Connect with us

Health

At Long Last, Can Malaria Be Eradicated?

Published

on

At Long Last, Can Malaria Be Eradicated?

All via childhood, Miriam Abdullah was shuttled out and in of hospitals, her skinny physique wracked with fever and ravaged by malaria. She was so sick so usually that her fixed remedies drained her mother and father, who additionally cared for her many siblings, each financially and emotionally.

“Sooner or later, even my mum gave up,” recalled Ms. Abdullah, now 35.

In Nyalenda, the poor neighborhood in Kisumu, Kenya, the place Ms. Abdullah lives, malaria is endemic and ubiquitous. A few of her buddies developed meningitis after turning into contaminated; one died. “Malaria has actually tormented us as a rustic,” she stated.

There are tens of hundreds of thousands of horror tales like Ms. Abdullah’s, handed down from era to era. However now change is within the air: Malaria is the uncommon international well being scourge about which consultants are sanguine — a lot in order that some have begun to speak about eradicating the illness.

“I believe there’s a lot room for optimism,” stated Philip Welkhoff, director for malaria applications on the Invoice and Melinda Gates Basis. “Later this decade, we may really launch a push that will get us all the way in which to zero.”

Advertisement

China and El Salvador had been licensed malaria-free final yr, and the six international locations within the Larger Mekong area, together with Vietnam and Thailand, have pushed down instances by about 90 %. About 25 international locations are anticipated to have eradicated malaria by 2025.

The majority of infections now happen in Africa. Even there, regardless of the restrictions imposed by the coronavirus pandemic, almost 12 million extra African youngsters acquired preventive malaria medicine in 2020 than in 2019.

However it’s the arrival of two new vaccines that portend a sea change. The primary, known as Mosquirix, was 35 years within the making. It was accredited by the World Well being Group simply final yr and could also be distributed as quickly as late subsequent yr.

A extra highly effective malaria vaccine, developed by the Oxford staff that created the AstraZeneca Covid vaccine, could also be only a yr or two away. Many consultants imagine it’s this formulation, which has proven an efficacy of as much as 80 % in scientific trials, that will rework the struggle towards malaria.

Nonetheless extra choices are on the horizon, together with an mRNA vaccine being developed by the German firm BioNTech; monoclonal antibodies that may stop malaria for six months or longer; mattress nets coated with long-lasting pesticides or with chemical substances that paralyze mosquitoes; in addition to new methods to lure and kill mosquitoes.

Advertisement

“It’s an thrilling time,” stated Dr. Rose Jalang’o, who led a pilot take a look at of the Mosquirix vaccine in Kenya, the place it was given to youngsters alongside different immunizations.

However attending to a malaria-free world would require greater than promising instruments. In lots of African international locations, distribution of vaccines, medicine and mattress nets requires overcoming myriad challenges, together with tough terrain, different pressing medical priorities and misinformation.

Whereas the funding for malaria applications is extra beneficiant than for a lot of different illnesses that plague the poorest nations, sources are nonetheless restricted. Cash devoted to 1 strategy usually leads funders to neglect others, fueling competitors and generally rancor.

Mosquirix price greater than $200 million to develop over greater than 30 years, however its efficacy is roughly half that of the Oxford vaccine, known as R21. The primary doses of Mosquirix won’t be delivered to African youngsters till late 2023 or early 2024. The availability can be severely constrained for plenty of causes, and is predicted to stay so for years.

In December, Gavi, a nongovernmental group that helps vaccinations worldwide, dedicated $156 million to distribute Mosquirix. And in August, Unicef granted the vaccine’s producer, GlaxoSmithKline, a $170 million contract, sufficient to supply 18 million doses over the following three years.

Advertisement

However that may be a far cry from the estimated 100 million doses that can be wanted every year.

R21, the second vaccine, seems to be extra highly effective, cheaper and simpler to fabricate. And the Serum Institute of India is ready to supply greater than 200 million doses of R21 per yr.

Some malaria consultants observe that given the pressing want, the world wants each possibility it could possibly get. However others fear that each greenback directed to Mosquirix now’s a greenback much less for creating different instruments.

