illness involving dementia can be very difficult, time-consuming, and stressful – (serious understatement here). Here are some more things a care giver can do to help the person with Alzheimer’s disease while also reducing the substantial burden that comes with care giving:

* Stay Informed - Knowledge equals power. The more you know about Alzheimer’s disease or any other signs of dementia, the better you can prepare yourself to deal with problems that may arise.

* Share concerns with the person - A person who is mildly to moderately impaired can assist in his/her own care. Memory aides and other strategies can be created by the person with dementia and the caregiver together. This is easier said than done I know but you have to give it a try. But, and this is a big but (no laughs here please) it is essential that you realise that you are probably dealing with a person who if they have any cognisance at all, will be in denial.

* Solve problems one at a time - A multitude of problems may occur that may seem insurmountable at the time. Work on one specific problem at a time — you do not have to solve every problem all at once. As the saying goes “Success by the inch is a cinch, by the yard it’s hard” and in this case this has never been more true.

* Use your imagination - One of the keys to handling this disease is your ability to adapt. If something can’t be done one way, try another. For example, if the person only uses his or her fingers for eating, do not keep fighting; just serve as many finger foods as possible!

* Establish an environment that encourages freedom and activity within limits Try to create a stable, balanced schedule for meals, medication, etc. but also encourage activities that the patient can handle such as taking a walk or visiting an old friend. Remember, the person with AD is not the only one whose needs must be taken into consideration. You as a caregiver have needs and desires that must also be met. First, try and find some time for yourself. Even though this suggestion may seem like an impossibility, find some time during the week where you can have someone else watch the patient — be it a relative, friend, or neighbour — and do something for yourself.

* Avoid social isolation - Keep up contacts with friends and relatives. It’s easy to get burned out when it seems like you have no one to turn to. Another way to establish contacts is by joining the Alzheimer’s Association or other such support groups. Talking with other families who share many of the very same problems can be reassuring as it helps you know you are not alone in your round-the-clock struggles.

Stephen is the principal advisor for Connecting Carers, an independent advisory organisation in Primary Caring.
www.connectingcarers.com, www.stressrelief.ws & www.stressdiaries.com

Youth, it is said, is wasted on the young. Too busy figuring life they hardly take the time to enjoy it. Fortunately, with medical research and scientific progress, lifespans have doubled over the last century. We can now start life at fifty and have another go at youth. Health consciousness, appropriate diet and exercise, can make the later years of life a pleasant experience. Dietary principles play as especially important role in this regard. Compensating for the physiological changes of aging, they can give us better odds at achieving our genetically determined lifespans.

The advancing years experience a complex interplay of changes affecting the mind, body, and the environment. Alterations in organs systems and cellular function can often predispose to malnutrition and a host of chronic illnesses (Servan 1999). Some of these problems can be attributed to the decrease in the total protein content and are in themselves preventable with appropriate attention to the protein content of the diet.

A decrease in protein turnover, such as that seen in aging, has far reaching effects (Chernoff 2004). Vital organ systems like the heart and lungs slow down, becoming incapable of further exertion. Neural processes like thought, planning and cognition are also affected. The immune system becomes weak, exhibiting a delay and difficultly in dealing with infections (Thompson 1987). Wound healing and repair, which requires a constant supply of amino acids, is also compromised.

Another issue associated with aging is the reduced capacity to deal with free radical species. These highly reactive molecules are produced by cells under stress. Free radicals can precipitate a chain reaction, damaging cell membranes and the genetic code. They have been implicated in a variety of disease processes from infection, heart attacks and cancer. This inability to handle free radicals is also responsible for aging. It is now believed a high protein diet can be helpful in attenuating many of these problems (Chernoff 2004).

Merely providing proteins through regular diets fail to meet the special requirements of the elderly. A protein supplement is often needed to ensure easy digestion, rapid absorption and assimilation. The protein supplement should also be of good quality and contain all the essential amino acids in adequate quantity. Such a supplement can adequately provide essential amino acids irrespective of the gut’s ability to assimilate them. Such a protein supplement will be able to address the increase protein demand and malnutrition seen in the elderly, restoring the ability to build and repair tissues. A good protein supplement also has other significant benefits in the elderly that often go unrecognized.

