Part 6 for Minnesota’s (ADWG) Alternative Remedies to AD Bankruption

Nicholas Kristof wrote an OpEd appearing today in the New York Times that blends remarkably with this the next issue for my series on the needs of folks affected by Alzheimer’s Disease (AD). It discusses Divorce which is an alternative in Estate Planning for AD. I have posted the article in my Archive. You can link to it by clicking on Until Medical Bills Do Us Part The posting that follows comprises the counsel I was given when I considered Divorce as an Alternative.

Bankruption is a word fabrication of mine to describe the act of bankrupting brought about by AD and the laws as they are for the middle class as they pertain to paying the Cost of Care. The potential of that is BANKRUPTION, leaving the AD afflicted sitting pretty because of his/her qualification for Government Aid to pay the bills.

The converse is where it leaves the spouse, not so pretty. The likelihood is in poverty. There will be inadequate funds for her/him to live on. What’s wrong with this picture?

An alternative form of Estate Planning is for the married couple to divorce.

Estate Planning: Divorce an alternative

When divorce is considered it asks the question “Why not?” Transfer it all to your spouse. Have papers prepared and go into Court for a no fault divorce. This is allowed in many states.

Is it feasible? In many cases it is not quite that easy. These are the reasons I was given when we counseled with our attorney when we considered this alternative.

A Judge would not be likely to grant a divorce that left the AD afflicted spouse with nothing. If you told the Judge the reason you were doing it the Judge could not do it. It would be illegal for him/her. It would involve the Court aiding and abetting an attempt at fraud on creditors, namely the State as the potential creditor to be defrauded.

In a STIPULATION AGREEING TO PROPERTY DISTRIBUTION IN THE EVENT THE COURT GRANTS THE DIVORCE, (so called in my State which is in fact a DIVORCE SETTLEMENT AGREEMENT), if one spouse gets more than one half of the combined estate Medical Assistance could exercise the discretion to determine that part more than half that if not all is subject to the five year look back rule and thereby disallow any exemption attempted for that.

There are more complications than just the Judge. If the estate consists of tax deferred deposits (like IRAs) where income tax is payable at the time when amounts are withdrawn in such cases this could apply: If the AD afflicted transfers these sums to anyone including the spouse income tax is payable on the amounts transferred at the time of transfer whether or not they are cashed in are taxed in their entirety and subject to penalty for early withdrawal.

A transfer as part of a divorce would be treated differently. The tax becomes payable by spouse to whom transferred, but only as she/he takes the sums out of the IRA portions that the divorce decree transfers.

If the spouse owning the deferred income account dies and the transfer then occurs to the surviving spouse the deferred tax treatment remains as it would in the divorce transfer and he/she pays the tax when sums are actually drawn out.

There are also more complications which need length to explain so I will not make that attempt. See your Lawyer before considering this.

If the settlement agreement could be finessed (slipped) by a Judge the judgment obtained thereby would be vulnerable to being set aside retrospectively. The impropriety of the finesse could make it what the law calls rebuttable, namely capable of being attacked by anyone affected by it.

If it is capable of being attacked this means: Anyone affected by the divorce, such as creditors, children, heirs or the State could appear in Court and ask that the decree be reviewed and set aside because they have suffered loss because of it.
If the Judge reads the agreement giving all to one, as is often the case when a

Judgment is required to be “Proved up Before the Court” its enforcement could easily be denied. The Judge could deem it a fraud as discussed above, If the divorce is granted under the agreement terms it is still vulnerable subject to attack as rebuttable.

If transfers are done outside of the decree Medical Assistance would still have the discretion to determine that all or what part more than half be subject to the five year look back rule and thereby disallow any exemption attempted for that.

These are but some of the pitfalls. I am not an attorney my license ran out as I retired. I have not kept up with the law on these issues. This is based on what I think a lawyer might advise you. Do not rely on this see a Lawyer.

Part 5 for Minnesota’s Alzheimer’s Disease Working Group (ADWG)

THE PERSONAL FINANCIAL COST OF CARING AND TREATMENT OF AD

In the last four installments of this series I have discussed issues pertaining to Care, Cost of Care, source for the Care payment, Treatment beyond issues of institutional Care. I have given emphasis to economic needs of creating more programs to treat those of us in early stage in order to stay in Early Stage longer. This will save the Community the Cost of Care of providing home care and institutional care that will soon enough be required.

Quality of life is another important aspect of providing modalities of care designed to keep folks in Early Stage Longer. Taking medication, following the Mantra: Eat Right, Exercise Daily, participate in Social Creative Intellectually Stimulating Activities, will keep us here longer. For this we need a lot of help from the Caring Community. We are unable to wholly provide this ourselves. We can provided for our care but we have a disease that presents many difficulties in carrying out all that is needed.

In dealing with Alzheimer’s Disease (AD) the Community, particularly the Legislative, Administrative and the Caring Communities dealing with AD need to take a whole and an holistic approach to care and treatment.

Those in need of care are everyone affected by this disease. The object of Care needs to address the Universe of Need. That Universe includes all of us affected or afflicted. It includes all of our needs from supportive help to in-home and institutional palliative and end of life care. AD produces trauma of many shades to those affected. All of them and all of it need to be provided in a positive, helpful, compassionate way addressing the heartfelt pain of dealing with it.

We need programs designed to provide Complete Compassionate Care to the Community in need by the Community positioned to provide it.

This is the spiritual and public duty we owe one another. My Blog and all of my writing speaking from the platform of the Early Stage of this Disease. It is my way of trying to do my part for others. I ask all of these who read this to join me in this endeavor.

If we don’t do it with our hearts and our souls lets do it through our financial self interest. The Cost of this Disease as it Escalates as more and more become in need will overwhelm us economically. Care is spotty now and needs so much improvement.

Today my topic is the Personal Financial Cost inherent in dealing directly with this disease. I have a paper on Financial (Estate) Planning for AD. It is too long to run on this Blog. For this reason it is in my Archive and linked as: ESTATE PLANNING FOR ALZHEIMER’S
Click on the link and it will take you there. It is addressed to those not rich enough to comfortably pay their own care but having more than qualifies for Government Assistance. This group, Middle Class, comprise a huge donut hole.

They have no help and must spend all they have before qualifying for help. At first blush this seems as it should be. But, upon stopping and evaluating what this means it boils down to quickly to this:

UNLESS YOU CROAK BEFORE YOU SPEND IT ALL, WHEN FINALLY YOU PAY IT DOWN TO QUALIFICATION, THEN, THE REST QUICKLY DISSIPATES IN LIVING EXPENSE LEAVING YOUR SPOUSE IN POVERTY!

THIS IS REPREHENSIBLE! THE ESTATE PLANNING CONSEQUENCES OF THIS DISEASE IS NOTHING BUT APPALLING!

Part 4 for Minnesota’s Alzheimer’s Disease Working Group (ADWG)

On the boards and in the blogs I have been reading statements like:

• “I think we can all agree, this monster is hell. Its tentacles are climbing inside out of our brain(s). It is trying to control us. Yes we get kicked in the gut, but somehow, we always manage to get back up.