“Current malaria management measures are already underfunded,” stated Dr. Javier Guzman, director for international well being coverage on the Middle for World Improvement in Washington. “I don’t wish to be unfavorable, however a brand new software with out further funding principally means sacrifices and means a possibility price.”

Malaria is among the many oldest infectious illnesses and one of many deadliest. Years of fast progress stalled a few decade in the past, leaving the toll in 2019 at a staggering 229 million new infections and 558,000 deaths.

Advertisement

Whereas the Covid pandemic didn’t ship malaria infections skyrocketing, as occurred with tuberculosis, the pandemic reversed a sluggish downward pattern in malaria deaths, which ratcheted as much as 627,000 in 2020.

Almost the entire lives misplaced to malaria are in sub-Saharan Africa, the place about 80 % of the deaths are in youngsters youthful than 5.

Many methods to struggle malaria are dated, but nonetheless inaccessible to hundreds of thousands. Solely about half of African youngsters sleep beneath insecticide-treated mattress nets, as an example, and even fewer obtain seasonal medicine that stop the an infection.

Malaria compounds social inequities. It robs youngsters of the power to struggle different pathogens, overwhelms well being care techniques and devastates complete communities. One untreated particular person with malaria can stay unwell for six months, giving mosquitoes the chance to unfold the parasite to as many as 100 different folks.

Designing a vaccine towards a parasite has proved far more difficult than creating one towards a virus or bacterium. Plasmodium falciparum, the organism that causes malaria in Africa, quickly cycles via a number of life levels, morphing into a brand new kind every time.

Advertisement

The physique struggles to acknowledge and defend itself towards this shape-shifter, leaving folks susceptible to repeated bouts of illness.

A mosquito chew delivers solely about 10 “sporozoites,” the type of the parasite that may be transmitted. However inside half-hour of an infection, the sporozoites invade the liver, and start multiply into an unbeatable military of 1000’s. Mosquirix and R21 goal sporozoites within the couple of minutes earlier than they enter the liver.

The parasite wrecks the physique so rapidly that by the point youngsters are taken to the hospital, many are in dire want of a blood transfusion. However blood is usually in brief provide in sub-Saharan Africa, and utilizing a bag for a small baby can imply that half or extra can be discarded, stated Dr. Mary Hamel, who leads the W.H.O.’s malaria vaccine implementation program.

“You see a baby who’s so pale and floppy and respiration so quickly, and so they’re simply splayed on the cot — and there’s nothing you are able to do,” she stated.

“You’ve bought to stop malaria — it simply progresses too quick,” she added.

Advertisement

Mosquirix, the primary vaccine towards any parasite, is a technical triumph. However its efficacy, at about 40 %, is far decrease than scientists had hoped.

Ideally, the vaccine could be deployed alongside present controls, like insecticide-treated mattress nets and preventive medicine, based mostly on knowledge indicating the place the instruments are most wanted and delivered by a sturdy well being care work power.

“In case you mix with the fitting software, you will get a a lot, a lot greater affect,” stated Dr. Thomas Breuer, chief international well being officer at GlaxoSmithKline, which manufactures Mosquirix.

The vaccine, which may be refrigerated, was examined in Kenya, Ghana and Malawi in youngsters youthful than 2 years — and extra simply than some consultants had feared. “It’s extra deliverable in rural, distant settings than many different vaccines have been,” stated Prashant Yadav, an knowledgeable in well being care provide chains on the Middle for World Improvement.

Group well being employees went door-to-door to publicize Mosquirix, and governments unfold the phrase by way of native tv and radio exhibits. Regardless of misinformation that circulated on WhatsApp and social media, uptake of the vaccine was akin to that of routine immunizations.

Advertisement

However in lots of African international locations, distrust of vaccines is excessive. In a single survey, about half of individuals in Niger and the Democratic Republic of Congo stated they’d not belief a malaria vaccine.

Furthermore, Mosquirix have to be given in 4 doses, the primary at 5 months of age and the fourth after 18 months of age. However few different vaccines are given to youngsters older than 18 months, and lots of mother and father in Africa face monumental logistical hurdles in taking youngsters to a clinic.

Mother and father may wrongly assume that the primary three doses of Mosquirix are protecting sufficient, researchers stated. (In contrast, R21 has an efficacy of 70 % after three doses given earlier than 17 months of age. A booster given a yr later maintains and even enhances its efficiency.)

