You can choose a person to make medical decisions for you if you are unable to communicate them yourself, whether it’s due to a serious illness, injury, or other reason. This person is called a health care proxy. Having a health care proxy can help you plan for unexpected situations that may not be covered in your living will.

Some important things to know:
Your proxy can only make decisions if you are too sick to make them yourself. In addition, you can specify how much say your proxy has over your care.
Your proxy will work with your health care team to ensure your care and treatment preferences are followed.
You can change your health care proxy at any time. Simply fill out a new proxy form and let your family and health care team know about the change.
You may name an alternate proxy if your proxy is unavailable.

It’s important to find someone who you trust to honor your wishes and who is comfortable speaking up on your behalf with loved ones and health care providers. You may want to talk to more than one person about your wishes before deciding who is the right proxy for you.

by National Institute on Aging

You can ask a doctor to help you think through health care choices that may be covered in your living will, like life-sustaining care and other treatment decisions, before you put them in writing. For example, you might ask about the decisions you or your family may face if your high blood pressure leads to a stroke.

You can also ask a doctor about other medical orders you may need in an emergency situation or at the end of life. Common orders include:

Do not resuscitate (DNR) order. A DNR becomes part of your medical chart to tell medical staff that you don’t want CPR or other life-support measures to restore your heartbeat and breathing.

Do not intubate (DNI) order. A similar document, a DNI tells medical staff that you don’t want to be put on a ventilator.

Out-of-hospital DNR order. An out-of-hospital DNR alerts emergency medical staff to your wishes to restore your heartbeat or breathing if you aren’t in a hospital.

Physician orders for life-sustaining treatment (POLST) and medical orders for life-sustaining treatment (MOLST) forms. These forms provide guidance about your medical care that medical staff can act on immediately in an emergency. Typically, you create a POLST or MOLST when you’re near the end of life or critically ill and know the specific decisions that might need to be made on your behalf.

Prepare for your appointment by:

Asking your health care proxy to come with you if that makes you more comfortable.

Writing down some of your current health issues and your questions about future health care and end-of-life care.

Completing the Tips for talking with your doctor about advance care plan worksheet.

You may find it difficult to ask your doctor directly about your current prognosis or about end-of-life care. Remember, the goal is simply to start the conversation. You do not have to make specific decisions about your medical care until you feel ready.

by the National Institute on Aging

Each year, millions of people suffer from seasonal influenza, which is often called the flu. Flu is a respiratory illness caused by viruses that infect the nose, throat, and sometimes the lungs.

Flu is a mild illness for some people. But for others, including older adults and those with chronic (long-lasting) health conditions, the flu can be very serious and even life-threatening. Getting a flu vaccine every year can help prevent the flu. The vaccine is safe, effective, and available for little to no cost to you.

Most people who get the flu feel better after a few days to two weeks. However, the flu can make you seriously ill. Some people develop other health issues, called complications, because of the flu. Complications can be mild, such as a sinus or ear infection, or more serious, like pneumonia.

Anyone can get sick from the flu, but some people are more likely to have complications. You are more at risk for flu and its complications if you:

Are age 65 or older

Have certain medical conditions such as asthma, diabetes, or chronic kidney disease

Have heart disease or have had a stroke

Live in a nursing home or other long-term care facility

Pregnant people and children younger than five years old are also more likely to get very sick from the flu. Flu vaccination is especially important for people in these higher-risk groups. Learn more about people at increased risk for flu and its complications.

Why is the flu more dangerous for older adults?

The flu is more dangerous for older adults for a few reasons. One reason is that the immune system — which helps your body fight infections — weakens as you age. For example, because your body is busy fighting off the flu, you might pick up a secondary infection such as pneumonia. A second reason is that older adults are also more likely to have other health conditions, like diabetes, that increase their risk for complications from the flu.

The good news is the flu vaccine reduces your risk of getting the flu and of getting seriously ill if you do get sick with the flu. Flu vaccination is especially helpful for people with chronic health conditions. For example, it has been linked to lower rates of heart problems (cardiac events) among people with heart disease and fewer hospitalizations among people who have chronic lung disease or diabetes. Learn more about the benefits of flu vaccination.

How does the flu spread?