What's difficult? When you're slap dag in the middle of anxiety, anger, pain, confusion, whatever it is that the monster is creating...that's when we need each other, not fight each other!”

• “It is my opinion, based on decades of fairly significant political awareness, that our government is the logical result of a representative democracy in a capitalistic system. Nothing happens except by bribery. They've even legalized bribery, calling it "campaign contributions." There is a snake-pit of ways they can funnel the money into this and that.

We, the dementia community, couldn't possibly muster the money needed to bribe enough House members to make a difference, and no way we could afford a Senator.

Another reason to despair is that we are going to cost way too much money in the long run. It's far more economical to let us get by on what little there is now, than to commit to higher spending levels. Remember, our government is the only democracy that lets people go without healthcare as a national policy.

Our government is already accustomed to letting people die without adequate healthcare. They turn a deaf ear every day.”

If I am going to be kicking and screaming it will be in a purposeful way. My way is to try ardently yet patiently to get something done.

I write and I write about it and I am starting to hear echoes.

People are looking at doing more for Early Stage.

Alternative care models are being looked at. Things like group homes and spousal self supported assisted living are being discussed. Non-profit services dedicated to providing a cadre (dedicated group) of available home health service providers to serve a group in a multiple living facility or neighborhood are being tested.

These are some of the things we can do for ourselves by promoting and grouping together.

I have more hope for a new and better way emerging with the change we have seen in government over the net effect of "starving the beast" that we have been employing in the past. It will need time, funds have been squandered on war, Wall Street and tax cuts. Sometimes government can find incentives making possible what it cannot fund.

Lets look with hope as expect more of the same duplicitous crap!

So everyone, channel the anger, focus the rage, make it make a difference for us!!!!!!!!!!!!!!!!!!!!!!!!!!!

Part 3 for Minnesota’s Alzheimer’s Disease Working Group (ADWG)

THIS CALAMITY WILL NOT GO AWAY. IT WILL GROW AND GROW!

As a local and national community we have concentrated great effort to fund research to find a cure. This is as it ought to be. Finding a cure is possible. Once found it would relieve a coming catastrophic epidemic that will occur as the boomers come of senior age and the increase incidence of Alzheimer's Disease (AD) multiplies exponentially.

If we think the bank has been broken or nearly broken by the current financial crisis just wait for the crisis that will be occasioned by the surge of people needing care for AD!

Are we positioned to respond to this impending calamity? The answer is NO! If all we have in place is what now exists for care of those of us afflicted with AD we are in real trouble

WE NEED TO CONCENTRATE MORE EFFORT, TIME, AND GET RESULTS

We need to concentrate on this in the arena of economy of care or the cost of care will eat us alive!

This issue must be front and center!

We have possibilities of solutions such as:

a. Enabling legislation,

b. Innovative structural change within the health service industry and

c. Advocacy by those of us with the disease positioned to talk about it and faced with the eventual physical and mental dissolution that occurs from it.

We need to get about finding solutions!

1. We should initiate discussion on this issue. There is a public interest in doing so. We do not need another financial catastrophe following the one we are currently in.

2. We who have or are affected as care givers or loved ones are in a unique position to get down and personal on the issue and start educating each other and everyone else about what it is really like with this disease.

3. A first tier issue comes from the benefit of early diagnosis followed by treatment of us while we are in the earliest stages of the disease.

In the early stage we are still quite functional in society and have so many of our cognitive abilities intact. We can talk about the disease, our experience of it, what can be done about it.

The primary message at this level of discussion is to let it be known, the more we work positively to stay at this level the longer we have a likelihood of doing it. At this early stage level we cause the least cost of care. With more of us staying longer in this early stage the economy relieved the cost of paying for care. This is true whether or not it is out of our own pockets of out of the public pocket.

HOW DO WE DO STAY IN EARLY STAGE LONGER?

The first line of defense is eat right, exercise, and stay in active contact with both your mind and with people. Studies show that this prolongs the early stage state. It also provides a quality of life far superior to that of simply letting your self go into the various stages of debilitation this disease maps out for us.

We need to dispel the all too common fallacy that when we have it we are no longer functional. This may be true if diagnosis is not made until we reach later stage. If we are diagnosed in early stage we are still quite functional and able to help ourselves in staying right there!

As functional people afflicted by AD we can communicate intelligently. Just because we have the disease doesn't mean we should be relegated to secondary status. The time will of course come; our personal clock is ticking as our time runs out. Until it does it is our choice to ward it off just as long as possible. It is equally in our interests to use whatever time we have to advocate on the issues of Economy of Care. We still have worth to us. We can use our experience to help all prepare for the increased need for care.

I URGE AND ALSO GIVE THIS CAUTIONARY INSTRUCTION:

4. We need to pull out of ourselves and recognize our worth, our value, produced by having this disease or a member close to us having it. Although it is a tragedy to get it, it can be a gift to use it in a purposeful way.

One person recently suggested on the Alz.Org bulletin board: “Maybe we (people with Alzheimer’s and their caregivers) should spend a little less time being depressed and accepting and a little more time being irate!” I agree with this in every respect excepting anger. I would replace “anger” with these words: “compassionate of others.”

I believe we who have the disease can get a little too self absorbed at the expense of everyone and everything around us.

Probably our first level of oversight in our self-absorption is the greater plight of those close to us who suffer the affects of our disease without having it. It is truly a family disease. The Caregivers are the unsung heroes on the front line too often overlooked.

The second level of self absorption I see is the lack of interest in becoming involved! In the normal world we have gotten used to leaving it to the other guy. It is safer to stay in our quiet little corner and not make waves. Unfortunately, this style of behavior becomes more pronounced after diagnosis and before real incapacity sets in. We have no excuse for this malaise. If we are not going to be IRATE and do something about it, how can we expect anyone else to do so?

COST OF CARE IS OUT OF SIGHT!

5. The cost of care of this disease is both appalling and personal. Until you exhaust both your estate and the estate of your spouse, YOU PAY THE BILL YOURSELF! This includes nursing home, home care and anything in between. These costs are significant. An economical nursing home will cost 70 - 100,000 a year. The government will step in and help out only after you have drained your retirement, savings and most of your assets.

The cost of care is prohibitive. Like all other Health Services today it has become confiscatory. Every service is regulated, formalized and organized under gargantuan health service organizations whose service is uniform and provided at premium cost. This is not only true of most nursing home services it is also true of so many of the assisted living and in home care services. It seems so long as there is a third party to pay, (insurance, government, charitable organizations) little concern is exercised in containing the cost of care.

Only recently are service organizations looking at remaking their wheels to provide a more practical economical service package. This needs to be encouraged, furthered and implemented.

In home care is probably the most efficient form for economy and quality of care. Group homes where common services are pooled for the recipients offers much of the same. Whether this be the Ma & Pa home on the lake or people pooling their need for services out of a common location such as an apartment complex or multiple living facility, these offer economy and efficiency that needs to be further implemented.

I would hope a more direct service program without the huge and expensive regulated uniformity will be possible.

Tax breaks, creative government programs providing funding and/or creative schemes to reduce the cost of service and provision of it is more directly needed.

