Category Archives: Parkinson’s Disase

Fall prevention essential to preserving health of older adults


Kim, Alice 09 colorBy Alice Kim, MD
Virginia Mason Issaquah Medical Center
Contributing Writer

If you are an older adult a simple thing can change your life, like tripping on uneven pavement or slipping on a slick surface. If you fall, you could break a bone, like thousands of older men and women do every year. Although a broken bone might not sound bad, it could prompt more serious health issues.

Many things can cause a fall. Your eyesight, hearing and reflexes might not be as sharp as they were when you were younger. Diabetes, heart disease or problems with your thyroid, nerves, feet or blood vessels can affect your balance. In addition, some medications can cause you to feel dizzy or sleepy and make you more likely to fall.


Virginia Mason physical therapists working with a patient on gait and stability.

However, it’s important to not allow a fear of falling keep you from being active. Doing things like gathering with friends, gardening, walking or going to the local senior center helps you stay healthy. The good news is there are simple ways to prevent most falls.

Do the right things

If you take care of your overall health, you may be able to lower your chances of falling. Most of the time, falls and accidents don’t just happen. Here are a few tips intended to help you avoid falls and broken bones:

  • Stay physically active. Plan an individualized exercise program that works for you. Regular exercise improves muscle health and makes you stronger. It also helps keep your joints, tendons and ligaments flexible. Mild weight-bearing activities – such as walking or climbing stairs – can help slow bone loss from osteoporosis.

Continue reading


Dementia taks toll of unpaid caregivers, study


And younger man's hand holds an elderly man's handBy Michelle Andrews

Unpaid caregivers and family members spend more than 100 hours a month, on average, assisting elderly people with dementia who live in the community and not in residential care or nursing homes, according to a new study.

As people live longer, the number with dementia will increase, further straining caregiving resources.

The time commitment was significantly higher than for similar caregivers who helped elderly people without dementia, who themselves put in an average 73 hours each month.

Overall, people with dementia make up 10 percent of noninstitutionalized adults age 65 or older, but they account for more than 40 percent of unpaid caregivers’ time. Continue reading


As Alzheimer’s symptoms worsen, hard conversations about how to die


As Alzheimer’s Symptoms Worsen, Hard Conversations About How To Die
September 19, 2015 • Six years after he was diagnosed with both cancer and Alzheimer’s, Greg O’Brien is beginning to talk to his doctor, and to his family, about his “exit strategy” for the final years of his life.


Calming dementia patients without powerful drugs


By Rachel Dornhelm, KQED

Diane Schoenfeld comes every Friday to the Chaparral House nursing home in Berkeley, Calif. to spend time with her aunt, Lillie Manger.

“Hi Aunt Lill!” she says, squatting down next to her aunt’s wheelchair, meeting her at eye level.

Manger is 97. She has straight white hair pulled back in a neat bun today. It’s tied with a green scarf, a stylish reminder of the dancer she used to be.

Diane Schoenfeld, left, shows a family photo to her 97-year-old aunt, Lillie Manger. (Photo by Rachel Dornhelm/KQED)

Diane Schoenfeld, left, shows a family photo to her 97-year-old aunt, Lillie Manger. (Photo by Rachel Dornhelm/KQED)

They go together to the dining room to look over family pictures. Manger needs to be reminded who is in them. Including one of herself. “That’s me?” she asks. “That’s you,” her niece confirms.

“Am I supposed to remember?” says Manger.

Schoenfeld smiles at her encouragingly: “I don’t know if you’re supposed to. It’s OK either way.”

Manger has dementia. Schoenfeld is her “surrogate decision maker” meaning that legally, she is the person who makes decisions about Manger’s health care. Continue reading


Some dementia can be treated, but my mother waited 10 years for a diagnosis

Pauline Rabin with granddaughters Emma and Aviva Rabin-Court near the C&O Canal in Great Falls, Md. (Photo courtesy of Roni Rabin).

Pauline Rabin with granddaughters Emma and Aviva Rabin-Court near the C&O Canal in Great Falls, Md. (Photo courtesy of Roni Rabin).

By Roni Caryn Rabin

When my mother, Pauline, was 70, she lost her sense of balance. She started walking with an odd shuffling gait, taking short steps and barely lifting her feet off the ground. She often took my hand, holding it and squeezing my fingers.

Her decline was precipitous. She fell repeatedly. She stopped driving and she could no longer ride her bike in a straight line along the C& O Canal. The woman who taught me the sidestroke couldn’t even stand in the shallow end of the pool. “I feel like I’m drowning,” she’d say.

