The Life Matters Media Newswire aims to serve as a comprehensive portal of all news related to end of life decision making and care. We aggregate stories from other media outlets in one place- here, where you can access them easily. We also strive to produce original content covering stories we feel are receiving scant attention.
In what is being called the strictest medical marijuana law in the nation, Illinois lawmakers have agreed to legalize the drug for some terminally ill patients.
Only physicians with existing relationships with certain patients could prescribe the drug, and patient background checks are mandatory. Patients would not be allowed to grow their own marijuana or use the drug around minors or in public. “What this would set up is a four-year trial program for patients who have an established relationship with a doctor and who can demonstrate that they need this to ease symptoms and take them out of pain,” WGN-TV reports.
The bill also sets a 2.5 ounce limit per patient per purchase from 60 state regulated dispensaries. Illinois will license about 20 growers.
“This bill is filled with walls to keep this limited,” said Democratic Sen. Bill Haine, The Chicago Tribune reports.
The bill now heads to Gov. Pat Quinn, who has remained tight- lipped about whether he will sign the bill into law, saying only that he is “open minded” about the issue. Lt. Gov. Sheila Simon, a former prosecutor, said that after meeting with patients, she favored the plan, The Associated Press reports.
“We are embarking here on a way to achieve relief, compassionate relief, consistent with the law (with) a system which avoids abuse,” Haine said. “It’s the tightest, most controlled legislative initiative in the United State related to medical cannabis.” The Senate vote was 35-21, with five more than needed for passage.
“At the end of the day, we’re talking about a plant,” said Sen. William Delgado, a Democrat from Chicago.
But not all lawmakers are pleased with the legislation. “For every touching story that we have heard about the benefits of those in pain, I remind you today that there are a thousand times more parents who will never be relieved from the pain of losing a child due to addiction, which in many cases has started with the very illegal, FDA-unapproved, addiction-forming drug you are asking us to make a normal part of our communities,” said Republican Sen. Kyle McCarter before the vote. His daughter died in 2006 from a drug overdose.
According to the bill, “Modern medical research has confirmed the beneficial uses of cannabis in treating or alleviating the pain, nausea, and other symptoms associated with a variety of debilitating medical conditions, including cancer, multiple sclerosis, and HIV/AIDS,” citing a 1999 study published by the National Academy of Sciences’ Institute of Medicine.
“Medical marijuana works really well for hospice patients,” said Dr. Matthew R. Sorenson, an associate professor at DePaul University’s School of Nursing. “Based off my research, I think this type of bill has a lot of potential. Marijuana has a lot of benefits for other patients, especially for those suffering from MS or chronic nausea.”
Pet avatars offered as a solution to caregiver crisis at TEDMED
The thought of virtual pets evoke 1990s toy memories for millennials, but a new incarnation of such may help stave off dementia in their grandparents- and provide them enriching social connections.
GeriJoy companions, virtual “talking dogs,” are now providing pet therapy, personal companionship and computer services to the elderly, and peace of mind to their long-distance loved ones.
“We’ve transformed what it is like to be a caregiver,” said GeriJoy CEO Victor Wang, as he presented his tablet-based software at the TEDMED 2013 conference in Washington, D.C.
Wang says he was inspired to create the real-time avatars as a result of his family’s experience emigrating from Taiwan- and his grandmother’s subsequent deep depression as she remained behind, alone in their home country. His parents could not afford to employ the services of a caregiver, so they lived in fear that his grandmother would harm herself, while they were rendered helpless.
“We can help increase seniors’ self-worth and improve their mental health,” Wang says, noting that more than 800,000 Americans suffering from Alzheimer’s disease live alone, and that more than half of those lack a caregiver. These numbers are expected to exponentially increase in the next two decades, and the current four-to-one ratio of able-bodied caregivers per senior is expected to drop to one-to-one.
“There are not enough real people in the U.S.,” says Wang, and he sees his GeriJoy companions as a solution to not only providing seniors with emotional interaction, but capable of updating scattered family members with the condition and overall well-being of their loved one.
Each avatar is monitored 24 hours a day by GeriJoy staff who are available to engage each virtual pet in dialogue with its senior. Relatives can use the company’s website to upload photos and updates for seniors to view and talk about with their companion. GeriJoy staff log the content of each interaction online, so that family can see how their loved one is faring.
Wang predicts that his software will soon be helpful in detecting senior abuse and accidents, as well as have the capacity to provide daily medication and activity reminders.