A high protein diet has a ‘thermogenic’ or fat-burning effect. The body spends more energy to assimilate protein than carbohydrates or fats. This energy is often derived from the adipose tissue, thus burning fat in exchange for protein (Bloomgarden 2004). Then if the protein supplement has whey in it, it can also inhibit cholesterol absorption in the gut, reducing the risk of obesity and cardiac disease (Nagaoka 1996). Protein supplements that have casein can form a clot in the gut, thereby slowing down intestinal motility (Boirie et al. 1997) and giving the gut enough time to absorb all the amino acids from a meal. This property is important considering that aging also slows down and compromises digestion.

Protein supplements that combine casein with whey multiply the advantages of each component. Both casein and whey protein have a group of substances called kinins that can lower blood pressure by relaxing the blood vessels (FitzGerald, 2004.). Both proteins enhance the immune system through several mechanisms (Ha and Zemel, 2003). Lactoferrin, in whey protein, binds iron and depriving many micro-organisms of a growth stimulus. Free iron induces the formation of free radicals and is one factor responsible for colon cancer. This is also prevented by protein supplements that contain lactoferrin (whey).

Whey also has other antioxidants to offer. It is rich in cysteine, a precursor of Glutathione that is potent at mopping up free radicals (Counous, 2000). This generalized improvement in antioxidant capacity can counter cancerous and aging processes seen in the later years of life. Whey protein is also known to enhance memory as it promotes the synthesis of a neurotransmitter, serotonin that is involved in cognition and thought (Markus 2002). Milk basic protein, a component of whey, has the ability to stimulate proliferation and differentiation of bone forming cells as well as suppress bone resorption as found in vitro and animal studies. This can protect against weak bones, or osteoporosis, especially in the post-menopausal women (Toba 2000).

Thus there is extensive medical literature in support of a high protein, casein and whey supplement in the elderly population. These studies have also failed to document any major adverse effects with long-term intake of such supplements. Such a supplement can go a long way in making the later years of life more productive and fruitful.

ABOUT PROTICA

Founded in 2001, Protica, Inc. is a nutritional research firm with offices in Lafayette Hill and Conshohocken, Pennsylvania. Protica manufactures capsulized foods, including Profect, a compact, hypoallergenic, ready-to-drink protein beverage containing zero carbohydrates and zero fat. Information on Protica is available at http://www.protica.com

You can also learn about Profect at http://www.profect.com

REFERENCES

1. Arnal MA, Mosoni L, Boirie Y, et al (1999). Protein pulse feeding improves protein retention in elderly women. Am J Clin Nutr; 69: 1202-1208.

2. Bloomgarden ZT, Diet and Diabetes. Diabetes Care, volume 27, number 11, 2004

3. Boirie Y, Dangin, M, Gachon P, Vasson, M.P et al. (1997) Slow and fast dietary proteins differently modulate postprandial protein accretion. Proclamations of National Academy of Sciences, 94: 14930-14935.

4. Bounous G (2000). Whey protein concentrates (WPC) and glutathione modulation in cancer treatment. Anticancer Res 20:4785-4792.

5. Campbell WW, Crim MC, Dallal GE, Young VR and Evans WJ(1994).Increased protein requirements in elderly people: new data and retrospective reassessments. American Journal of Clinical Nutrition, Vol 60, 501-509.

6. Chernoff R (2004). Protein and Older Adults. Journal of the American College of Nutrition, Vol. 23, 627S-630S.

7. Counous, G (2000). Whey protein concentrates (WPC) and glutathione modulation in cancer treatment. Anticancer Research, 20: 4785-4792

8. FitzGerald R J, Murray B A, and. Walsh D J (2004). Hypotensive Peptides from Milk Proteins. J. Nutr. 134: 980S–988S.

9. Ha, E. and Zemel, M.B (2003). Functional properties of whey, whey components, and essential amino acids: mechanisms underlying health benefits for active people. Journal of Nutritional Biochemistry, 14: 251-258.

10. Hernanz A., Ferna´ndez-Vivancos E., Montiel (2000). Changes in the intracellular homocysteine and glutathione content associated with aging. Life Sci, 67: 1317–1324.

11. Kent KD, Harper WJ, Bomser JA (2003). Effect of whey protein isolate on intracellular glutathione and oxidant-induced cell death in human prostate epithelial cells. Toxicol in Vitro, 17(1):27-33.