“It might be simpler if the final shot was at 18 months,” Dr. Kwame Amponsa-Achiano, a doctor and epidemiologist who leads the vaccine program at Ghana’s ministry of well being, stated of Mosquirix.

In comparison with the billions of {dollars} poured into Covid vaccines, the funds for malaria are a pittance. The Gates Basis spends about $270 million a yr preventing the illness, not counting its contributions to the World Fund to Struggle AIDS, Tuberculosis and Malaria.

Advertisement

The shortage of sources signifies that folks — and organizations — find yourself choosing favourite methods. Some preserve that controlling mosquitoes is the logical path, whereas others push vaccines. Nonetheless others say monoclonal antibodies are the way in which ahead.

In such a extremely aggressive enviornment, Mosquirix doesn’t emerge as the apparent winner.

“Deploying a software which is pricey, and never that efficient, with a brief length of motion, will not be the factor that you just wish to result in first,” stated Dr. Scott Filler, head of malaria applications for the World Fund, which helps greater than half of malaria applications worldwide.

The cash could be higher spent growing use of mattress nets, or making certain that individuals have entry to fundamental main well being companies, together with testing, treating and monitoring for malaria, Dr. Filler stated.

Even the Gates Basis, which has poured greater than $200 million into the event of Mosquirix, is now lukewarm on the vaccine and is focusing as an alternative on dashing newer instruments to Africa.

Advertisement

“A few of this different stuff within the portfolio goes to be higher, cheaper, simpler to deploy and simpler to scale up,” Dr. Welkhoff stated.

However different consultants imagine that given malaria’s devastation, a vaccine with low efficacy is healthier than none.

“Now we have this vaccine that has been examined very, very extensively — greater than any vaccine previous to approval,” stated Michael Anderson, a former director common of Britain’s Division for Worldwide Improvement who now heads MedAccess, a nonprofit group financed by the British authorities.

R21 has price lower than $100 million to develop. If regulators are as quick and nimble as they had been with Covid vaccines, it might be approved just a few months after the researchers submit ultimate knowledge on the finish of this yr.

The 2 vaccines will not be essentially in competitors, stated Dr. Adrian Hill, R21’s architect and director of the Jenner Institute on the College of Oxford.

Advertisement

The most important downside with Mosquirix “is there isn’t sufficient of it,” Dr. Hill stated. Nonetheless, R21 could be easier to ship as a result of it’s “a extra fashionable product,” he added. “It was designed in 2012, not within the Eighties and Nineteen Nineties.”

For a lot of mother and father in Africa, a vaccine can not come quickly sufficient. In Kisumu, Ms. Abdullah is anxious to immunize her 2-year-old daughter, who has already had malaria as soon as, towards the sickness that marred her personal childhood.

“I’d go for it instantly,” she stated. “In reality, I’d go for it earlier than I even go for the Covid-19 vaccine.”

Continue Reading
Advertisement
Click to comment

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Health

How a Company Makes Millions Off a Hospital Program Meant to Help the Poor

Published

on

How a Company Makes Millions Off a Hospital Program Meant to Help the Poor

Soon after being diagnosed with metastatic breast cancer, Virginia King sat in an outpatient clinic in Santa Fe, N.M, while a nurse injected her with a powerful drug to slow damage to her spine, where the disease had spread.

Even though the drug had a list price of about $2,700, the hospital that owned the cancer center billed Mrs. King’s insurance company $22,700. Her insurer paid $10,000, but the hospital wanted more.

She got a bill for over $2,500 — “more than half my take-home salary for a month,” said Mrs. King, 65.

She had unknowingly sought care from a hospital that participates in a federal program allowing it to buy drugs at a steep discount and charge patients and insurers a higher amount, keeping the difference.

The intention behind the program was for a small number of safety-net providers to have access to affordable drugs and be able to expand their care for needy patients. But instead, the program has exploded: Now, more than half of nonprofit hospitals in the United States take part. While some providers say it has helped keep their doors open, others — especially large nonprofit health systems — have been accused of maximizing payouts and swallowing the profits.

Advertisement

The program’s escalation has driven up health care costs for employers, patients and taxpayers, studies show.