Wang says GeriJoy is changing the traditional definition of caregiver. “It’s about the joy, conversations, friendships and health that comes from all of this and the relationships that we build.”
To learn more: www.gerijoy.com
As millions of aging Americans face cognitive decline, waiting for a cure to dementia is not an adequate plan for the future. So, TEDMED facilitated a live discussion about some possible solutions to the dementia epidemic with health care experts this week, as part of its Great Challenges series.
By 2020, there will be 43 million Americans 65 and older, 15 million 85 and older- double the numbers of 1980. The costs of dementia-related care will more than double by 2040, according to new findings published in The New England Journal of Medicine.
One of the most important solutions will be training all health care professionals about the issues of the aging population, said Dr. Sharon Brangman, a professor of medicine and division chief of geriatric medicine at SUNY Upstate Medical University. “The fastest growing segment of our population are those people 85 and older, where the biggest risk for Alzheimer’s disease is.”
Echoing Brangman’s ideas about educating doctors and pharmacists was Dr. Guy S. Eakin, vice president of scientific affairs at the BrightFocus Foundation.
“The scale of the problem is huge. Right now, less than 1 percent of our nurses, our physicians assistants, and our pharmacists are certified in geriatrics, but 26 percent of their patient visits are from geriatric populations,” Eaken said. “That’s a huge discrepancy and training programs are necessary.”
The discussion was not intended to formulate concrete solutions, but provoke thoughts about possible remedies to address cognitive disease and the barriers to achieving them. For example, George Vradenburg, the chairman and co-founder of the USAgainstAlzheimer’s Network, noted the lack of funding available for research.
“Today we spend about $6 billion on cancer research, $3 billion on HIV and AIDS research, and less than $500 million a year on Alzheimer’s and dementia research,” Vradenburg said, while acknowledging concern about the sequester’s impact on medical grants through the National Institutes of Health. “The cost problem is an enormous one in this country.”
How can individuals help lower their chances of getting dementia? Brangman suggested exercise- even just walking to the mall from farther parking spots. Vradenburg said there may be a relation between cardiovascular disease and cognitive decline. “Being healthy gives you greater resistance to disease, but it doesn’t stop the disease,” he said.
Still, despite the lack of funding and volunteers in the U.S. for dementia research, “there really is no system doing it better,” Brangman said. “I really think the United States is the leader, we see a demographic shift in the whole world, where there are fewer young people.”
Many U.S. cancer clinics have started to turn away thousands of patients due to the sequester’s cuts to Medicare.
As The Washington Post’s Sarah Kliff reports, some oncologists say the reduced federal funding makes it impossible for community clinics to administer expensive chemotherapy to seniors and remain financially stable. These patients must now seek treatment elsewhere, even as hospitals accepting Medicare beneficiaries grow more overcrowded.
Jeff Vacirca, chief executive of North Shore Hematology Oncology Associates in New York, told Kliff, “If we treated the patients receiving the most expensive drugs, we’d be out of business in six months to a year.” Vacirca said his clinics have stopped administering drugs on which they lose money. His clinics have also ceased to treat one-third of their 16,000 Medicare patients.
Pancreatic cancer patient Harold Rosen, 81, has been receiving chemotherapy at one of Vacirca’s cancer centers, but sequester cuts will soon change that.
“When I first came here, I was afraid to come because everyone’s dying. But everyone here is so pleasant. They smile, they laugh, they care about you. You would never know it’s a place of cancer,” Rosen said to NBC News. Rosen’s physician told him he must start receiving treatment in a hospital.
Vacirca said he is sad to turn away patients like Rosen, but he insists he must.”I have to be financially responsible to be here,” he said. “I owe it to my patients to not go out of business.”
Although Medicare is only facing a 2 percent reduction in funding- much less than other federal programs- oncologists say cancer patients are losing the most.
Seniors’ medications are mostly covered under the optional Medicare Part D. However, cancer drugs must be administered by physicians, and they are paid for by Medicare Part B. Part B covers doctor visits and is facing the sequester’s cuts.
According to Kliff, “The federal government typically pays community oncologists for the average sales price of a chemotherapy drug, plus 6 percent to cover the cost of storing and administering the medication.” But physicians cannot change drug prices, so the 2 percent cut will have to come out of the 6 percent cover charge- “akin to a double-digit pay cut” for clinics.
A recent survey of more than 300 oncology practices by the Community Oncology Alliance determined that 72 percent of them will change how they treat Medicare patients if the cuts continue.