The current formula for qualification for public assistance needs to re-addressed. Our current scheme is designed to prevent the abuse too often occurring in the family turning the farm over to kids to avoid Old Age Assistance Liens. This is something for which remedy is still needed, but the uniformity of it creates an unreasonable burden for those of us afflicted with AD.

A study was reported nationally recently stating the cost of caring for the AD patient was twice that of equivalent senior illness and disability. As we have learned from the banks threatening to fail in the current economic crisis the cost of Alzheimer’s will create a separate similar calamity. We can and should take the steps to avoid that now!

WHAT CAN WE DO?

6. Our first line of defense is with those of us in early stage. The object is to keep us in that stage as long as possible. It affords as a superior quality of life. It saves our community the cost of caring for us.

Early diagnosis is one of the best means to identifying and dealing with the disease in its early stage. There is a huge bias against entertaining the diagnosis of AD as a possible cause of a set of symptoms suggestive of it. The Health Care Provider is too quick in delaying diagnosis to see if another reason presents itself other than AD. Often as not this simply allows the disease to develop to a more debilitating stage where treatment is not as likely to be successful.

CONCLUSION

I have the disease. It is not near as bad having it as worrying you might get it. I could let myself get upset and down about my prospects because there is nothing nice about them. Instead it is my choice to find value in having this disease.

My value is this: With my personal experience of it which I can share, with the cognitive acuity I yet have, I want to do something worthwhile with this disease I have. Advocating the foregoing is one of the good things I can do.

Writing like this is another. I hope in what I say another might read it and say: “That makes a lot of sense. We are uniquely positioned to make a contribution. I will join in this effort both to advocate and to get others involved.”

I hope this is not construed as so much babble but seen as something having sense and purpose.

Mike Donohue

Part 2 for Minnesota’s Alzheimer’s Disease Working Group (ADWG)

THE TERRIBLE TRUTH ABOUT THE COST OF ALZHEIMER’S DISEASE!

I was diagnosed as having Alzheimer’s Disease (AD) on June 30th 2006. At the time I was a retired lawyer aged 69. My wife and I had accumulated an estate for retirement sufficient to take care of us comfortably for the rest of our life.

This retirement fund was all in funds we saved, invested, sheltered in part in deferred income tax funds, other of it in funds on which we paid taxes. We did not have public or private pensions available to us. We had done it the American Way, saved for our retirement and funded that ourselves.

One of the first things we did upon learning of my diagnosis (dx) was to contact the financial professionals through whom we invested and my old law partner who had done my estate planning to determine whether or not any changes were in order with our new circumstances. What we learned was beyond RUDE!

The Cost of Care

Currently I am in what is called Early Stage AD. This is looking on AD occurring in three stages.

The first, Early Stage, is when we remain fairly functional, we need little or no help functioning and don’t need someone to take care of us. The greatest change is the cost of being on medication and being unable to remain working.

This is where the giant whirlpool starts sucking our finances down the angry eddy of Cost of Care.

The second state, Mid Stage, is when more help and care is needed. We need someone keeping an eye on us, need things to be done for us, are often unable to be left alone. It is during this time that we start needing an attendant, day care, assisted living if unavailable at home and a variety of other forms of maintenance to simply see our days through.

The giant whirlpool gets worse!

Late stage is usually when we need to be institutionalized or need constant care. This is the pretty bleak zone where all of us, and more so our loved ones would rather not see us going. Having no choice Euthanasia currently legally and morally unacceptable we have to tough it through.

Here the giant whirlpool becomes a wide open drain!

Long Term Health Care Insurance

Unless you have long term health care, which is limited by amount and time based on premium, you are on your own when it comes to funding the cost. Without it Medicare, Health Coverage, Public Aid are no help at all. You can get financial assistance from the Government when your spouse and you have spent down your entire estate excepting your homestead to a little more that $100,000.

Sheltering Estate to Qualify for Public Assistance

You can shelter your estate to qualify for government assistance. There are rules that need to be followed that need to be understood. Nonetheless, there are greater risks if not complications in any of the sheltering schemes.

I of course looked at sheltering and concluded it made sense to do nothing and hope for the best.

Because you have your own funds accumulated for retirement that exceed the threshold (minimum) levels you cannot depend on Public Aid. This may be as it ought to be. Considering the practice in the past, when mom & pop signed the farm over the to the kids then entered the Nursing Home in town, it was changed

You pay your own way now. You pay it yourself. You pay it down until there is no more left than the threshold amount at which time you can then apply for aid. No problem here. We are blessed to have what we have. We can stand some of this risk.

This is true! However $100,000 can slip away pretty fast at 6,000 or 7,000 a month. Currently a nursing home in the Midwest runs about $7.000 a month; assisted living about $6,000 for the same month. Some are cheaper but I am advised this is average. When the survivor of two who are married outlives the person cared for, will there be anything left for that survivor to live on? $100,000 will not go very far.

Paying down an estate at $72,000 to $84,000 for care a year will drain the funds of a husband and wife pretty quickly. Consider not only the pay out for care, add: living expense (for the one not being cared for) insurance coverage, medical and drug costs, housing, clothes, food, etc., everything pays out quickly. Those living expenses continue after the death of one of them.

If you have funded your own retirement as many people not having the benefit of pensions have done things can get pretty bleak pretty quickly. The IRAs the other profit sharing or deferred income accounts to which we have all contributed are usually considered part of your estate when considering entitlement for Public Assistance for any care. They must be spent down before application for help.

WE NEED TO FIND NEW STRATEGIES FOR ECONOMY OF CARE!

We need to find alternative ways of care for Alzheimer and other folks eventually needing home or institutional care services. AD gives a best case illustration. AD has the capacity of reaching epidemic level when the Boomer Generation reaches the doorstep of aging as they are now starting to do. By number there are so many. They are living longer.

The risk that accompanies the quantity to become afflicted when measured in anticipation of the escalation in their number is scary. Neither Social Security nor private health care entities are going to be able to fund it. Nor will Government fare better. AD alone has the capacity of breaking our economy far more than anything else now or in the predictable horizon does.

CARE NEEDS TO BE PROVIDED AT REDUCED COST

What are sorely needed are lower level care facilities and assistance programs. Whether these be in the form of boarding and care homes, co-ops, foster homes as they are sometimes called or people simply buying a group home and hiring their own care persons. In support of this is the need for programs which will help organize, facilitate and maintain these kinds of programs.

One possibility of accomplishing this is through charitable, benevolent or local groups. Some entity at a lower level than the Federal Government. This is seen being done in some areas; so much more is needed.

Tax Breaks and Public Incentives

Additionally tax breaks are needed. This is where the Federal Government can help the most. Right now so much effort has gone into removing any opportunity for anyone to game the system on the receiving level. This may be as it ought.

Nonetheless it seems irrational when it drains the funds needed survive and leads to eventual penury. The epidemic proportions of the issue and the economic devastation it will wrought need our attention.

We need tax breaks providing deductions, credits or incentives for in home cost of care, day care, respite care, any care in other forms less costly because they are provided at home or in a local economy facility.

