by Dr. Thomas Duncan, DO, FACS, FICS. This article first appeared in LIVEWell

Falls are still the leading cause of injury deaths among people over the age of 60, and the most common reason for hospital admissions, doctor visits, and emergency room visits. Despite our best efforts, up to 33 percent of adults over the age of 60, and 50 percent of adults over the age of 80, will fall each year. Hip fractures remain the most common injury associated with falls. More than 40 percent of seniors recovering from hip fractures are unable to return to their homes due to complications.

The cause of falls can vary greatly, including inappropriate footwear, clutter, taking multiple and duplicate medications, weak strength in the legs, declining vision, chronic health problems, and occasionally small pets. The COVID-19 pandemic caused another layer of complexity to our seniors’ lives by their needing to negotiate safety guidelines while trying to avoid a life-altering fall.

We live in a county that has many seniors. By 2030, approximately 30 percent of Ventura County’s citizens are expected to be 60 years of age or older. Ventura County’s Elderly Fall Prevention Coalition (EFPC) was originally founded in 2013 after recognizing the life-changing effects of falls suffered by our elders. The coalition was established by a multidisciplinary group overseen by the Ventura County Medical Center (VCMC) trauma department. The goal of the coalition is to reduce primary falls that have been recognized as being largely preventable.

The cost of caring for each fall ranges from $37,000 to $60,000. This figure is calculated based on the severity of injury and level of care provided. In 2013, the total cost of fall-related injuries in the U.S. was more than $36 billion. That figure rose to $60 billion in 2020. The average cost of annual healthcare dollars in California for non-fatal falls is $2.4 billion. It is remarkable that an elder dies from a fall every 29 minutes, while similar-aged elders are treated in an emergency room for a fall-related reason every 14 seconds. Local data demonstrates that most falls – 68 percent – occur in elders’ primary residences. As such, our efforts are directed toward their homes.

It is our goal to raise awareness of the dangers of falls by holding multiple presentations at the local and national level. The total number of forums held year-to-date is 16, with the last three conducted virtually.

To raise awareness in the field, the coalition created the Elderly Fall Prevention Program (EFPP) in 2014, which involved EMS championing fall prevention awareness efforts at the point of contact. This pilot program was started in west Ventura County. At the scene of injury, EMS providers determine whether the individual’s call is truly due to a fall when responding to a 911 call. A quick home assessment and mitigation is conducted, including recommendations for improving hallway and room lighting, clearing hallway clutter, affixing rugs, and/or advocating for a medication check by their primary care provider.

We truly appreciate the Ventura County Board of Supervisors’ commitment to preventing elderly falls. Such devotion is shown by a yearly proclamation awarded to the EFPC since 2013. The coalition received an award from the National Association of Area Agencies on Aging in 2015 for ‘a successful program that improves lives of older adults and caregivers.’

The coalition continues to gain ground in the county but appreciates any funding sources that will enable it to maintain sustainability. It is very thankful for the cohesive voluntary efforts of all organizations involved and will not be successful without the multidisciplinary collaboration.

For further information on the fall prevention coalition and program, please visit www.vcaaa.org or call (805) 477-7343.

Note: Dr. Thomas Duncan is the chair of the Elderly Fall Prevention Coalition of Ventura County and Trauma Medical Director at the Ventura County Medical Center

Did you know that your sense of smell and taste are connected? As you get older, these senses can change. Changes in smell or taste can also be a sign of a larger problem.

Smell is an important sense. Certain smells, like your dad’s cologne, can help you recall a memory. Other smells, like smoke from a fire, can alert you to danger. When you can’t smell things you enjoy, like your morning coffee or spring flowers, life may seem dull.

Many problems cause a loss of smell that lasts for a short time. This temporary loss of smell may be due to:

A cold or flu that causes a stuffy nose. The ability to smell will come back when you’re better.

Coronavirus infection, which sometimes causes a new loss of smell. You should regain your sense of smell after all other symptoms have gone away, however if it doesn’t return, seek medical care as soon as possible.

Allergies. Try to stay away from things you’re allergic to, like pollen and pets. Talk to your doctor about how to manage your allergies.

A harmless growth (called a polyp) in the nose or sinuses that gives you a runny nose. Having the growth removed may help.

Some medications like antibiotics or blood pressure medicine. Ask your doctor if there is another medicine you can take.