12. Lands LC, Grey VL, Smountas AA (1999). Effect of supplementation with a cysteine donor on muscular performance. J Appl Physiol 87:1381-1385.

13. MacKay D. Miller AL, 2003. Nutritional support for wound healing. Altern Med Rev; 8:359-377

14. Markus C R, Olivier B, and Haan E (2002). Whey protein rich in α -lactalbumin increases the ratio of plasma tryptophan to the sum of the other large neutral amino acids and improves cognitive performance in stress-vulnerable subjects. Am J Clin Nutr, 75:1051–6.

15. Meyyazhagan S,. Palmer R.M (2002). Nutritional requirements with aging. Prevention of disease. Clin Geriatr Med, 18: 557–576.

16. Nagaoka S (1996). Studies on regulation of cholesterol metabolism induced by dietary food constituents or xenobiotics. J Jpn Soc Nutr Food Sci, 49:303-313.

17. Servan R P, Sanchez-Vilar O, de Villar G N (1999). Geriatric nutrition. Nutr Hosp, 14 Suppl 2:32S-42S.

18. Shah NP (2000). Effects of milk-derived bioactives: an overview. Br J Nutr, 84:S3-S10.

19. Thompson JS, Robbins J, Cooper JK (1987). Nutrition and immune function in the geriatric population. Clin Geriatr Med, 3(2):309-17.

20. Toba Y, Takada Y, Yamamura J, et al (2000). Milk basic protein: a novel protective function of milk against osteoporosis. Bone 27:403-408.

21. Walzem RL, Dillard CJ, German JB (2002). Whey components: millennia of evolution create functionalities for mammalian nutrition: what we know and what we may be overlooking. Crit Rev Food Sci Nutr, 42:353-375.

22. Weinberg ED 1996. The role of iron in cancer. Eur J Cancer Prev, 5:19-36.

Copyright Protica Research - http://www.protica.com

Aquasana shower filter

Nowadays, water pollution is becoming the real threat to the
people and it has been seen that majority of the populace is
falling under the trap laid by it. This grown threat has created
a rage among the people which has led to the installation of
best shower filter in town. Whenever we hear the word shower
filter Aquasana is the first company that strikes our mind. They
are said to be the pioneers in producing best shower filter in
town and that too the most powerful and advanced. Aquasana
shower filter are the most trusted and widely used shower filter
as they not clean the water but also eliminate the bad whiff
from it. These days people are becoming very health conscious so
in order to get clean drinking water they not only install water
filter but now many people have started installing shower filter
for getting clean water with which they can bath. Having shower
filter ensures complete safety and clean water for bathing.

In a recent survey it was revealed that Aquasana have captured
the maximum market and are always in the hunt of ways of
producing best and top rated shower filter. Aquasana shower
filter completely removes the chlorine from the water and
reduces the chances of having lung or eye infection, dryness of
skin, dry and fragile hairs and many more to mention. After
having bath from it you are guaranteed of having pliable and
sinuous skin which can make anyone go drool over it. Water is
filtered in three stages while passing through Aquasana shower
filter which makes sure you get the cleanest of water. In the
shower filter producing companies Aquasana simply leads the way
as they are equipped with ph balancer which ensures the safe
bath anytime you go in for shower.

Despite being so advantageous they are still available at a very
competitive price that is, now you can find the best Aquasana
shower filter in only $61. There mobility makes them the most
admired and widely used shower filter and the heights conquered
by them is very difficult to conquer. They also have the inbuilt
sensors which informs you, when the cartridges need to be
changed. So if you are a health freak and want to bath in the
clean and germ free water then simply install the Aquasana
shower filter as only they can provide you the protective
coating from the germs and their related diseases.

PART I: Physical Abuse of the Elderly vs. Tennessee DHS Abuse of Families

During the week of October 26, 2003, newspapers across the state of Tennessee published an Associated Press story that featured the glaring news headline, “Reports of neglect and abuse of senior citizens up 40% in six years.” The second sentence of the story indicated the Tennessee Department of Human Services’ (DHS) Division of Protective Services has a staff of only 83 to cover Tennessee’s 95 counties. Juxtaposed this way, the Associated Press story implied that abuse of the elderly in Tennessee is growing, the state has far too few resources devoted to the problem, and by implication the state needs to rearrange its priorities and spend more, much more, on adult protective services.