Personal tax breaks are needed for the cost of care facilities. There needs to be a scheme to reward economy of costs in providing services. Other tax benefits are needed for programs to supplant the need of public funding for care.

These need to be explored and the best of them provided.

We Need To Find A More Economical Way Of Providing Care And Respite.

The problems today with cost of living, health care and insurance costs, medical and hospital costs, the inability of our politicians to get it together in any meaningful way clearly demonstrate our future. The prospect of what we will face is inversely magnified by the inability of our culture, institutions and governmental processes to care for the current insurmountable costs we have caring for ourselves.

How then are we to meet this coming crises bearing down on us at breakneck speed?

Minnesota’s Alzheimer’s Disease Working Group (ADWG)

I have recently been appointed to Minnesota’s Alzheimer’s Disease Working Group (ADWG). This is an hybrid group authorized by the past legislative session in Minnesota given the following directive:

to examine the array of needs of individuals diagnosed with Alzheimer’s disease, available services, and the capacity of the state and providers to meet these needs. Requires the working group to make recommendations on the following:
• Trends in the state’s Alzheimer’s population and the service needs
• Existing resources, services, and capacity
• Needed policies or responses

This event was reported by the MN State Legislature dated 5/28/09,

NEWS RELEASE! GOTTWALT'S ALZHEIMER'S GROUP GETS PAWLENTY'S APPROVAL
Rep Steve Gottwalt, R-St. Cloud, authored the legislation (H.F. 2036) to help Minnesota get ready for an expected sharp increase in Alzheimer’s disease cases over the next two decades. The working group is charged with delivering specific recommendations to the State Legislature in a year. It will disband after its mission is complete.

“As the baby boomers age, and we live longer, the incidences of Alzheimer’s will increase dramatically, and there is no known cure for this terminal illness,” said Gottwalt, who serves on both of the health care and human services committees in the House, the Legislative Commission on Health Care Access, and the Minnesota Rural Health Advisory Board. “At age 65, one in eight people are stricken with Alzheimer’s. At age 85, one in two people have this terrible disease.”

A recent study issued by the national Alzheimer’s Association indicates the number of people aged 65 and older with Alzheimer’s disease is estimated to reach 7.7 million in 2030, more than a 50-percent increase from the 5.1 million aged 65 and older who are currently affected.

“Considering the needs of those with Alzheimer’s and their caregivers, we face an incredible challenge,” Gottwalt said. “Experts predict the disease will soon cost Minnesota billions of dollars each year. We need comprehensive planning to get ready, and this working group is an important start.” Gottwalt said he hopes the legislature will act on the group's recommendations.

Because of the cooperation between the Minnesota Alzheimer’s Association and the Board on Aging, the work group carries no cost for the state – but Gottwalt said the group’s recommendations could save Minnesota billions of dollars down the road.
I am pleased to see this commission given by the Legislature to make the findings it directed and to report back with them no later than January 15, 2011. The Group consists of 20 members drawn from the MN Dep’t of Aging, Public and Private Experts in the treatment and care of Alzheimer’s Disease (AD) and two members, one an AD Caregiver and the other a person afflicted with AD.

I was pleased with the appointment as the AD Rep. It will give me the opportunity to be in on the ground floor of changes that need to happen with the care and treatment of AD. This disease is a calamity waiting to happen as its numbers are escalating exponentially.

I have written arduously on issues pertaining to this need during which times I have seen things happening on the Federal level. This legislation with its direction to examine, find and make recommendations enhances the effort on the local state level.

In June of this year my wife Diane and I had the opportunity to appear on a panel in Washington DC convened jointly by the National Alzheimer’s Association (Alz.Org) and the Federal Administration on Aging (AoA) which was following the same directive. Their directive was to investigate and determine policies and programs needed in the care of Early Stage Alzheimer's Disease (AD).

We were there along with two other members of the Early Stage Advisory Group of the National Alz.Org, who with there spouses and/or caregivers discussed the needs of those affected by the Early Stage of AD.

We were well received by the rest of the group attending this all of whom were professionals or government officials who are charged with making policies and programs for AD in the country. Lisa Gwyther, a professional from NC who conducted our panel as moderator stated she learned more from us in one sitting than she did in 30 years of professional practice. (Perhaps hyperbole it sure sounded nice to hear it!)It was gratifying.

I presented written material to this group which consisted of the memorandum which follows entitled: Programs Worth Advocating For ESAD. This is the summary of a more detailed essay that I have posted in my archive entitled: A GREATER NEED OF CARE IN EARLY STAGE ALZHEIMER’S


PROGRAMS WORTH ADVOCATING FOR ESAD

Specifically what we can work on are the following:

a. First Stop Programs: A Place With People such as Early Stagers that patients just diagnosed can come to and learn about AD and how they and families can deal with it. This could be supplemented to Alz.Assoc with a resource list of services. The existence of this should be circulated throughout the Health Care Community.

b. Support Groups: A Place With People where Early Stagers agree to attend with regularity and be open to the public designed for Early Stage offering support, camaraderie and regularity.

c. Volunteer Coordination: We need to put together a central source to find volunteer opportunities for Early Stage AD where they can be directed to do volunteer work in the range of their respective ability.

d. Structured Wage Earning Workgroups: Something comparable to Sheltered Workshops for Early Onset AD’s to provide both work and wage when they have lost their jobs, still need gainful employment. Not everyone has disability insurance and not all disability insurance is enough. Social security can take two years to get if at all.

e. Creative Programs: To Stimulate the Minds and Prolong Early Stagers in Early Stage. These need to be structured in such a way that they are social, creative, intellectually stimulating and such to capture a person still functional and in need of more than the distraction afforded by most day care programs.
These are some of my ideas. We need the organizations to promote and help organize this.

In the public/Gov’t sector we are talking all of this and more involving funding of programs and provision of incentives for economizing care as institutionalizing it as is done now.

Enhance And Preserve Brain Power

It may sound like I am trying to beat the proverbial dead horse. Here I go again on my favorite mantra: Eat Right, Exercise Daily, Get in Social, Creative and Intellectually Stimulating Activities. They work to keep us better. What follows is yet another recitation of what I have been emphasizing and gives further validation to it. Take a Look at What it Says!

According to the most rigorous and comprehensive review of the scientific findings ever, there is clear evidence that cognitive-enrichment activities including intellectually stimulating pursuits, social engagement, and especially physical exercise may indeed preserve or enhance various aspects of cognitive functioning as we age.

How To Enhance And Preserve Brain Power As We Age

Article Date: 15 Aug 2009 - 1:00 PDT

In 1900, only 4.1 percent of U.S. citizens were older than 65; in 2000 that number had jumped to 12.6 percent; and by the year 2030, 20 percent of our population could be in that category.

Cognitive decline was long seen as an inevitable consequence of aging, but recent years have seen a surge of interest in activities and products touted to forestall this outcome. What is the truth? Is decline inevitable, or is there a possibility of retaining our faculties if we exercise them? And which kinds of exercises and products are effective, and which are merely hype?

According to the most rigorous and comprehensive review of the scientific findings ever, there is clear evidence that cognitive-enrichment activities including intellectually stimulating pursuits, social engagement, and especially physical exercise may indeed preserve or enhance various aspects of cognitive functioning as we age.