The Ventura County Area Agency on Aging and the Ventura County Elderly Fall Prevention Coalition’s award-winning Fall Prevention Program has a new set of Tai Chi: Moving for Better Balance classes starting up in August.

There are six options at four different sites in Ojai, Oxnard and Ventura:

HELP of Ojai (108 S. Montgomery Street) – Tuesdays & Thursdays – August 8 through October 26 – 10 a.m. to 11:30 a.m.

Oxnard Performing Arts Center (800 Hobson Way) – Tuesdays & Thursdays – August 8 through October 26 – 9 a.m to 10:30 a.m. OR 10:45 a.m. to 12:15 p.m.

County of Ventura California Room (669 County Square Drive) – Wednesdays & Fridays – August 9 through October 27 – 9 a.m to 10:30 a.m. OR 10:45 a.m. to 12:15 p.m.

Ventura Church of Christ (5401 N. Bryn Mawr Street) – Wednesdays & Fridays – August 9 through October 27 – 10:45 a.m to 12:15 p.m.

Classes, which are free, are designed for individuals 60 and up. For additional information visit vcaaa.org/falls. To register for most classes, call the VCAAA at (805) 477-7300, option 6, or email [email protected]. For the Tai Chi class being hosted by HELP of Ojai, call (805) 646-5122.

Tai Chi: Moving for Better Balance is an exercise program developed especially for older adults using modified practices designed to improve and strengthen balance and mobility. Classes are intended for beginners. Canes and walkers are welcome. This class is proven to reduce falls by 55 percent.

Individuals concerned about falls or those who have recently experienced a fall, as well as those who are interested in improving balance, flexibility, and strength, are encouraged to participate. Nationally recognized research shows that one in four adults over the age of 65, and half of the population over the age of 75, fall each year. One out of every five falls results in a serious injury, and about three million older people are treated at emergency departments for fall injuries each year. Approximately 32,000 older adults die each year as a result of falls.

The Ventura County Area Agency on Aging, a division of the County of Ventura’s Human Services Agency, is charged with the responsibility of promoting, developing, and implementing a comprehensive coordinated system of care that enables older individuals, children and adults with disabilities, and their caregivers to live in a community-based setting. The VCAAA advocates for the needs of those 60 years and older in the county, providing leadership and promoting citizen involvement in the planning process as well as in the delivery of services.

by Patricia Schallert

I met Cheryl Immel almost immediately upon moving into the Ventura Marina Community Park. She is a senior among us who continues to live a life that can be considered a successful and happy story.

Cheryl was born in Sherman Oaks, located in the San Fernando Valley. She and her husband Dean were given a sailboat as a wedding gift in 1994 and it was stored at the Channel Island Marina. They often came up to sail here and fell in love with the community of Ventura and always kept Ventura in mind for future retirement.

As a registered nurse for 17 years, Cheryl received her teaching credentials and taught Science at Burbank High School. She also taught at the New York Film Academy campus located at Universal Studios. Dean, Cheryl’s husband, taught instrumental music at Burbank High School and then went on to teach music at USC.

Cheryl and her husband decided to retire when felt they were ready to move on and were old enough after teaching for so many years. Always keeping Ventura in mind  Cheryl and her husband settled into the Ventura community full time in 2013.

The friendships that she has made in her community have made her very happy and it is evident in her infectious smile and laugh. She and her husband have joined the Ventura County Concert Band through Ventura’s Adult Education program. She plays the flute and Dean plays the bassoon and he is a also guest conductor.

Cheryl has reflected on the many things she has learned as a retired person. She is the editor of the monthly community newsletter, “The Village Voice” and is Vice President of the HOA Board of Directors at the Ventura Marina Community Park.

She currently works with the Activities Committee and is the director of the “Footlighters Theater Company”.  During the pandemic, Cheryl had time to write a play called “Come Sail Away” for the “Footlighters Theater Company” and she is proud to have it being performed September 8, 9, 10, 2023 on stage in the Ventura Marina Park Community.

Retirement has given Cheryl opportunities to do many things she didn’t have time to do before retirement.  She continues to follow her interest in music, theater and writing along with discovering other possible projects as she goes along.  Cheryl is not afraid to try new things and have new experiences. Taking the time to listen to stories from friends and families is important to her and allows patience…. And she always has a good book lined up to read.