In 2023, for instance, New York changed the way it administers drug benefits for Medicaid patients, in part because the state had discovered the cost of the federal program had increased by more than 200 percent over three years, said Amir Bassiri, the state’s Medicaid director.

“The numbers and the growth were staggering,” he said. “We all bear the cost.”

Along the way, one little-known middleman has been cashing in, The New York Times found.

The company, Apexus, has worked behind the scenes to supercharge the program, according to interviews with current and former employees and emails, internal reports and other documents.

Advertisement

Twenty years ago, the federal government chose Apexus to manage what was then a small program, negotiating with drug distributors and manufacturers to secure better prices and access to medications. But Apexus is allowed to collect a fee for almost every drug sold under the program, giving the company an incentive to help hospitals and clinics capture as many prescriptions as possible:

  • Its “purchasing optimization team” shows hospitals how they can make more money by buying different drugs.

  • A certification program and an Apexus-run “university” trains providers in boosting earnings.

  • Apexus employees give advice that broadly interprets the rules of the program so hospitals can claim additional patients and drugs.

Apexus was on track to double its revenue from 2018 to 2022, projecting $227 million that year, according to a 2022 internal memo written for the directors of Apexus’ parent corporation and reviewed by The Times. The company costs relatively little to operate and has enjoyed profit margins above 80 percent, according to that memo and three former employees.

In a statement, Apexus said it simply executed its government contract and did not contribute to the growth of the program, called the 340B Drug Pricing Program. “The drivers of growth are multifaceted,” the statement said.

But in the 2022 memo, the president of Apexus, Chris Hatwig, posed a question: “Are there other areas for program expansion within 340B that we are not thinking about?”

Government officials have told Apexus to focus solely on administering the program and not to influence drug purchases. But Apexus leaders have sometimes ignored that request, according to two complaints filed with a government watchdog and six current and former employees, speaking on the condition of anonymity because they feared professional or legal retribution.

Advertisement

In its statement, Apexus said it was “fully transparent” with the Department of Health and Human Services and had never breached its contractual obligations.

The Health Resources and Services Administration, an agency within H.H.S. that oversees the program, declined to answer detailed questions from The Times. But in a statement, a spokeswoman said the agency “conducts rigorous oversight of all contracts,” and “to our knowledge, Apexus has not violated” its contract. Regulators and leaders of the company meet frequently to discuss the company’s work and prevent conflicts of interest, the spokeswoman said.

The growth of 340B has drawn criticism for years from Congress, drugmakers and employers, who say it has added to ballooning health care costs. But the role of Apexus has largely gone unexamined.

“They’ve got a license to hunt,” said Marsha Simon, who as a staff member of a congressional committee helped write the bill that authorized the program.

Established in 1992, the 340B program essentially requires pharmaceutical manufacturers to offer discounts on outpatient drugs to hospitals and clinics that treat a greater share of low-income and uninsured patients.

Advertisement

The hospitals then can charge insurers and patients the standard price and keep the profits. Although the money is supposed to encourage care for impoverished patients, there are few rules to enforce that.

Patients rarely know they are part of this system. Their prescriptions can be counted as 340B when they get outpatient treatment at a hospital or clinic that qualifies for the program, regardless of the patients’ own income or insurance status. The provider can continue to make money off the patients’ future outpatient prescriptions, even if they get them somewhere else.

Apexus has had contracts to handle the program since the early 2000s. The government does not pay Apexus — instead, drugmakers and distributors pay the company a small percentage of sales.

Based in Irving, Texas, it is a subsidiary of Vizient, a private business owned by hospitals that negotiates a range of health care discounts. Apexus was established as a small nonprofit in 2007 but became a for-profit company in 2014.

Around the same time, 340B began to explode for a number of reasons. More hospitals qualified for the program after the Affordable Care Act expanded the number of people on Medicaid. Other health care systems qualified after acquiring hospitals and clinics in poor areas. Some, already eligible for 340B, bought up practices that used high-margin drugs, like oncology clinics. And a government rule change meant hospitals could make money from prescriptions filled at a greater number of pharmacies.

Advertisement

A decade ago, sales of 340B drugs were $12 billion. In 2023, they reached a high of $66 billion.

Fighting the program’s growth has become a top priority for drugmakers, as well as some employers and insurers.