This perspective was echoed by state Rep. David Shephard, D-Dickson, who was quoted in the article as saying, “We are looking at a problem that is going to get bigger as medical advances continue and people live longer.” State Rep. Dennis Ferguson, D-Kingston, who chairs the House Health and Human Resources Committee, shifted the focus to preventing fraud perpetrated on the elderly: “A lot of time people are getting old and they don’t have a family and people take advantage of that. They go over and say ‘We want to help you’ and the first thing you know is they have their checking account and run through their money.”

While it is true that fraud and other scams perpetrated against the elderly is a serious and growing national problem, the extent of physical abuse and neglect of the elderly in Tennessee needs further scrutiny. The source of the Associated Press’s “40% increase” figure is none other than the Tennessee DHS. After reviewing how DHS classifies complaints, reasonable people may conclude that DHS is not properly closing its cases.

In the spirit of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), The Tennessee Law Times has constructed the following composite scenario based on actual cases that we have investigated and verified are true. This composite scenario respects the privacy rights of both medical patients and DHS staff, who may not want to be identified by name. The paper recognizes that some DHS staff may have been directed to take actions that violated their own sense of ethical standards and fair play.

Composite Case. An elderly patient with a broken hip was placed in a nursing home to recuperate following his hip repair surgery. The orthopedic surgeon initially places orders for nurses that the patient should not place weight on the leg associated with the repaired hip. Over time the surgeon changes the orders to allow 25% weight bearing, then 50% weight bearing, as the bone heals and the patient needs more physical therapy. Eventually, the surgeon is to allow full weight bearing on the leg with the repaired hip.

Through negligence of the nursing home, the patient is not brought to the surgeon for a scheduled follow-up appointment. Consequently, the surgeon’s 50% weight-bearing instruction is left on the patient’s chart long after the doctor’s order has become stale and the patient is seen walking on his own without assistance using both legs.

A family member visits the patient in the nursing home and helps him walk by providing assistance with his arm. A physical therapist at the nursing home and his assistant witness the patient walking with the family member, and they claim the family member was encouraging the patient to put full weight on his leg. The following day a social worker at the nursing home phones in a complaint to the Tennessee DHS Adult Protective Services unit. One might expect the over-worked and stressed DHS staff would quickly surmise that the patient is walking on his own, that the doctor’s orders are stale, and that a family member’s assisting the patient to walk certainly does not constitute physical abuse.

Indicated Abuser. Wrong! In actual cases, DHS’s Adult Protective Services unit initially labels the family member as an “accused” physical abuser of the elderly patient. The fact that more than one witness observes the alleged “abuse” automatically transforms the status of the family member from “accused” to “indicated” abuser, in DHS terminology. Meanwhile, the family member has no due process rights to learn the identity of the nursing home staff members who filed a complaint or even learn the circumstances of what they allege to DHS has occurred.

When the family member explains to DHS’s Adult Protective Services staff that the medical orders are stale, that the patient is walking on his own, that he merely provided a guiding arm to assist the patient who walked on his own, the DHS staff refuses to close the case. They continue their investigation and try to seek medical records on the patient from other doctors to seek evidence of physical abuse reported anywhere by anyone. No evidence of abuse is found after contacting multiple doctors, and still DHS will not close its investigation.

Stale Medical Orders. The family member, who is also healthcare attorney in fact for the patient, orders that the patient be brought to the surgeon’s office, using an ambulance at Medicare’s expense as the bureaucracy requires. The surgeon observes the patient walking and promptly corrects his now stale medical orders for the physical therapist to allow the patient to place full weight on the repaired hip and leg. This change in medical orders within a few days of the complaint being filed with DHS’s Adult Protective Services, thereby suggesting that the patient has been able to have full use of his leg for days. But still DHS will not close its investigation.

Text Box: The fact that more than one witness observes the alleged “abuse” automatically transforms the status of the family member from “accused” to “indicated” abuser, in DHS terminology. Meanwhile, the family member has no due process rights to learn the identity of the nursing home staff members who filed a complaint or even learn the circumstances of what they allege to DHS has occurred.

