Caring Currents

Big news this week for men with prostate cancer (and their families) who are using hormone therapy: It may not actually work. Researchers at the Cancer Institute of New Jersey followed almost 20,000 men age 66 and older for an average of 18 months and found that those treated with androgen deprivation therapy, which involves taking medication (Lupron, Viadur, Eligard, or Zoladex) to eliminate testosterone production, had no better survival rate than those treated with conservative management. (Conservative management, also called "watchful waiting," means essentially doing nothing while carefully monitoring for disease progression.)

The study, published in last week's Journal of the American Medical Association (JAMA), got lots of oncologists talking because in the past decade, hormone therapy has become a popular alternative to surgery, radiation, or conservative management...  Read more

If you're taking care of someone age 65 or older who's on medications, check out this handy reference guide.

Researchers are the University of North Carolina at Chapel Hill have compiled a long list of prescription drugs -- including common antidepressants, seizure medications, and painkillers -- that can increase the risk of falling among older people who take four or more meds.

What do these drugs all have in common? They depress the central nervous system, which may make your parents both less alert and slower to react and thus more likely to be unsteady on their feet.

We've written a lot about the dangers of falls and fall prevention among the elderly in recent weeks. Falls are the leading cause of both fatal and non-fatal injuries and a major factor in head injuries among the elderly. Studies suggest that seniors taking four or more medications are at two to three times greater risk for a life-altering stumble than those who don't...  Read more

Today's shocking news that Senator Edward M. Kennedy has brain cancer has everyone talking about gliomas and what the diagnosis of such a tumor means for his future.

Len Lichtenfeld, a physician with the American Cancer Society pointed out the sad irony that Kennedy has a been a "major force in cancer research and treatment," and has only recently led hearings calling for expanded federal funds for cancer research.

Predictably, news reports immediately went in search of commentators willing to speculate about Kennedy's potential prognosis. And of course, the news wasn't good. Gliomas are scary; they're typically aggressive and the treatment options limited, particularly for tumors that are too big or invasive to be surgically removed.

Fox News quoted Lynne Taylor, a neuro-oncologist at Virginia Mason Medical Center in Seattle, speculating that if  the tumor is a glioblstoma multiforme, the most common type for someone of Kennedy's age, the prognosis would be nine to 18 months...  Read more

Last month I looked at the link between Alzheimer's disease and diabetes, two diseases that are soaring at an alarming rate in the U.S. Recent research reveals people with type 2 diabetes have a 65 percent higher risk of developing Alzheimer's disease than people who don't have diabetes.

Why this is so remains a medical mystery. But a study just out may provide some answers to the connection between the two conditions. Researchers at the Salk Institute for Biological Studies recently published a report that reveals that the blood vessels in the brains of young mice with diabetes are damaged by the interaction of high blood sugar, a characteristic typical of diabetes, and low levels of a compound called beta amyloid, a protein that clumps to form the senile plaques that riddle the brains of people with Alzheimer's.

What's more, this brain vessel damage occurred well before any obvious signs of Alzheimer's emerged, such as nerve cell death or amyloid deposits, the hallmark of the disease, could be detected in the mice's brains...  Read more

The majority of seniors want to live in their own homes as long as possible -- which, as a caregiver, can cause you a great deal of anxiety.

Are your parents taking their medication regularly? What if they fall down the stairs? Are they really able to take care of themselves in their own homes, or would they be better off in a retirement community?

If worries such as these are keeping you up at night -- and especially if you and your parents don't see eye to eye on the matter -- try this short (and entirely unscientific) quiz to help assess your parents' situation, and maybe alleviate some of your worries along the way:

1. Is their house clean and well-cared for, and are basic home-maintenance tasks getting done? yes/no
2. Can someone check in on your parents on a regular (preferably daily) basis? If not, are they willing to consider a Personal Emergency Response System or daily calling service? yes...  Read more

If you've had difficulty finding a physician knowledgeable in treating the elderly, you're far from alone. And this shortage of geriatric specialists is only going to get worse. The "Silver Tsunami" is coming -- baby boomers on the verge of retirement -- and on their wish list: A physician who specializes in treating older people. But, according to a recent survey, few can locate such a doctor.

Nearly 9 out of 10 women polled considered it important to have a doc with senior-care expertise and some 26 percent say their health may have suffered because their provider didn't have such training, according to a nationwide survey of adults 55 and over, conducted by Zogby International for ASAH or the American System for Advancing Senior Health.

These findings are borne out elsewhere. A report last month from the Institute of Medicine revealed that geriatricians are already in short supply...  Read more

Do your parents skimp on sleep or slumber endlessly? Research just in adds to growing evidence that suggests poor sleep patterns can harm the body and mess with the mind.

If your parents sleep fewer than six hours a night, they're more likely to be obese than people who get the proper amount of rest, according to the new report, from the Centers for Disease Control and Prevention's National Center for Health Statistics. The study also linked poor sleep hygiene to lower rates of physical activity across all ages.

It's not clear from this survey whether it's a sleep deficit or oversleeping that leads to inactivity, or if inactivity impacts sleep. The study doesn't draw conclusions about cause and effect. But we can. It doesn't take a government scientist to figure out that your folks need to get enough -- but not too many -- zzzzs. Sleep experts recommend people go to bed when tired and wake naturally in the morning...  Read more

Is it a mouse? A loose floorboard? A door hinge that needs oiling? Believe it or not, that squeak you hear may be caused by your parents' artificial hip.

Yes, folks, according to the New York Times, hundreds of recipients of hip implants made from ceramic materials -- heralded as the new, more durable models than older artificial hips made of metal and plastic -- are complaining that the sound emanating from their hip interferes with their everyday life. It's annoying when bending down. It's embarrassing when climbing stairs. It's a romance killer when engaging in the, um, most intimate of activities. Oh my!

This unwanted creaking malfunction remains something of a medical mystery. Patients and surgeons who talked with the Times raised concerns about whether the unwanted sound may signal that these replacement joints are wearing out prematurely. Some have opted to have subsequent surgeries to have the squeaky offenders removed...  Read more

I'll bet you think that osteoporosis (bone thinning) is a woman’s condition. I did. Looks like we need to adjust our thinking -- and we’re not alone. The American College of Physicians released new clinical guidelines this month on screening men for osteoporosis. This is good info to share with your dad and with his doctor.

These first-ever guidelines call for doctors to periodically screen older men using these risk factors: 

• Low body weight or recent weight loss combined with physically inactivity
• Ongoing use of corticosteroid drugs (such as prednisone) or some drugs used to treat prostate cancer
• Low calcium diet
• Smoking
• Previous fractures not caused by trauma

Doctors are advised to give high-risk men further x-ray testing -- as early detection is key with osteoporosis -- and several simple approaches can slow its progress, such as increasing Calcium, Vitamin...  Read more

In a wonderful post this week, American Cancer Society blogger Dr. Len Lichtenfeld writes about the unique challenges of caring for someone with cancer, suggesting that the term "carepartner" would be a better description of the role. Calling it, "one of the most special partnerships you can imagine," Dr. Len explains that when you're helping someone you love battle cancer, you're right there on the front lines with them. Whether you're an adult child, spouse, partner, or friend, those caring for cancer patients are "the ones who listen, the ones who help, the ones who check out the Internet for the latest and best places to get treatment," he writes.

His thinking resonated deeply with me, and I'm guessing it will for others caring for a loved one with cancer, or any serious medically challenging disease.  From the moment patients hear the word "cancer," they're asked to absorb an incredible amount of information, much of it technical...  Read more