In this report, the researchers point to recent studies confirming that engaging in intellectually stimulating pursuits have substantial benefits for older adults. One such study shows that every day activities, such as reading, can indeed help. Four thousand old people were recruited for a study and rated their frequency of participation in seven cognitive activities (e.g. reading magazines). The researchers conducted in-home interviews and tested the participants' cognitive function for nearly 6 years. Those who engaged in more frequent cognitive activity experienced a reduced rate of cognitive decline.

Your brain also stays in better shape if you work out. The authors of this report point to a recent study looking at 5925 women over the age of 65. Researchers assessed their physical activity by asking the women how many city blocks they walked per day and how many flights of stairs they climbed daily. The women also responded to a questionnaire detailing their participation in 33 different physical activities. Looking at the cognitive function of these women 6 to 8 years later, the researchers found that the most active women had a 30 percent reduced risk of cognitive decline. Interestingly, walking distance was associated with cognition, but walking speed was not. It seems that even moderate levels of physical activity can serve to limit declines in cognition in older adults.

Social engagement and maintaining a positive attitude are also powerful tools in deterring the arrival of dementia. Individuals who are optimistic, agreeable, open to experience, conscientious, positively motivated and goal-directed are more likely to experience successful aging. Animal research supports these findings. These studies show that exposing animals to enriched or complex environments (usually including running wheels, a multitude of toys and objects to climb, and animal companions) yields several physiological benefits, including neuronal changes in the brain.

The science in this report also debunks the old saw: "Old dogs can't learn new tricks." While older adults generally learn new pursuits more slowly than younger people do, they nevertheless can improve their cognitive performance by keeping their minds and bodies in shape.

Psychological Science in the Public Interest is a journal of the Association for Psychological Science. This monograph was supported by a grant from the National Institute on Aging.

Source: Association for Psychological Science

IS SLEEEPING LONGER A CLUE TO ALZHEIMER'S COMING?

Alzheimer’s Society comment on longer sleep duration being associated with an increased risk of dementia

Published Thursday 13th August 2009 in Research news

Older people who reported sleeping for more than nine hours in each 24 hours and feeling sleepy during the day were more likely to develop dementia according to new research.

The study of more than 3,000 people in Spain investigated the correlation between sleep patterns and the development of dementia over a three year period. While sleeping longer than normal resulted in an increased association, there was no direct link found between sleeping less than normal (six hours or less in 24 hours) and developing dementia.

Alzheimer's Society comment:

'This report suggests that sleeping longer than normal and feeling sleepy during the day is a sign of developing dementia. There is no apparent physiological link and it is unlikely that sleeping more than normal is a direct risk factor for dementia. It maybe that this is just a statistical coincidence or perhaps that sleeping is an early sign of a yet undiagnosed condition.

As currently only a third of people with dementia ever receive a formal diagnosis, more research is now needed to investigate these results although research is drastically underfunded. One million people will develop dementia in the next 10 years. We need to act now.'

IS THE BRAIN INDEED PLASTIC?

I read the most interesting article entitled Brain Is a Co-Conspirator in a Vicious Stress Loop which appeared in the New York Times on 8/18/09. I have posted it on MY ALZHEIMER’S ARCHIVE OF ARTICLES AND MEMORANDA

This is an interesting and thought provoking article about three things of interest to me:

1. Alzheimer’s Disease (AD) may be caused by stress.
2. The ability of the brain to change and regenerate can overcome some of the effects of AD.
3. The affects described, namely, perseveration — uncontrollable repetition.

Caused by Stress? Between Alcoholism and a highly stressful life style as a trial attorney, along with a lot of other painful crap along the way I traumatized by body, mind and psyche no end. Look at my book From AA to AD, a Wistful Travelogue, my Alzheimer's afterthoughts.

Something had to pop. Guess what, it did! I got AD!

Brain Can Regenerate: Living the mantra “Eat Right, Get Daily Exercise, Participate in Social, Creative and Intellectual Stimulating Activity.” That along with medication will keep you in the Early Stages of AD longer.

How can that be? I believe it is because we are able to work around our deficiencies caused by the brain damage of AD and build new pathways in the brain to get many of the same jobs done for which the ability has been lost.

The study described the changes resulting from stress were overcome by removal from the stress and time out or vacation as they described it. They reported this finding stating: The brain is a very resilient and plastic organ…. Dendrites and synapses retract and reform and reversible remodeling can occur throughout life.

Why does this change occur? Possibly it is because we have quit persevering in trying to make the brain what it once could and relieve that pressure by seeking new ways of doing it?

Living the mantra puts our bodies in the best possible condition to affect the efforts, Getting out, separating our self absorption by our social contact and doing creative and intellectual activities draws us further outside of ourselves, removes us from the rut of perseveration and gives us the time out to let new things happen. The stimulation we give ourselves directs us to that and improves our minds and bodies to let this happen.

Perseveration — Uncontrollable Repetition: This describes a symptom so evident to me in my AD. I crave my routine. I like to follow the same thing every day, over and over again. I eat the same things over and over. I do things at the same time every day. There is absolutely no reason why I do this. I feel better and more secure doing it so I keep doing it. I am more at peace doing it. Disruption bothers and irritates me. Fielding new situations tires me out. Too much distraction causes me anxiety, depression and jitters. I find myself shaking on the inside, an internal tremor, which is quieted only be rest.

I have learned I need a balance to my routine. I need to get out, socialize; get involved in activity. Routine for me is OK as fall back to rest and rejuvenate, but too much of it suffocates.

It is for the foregoing reasons I found this article of such interest to me.

p.s. IF MY PREVIOUS POST IS NOT ENOUGH? Try this!

Krugman today centered on those Socialized European Systems. He is on the mark. How can the B.S. of the propaganda machine be so readily believed by public opinion?

Woe on to thee Populace of America, so easily duped in the past so readily duped again and again and yet again today!!!!!!

Read Krugman THE SWISS MENACE in my archive.

HEALTH CARE REFORM IS IN THE TOILET WAITING TO BE FLUSHED

The two excerpts from today’s Washington Post along with the article I have posted today to MY ALZHEIMER’S ARCHIVE entitled: COMMENTARY: HOW INSURANCE FIRMS DRIVE DEBATE describes the HEAT OF AUGUST as I call it being carried in the media this month.

Did you believe the delay of the Health Care Reform vote until after the Congressional recess for vacation had anything to do with reasoned consideration of the bill as the plea for delay was touted?

It should be evident now that the Conservative/Corporate Joint Venture needed the time to kill it. And Killing It they are doing.

The article posted in the archive speaks pointedly on the subtle agenda being fomented via the media under the false sound bite philosophy contrived to incite public paranoia and opposition to the bill with no thought whatsoever about remedy of the problem giving need to the reform.

Part D Drug coverage proposed by the Bush Administration and adopted by a Republican Congress best exemplifies this. I had better coverage at less overall cost before Part D was enacted which at the time was offered by the same carrier writing my private drug coverage. They offered their Part D coverage with substantially lower premium and no Do-Nut Hole that is equivalent to a large deductible. The insurance was no longer than 2 years in effect when the Do-Nut Hole was put in and premiums started to escalate. Every other policy of the Byzantine Bunch of them written had the same large Deductible Hole!