Within a week, the family member discharges the patient from the nursing home and brings him home. DHS insists on conducting a home study visit, afterwards concluding that the family member is providing “excellent care” for the senior citizen. But still DHS will not close its investigation. DHS wants assurance that the former patient will not live alone, but the family is not prepared to offer such a blanket guarantee until they can observe how well the patient adjusts to living at home. For two months, DHS continues to call the patient’s home and calls relatives living out of state to learn whether the patient will be living with family members.

Stroke Risk With Nursing Home Negligence. As an interesting footnote to this story, a social worker at the nursing home told the family member that in her professional opinion, the patient was so mentally impaired that he needed 24-hour assisted living care of the kind provided in their nursing home. But the nursing home in fact provided grossly negligent care. A nurse practitioner at the nursing home unilaterally took the patient, who has atrial fibrillation, off a life-sustaining drug, Coumadin, in violation of doctors’ orders. For patients with atrial fibrillation, the absence of Coumadin increases the risk of stroke on a logarithmic scale.

The result was that this patient had an increased risk of developing a blood clot and stroke that was 5 times the normal risk: not a 5% increase in risk, a 500% increase in risk that went on for six weeks until the family member detected the negligence. When the family member told the social worker that under no circumstances would his father be left in the nursing home, the social worker retaliated a day later by phoning in a complaint of patient abuse to the DHS Adult Protective Services. In its defense, the nursing home stated the timing of the complaint was just a coincidence.

One would think that DHS staff could look into the motives of those alleging abuse to see if they were trying to confine the patient indefinitely to the nursing home against his will and also question whether there had been any animosity or retaliation of the nursing home staff directed at the family member. But DHS staff did not evince any deductive reasoning. Instead DHS Adult Protective Services staff viewed all doctors’ orders as black and white. They could not conceive of orders becoming stale. DHS staff also stated that doctors’ orders apply not only to nurses and physical therapists, but also to lawyers, family members, and visitors. According to DHS, doctors have a right to order lawyers, family members, and visitors how to care for a patient.

Informed Consent. DHS staff failed to recognize the basic elements of the legal relationship between doctor and patient, e.g., any patient has a right to fire a doctor she feels is not properly treating her, or patients could challenge any doctor’s orders by seeking a second opinion from another doctor. More important, even without benefit of a second medical opinion, a patient and her health care attorney have a right to listen to a doctor’s advice and reject it. That is what the legal doctrine of informed consent is all about.

Yet DHS acted as if they have a right to supersede the wishes of an elderly citizen and decide for him what is best for him to live the remaining years of his life. DHS intruded into the family’s peace and care for their elderly parent and would not back off when ordered to close the case by the patient, by his educated and articulate health care attorney in fact, and by other family members. DHS knew that it could not prevail in court in such a case. Yet DHS continued to harass the patient’s family and repeatedly refused to rule out the possibility that DHS would use the police powers of the state to place the patient in a nursing home against his will.

This case was an enormous waste of the taxpayer’s resources, and the only good DHS accomplished was to recommend that family members install handicapped bars on the complete circumference of the patient’s shower room at home. Once DHS begins an investigation, the citizens and taxpayers have no oversight. DHS thus spends as much time and resources as it chooses on any given case. The state legislators imposed specific guidelines requiring DHS to close obvious cases of non-abuse within a week or two.

Standard for Imminent Harm. These guidelines require DHS to cease prosecution of cases in which a subject cannot be shown to face imminent risk of harm. But DHS routinely ignores this legislative constraint and, in the several cases presented to The Tennessee Law Times, has stretched trivial cases into investigations taking several months. Consequently, DHS’ Adult Protective Services has expropriated for itself absolute power to prolong its investigations and snoop around at the taxpayers’ expense. As the British historian Lord Acton once said, “Absolute power corrupts absolutely.”

Legislative Oversight Failures. A number of state legislators are to blame for the continuing lack of oversight over DHS’s overreaching behavior. For many years, state Rep. Joe Armstrong (D – Knoxville) formerly chaired the House Health and Human Services Committee. Armstrong continuously refused to allow the family member or the 79-year old patient to testify before his committee on DHS’s overreaching behavior with its Adult Protective Services. On six separate occasions, Armstrong rebuffed the family’s offer. Perhaps Armstrong did not want to hear direct criticism of DHS by highly articulate and educated witnesses, or perhaps Armstrong was embarrassed that a patient labeled by a licensed Tennessee nursing home social worker as so mentally impaired he required 24-hour nursing home care would indeed have the mental capacity to testify before a committee of the Tennessee General Assembly.