The flu is contagious, which means it spreads from person to person. It mostly spreads through droplets in the air when people with flu cough, sneeze, or talk. It can spread from up to six feet away. Although it isn’t as common, the flu can also spread from surfaces — for example, if you touch something the virus is on and then touch your nose, mouth, or eyes.

It’s possible to spread the flu before you feel sick and when you have symptoms. Typically, people with the flu can spread it a day before, and up to a week after feeling sick. Young children and people with weakened immune systems may be able to spread the flu for even longer. If you or someone you know is sick with the flu, take steps to help prevent spreading the disease.

by National Institute on Aging

These small private facilities, also called residential care facilities or group homes, usually have 20 or fewer residents. Rooms may be private or shared. Residents receive personal care and meals, and staff are available around the clock. Nursing and medical care usually are not provided at the home.

In most cases, you must pay the costs of living at a board and care home. Medicare does not cover these costs. Medicaid may provide partial coverage, depending on the state and whether the person is eligible. If the older person has long-term care insurance, check their plan to see if it includes coverage for this type of facility.

Nursing homes, also called skilled nursing facilities, provide a wide range of health and personal care services. Their services focus more on medical care than most assisted living facilities or board and care homes. Services offered in a nursing home typically include nursing care, 24-hour supervision, three meals a day, and assistance with everyday activities. Rehabilitation services, such as physical, occupational, and speech therapy, are also available.

In many cases, people must pay for nursing home care themselves. Medicare generally doesn’t cover long-term stays in a nursing home, but it may pay for some related costs, such as doctor services and medical supplies. Medicaid may also cover some of the costs of nursing homes for people who are eligible based on income and personal resources. If the older person has long-term care insurance, the policy may include some coverage for nursing home care. Check with the insurance company for details.

Assisted living is for people who need help with daily care, but not as much help as a nursing home provides. Assisted living facilities range in size from as few as 25 residents to 100 or more. Typically, a few levels of care are offered, and residents pay more if they need extra services or special care.

Assisted living residents usually live in their own apartments or rooms and share common areas. They have access to many services, including up to three meals a day; assistance with personal care; help with medications, housekeeping, and laundry; 24-hour supervision, security, and on-site staff; and social and recreational activities. Some assisted living facilities are part of a larger organization that also offers other levels of care. For example, continuing care retirement communities may also offer independent living and skilled nursing care. Exact arrangements vary by facility and by state.

Most people pay the full costs of assisted living themselves. This option tends to be more expensive than living independently but less expensive than a nursing home. Medicare does not pay for assisted living. Medicaid may provide coverage for some aspects of assisted living, depending on the state and whether the person is eligible. This care option is partially covered by some long-term care insurance policies.

Low-dose daily aspirin does not provide significant protection against stroke resulting from blood clots and may increase risk of bleeding in the brain or skull after head trauma, according to an NIA-funded study. The findings, published in JAMA Network Open, provide new evidence countering past conventional wisdom recommending a daily low-dose or baby aspirin for healthy older adults.

In this study, an international team led by Australian researchers analyzed data from the ASPirin in Reducing Events in the Elderly (ASPREE) trial. ASPREE includes about 19,000 healthy older adult volunteers from Australia and the United States who were randomly assigned to take a daily 100 milligram aspirin or a placebo pill and were monitored for approximately five years.

The research team found no statistically significant difference in stroke incidence between those who took aspirin and those on the placebo. While a relatively small overall number of brain bleeds occurred in participants during the study period — 187 total, with 108 from the aspirin group and 79 from the placebo one — bleeding events were 38% higher among participants who were taking aspirin daily, regardless of their gender, age, or cardiovascular risk. Bleeding into the brain or onto its surface are common and serious results of fall-related head injuries in older adults. In this study, nearly half of these bleeding events were due to trauma.

In a related recent study, the ASPREE team also found that daily aspirin could increase anemia risk in older adults. In 2022, in part due to ASPREE findings, the U.S. Preventive Services Task Force updated its past recommendations to state that healthy adults age 60 or older should not start taking low-dose aspirin as a primary prevention strategy for cardiovascular disease. These recommendations do not apply to individuals taking aspirin for a known cardiovascular condition.

The ASPREE investigators view these recent results as further evidence that healthy older adults with no history of stroke or cardiovascular disease should talk with their doctors about the potential risks and benefits when considering taking aspirin daily. They further note that older adults who have had past strokes or are in higher risk groups for cardiovascular disease may still benefit from aspirin’s blood thinning effects, so these individuals should also ask about the benefits of aspirin versus other drugs such as statins.