A retired psychiatrist, my mother had numerous advantages — education, resources and insurance — but still, getting the right diagnosis took nearly 10 years. Each expert saw the problem through the narrow prism of their own specialty. Surgeons recommended surgery. Neurologists screened for common incurable conditions.

The answer was under their noses, in my mother’s hunches and her family history. But it took a long time before someone connected the dots. My mother was using a walker by the time she was told she had a rare condition that causes gait problems and cognitive loss, and is one of the few treatable forms of dementia.

“This should be one of the first things physicians look for in an older person,” my mother said recently. “You can actually do something about it.” Continue reading


Alzheimer’s support model could save states millions


And younger man's hand holds an elderly man's handBy Lisa Gillespie

As states eye strategies to control the costs of caring for Alzheimer’s patients, a New York model is drawing interest, and findings from a study of Minnesota’s effort to replicate it shows it could lead to significant savings and improved services.  Continue reading

tacuin women

Women’s Health – Week 14: Dementia


From the Office of Research on Women’s Health

Dementia is the loss of thinking, memory, and reasoning skills to the extent that it seriously affects a person’s ability to carry out daily activities. Dementia is not a disease itself but a group of symptoms caused by certain diseases or conditions.

The most common form of dementia is Alzheimer’s disease. People with dementia lose their mental abilities at different rates and may eventually need total care.

Symptoms of dementia
  • Being unable to remember things.
  • Asking the same question or repeating the same story over and over.
  • Becoming lost in familiar places.
  • Being unable to follow directions.
  • Getting disoriented about time, people, and places.
  • Neglecting personal safety, hygiene, and nutrition.
  • Changing clarity in memory, language, and reasoning.
  • Changing moods and personality.
  • Losing the ability to perform daily activities like driving a car or handling money.

A person with dementia should be under the care of a health care provider. The health care provider might prescribe medications that may help maintain thinking, memory, and speaking skills, and that may lessen certain behavioral problems for a few months to a few years.

Family members and friends can help people in the early stages of dementia to continue their daily routines, physical activities, and social contacts. If you are concerned that you or someone you know has a serious memory problem, talk with your health care provider.

There are now drugs to treat diseases such as Alzheimer’s disease. Although these drugs do not stop the disease or reverse existing brain damage, they may be able to lessen symptoms of the disease for a time. This may improve a person’s quality of life, ease the burden on caregivers, or delay admission to a nursing home.
For more information:

Weekend Reading: Dr. Drew cashes in. Hiding Parkinson’s. Doctors learning to talk.


By Shefali S. Kulkarni

Every week, KHN reporter Shefali S. Kulkarni selects interesting reading from around the Web.

The New York Times: Keeping Parkinson’s Disease A Secret

When Nancy Mulhearn learned she had Parkinson’s disease seven years ago, she kept the diagnosis mostly to herself, hiding it from friends, colleagues – even, at first, her mother, sister and teenage children. After seven months, she decided she had to tell her family, and they settled into an unspoken agreement not to talk about the disease. … “I didn’t want anybody to feel sorry for me,” she said. “To have people look at you and start crying – that’s not what anyone wants.” In that, Ms. Mulhearn is hardly alone. Doctors and researchers say it’s not uncommon for people with Parkinson’s to conceal their diagnoses, often for years. But the secrecy is not just stressful to maintain; experts fear that it also may be slowing down the research needed to find new treatments  (Katie Yandell, 7/9).

Photo courtesy of BlueGum

Slate: Dr. Drew Cashes In

If you’ve ever seen Dr. Drew Pinsky on TV, you’ve seen the look: lips pursed, eyes narrowed, head slightly tilted to stage right.

It’s an expression that seems practiced in front of a mirror, designed to dispense to his troubled patients precisely the right dosage of compassion tinged with disapproval — but, instead, it makes him look like his mind is somewhere else, off golfing or figuring out where his next paycheck is going to come from.

Thanks to the Justice Department, we now know of a Dr. Drew payday large enough to trigger a reverie or two. As part of its monstrous $3 billion settlement with the pharmaceutical giant GlaxoSmithKline (GSK), the DOJ unsealed documents showing that the dear doctor had taken in at least $275,000 for “services for Wellbutrin.”

… According to the government’s complaint, Dr. Drew was hired to “deliver messages about [Wellbutrin SR] in settings where it did not appear that Dr. Pinsky was speaking for GSK.”

After Pinsky suggested that Wellbutrin might be responsible for increasing a woman’s orgasm rate — to as many as 60 orgasms in a good night — an internal GSK memo noted approvingly that Dr. Drew had “communicated key campaign messages” about Wellbutrin to the public (Charles Seife, 7/9).