Similarly, state Rep. Dennis Ferguson (D – Kingston), the current chair of the committee, wrote to the patient’s family that then DHS Commissioner Angela Metcalf said her department’s staff did not engage in overreaching behavior. Ferguson was satisfied to take Metcalf’s word for it (over the objections of several of his own constituents in Roane County).

In contrast, a number of state senators advised the patient’s family that they had received numerous complaints about overreaching and overbearing behavior by Adult Protective Services staff. In a subsequent article, The Tennessee Law Times would like to highlight the positive changes in oversight, if any, that these legislators will implement with respect to DHS.

Mildred Yarberry Case. Regrettably, this composite true story is not an isolated case of DHS overreaching behavior. In the Mildred Yarberry case reprinted in the section on trial court opinions, a courageous Knox County chancellor stood up to DHS violations of their own governing statutes for protective services and ordered DHS to release a senior citizen that DHS had seized and placed in a nursing home against her will. The facts in this case are stated clearly in the chancellor’s opinion. Two points deserve special mention.

First, in this case DHS unquestionably encountered living conditions in the patient’s home that most readers would find appalling: roach infestation, rotten food in the refrigerator and on the front porch, unsanitary bathroom, living areas in various states of disarray. However, neither the readers nor DHS has the right to say in what level of cleanliness a senior citizen in Tennessee must live or that a citizen of Tennessee must, in the final year of her life, give up the only home she has known.

Second, although DHS professed to have “good intentions” towards Mildred Yarberry, they seized her against her will and without any warning, they confined her in a nursing home against her will, and DHS adopted the attitude that Mildred Yarberry, like so many of the other helpless victims of DHS overreaching behavior, was mentally impaired and therefore whatever she stated that she wanted could be legitimately ignored. DHS did not respect the “risk of imminent harm” statutory obligation in this case, nor do they respect that obligation in other cases they are investigating at the present time.

Felt Confined to a Prison. Mildred Yarberry said that she felt she was in a prison while confined against her will in the nursing home, but DHS did not care. Her elderly brother pleaded with the court to let her sister return home and said he would do what he could to assure she was well, but DHS was not moved by the wishes of family members or next of kin. Mildred Yarberry went into deep depression at the nursing home and had given up on life, but DHS was content to have her die in the nursing home prematurely rather than let her live out her life as she desired: in her own home.

DHS Leaves Patient Penniless. Readers should put themselves in the place of Mildred Yarberry. Suppose you are aware your mind is failing, although you may not be aware of the extent of your own limitations. DHS seizes you against your will and confines you to a nursing home. DHS seizes your social security checks and every possible source of income you have. You are trapped. You do even have the money to pay for a taxi ride back home. You do not know who to call for assistance; you are helpless. In all likelihood, DHS will attempt to take ownership of your house, sell it, and use the proceeds to pay for the $120/night cost of the nursing home, which you do not want. You will lose your home and all your possessions – all in the name of doing what is best for you. Under those circumstances, it is clear why patients seized by DHS feel they have been robbed of every cent they own and why families feel DHS is burdening them with nursing home bills that could drive them into bankruptcy.

Get Houses Cleaned. The state legislature needs to equip DHS and its Adult Protective Services unit with more assistance to those in need and less draconian solutions. DHS should be able to arrange for “meals on wheels” to be brought to people who cannot cook for themselves. Instead of seizing an elderly person in an unclean house, DHS should arrange for the house to be cleaned. It comes down to whether Tennessee is going to respect the dignity of each individual or continue to threaten and force elderly people into nursing homes against their will.

Dr. Michael A. S. Guth, Ph.D., J.D., is a legal brief writer and law newspaper Editor-in-Chief. He writes a variety of articles on constitutional law, elder care, consumer credit card debt, appellate court term reviews, and law and society. See http://riskmgmt.biz/ for an introduction to his legal work, and http://riskmgmt.biz/lawarticles.htm for a listing of many of his articles. Dr. Guth writes legal articles and briefs for other law firms, and he assists pro se parties (those without a lawyer) in preparing documents they can file in court such as motions pertaining to child custody, visitation interference, and child support defense.