This research was supported in part by NIA grants AG029824 and AG062682.

Scientists found both potentially new and previously discovered Alzheimer’s disease genetic risk factors by analyzing the genomes of a relatively small group of people who were identified as being of Ashkenazi Jewish ancestry. The results from the NIA-funded study, published in Alzheimer’s & Dementia, suggest that genomic studies of Ashkenazi Jewish people and other closely related “genetic founder” groups may help clarify the genetic basis for Alzheimer’s.

People of Ashkenazi ancestry descend from a population of Jewish people who founded communities in Central and Eastern Europe during the Middle Ages. For many centuries, Ashkenazi Jewish communities in Europe were culturally isolated from non-Jewish Europeans, and as a result, the population is genetically distinct from non-Jewish Europeans. Due to this reduction in genetic variation, or “founder effect,” several hereditary diseases and types of cancer are found predominantly or more frequently in people of Ashkenazi Jewish descent. In this study, the researchers hypothesized that Alzheimer’s disease genetic risk factors may appear more frequently — and thus be easier to identify — than in broader, more genomically diverse European populations.

Led by scientists at Boston University, the researchers used genomic information about the Ashkenazi Jewish population to analyze data of three different large genomic and genetic Alzheimer’s disease studies involving more than 80,000 participants of European descent. More than 6,500 individuals appeared to be of Ashkenazi Jewish descent. Approximately 2,800 of these people were diagnosed with Alzheimer’s and about 3,700 were not.

By comparing those who had Alzheimer’s with those who did not, the researchers found previously identified risk factors such as variants of genes called APOE and TREM2. The APOE associations were relatively strong given the small sample size. They also found several potential new risk factors that had borderline levels of association with Alzheimer’s. For example, one was found linked to a gene called RAB3B, which is involved in the release of dopamine, an important chemical signal in the brain.

Experiments on autopsied brain tissue provided further support for the idea that the variants identified by this analysis are Alzheimer’s disease genetic risk factors. The researchers note that studying a population with very similar genetics enabled them to uncover new genes that would have been hard to identify in a genetically heterogeneous population.

Further studies are needed to confirm these findings and potentially identify other genetic changes associated with Alzheimer’s in people of Ashkenazi Jewish descent or in other historically isolated populations.

This research was supported in part by NIA grants.

Ventura County Parkinson’s Support Group gets together every month with skilled, experienced professionals who present significant breakthroughs, strategies and related issues surrounding Parkinson’s. The group’s mission is for participants to better understand and talk about how this information impacts their own lives and affects immediate family members. In addition to those diagnosed with PD, caregivers, family members and friends are all welcome to attend free of charge.

More than just a meeting, all discussions/presentations offer interactive, compassionate, relevant education on PD. Topics range from “How to get up off the floor when you’ve fallen,” to “Nutrition and Parkinson’s” to “The benefits of deep brain stimulation and assessing if you’re a good candidate for DBS” to the importance of laughter in life and for healing.

Jon Everhart, retired accountant, US Marine and regular group attendee said, “It’s nice comparing treatments, symptoms, and the challenges we all face living with Parkinson’s.” This caring group empowers people like Jon to be more proactive and to participate in deciding the direction of his treatment, complemented by his team of doctors’ suggestions.

This unique group gives everyone a great opportunity to learn more about current PD research, to gain more awareness about local help and resources, to share relevant experiences with others — and to have fun along the way.

The Ventura County Parkinson’s Support Group was recently resurrected (post-Covid) by Dr. Vanessa White, owner of Ventura County Neurofitness (a local fitness program designed specifically for those with Parkinson’s and other neurological degenerative diseases). The impetus for her assuming this responsibility was after her mother-in-law, Toy White, was diagnosed several years ago with PD. This important, special group was born upon her passing.

Meetings are held monthly on the third Tuesday, 10-11am, at Crosspointe Church (5415 Ralston Ave.)

The next meeting will be on Tuesday, December 19th and it will be a holiday social (sponsored by the Parkinson’s Foundation) with lots of fun, good food, games ,and fabulous prizes. And, it’s all free—please RSVP by Dec. 12th if you plan to attend Vanessa at 805.300.7749.