Is this bait and switch or what is?

THE PUBLIC OPTION IS A KEY TO CONTROL THE VAST INFLUENCE LOBBY OF THE INSURANCE AND PHARMACEUTICAL INDUSTRIES FROM THEIR CONTINUED PILLAGING OF THE PUBLIC AND PRIVATE DOLLAR. WITHOUT THE PUBLIC OPTION WE ARE AGAIN AT THE MERCY OF THE BAIT AND SWITCH BUNCH!

HEADLINE

Key Feature Of Obama Health Plan May Be Out
Administration Hints That Public Option Isn't Only Way to Go

By Ceci Connolly
Washington Post Staff Writer
Monday, August 17, 2009

Racing to regain control of the health-care debate, two top administration officials signaled Sunday that the White House may be willing to jettison a controversial government-run insurance plan favored by liberals…

HEADLINE

More Crises Needed?
The Only Way to Start Reform

By Fareed Zakaria
Monday, August 17, 2009
Washington Post
…
...Now, to see the weakness of the American system, consider the past two weeks and the debacle of the health-care debate. Clearly the U.S. health-care system is on an unsustainable path. If current trends continue -- and there is no indication that they won't -- health care will consume 40 percent of the national economy by 2050. The problem is that this is a slow and steady decline, producing no crisis. As a result, we seem incapable of grappling with it seriously.

It's not as if the problems aren't apparent to everyone, whatever your political persuasion. Costs are rising so fast that every day more than 10,000 Americans lose their insurance coverage. In 1993, 61 percent of small businesses provided health insurance for their employees. Now only 38 percent do. Larger firms face greater health-care costs. Yet, Americans do worse on almost every health measure than most advanced industrial countries, which spend about half as much on health care per person and have proportionately more elderly people.

Meanwhile, the political debate is unreal, with conservatives suggesting that President Obama is endorsing euthanasia and murder boards, and turning America into Russia. (I guess they haven't noticed that Russia isn't communist anymore.) The lack of serious discussion is tragic, because the Democrats' proposals leave much to be desired. They include only a few, vague measures to rein in costs, and the chief one -- a medical board -- assumes (improbably) that Congress will cede massive powers to five unelected people who would have the power to deny people treatments and drugs.

The likely scenario is that expanded coverage and new benefits will be enacted, while the cuts and curbs will be pushed off to be tackled another day.

Health care is the nation's most serious long-term problem. Social Security, government pension liabilities, state-government deficits and energy dependence all pose the same issue. Each of these problems is getting worse by the day, yet the political system seems unable to take them on and make major reforms. On these critical issues, America is caught in a downward spiral. It makes you wish for a crisis.

LET’S SUE THE CHARLATANS!

I have been asked to submit a proposal of a colleague of mine in the practice of law who still persists in trying to do it, my having learned better and quit! He asked me to direct his proposal to as many Alzheimer’s Groups to which I have access.

He follows my Blogs. He read the posting I made two days ago to MY ALZHEIMER’S ARCHIVE OF ARTICLES AND MEMORANDA entitled What’s Wrong with this Picture. His proposal responds to the concerns I raised in it that posting.

Read the proposal on that Blog entitled: SUPERCILIOUS SOLICITATION, or is it? posted yesterday.

Although the proposal may be considered as written with “tongue in cheek” there is a rude kind of irony to it. What I mean is this. There is certainly cause to haul some of these disingenuous activities undertaken supposedly for the folks afflicted by Alzheimer’s Disease (AD) into Court for breach of contract, malfeasance, non-feascance, common law fraud or violation of fiduciary duty. These would all be good legal counts giving cause to legal proceedings for damages before a jury.

Sound screwy and off the wall? Is the AD virus really getting to me? Not really!

Legally suit could be brought against various organizations who under the color of altruism raise money and promote programs for the benefit of doing for Alzheimer’s. These organizations often violate their trust having undertaken a service for people in need and not performing truly in that capacity.

Consider:

How much money is raised by volunteer groups for AD? Who decides the purpose for which it is raised? How much of it goes to the purpose for which it is raised? Who else benefits from the acquisition of the money it raises?

Look at the organizations that provide services. This is discussed with some detail in my 8/13 post on my archive entitled What’s Wrong with this Picture. There seems to be a Cabal of units of Government, large Corporations and movers and shakers in the fields of Health Care Professionals, Leveraging Entrepreneurs, Investment Bankers, Lobbyists, Public Servants and a host of others at the trough gleaning enormous gain off the available public money and charitable funds under the guise of building infrastructure for purpose of providing services for the AD Afflicted.

The profit in these ventures for the initiators, the high level executives and administrators and the investors is astronomical!

An illustration of how the fruits of their work were discussed in detail in my own experience and that of Rose Lamatt in my post on AGING IN PLACE made on 8/13.

So much of the fund raising activity is for finding the cure. This is done at the expense of providing care. The cost of care is prohibitive bordering on confiscatory, but others are “rolling in dough” from the development of products designed purportedly to provide care..

Both private funds raised by volunteer groups and government funds go to researching for a cure. In turn much of the research carried on by the Drug Companies for which the contribution is sought and for which the Drug Companies charge exorbitant non-negotiable costs for their discoveries is done by government funded research facilities.

Funding to find the cure is extensive, success negligible if not illusory. Is it possible to find a cure? Hey I hope it is. I got this disease. But it probably won’t occur before I am in the grave. In the meantime I wonder if after I have paid the enormous amounts for care whether or not there will be anything left for my wife to live on through her remaining years. This is a despicable probability!

Couldn’t more of the funding generated be spent on developing programs for Economy of Care as spend all that is being spent from so many directions down the big black hole of Finding a Cure?

In my ruder more paranoid moments I wonder this. How much of the agenda directed to all of the worker bees raising funds is choreographed as a hidden agenda of the Drug Industry?

After the fall of Wall Street and the Resuscitation of the cadaver it became I wonder too much about hidden agendas of the massive Geo Political Corporate Industrial Cabal running rampant looting all levels of our economy. Could funding for AD be but one more of these?

Under the law when a legal entity, (person, corporation or legally constituted association) undertakes to provide a service for a group knowing the group relies on what they are doing, a high legal duty is placed on the entuty undertaking to act. This follows theories of Contract (Breach and Third Party Beneficiary) Tort (Malfeasance, Non Feascance, Violation of Fiduciary Duty) General Theories of Equity and Abuse of Process when public funds are involved.

In other words they gotta do it right or not at all! If they do it for their own benefit they are at risk of having to pay for their ill gotten gains.

Such lawsuits are onerous, complicated, expensive, and time consuming. Class Action or RICO offer some of the better methods of doing them. The lawyers gain the most by bringing them. The value of there being brought is the cost to the targets if they are in fact acting in their own interests under the color of acting for the benefit of another.