Earlier from KHN:� Doc Payments Show Underbelly Of Pill Marketing

The Economist: A Sweet Idea

Like any other electrical device, a pacemaker needs a power source. Since the first permanent pacemaker was installed in 1958, manufacturers of implantable medical devices (IMDs) have tinkered with many different ways of supplying electricity to their products. A variety of chemical batteries have been tried, as well as inductive recharging schemes and even plutonium power cells that convert the heat from radioactive decay into electricity. … Today, non-rechargeable lithium-based batteries are common. Used in many cardiological and neurological implants, they provide between seven and ten years of life. … But that has not dissuaded researchers from continuing to seek perfection, in the form of a compact, perpetual energy source which does not require external recharging. Now, several researchers are closing in on just such a solution using glucose, a type of sugar that is the main energy source for all cells in the body (6/30).

JAMA: Learning To Talk

The more doctor-speak becomes second nature to us, the more it can distance us from our patients. It is easy to lose sight of the possibility that even the most basic medical words may be jibberish to our patients. … I recently caught myself launching into a monologue from the door in the emergency department about precautions to take and what to expect after a concussion to a 22-year-old patient. I paused, examined his frightened face, and then asked if he knew what a concussion was — he hesitated, then shyly shook his head no. I sat down by his bed, started over, and walked him through it. I felt like I had made a connection (Dr. Alison Landrey, 7/11).

This article was reprinted from with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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Check list

Tips for buying long-term care insurance


By Caroline E. Mayer

Determine if you qualify financially

Washington state has prepared a guide to buying long-term care insurance

Don’t buy if the out-of-pocket cost for the coverage would be more than you can afford. Consumer Reports advises people that if their net worth, excluding their home, is below $300,000, long-term care insurance is not a good buy for them.

The National Association of Insurance Commissioners also recommends that consumers spend no more than 5 percent of their income on a long-term care policy.

If you need long-term care but have few financial resources, Medicaid should quickly kick in to pay, although that will probably limit your choices for care.

On the other hand, if you have a lot of resources (some financial advisers put that threshold at $2 million), you may be able to self-insure and pay the costs as they arise, thereby eliminating the need to buy a policy.

Shop around.

Unlike car insurance where you can switch carriers easily, it can be expensive to change long-term care policies because the premiums increase as you age and you lose the investments already made. Comparison shopping is critical.

Some companies and associations (such as alumni groups and AARP) offer group policies with relatively liberal eligibility, making it easier to obtain coverage if the policyholder has any health issues.

However, these policies may have more limited benefits than individually purchased plans.

If you are young or in excellent health, a group plan may also be more expensive; you may end up paying more to subsidize your less healthy peers.

And if you are certain you want LTC insurance, the younger you are, the better. Your annual premiums will be smaller, and you have less chance of being denied for health reasons.

Know what’s covered.

Policies differ greatly so know what you are buying:

    • What services are covered?
    • How long is the disability period before benefits kick in and what happens if you move from one facility to another?
    • How much does the policy pay per day for nursing home care, home-health care and assisted living?
    • How long will benefits last?
    • Is there an inflation adjustment that anticipates rising medical costs as you age?
    • How long are benefits extended (one, three or five years, or indefinitely)?
    • Who determines benefit eligibility — your doctor, or the insurance company’s doctor — and on what basis?
    • Are preexisting conditions excluded?
    • Does the policy cover mental or nervous disorders, alcoholism, drug abuse or self-inflicted injuries?

The National Association of Insurance Commissioners advises consumers to look for policies that include at least one year of nursing home or home health care coverage, including intermediate and custodial care; coverage for Alzheimer’s disease; inflation protection; a guarantee that the policy cannot be terminated because you get older or your health deteriorates; no requirement that the beneficiary has to first be hospitalized to receive benefits and a 30-day cancellation period after purchase.

Check out the insurance company.

Review a carrier’s record with your state insurance commissioner’s office. Find out how long it has been in business its complaint record and history of raising rates. Stick with a company that has an A financial rating.

Also, the National Association of Insurance Commissioners and the American Association for Long-Term Care Insurance have consumer guides on their Web sites.

The Department of Health and Human Services provides extensive information on it’s website,

KHN wants to hear from you: Contact Kaiser Health News

This article was reprinted from with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

Illustration of the skull and brain

Swedish to live stream deep brain stimulation surgery


Seattle’s Swedish Neuroscience Insitute will live stream a deep brain stimulation surgery for essential tremor online tomorrow morning, Friday, December 16th.