The principal dilemma in current management of multiple
sclerosis is that while early diagnosis enables damage-sparing
treatment to begin, diagnosing MS too early increases the
likelihood of treating people who don’t actually have the
disease. Current disease-modifying drugs are all given by
injection and cost about $14,000 per year. Apart from being
inconvenient and expensive, there is some risk of harm from them
which, if the patient doesn’t actually have MS, occurs without
any offsetting benefit.

The dilemma would not be great if multiple sclerosis was easy to
diagnose, but unfortunately MS is among the most difficult
diagnoses in all of medicine to make, at least while still in
its early stages. Early in the course of symptoms, MS can
resemble other conditions; moreover, other conditions can
resemble MS.

Affecting 2.5 million people worldwide and 350,000 people in the
U.S. alone, multiple sclerosis is not exactly a rare disease. It
affects women at least twice as often as men and begins early in
adulthood with most cases starting between the ages of 20 and 40.

MS is a so-called autoimmune disease, meaning that a person’s
immune system–ordinarily useful and essential in fighting off
infections–becomes overactive and attacks the individual’s own
bodily tissues. Rheumatoid arthritis is another example of an
autoimmune disease, but in MS the immune attack is not directed
against joints as it is in rheumatoid arthritis. Instead, the
immune system attacks large clusters of nerve-fibers generally
deep within the central nervous system which includes the brain
and spinal cord.

These attacks can produce a wide variety of symptoms depending
on what the usual function was of the nerve-fibers that are
under attack. When the attacked nerve-fibers have to do with
vision, the symptoms are visual, like loss of visual clarity or
even doubling of vision. When the nerve-fibers are involved with
the process of bodily sensation, then the symptoms can be
numbness or tingling. In fact, visual or sensory symptoms are
the most common initial symptoms in multiple sclerosis. But
initial symptoms might instead consist of dizziness, weakness,
clumsiness or difficulty with urination. The sheer diversity of
early symptoms that can be due to multiple sclerosis is one of
the chief difficulties in recognizing it for what it is and
properly diagnosing it.

It’s useful in this regard to consider the twin issues of
“false-positives” and “false-negatives.” In short, every medical
test and every diagnosis is subject to these errors.
False-positive means that a test or a doctor indicates that a
disease is present when it is, in fact, absent. A false-negative
error occurs when a test or a doctor indicates that a disease is
absent when it is, in fact, present. Despite the increased
confidence that expanding medical knowledge and ever-more
sophisticated tests provide, false-positives and false-negatives
are a fact of life and still apply to every test and every
diagnosis.

In multiple sclerosis there are three cornerstones to the
diagnostic process. In usual descending order of importance they
are the clinical evaluation, magnetic resonance imaging (MRI)
scanning and examination of the cerebrospinal fluid. Each of
these is important in its own way, but one component almost
never stands on its own merits, requiring one or both of the
other components for corroboration.

The clinical evaluation refers to the time-honored process in
which the physician elicits the history of the symptoms and
performs a physical examination. The physical examination
consists mainly of the neurological examination, which is a
battery of mini-tests that inventories the performance of
different components of the nervous system.

Even a test as high-tech and powerful as the MRI scan can lead
to diagnostic errors. False-positives often occur when a patient
has a scan for a totally unrelated reason–like headaches, for
example–and has pockets of increased signal within the brain
for which the radiologist raises the possibility of multiple
sclerosis. When the abnormal scan leads to consultation with a
neurologist, the neurologist often determines that multiple
sclerosis is out of the question, and the areas of increased
signal are either benign or due to another problem entirely.
MRIs less frequently produce false-negatives for multiple
sclerosis, but even so, this imaging test is believed to show
just the tip of the iceberg in this disease, failing to
demonstrate important changes that occur at the microscopic
level.

Examining the cerebrospinal fluid (CSF) is another valuable tool
in diagnosing MS. The CSF bathes the inside and the outside of
the brain and the outside of the spinal cord, so its cellular
and chemical composition often reflects what’s going on within
those structures. CSF is obtained by means of lumbar puncture,
also known as spinal tap, a safe procedure in which a needle is
inserted through the lower back and into the CSF space. The
fluid is collected as it drips out the back of the needle. In
cases of active MS there are usually abnormal proteins produced
by the immune system that can be detected and measured in the
CSF. However, here too there are false-positives and
false-negatives, so that some people with abnormal proteins
don’t have MS and other people with normal proteins still do
have the disease.