The Alliance has pledged to “fight this unjust and devastating cut to cancer care” with an online petition.
A Milliman report shows that half of all U.S. cancer spending is associated with Medicare beneficiaries. Chemotherapy in hospital settings costs the federal government about $6,500 more than treatment in community clinics does. Some of those costs are then handed to patients, who pay another $650.
Will hospitals be able to absorb these patients? The same study shows almost 70 percent of Medicare patients receiving chemotherapy are treated in community clinics. Clinics in Connecticut, New York and South Carolina have already stopped treating patients.
What is the sequester?
In 2011, Congress passed a law stating that if no legislation was passed to reduce the federal deficit by $4 trillion, some $1 trillion in automatic budget cuts would take effect in 2013.
Researchers determined dementia leads to total annual societal costs of more than $40,000 per case in the U.S.
The most comprehensive study on the costs of dementia shows the disease is more expensive than heart disease and cancer, costing society and families around $200 billion a year.
The costs of dementia-related care and the number of people suffering from the disease will more than double by 2040, according to research supported by the RAND Corporation, financed by the government and published in The New England Journal of Medicine.
Researchers determined dementia leads to total annual societal costs of $41,000 to $56,000 per case in the U.S., totaling up to $215 billion in 2010. More troubling were calculations that estimate the aging population will lead to an increase of almost 80 percent in total costs by 2040.
Most dementia-related costs stem from long-term institutional and home-based care, not medical care. Nursing home, formal and informal care account for up to 80 percent of the costs. These estimates place dementia among the most costly diseases. In 2010, almost 15 percent of Americans 70 and older suffered dementia.
By 2040, nine million people will have the disease. “I don’t know of any other disease predicting such a huge increase,” Dr. Richard J. Hodes, director of the National Institute on Aging, told The New York Times. “As we have the baby boomer group maturing, there are going to be more older people with fewer children to be informal caregivers for them, which is going to intensify the problem even more.”
Still, the findings are more conservative than previous calculations from the Alzheimer’s Association, which estimated that in 2010 the monetary costs alone were $170 billion, as compared to $110 billion.
Figuring costs of dementia
It is notoriously difficult to glean accurate data about the costs of dementia over time, which makes the new findings especially important to the medical community and financial institutions.
Dementia is a chronic disease associated with aging and is characterized by progressive cognitive decline, mostly affecting seniors already suffering from other ailments. This makes its financial implications difficult to separate.
Secondly, most of those suffering from dementia are looked after by caregivers, many unpaid, making it difficult to estimate monetary costs for caregivers’ time.
The researchers began with some 11,000 people from a long-running government health survey called the Health and Retirement Study, which began in 1992. They surveyed more than 800 of the people aged 51 years or older. To get a strong representation of dementia, those respondents underwent a three-hour in-home clinical assessment. Those results were then reflected upon the larger group.
Researchers then analyzed Medicare records and patients’ out-of-pocket expenses. Foregone wages from family caregivers who gave up work to care were tabulated, as were estimates of what the care may have cost if bought from formal providers. Spending on all other ailments, such as diabetes and high blood pressure was subtracted.
Dr. Kenneth Langa, a University of Michigan researcher who helped with the research, told ABC News, “This is an important difference” from other studies that did not determine how much health care cost was attributable to just dementia.
President Barack Obama signed the National Alzheimer’s Project Act into law in January 2011; it aims to track costs of dementia and improve the health outcomes of those living with the disease.
- Advance Care Planning
- Hospice and Palliative Care
- Life Choices
- Politics and Law
- Society and Culture
- Treatments and Illness
- Health Care
- Reuters Health: LMM Reports
- Voices in Bioethics: LMM Commentary
- Physician Assisted Suicide Conference Draws Supporters And Opponents To Chicago
- Doctors View End Of Life Care More Positively Than Nurses
- Support For Medicare Coverage Of End Of Life Discussions Among Providers
- Reimbursing Doctors For End Of Life Discussions
- Respecting Choices: Financial Facts And Figures
- May 2014
- January 2014
- December 2013
- November 2013
- October 2013
- September 2013
- June 2013
- May 2013
- April 2013
- March 2013
- February 2013
- January 2013
- December 2012
- November 2012
- October 2012
- September 2012
- August 2012
Subscribe via Email
Enter your email address to subscribe to this blog and receive notifications of new posts by email.
Daniel Gaitan serves as a content producer...More