These kinds of law suits can stop the rampant carnage wrought our country under the guise of service performed for gain by those doing it. That is the value of taking the proposal of Mr Doubletongue with a little gravity.

We are seeing the Health Care Debacle being played out in Washington DC, over the media and in the battle zones of Town Halls. When are we as a reasonable people going to say enough of this duplicity, hidden agendas, secret profit, disingenuousness perfidy. Either disband the government or let it do its job of protecting the common folk! This is absolutely nuts watching this ensemble fiddle while everything burns around us!

HEALTH CARE, A SERVICE OR AN INDUSTRY?

Is there purpose in the foregoing question? One might answer “It is both!”

I have written on the issue in the past and it came to the foreground the night before last as I was reading Just a Word by Rose Lamatt.

The story is about Lamatt, the caregiver, caring for her partner Carol who was diagnosed with Alzheimer’s Disease (AD) and lived another ten or so years. I have not finished the book so cannot be precise. In the later stage Rose placed Carol in a nursing home when Rose could no longer physically handle Carol.

The first nursing home was a disaster. Although well rated in the state a friend who worked at another nursing home said this was the worst of the worst. Based on the lack of care, gross in their omission of providing basic hygienic care, Rose transferred Carol to the nursing home of her friend. In each nursing home Rose provided and paid for private care to supplement that provided by the home.

In the first Rose found Carol in the bathroom pounding her frustrations out with the nursing home attendant and the private duty attendant one sitting in a chair the other lying on the bed outside the bathroom, well within hearing, watching TV. She found Carol, incontinent, not changed when needed, found a dirty diaper lying in the hall for two days outside of the door.

In the second home service was a little better but there were still dramatic oversights. One such was coming in to find Carol in the bathroom pounding on and breaking the mirror.

After listing much of this Rose made the following comment on pp. 1277-79 (Kindle Edition)

I understand things are tough, but what’s happened to, respect for your elders and the ill? Doesn’t it mean anything anymore? I’ve come to believe Health Care is an Industry not a service. … but it needs fixing, not with a bandaid, but an overhauling from top to the bottom. Too many generals and not enough soldiers. Too many suits and ties, and nice dresses, while hands on people are underpaid and overworked. When will it change? Order Just a Word at Amazon.com Book information:

Paperback: 180 pages
Publisher: CreateSpace (February 9, 2009)
Language: English
ISBN-10: 1440475172
ISBN-13: 978-1440475177

I asked at the start of this essay “Is there purpose in the foregoing question?” namely “is health care a service or an industry?” This question in its asking so succinctly describes what I have lamented in earlier essays I have written.

I have posted part of an essay I posted on an Alz.Org Message Forum this past April following my experience of ½ a month in a transitional care unit. Transitional Care is a euphemism that falls between and extended care ward of a hospital and a nursing home. It is in all ways a nursing home.

My Essay WHAT’S WRONG WITH THIS PICTURE? Click on the hypertext of the title to read it.

I was in the best of the best of the nursing homes in my area. I was appalled at the service wondering what it must be for some of the less costly ones. In the essay I illustrate my treatment, or lack of it. I also question the system.

My questions of the system was where does the money go? It goes to the Heads, the Supervisors, the Consultants, the variety of programs that support the infrastructure. When all of that is paid there is nothing left with which to pay staff.

Therefore professional service providers receive minimal pay and aids receive minimum wage. In my experience in a “good home” at best no more than half the aids could communicate with the patients because of inadequate language skills.

In my home County years ago the County Supervisors built a new Court House. When they did they forgot to put in Court Rooms. They remembered good offices and great meeting rooms, but Courtrooms? Oooops, they built an annex.

We have some great well run nursing home but poor and cheap service.

Industrialization has diminished service; Rose Lamatt said it so well!

Hope, With a Deductible

I have posted another article in my archive: MY ALZHEIMER’S ARCHIVE OF ARTICLES AND MEMORANDA entitled Hope, With a Deductible. (Click on the blued title to read the article on the Site.)

Its interest to me is this: It dovetails so well with my issue for advocacy about too much concentration on finding a cure. It seems to me this is often at the expense of concentrating on caring for the afflicted. The medication makers offer the care that can be given with drugs to prolong our stay in the earlier stages of the disease. AD groups seek financing for that along with financing research for discovery for a cure. This is all for the benefit of the pharmaceutical industry.

Too few are making the effort to establish programs which provide the kind of care that will prolong our stay in the earlier stages of the disease other than that of the drug kind.

One approach may complement the other. Both directions certainly don’t hurt. Aricept has helped me. I regained cognitive acuity once on it. I have had beneficial results for 2 ½ years. I have also followed my doctor’s admonition: Eat Right, Exercise Daily and Get Involved in Social Creative and Intellectually Stimulating Activities. Both have been helpful.

What we don’t know is whether or not medication and/or the admonition to Eat Exercise and Stimulate are one better than the other or a wash between the two.

My point is this. So much more is needed in providing programs and activities of the kind that can help those of us in Early Stage stay there. Support groups are spotty at best. Day Care directed to positive programs of brain enhancement is almost universally absent. Most if not all are baby sitting programs. There are few programs for people newly diagnosed to learn how best to deal with there new paradigm.

So much more can be done that would be beneficial. It would be affective in helping folks stay in the Early Stage. While in Early Stage, we the AD Afflicted have a far better quality of life and do not present the problems that to soon we will produce. This is also the stage where little or no cost is involved in our care saving both our communities and the country.

With all of the money being spent raising money; with all of the funding going to finding a cure, couldn’t a little more be used to help those more in need of help, namely the afflicted and their families and care givers?

For the Time Being

I have posted an article that appeared in the New York Times today entitled For the Time Being by Norman Fischer He is a Zen Buddhist Priest who gives retreats in Mediation. He describes his topic around a quote he used as the subject of a recent retreat. It speaks so well of the contentment found in staying in the Now. This will free you from becoming enmeshed in the cacophony of daily living.

The entire article can be read on my Blog MY ALZHEIMER’S ARCHIVE OF ARTICLES AND MEMORANDA

What Zen Master Dogen discusses in the following essay is a proposition necessary for me to operate within the frame work of living with Alzheimer’s Disease (AD). If I would not restrict myself to living in Now, the range of negative contrary destructive emotions that would erupt would eat me alive! I cannot look back. That comprises so much of the life I have lost, all of what I once was. To look forward is impossible. I have nothing to look forward to. For the first time in my life to look forward is a place of no entry. Tomorrow will be worse than today. That is an absolute.

So, short of slitting my wrists what can I do? What of this life can I cherish? I can treasure Now, this moment and make it the best possible. Having been severed by my circumstance having AD, split from yesterday and tomorrow, I have only this:
I am forced to find all of my life and any quality from it in the immediate Here and Now. I am not given any other kind of a choice. My only beneficial time is found in my moment.

Really, that is all the life I have anyway.

This is Dogen’s proposition in the following essay: He says this is all there is. “To really live is to accept that you live “for the time being,” and to fully enter that moment of time” That is all there is. “Being is always and only being in time; time is nothing other than being.”

For us to let our lives be caught up with anything else but immediately this moment opens the doors of our life to so much that is alluring, false, destructive and in no way real or all that helpful.