So the diagnostic process–including clinical evaluation, MRI
scanning and CSF examination–is fraught with the possibility of
error at each step of the way. Yet there is considerable
incentive to make the diagnosis as early in the disease as
possible (which is also when the risk of diagnostic errors is
greatest) in order to initiate treatment that tames the
out-of-control immune system. Sifting through the diagnostic
information to make a timely and accurate diagnosis almost
always requires the assistance of a neurologist, and even with
the help of these specialists in disorders of the nervous
system, sometimes the diagnosis gets revised as time passes and
clues become more definite.

(C) 2005 by Gary Cordingley

1. Multiple Sclerosis:

Multiple Sclerosis is one amongst the widely afflicting diseases
today. It can be interpreted to be a disease of nervous system
where it worsens over a period of time with loss of feeling and
loss of control of movement and speech. So, MS attacks the
individual’s central nervous system that is constituted of
different nerves and nerve fibers. It involves a threat to his
brain, spinal cord and eye or optical nerves. Basically MS
hampers or destructs the protein that safeguards the nerve
fibers. This protective protein is known as myelin and it aids
in the communication between nerve cells. Once myelin gets burnt
up, a breakdown occurs in the nerve cells’ co-ordination. Its
effect is visible in the behavior (that drifts from normal to
abnormal) of the individual. Along with this there appear
lesions and plaques occur on that part of the body where
demyelination takes place. But this is not all. Most often the
cells that help in regaining myelin are even eliminated. The
individual’s body then succumbs to damage and disability.

2. Invoking and Provoking Multiple Sclerosis: Various
conditions are deemed to invite multiple sclerosis.

• An individual’s genes are the first and foremost factor that
contributes to the risk of developing MS at any stage of life.
Medical research reveals that the kids born of those parents
where either of them has a history of MS, are largely prone to
it.

• Apart from the genes, an environment change is also
instrumental in causing MS.

• Viruses of diseases such as herpes, measles, flu etc. have
proved to be quite effective in invoking multiple sclerosis.

• Hormones, especially the sex hormones like estrogen and
progesterone have weakened the immunity system and instigated MS.

3. The Indications:

MS may be exposed differently in different people or a single
person may face various symptoms. Actually, the time MS strikes
the nervous system, it becomes manifested via some or the other
indicator. For instance, as soon as demyelination begins, the
individual may experience lack of balance of his body, tremors,
a paralytic attack and so forth. Gradually, these symptoms
translate to outburst of the disease.

4. The Varying Features:

According to doctors, there are differing types of multiple
sclerosis. The primary is the Relapsing- Remitting MS. As the
name suggests, relapsing MS is that where MS dissolves or
disappears but only initially, it recurs after a span of time.
After relapsing, the disease begins to catch pace and so injure
the spinal cord and brain. If the nervous system starts
worsening right after the inception of the symptoms, it is
Progressive-Relapsing MS. Similarly there are
Primary-Progressive and Secondary Progressive stages of Multiple
Sclerosis. At the onset of this disease, the doctors by studying
the symptoms determine or adjudicate which form it will take.

5. Diagnosing and Medication

Right after the perception of MS indicators, in order to
confront the actual status of multiple sclerosis, doctors ask
the individual to undergo different tests. MRI and blood tests
are commonly advised to estimate the actual status of the
disease. Besides the tests, medicines too are prescribed. There
are quite a few good drugs available in the market such as
Avonex, Rebif etc. However, MS does not seem to be cured by any
of these measures then chemotherapy is the final resort. It is
an extremely difficult treatment but it entails positive
results.

6. Precautionary Measures:

• The best possible defence against all diseases is the intake
of a rich balanced diet that strengthens the immunity system.

• If an individual has a background of diseases like
hypertension, kidney issues and fluid retention etc. then the
doctor ought to be ultra cautious prior to recommending any
medicine. For there can be many serious hostile effects of these
antibiotics.

• Those who fear MS due to appearance of some similar symptoms
must go for an instant check up. Otherwise also, the people born
of any of the MS parents must pay extra heed to their health ad
consult doctor time and again.

• The effects of an environmental change should be carefully
studied before making any trip to a foreign place.