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.
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Indiana's busy holiday roads can put older drivers to the test.
With 2.8 million Hoosiers traveling this season, the AAA Hoosier Motor Club encouraged families to help senior drivers stay safe.
Christina Griffiths, manager of public affairs and communications for the club, highlighted the importance of preparation for older drivers.
"It really isn't about age necessarily," Griffiths explained. "It truly is a case-by-case basis of what am I dealing with physically, mentally, emotionally, and what can I do better to be as safe as possible?"
Griffiths recommended older drivers take simple steps to prepare for challenging conditions. She suggested checking car tires, brakes and visibility aids like wiper blades. For all drivers, she also stressed the value of adjusting travel times to avoid peak traffic and bad weather.
Winter weather raises the stakes for older drivers. Snow and ice create extra challenges, increasing stress and risk on the road. Griffiths pointed out AAA offers free online assessments and refresher courses to help seniors adjust to physical or emotional changes affecting driving.
"It asks a bunch of questions that you can evaluate: Am I checking behind me when I change lanes? Do I have difficulty with merging, or do I just feel that anxiety, I think is a big one too!" Griffiths outlined. "Maybe you have specific things you need to brush up with on your own skills."
Griffiths urged families to talk openly about driving habits. Small adjustments, like shorter trips or avoiding peak travel times, help seniors stay safe without giving up their independence. She added preparation and support help protect everyone on the road.
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Dementia, a disease with profound effects on families, loved ones and caregivers, affects more than 55 million people globally, including 6 million in the U.S.
New research shows people can reduce their risks by making even small changes in their daily routines, for example, through exercise and eating more vegetables.
Sarah Lock, senior vice president for policy at AARP, said there are also important steps policymakers can take to make it easier for people to maintain healthy behaviors.
"When we do that, we can disrupt dementia," Lock asserted. "That's a really exciting possibility, given that so many of us -- as our nation is aging -- are facing that risk."
Dementia is the third-largest cause of death in the nation for people age 70 and older, and two-thirds of Americans have at least one major potential risk factor. People who smoke five cigarettes per day have a 16% higher dementia risk than nonsmokers. People with prediabetes face a 25% increased risk, which rises to 50% with full-blown diabetes. Prolonged exposure to air pollution is also a major dementia risk factor.
Other risk factors include alcohol use, depression, high body mass index, hearing loss, hypertension, low education, physical inactivity, social isolation and traumatic brain injury. Lock pointed out policies to reduce these risks can vary by state. For example, in Colorado, physical inactivity may not be as big of a
problem as in other states, but hearing loss is relatively high.
"We can suggest to policymakers that they focus on ways to help people screen and correct for hearing loss," Lock noted. "In Colorado, that might be a wiser use of public dollars, to go after the problem that seems to be biggest in your state."
Lock added the goal of the research is to offer people pathways to better brain health and to give older Americans more quality time with their loved ones. The findings were released by the new Dementia Risk Reduction Project, a collaboration between AARP, the Alzheimer's Disease Data Initiative and the University of Washington.
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Changes coming to Medicare in 2025 could be beneficial for Oregon residents who are eligible for the program.
Oregonians who qualify for Medicare are now in the open enrollment period through Dec. 7, which allows them to search for health coverage plans to best suit their needs.
Ryan Kibby, Oregon Senior Health Insurance Benefits Assistance project director for the Oregon Department of Human Services, said there will be expanded care options for dementia patients with the Guiding and Improved Dementia Experience or GUIDE program.
"Some of the resources available through GUIDE would include a 24-hour support line, caregiver training and up to $2,500 a year for respite services," Kibby outlined. "That's really just going to help benefit the people who are providing these family caregiver services."
There will also be expanded mental health benefits for people with Medicare in 2025. In 2023, nearly 920,000 Oregonians were enrolled in Medicare. People can get free help to find coverage through Oregon's SHIBA program, either on its website or at 800-722-4134.
Kibby pointed out another major improvement in 2025 is prescription drug costs will be capped.
"There will be a lower maximum to pay for covered drugs, under both Medicare Part D policies and Medicare Advantage drug coverage," Kibby explained. "The maximum amount that people will pay in 2025 is $2,000, and they won't have to pay anything for covered drugs once they reach that amount."
Prescription payment plans will be an option for people who cannot pay in full up-front. The out-of-pocket cost cap also eliminates a gap in coverage, known as the "donut hole," which some have experienced in the past. While Medicare cannot cover prescriptions specifically for weight loss, people can access these drugs for treatment of conditions like Type 2 diabetes.
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