In North Carolina, prescription drug spending for state employees jumped almost 50 percent from 2018 to 2022. A report in May from the state treasurer’s office found that 340B was partly to blame: Hospitals that participated in the program billed the state health plan far more than hospitals that did not — almost 85 percent more for certain cancer drugs. In one example, hospitals bought a drug commonly used to treat melanoma for an average of $8,000 but billed the state $21,512.

In some cases, costs are passed along to patients.

Mrs. King, the cancer patient in New Mexico, refused to pay her $2,500 bill, and the hospital, Christus St. Vincent, sent it to collections in July.

Advertisement

After The Times asked about the bill last month, a spokeswoman for Christus St. Vincent said the charge was “a misunderstanding and has been resolved,” adding that the drug program helped the hospital provide charity care and reinvest in cancer treatment and primary care.

Mrs. King switched to a free-standing oncology clinic that does not qualify for the federal drug program. That clinic billed her insurance $8,000 for the injection, about a third of what Christus St. Vincent had charged. Her responsibility was nothing.

Ms. Simon, who helped draft the legislation creating 340B, said the government chose an outside contractor like Apexus in order to negotiate with distributors and drugmakers on behalf of small hospitals and clinics without a lot of buying power.

But regulators and Apexus have expanded that role, allowing the company to build a highly profitable business off the program and the loosely written statute that authorized it. The company has been “aggressive” in helping health care facilities maximize their revenue from the program, said Shawn Gremminger, chief executive of the National Alliance of Healthcare Purchaser Coalitions, which represents employers who buy health insurance for more than 45 million people in the United States.

“This is a government contractor, and the goal of the government should not be, ‘How do we make more money for 340B providers?’” said Mr. Gremminger, whose organization has pushed for the program to be overhauled.

Advertisement

Over the past two decades, Apexus has adapted its business model to harness 340B’s tremendous growth. A 2022 PowerPoint presentation obtained by The Times showed that Apexus employees received bonuses if the company increased its revenue each year.

With exclusive access to sales data, Apexus’ “purchasing optimization team” will analyze a hospital system’s drug-buying habits and compare them with those of their competitors, according to four current and former employees. In some cases, Apexus will suggest that a hospital buy more 340B drugs or tweak its inventory in ways that can churn more cash.

Apexus declined to answer detailed questions about its optimization team, but said in a statement that the company “only provides technical assistance” in keeping with regulations.

Apexus also holds “340B University” events to help providers and others in the health care industry understand the program, and it fields questions through a national call center. But the rules governing the program are ambiguous, and Apexus offers broad interpretations, according to four current and former employees.

For instance, one of the thorniest issues is which patients can be claimed by hospitals for discounted drugs. The further a hospital casts its net, the more patients and drugs it can include under the program, and the more money it can make. Apexus has advised hospitals that they can mine records as far back as 36 months for eligible patients they may have missed, two of those employees said.

Advertisement

Similarly, Apexus employees have showed hospitals how to maximize the number of pharmacies they work with, boosting the number of prescriptions that can qualify for discounts, those employees said.

In its statement, Apexus said those examples were inaccurate but would not say how. It added that the company encouraged “conservative and responsible stewardship” of the 340B program, and that all information it provided was approved by regulators.

A spokeswoman for H.R.S.A. said it reviewed materials prepared by Apexus but declined to comment on that specific advice.

The company has developed other ventures that have brought in revenue:

  • About eight years ago, Apexus began selling a $750 course for people to become “certified experts” in 340B.

  • It started a business to give hospitals better access to specialty drugs — for conditions like cancer, H.I.V. and autoimmune diseases — which are major drivers of 340B’s growth. That company, Acentrus, helped hospitals and clinics provide data to manufacturers in exchange for deeper discounts and access to those drugs. It was sold last year.

  • The company charges 3 percent in fees for a line of generic drugs that are managed and provided by drug distributors, according to former employees. Apexus simply provides access to the health systems.

For the last decade, Apexus has earned millions of dollars on drug purchases made outside the 340B program: Because not all outpatient drugs qualify for 340B discounts, hospitals must stock their pharmacies with medication purchased through different channels. Apexus acts as a middleman, making fees off those transactions.