AD is my blessing. It gives me no choice in the matter!

The 13th century Zen Master Dogen’s famous essay “The Time Being,” is a treatise on the religious dimension of time.

Dogen’s view is uncannily close to Heidegger’s: being is always and only being in time; time is nothing other than being. This turns out to be less a philosophical than an experiential fact: to really live is to accept that you live “for the time being,” and to fully enter that moment of time. Living is that, not building up an identity or a set of accomplishments or relationships, though of course we do that too. But primarily, fundamentally, to live is to embrace each moment as if it were the first, last, and all moments of time. Whether you like this moment or not is not the point: in fact liking it or not liking it, being willing or unwilling to accept it, depending on whether or not you like it, is to sit on the fence of your life, waiting to decide whether or not to live, and so never actually living. I find it impressive how thoroughly normal it is be so tentative about the time of our lives, or so asleep within it, that we miss it entirely. Most of us don’t know what it actually feels like to be alive. We know about our problems, our desires, our goals and accomplishments, but we don’t know much about our lives. It generally takes a huge event, the equivalent or a birth or a death, to wake up our sense of living this moment we are given – this moment that is just for the time being, because it passes even as it arrives. Meditation is feeling the feeling of being alive for the time being. Life is more poignant than we know.

Dogen writes, “For the time being the highest peak, for the time being the deepest ocean; for the time being a crazy mind, for the time being a Buddha body; for the time being a Zen Master, for the time being an ordinary person; for the time being earth and sky… Since there is nothing but this moment, ‘for the time being’ is all the time there is.”

More Cholesterol Linkage to AD Reported!!!

More Cholesterol Linkage Reported!!! The following was reported in the Times today. On July 21st I reported low good cholesterol linked to AD. That fit for me. In my early ‘40’s I had a cholesterol count of 255. This prompted the doc to put me on Mevacor the cholesterol lowering drug of the ‘70’s. I now qualify my diagnosis on two counts. This is further answer to why I have it with no family history of it.


August 6, 2009. New York Times
Vital Signs
Mildly High Cholesterol at Midlife Linked to Alzheimer’s
By RONI CARYN RABIN

Adults who had just slightly elevated blood cholesterol when they were in their early 40s were at greater risk of developing dementia decades later, compared with those whose cholesterol was at optimal levels, a new study has found.

The findings, which analyzed data from almost 10,000 health care plan members followed for four decades, surprised the investigators.

While earlier studies have shown an association between high cholesterol in midlife and an elevated risk of Alzheimer’s disease, “we were surprised to see the association with borderline levels,” said Rachel A. Whitmer, an epidemiologist with the Kaiser Permanente Division of Research and the paper’s senior author.

The study followed 9,844 members of the Kaiser Permanente Northern California Medical Group who had blood work done between 1964 and 1973, when they were 40 to 45 years old. All had remained members of the plan until at least 1994, when computerized outpatient diagnoses of dementia were made available.

Some 598 of the original participants were diagnosed with Alzheimer’s disease or vascular dementia, a less common form of dementia, between 1994 and 2007, when they were between 61 and 88 years old.

Those whose total blood cholesterol had been high — over 240 milligrams per deciliter — were 57 percent more likely to have developed Alzheimer’s disease than those with optimal levels. Those who had borderline cholesterol values — between 200 and 239 milligrams per deciliter — were at 50 percent greater risk of developing vascular dementia.

“What’s good for the heart is good for the brain,” Dr. Whitmer said, adding, “Midlife is not too soon to be thinking about risk factors for dementia. This is a modifiable risk factor. This is something you can change.”

The study is being published online this week in the journal Dementia & Geriatric Cognitive Disorders.

THE NEED FOR COST OF CARE CONCENTRATION ACCENTUATED!

Cost of care needs so much more concentration in efforts for sake of Alzheimer’s Disease (AD). The article I have posted on MY ALZHEIMER’S ARCHIVE OF ARTICLES AND MEMORANDA demonstrates this need. We are as a nation so in the clutches of the drug industry profit schemes. We are in the same clutches of Health Care, Medical and related Industries.

Our concentration on efforts has been so concentrated on raising funds for finding a cure. I often wonder how much this too is a hidden agenda for sake of the Drug Industry.

Government does the research then Drug Companies tag on for the profit.

If a greater concentration were directed toward finding greater economy in care it would both produce more benefit for those of us who suffer this disease. It could also reduce the cost of care particularly if directed to creating programs offering Social, Creative and Intellectually Stimulating activity for those in Early Stage.

This prolongs the quality of life and the savings accomplished by their prolonging their stay in the Early Stage. In that stage the need for care is the least of any stage of AD.

For a Sharp Brain, Stimulation

NEED MORE BE SAID? Eat Right, Exercise, Stimulate the Brain!


The New York Times reported May 13, 2008 under the title “For a Sharp Brain, Stimulation” findings consistent with the mantra often repeated on this Blog:

Eat Right, Exercise Daily, Participate in Social, Creative and Intellectual Stimulating Activity.

These articles with these kinds of findings are very supportive to the other mantra that is mine:

Cost of Care, Economy of Care and the Need of a Different Kind of Care for those in Early Stage AD This advocacy is my mission to make my having this disease come to some worth as sit in the shade and silently slip into mid-stage.

We as a community cannot afford a wait and see approach. The number of incidents of onset of Alzheimer’s Disease (AD) is escalating. The Health Facilities we have are not yet ready to meet this challenge. The Homogenization of Nursing Home Service has caused the cost to become confiscatory of the average estate. Assisted Care is close behind. The only economy is offered by part time Home Care.

Statistics tell us the Caregiver dies before the Afflicted too often because of the overburden of having to singularly provided care. Families, Friends and Community don’t get it because AD is either misunderstood or shunned altogether.

This leaves the best strategy which is available to those of us in Early Stage. It is following the first mantra, eat, exercise, stimulate! This will prolong your time in Early Stage not needing the services and incurring the costs that come later.
Many of us have been saying it. It is nice to see studies backing it up.

I have posted the article on my companion Blog: MY ALZHEIMER’S ARCHIVE OF ARTICLES AND MEMORANDA

UNIVERSE IN CREATION

I believe in God as an algorithm.
A system of formulas or laws,
Like in physics, that explain
How things have come to be,
Al Past


UNIVERSE IN CREATION

An algorithmically calculating influence
Concocts this colossal
Element of time in space,
All to make place,
For emanations of conscious conception
Bound in material like complexion,

The work of which in kind and place
Can dwell in passing trace
And move about
Within this closed confine
Throughout the vast horizon encasing it.

From nothing came this formation
To existence so it seems
But in fact a shadow of all that teams
Within the rules and limits
Made necessary by the ingredients
In which the emanations dwell

In order to experience
Each a virtual path
Bounded by birth to death
In a corporeal heap of bits and piece
Made into a sentient stuff

It grows then erodes,
During which it operates
Its brain part facilitates
Thoughts and dreams
Of all the data it conceives,

And assumes in what it sees
Is all there is to be
With no connection
To higher convection
Giving cause to it.

Mike Donohue ©2009