When Cheryl looks back on her life, her most treasured event was meeting her husband Dean.  He encourages her to go after her dreams and most of them include him which also makes her happy. As retirement seems to fit Cheryl, she continues to be open to new experiences and ideas while traveling different paths with her husband. Her values include kindness, helping others and not to be afraid to ask for help if needed.

I loved meeting Cheryl as she shares her joy in life with those around her.

Alzheimer’s disease is a national crisis. While there is currently no cure for the fatal disease that affects over 6.7 million Americans, treatments are being discovered to change the disease progression and offer more time to families.

In June 2021, Lecanemab received accelerated approval as a treatment for Alzheimer’s disease from the U.S. Food and Drug Administration (FDA). This was the first therapy that actually targeted one of the disease hallmarks instead of simply treating the symptoms, demonstrating that removing beta-amyloid from the brain reduces cognitive and functional decline in people living with early-stage Alzheimer’s.

Since then, additional anti-amyloid treatments have shown positive results to slow down the disease progression. Lecanemab received accelerated FDA approval in January this year, and last month.

While these treatments have shown a glimmer of hope for the future of Alzheimer’s, that hope was severely diminished by an unfortunate reality: lack of access.

In April 2022, the Centers for Medicare & Medicaid Services (CMS) issued an unprecedented decision to block Medicare coverage of all FDA-approved treatments that target amyloid for Alzheimer’s disease, severely limiting access by forcing people to join a clinical trial or pay out-of-pocket at the high cost of over $26,000-$28,000 per year.

Fourteen months later, after continuous efforts from the Alzheimer’s Association and advocates nationwide to change this decision, CMS announced on June 1, 2023 that it will cover Alzheimer’s treatments that receive traditional FDA-approval if physicians register and enter data in a registry.
“While registries are important, posing this condition of coverage on people living with early-stage Alzheimer’s still creates an additional and unnecessary barrier,” said Meg Barron, Alzheimer’s Association Region 3 Leader and Executive Director of the California Southland Chapter. “These families don’t have time to wait for a registry or search for a doctor who participates in one.”

Setting this requirement for registries is yet another unprecedented decision made by CMS towards this class of FDA-approved drugs.

Each day, the Alzheimer’s Association estimates that 2,000 people living with early-stage Alzheimer’s progress beyond the point where current treatments can help them.
On June 20, Alzheimer’s advocates from Ventura County and Southern California met in Los Angeles to rally at the Wilshire Federal Building, urging CMS to change its policy and expand access to FDA-approved Alzheimer’s treatments.

To get involved as an advocate or learn more about Alzheimer’s treatments and free support services, visit the Alzheimer’s Association online at alz.org/cacentral. Their Ventura office is located at 2580 E Main Street #201, and their 24/7 Helpline is 800.272.3900 for around-the-clock support and information in English and Spanish.

To diagnose dementia, a doctor will complete a medical history, physical exam, and neurological tests that assess balance, sensory response, reflexes, and memory and thinking skills. In addition, a doctor may order brain scans, blood tests, genetic tests, a spinal tap, and a mental health evaluation to help determine a diagnosis.

Because different types of dementia can share similar symptoms, providing an accurate diagnosis can be difficult. In addition, dementia may be difficult to diagnose as a single disease given that a person could have more than one type.

Visiting a primary care doctor is often the first step for people who are experiencing symptoms of dementia. Your doctor may refer you to a neurologist, which is a specialist in disorders of the brain and nervous system. Neurologists generally have the expertise needed to diagnose dementia.

While there is currently no cure for Alzheimer’s or related dementias, medicines are emerging to treat disease progression. There are also medications that may temporarily improve or stabilize memory and thinking skills in some people and may help manage certain symptoms and behavioral problems. A team of specialists — doctors, nurses, and therapists — can help with maintaining mobility; addressing speech and swallowing problems; and learning new ways to handle loss of skills with everyday tasks, such as feeding oneself.

Through substantial investments from the U.S. federal government and others, researchers continue to advance scientific growth and discovery to improve the diagnosis, treatment, and care of those living with dementia.

If you are concerned about memory problems or other symptoms of dementia, call your doctor. If you or someone you know has recently been diagnosed, explore the resources on this website and referenced below to find out more about dementia care, support, and research. It is important to educate family, friends, and caregivers about a loved one’s diagnosis. In-person and online support groups offered by nonprofit organizations can provide families and caregivers with additional resources and opportunities to share experiences and express concerns. You may also consider participating in a clinical trial or study.