Advertisement

That has frustrated drugmakers and competitors. In 2021, the drug manufacturer Baxter wanted to sell non-340B drugs to hospitals without going through Apexus, according to emails obtained under public-records laws. But government regulators would not allow it, a spokeswoman for Baxter said.

In early November, Premier, the main competitor to Apexus’s parent company, Vizient, sued the federal government over these sales. The setup, the suit argued, forces hospitals to pay higher prices for those non-340B drugs and drives revenue to drug manufacturers and Apexus.

In its statement, Apexus said its federal contract did not preclude it from developing other businesses, as long as they were not in conflict with the terms of the agreement.

Regulators were aware of these ventures, the company said, noting that its specialty drug business, Acentrus, was in “no way associated with” the 340B program. The 2022 company memo, however, said Acentrus “resulted in an additional $20 million” in revenue within the 340B program.

H.R.S.A. declined to comment on the scope of its authority over Apexus and whether it knew about all the company’s revenue-generating arms.

Advertisement

About six years ago, Krista Pedley, then the director of the H.H.S. office in charge of 340B, reprimanded Apexus leaders in a Skype meeting, saying it was acting more like a sales-driven business than a program administrator. She reminded them that Apexus’ role was not to help 340B grow, according to five former or current employees familiar with the meeting.

For about a month afterward, regulators reviewed any communication Apexus had with health care facilities to make sure the company didn’t overstep, the employees said.

But that did not seem to dampen the company’s pursuits. (In an email, Ms. Pedley said she did not recall that meeting, and noted that her former office met regularly with Apexus.)

In 2021, an unnamed Apexus employee filed a complaint with H.H.S.’s Office of Inspector General, an internal watchdog, saying the company was “always trying to grow the program.” The company, the employee wrote, had hired “sales-type” staff to influence hospitals’ drug-purchasing decisions.

The complaint said that regulators did not understand Apexus’ business, and that employees had been told by company leaders to describe its work as “education.”

Advertisement

Another anonymous complaint, filed in 2022, echoed the allegation that Apexus had hired staff to help shape hospitals’ purchasing decisions, and said it was using “data in ways to drive revenue for itself, without asking (or asking and disregarding) the government’s opinion.”

Apexus declined to answer specific questions about the meeting with Ms. Pedley, but said The Times’s account was a “mischaracterization of our day-to-day, collaborative discussions” with the agency.

Apexus rejected the allegations in the anonymous complaints and said it had been unaware of them until The Times provided it with copies. The spokeswoman for H.R.S.A. said that it, too, had been unaware of the complaints.

In interviews, four current and former employees said that for years, Mr. Hatwig, Apexus’ president, acknowledged that regulators did not want the company to develop sales-focused arms of the business but encouraged his staff to do so anyway, saying that the government would not know.

Apexus denied that, saying that “everyone at Apexus understands the expectation that they conduct themselves and perform their work in an ethical and compliant manner.”

Advertisement

Julie Tate and Carson Kessler contributed research.

Continue Reading

Health

3 signs your aging loved one may be ready for assisted living

Published

on

3 signs your aging loved one may be ready for assisted living

Join Fox News for access to this content

Plus special access to select articles and other premium content with your account – free of charge.

By entering your email and pushing continue, you are agreeing to Fox News’ Terms of Use and Privacy Policy, which includes our Notice of Financial Incentive.

Please enter a valid email address.

Having trouble? Click here.

As Mom and Dad grow older, the big question might be looming in the background: When is the right time to provide living support?

Dr. Macie P. Smith, a licensed social worker and gerontologist based in South Carolina, shared with Fox News Digital that there may be a few telltale signs that it’s time to make a move, whether it’s hiring an at-home aide or seeking out a living facility.

Advertisement

1. They’re at risk of harming themselves

Most importantly, Smith noted that if a senior is at risk of hurting themselves or getting into dangerous situations, it’s most likely time to call in help.

DEMENTIA REPORT REVEALS ‘SHOCKING’ SIGNS AT AGE 60 THAT YOU’LL DEVELOP THE DISEASE BY AGE 80

Smith, who specializes in seniors living with Alzheimer’s disease and cognitive impairment, recommended starting with enlisting at-home aid before pulling a loved one out of their home.