Viewers will be able to watch a deep brain stimulation surgical procedure, accompanied by a live web chat led by Drs. Ryder Gwinn and Ron Young of the Swedish Neuroscience Institute.

Essential tremor is a common condition whose cause is unknown. It is more common in the elderly but can occur at any age. The tremor sometimes runs in families, in which case it is called familial tremor.

In some cases, essential tremor can occur with other brain and nervous system disorders, such parkinsonism.

Essential tremor usually consists of small, rapid movements that typically affect the hands but can also affect other parts of the body, including the head and face.

The shaking can cause serious disability, making it impossible, for example, to perform such simple tasks as writing and eating.

In deep brain stimulation surgery, an electrode is placed in part of the brain called the thalamus and then connected to a pacemaker-type device that is implanted under the skin.

When successful, electrical stimulation from the device stops the tremor. The pacemaker device can be turned on and off, as needed, by the patient with a hand-held magnet.

Viewers of tomorrow’s live stream will be able to submit questions about essential tremor and deep brain stimulation surgery and any other essential tremor treatment options, during the live stream using an embedded chat feature or via Twitter using the hashtag #SwedishDBS.

Dr. Jennifer Witt, a movement disorders neurologist with the institute, will also be joining the conversation to discuss the medical management of essential tremor.


Friday, Dec. 16, 2011, 9 a.m. to 12 p.m.


The webcast can be viewed online at

Those interested may also join the conversation via Twitter by using the hash tag #SwedishDBS.

To learn more:

  • Visit the National Institute for Neurological Diseases and Stroke’s webpage on tremor.

Two free online health education resources


Special supplement on Parkinson’s disease

Nature has made a special supplement on Parkinson’s disease free online for a limited time.

In the introduction Michelle Grayson writes,

As this Nature Outlook reveals, we might be on the brink of a revolution in the diagnosis and treatment of Parkinson’s disease. The frustration of failing to find a simple or single cause is giving way to the hope that the complex web of gene and protein interactions might be starting to untangle. Candidate biomarkers for earlier diagnosis are emerging, and many new and exciting treatments are working their way into the clinic.

The supplement includes articles on research on the causes of Parkinson’s and new diagnostics and treatments.

To learn more:

Global Health Education

USAID’s Global eLearning Center offers free online courses on a range of global health topics. According to USAID site aims to:

  • Provide useful and timely continuing education for health professionals
  • Offer state-of-the-art technical content on key public health topics
  • Serve as a practical resource for increasing public health knowledge

And, according to USAID, the site offers:

A flexible learning program for busy professionals

Each course is authored by a subject matter expert or a team of experts, is highly focused, and can be completed in about one to two hours. Although courses are designed to be taken online, a printer-friendly format allows you to download course materials for further study.

A blend of technical and programmatic content

The courses combine technical content with program principles, best practices, and case studies. They are intended to provide concrete examples and to stimulate your thinking about ways you can use the principles you have learned in the course to solve problems in the field.

Among the courses offered:

  • Antenatal Care
  • Maternal Health
  • Antimicrobial Resistance
  • Cervical Cancer Prevention
  • Family Planning and Reproductive Health
  • Commercial Private Health Sector Basics
  • Diarrheal Disease
  • Emergency Obstetric and Newborn Care
  • Essential Newborn Care
  • Fostering Change in Health Services
  • HIV Basics
  • Human Resources for Health Immunization Essentials
  • Logistics for Health Commodities

To learn more:


Wellness conference on Parkinson’s Disease


Wellness Conference on Parkinson’s “Finding Balance in Life”


Bellevue, Washington

Dr. Monique Giroux, MD, Sierra Farris, PAC, Dr. Jan Fite, PhD and Dr. Martha Glisky, PhD and learn how self-care tools like the NWPF’s virtual Wellness Center can help you set and track your own personal wellness goals.

Presentations will include:

  • Nutrition – Learn to make healthy food choices for Parkinson’s and obtain practical advice on vitamins and supplements
  • Exercise and Fitness – Learn about your body’s physical changes with Parkinson’s and aging, the benefits of exercise and motivational tips to keep you going.
  • Stress Management and Emotional Health – Learn how stress affects your body and symptoms, simple techniques you can do to reduce stress and the power of positive thinking.



Saturday March 20, 2010


9:30AM – 10:00AM


10:00AM – 3:00PM


Hilton Hotel Bellevue Conference Center

Grand Ballroom

300 112th Avenue SE

Bellevue, WA 98004


Online or call 1-877-980-7500

This program is generously supported by educational grants from Teva Neuroscience, Boehringer Ingelheim Pharmaceuticals and Amgen with additional support from Medtronic and Aegis Living.