AUSTIN, Texas — Texas has reduced the misuse of antipsychotics in nursing homes in recent years, but some advocacy groups say much more can be done.

Amanda Fredriksen, associate state director at AARP Texas, explained about 12,000 nursing home residents are being given antipsychotic drugs for no legitimate reason, perhaps other than the convenience of staff in caring for patients who otherwise might be difficult. She said these medications are intended to treat schizophrenia, bipolar disease and Tourette's syndrome, but are dangerous for those with Alzheimer's and dementia.

"These drugs can increase the risk of falls, increase blood glucose levels, they dramatically increase the risk of stroke - all these risks are well known,” Fredriksen said. “We outlawed physical restraints many, many years ago and now we've moved to chemical restraints. It's fairly barbaric. "

Texas legislators are considering a pair of bills that would require the written consent of a patient or a family member before an antipsychotic drug is given to a nursing-home patient. House Bill 2050 was passed out of committee last week, and Senate Bill 1212 is expected to get a hearing in the coming days.

Fredriksen said there's no dispute that providing daily care for those suffering from dementia is difficult. However, she noted there are other alternatives to antipsychotics, including music and memory therapies and safer medications.

"There are also behavior techniques that can be used to know how to anticipate some of the reactions from residents and intervene with different kinds of behavior techniques that don't require any drugs at all,” she said.

Last session, the state passed legislation that required additional training for nursing-home staff. And Fredriksen contended written consent is the next move towards improving the quality of care.

"It added four additional hours of training for direct-care staff for people with Alzheimer's and dementia, and so that piece is there,” she said. “Getting that consent is really a modest step to protecting residents' rights."

Texas nursing facilities reduced the unnecessary use of antipsychotics among residents by more than 56 percent between 2013 and 2018.

AARP has selected four projects in Idaho to receive $49,000 in grants.

The projects were chosen by the organization's annual Community Challenge grant program. The program is designed to support proposals that make cities more livable for people of all ages, especially those age 50 and older, and can be built quickly.

Marie Bonaminio, a volunteer for AARP Idaho, said the program selected three of the four projects in the state this year to boost rural communities.

"A couple of the grants are things that will bring people outdoors, that will keep them active and also to help some of the things that have fallen apart, to be honest, in some of these areas," Bonaminio explained. "Because they just don't have the dollars to keep things, maybe, fixed up and in good condition."

Projects in the cities of Cascade, Marsing and Salmon will improve outdoor areas to encourage social gathering, especially among older Idahoans. The grant program also is providing $15,000 to LEAP Housing, an Idaho affordable housing nonprofit, which will use the funding to renovate housing in Nampa. The projects must be completed by Dec. 15.

Bonaminio added it is a thrill to get to be part of the Community Challenge grant program.

"You walk away just thinking, 'Wow, we have done so much for these small communities to keep them alive and vibrant,'" Bonaminio observed. "I'm so excited to be part of this project. I look forward to it every year."

This year, AARP is investing $3.8 million in more than 340 projects across the country. Since 2017, it has awarded 30 grants in Idaho, worth nearly $330,000 in total.

Isolation and a lack of regular nutritious meals are circumstances many older adults find themselves in. One organization is working to remedy this - and could use some help.

The Illinois Department of Public Health says the state's 60 plus population has increased from almost 2 million, to 3 million since the year 2000 - and now makes up more than one in five Illinois residents.

Community Nutrition Network Outreach Manager Geno Cisneros said he wants older adults to have reliable access to healthy food.

He said the organization could use more Meals on Wheels volunteers, with time and availability to help deliver food.

"The growing need for seniors and providing nutritious meals, and just for essential needs as a whole - it grows every day, especially with our senior demographic," said Cisneros. "And so, there's always a constant need for more clients who need our services - and not just provide a meal, but also provide that social touch that they need, since they are isolated or homebound."

The organization delivers to suburban Cook, Grundy, Kendall and Will counties.

The health department estimates by 2030, Illinois residents age 60 or over could reach 4 million and represent 25% of the state's population.

The network also has a "Friendship Line." Volunteers call homebound clients weekly to inquire about how they are doing, meal delivery times, and if the food quality is up to standards.

Cisneros said older adults are the most underserved, but asserts they are still very much a part of the state's economy.

"With their experience and with their direction, we want to be able to just provide the services that we can to them," said Cisneros. "But also learn from them, so that we continue to grow our economy and to grow our lives and ourselves."

Illinois ranks 39th in the country for older adults who are at risk for social isolation, according to the health department.

Volunteers must pass a background check, and training is provided for food handlers and deliverers.

The registration process also requires having a valid ID and passing a background check, and volunteers must commit to two hours a week of their time.

June was Alzheimer's and Brain Awareness Month, but the Michigan Alzheimer's Association says these should be year-round priorities.

More than 200,000 Michiganders over age 65 are living with Alzheimer's - although only about half receive a doctor's diagnosis. This can delay necessary care and future planning.

Kathryn Ribant Payne - communications director with the Alzheimer's Association in Michigan - said this year, the focus is on educating the public about how to take control of their brain health.

She said when there's a concern, early diagnosis is key.

"We're kind of coming into an era of treatment where we're seeing treatments come down the pipeline that necessitate early diagnosis," said Ribant Payne. "So, if people are experiencing cognitive decline that they've noticed, or their family members have noticed, we really encourage them to speak with their healthcare provider."

Ribant Payne said up to 40% of dementia cases could be caused by risk factors that a person could change by developing healthy habits.

These include challenging yourself by learning new things and staying in school.

Not smoking, getting regular exercise and properly managing other diseases, such as diabetes and high blood pressure, also improve brain health.

She said protecting your head by wearing a helmet for activities like biking, is important - as well as eating a healthy diet and sleeping well.

She added that if you think it's too late to improve your routine - you're wrong.

"These things that we are talking about, as far as the healthy habits, are not something that you have to start when you're in your 20s for them to do something," said Ribant Payne. "Any little thing you can start at any time will affect your health in a way that can cause positive results."

Ribant Payne emphasized that it's critical for caregivers of people with Alzheimer's disease to seek respite and reach out for help themselves.

Michigan leads the nation in the number of caregiver hours - and about two-thirds of caregivers in the state report having a chronic health condition as a result of the stress.




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