Memory loss can cause dangerous environments and behaviors for aging adults, experts warn. (iStock)

“The last thing anybody wants to lose is their independence,” she said. “The last thing anybody wants is to live in a space with 50 other strangers.”

Advertisement

At-home support can help lower the risk of self-inflicted danger from incidents like leaving the stove on, or mobility issues that could lead to falls.

2. The person is having memory issues

As people age, their capacity to remember things begins to naturally slow down.

DEMENTIA RISK FOR PEOPLE 55 AND OLDER HAS DOUBLED, NEW STUDY FINDS

Sometimes, this presents in the form of diseases like Alzheimer’s or dementia. The severity of memory loss in seniors dictates whether living support is necessary, according to experts.

Smith mentioned how forgetting familiar tasks and activities, like eating, can pose a danger to someone’s health.

Advertisement
Grandmother and granddaughter together outdoors

“Respect them enough to have the conversation, because they still have the ability to make decisions about their life.” (iStock)

“If their nutrition is poor, it may be because they are dealing with some pain that they are not expressing to anyone else,” she said. “They may be dealing with some depression and, frankly, they just don’t have the motivation.”

“Respect them enough to have the conversation, because they still have the ability to make decisions about their life.”

The expert advised watching out for signs of spoiled food in the refrigerator. 

The person may also forget how to do simple tasks like making a bed, doing laundry, washing the dishes or following cooking instructions.

AGING ‘HOTSPOT’ FOUND IN BRAIN, RESEARCHERS SAY: ‘MAJOR CHANGES’

Advertisement

“If they’re having trouble cognitively, they’re having trouble making decisions, and that’s going to ultimately impact … how they live independently,” Smith said.

3. They repeat themselves

Repetition of thoughts is also common in individuals living with Alzheimer’s disease and dementia.

For more Health articles, visit www.foxnews.com/health

Smith noted that if your loved one is repeating themselves more frequently, it’s a good idea to bring in some support not only for help with day-to-day living, but also for attention and friendship.

senior father bonding with his son

The repetition of thoughts is common in individuals who suffer from Alzheimer’s disease and dementia. (iStock)

“In some cases, it’s because they’re lonely,” she said. “It’s because they’re living by themselves, and they don’t have any type of engagement or motivation.”

Advertisement

‘Very difficult’ decision

Smith emphasized how difficult it can be to make the decision to place a loved one into care, especially if it means removing them from their home.

The senior should “always be a part of the conversation” when it comes to deciding the next steps, she urged.

CLICK HERE TO SIGN UP FOR OUR HEALTH NEWSLETTER

“The last thing you want to do is come in and uproot them from the place where they feel the most comfortable and safe, just because you feel they shouldn’t be there,” Smith said. 

“Always include them in the conversation, even if they’re in the early stages of dementia,” she encouraged. “They still have a lucidity … to be able to participate in the decision-making process.”

Advertisement
Bonding moment of father and son embracing and giving emotional support

Taking away your loved one’s control and independence can cause issues, the expert warned. Instead, “we need to be there to support them and wrap services around them.” (iStock)

Whether the decision is to bring in care or move somewhere new, Smith said the senior should never be made to feel unsafe or unfamiliar, as this can increase dangerous behaviors, cause agitation and lead to health decline.

The conversation also should not start with the assumption that the senior will not accommodate your request or suggestion.

“Don’t assume they’re not going to remember,” Smith said. “Don’t assume they’re going to be irritable and combative.”

“Respect them enough to have the conversation, because they still have the ability to make decisions about their life.”

Advertisement
Continue Reading

Health

Cancer Remission Like Catherine’s Does Not Always Mean the Illness Is Cured

Published

on

Cancer Remission Like Catherine’s Does Not Always Mean the Illness Is Cured

Princess Catherine, wife of Prince William, reported on Tuesday that her cancer was in remission. But what does it mean to be in remission from cancer?

Doctors discovered her cancer unexpectedly last March when she had abdominal surgery. She has not revealed the type of cancer she has, nor how advanced it was when it was discovered.

But she did say she had chemotherapy, which she said had been completed in September. She told the British news agency PA Media that she had a port, a small device that is implanted under the skin and attached to a catheter that goes into a large vein. It allows medicines like chemotherapy drugs to be delivered directly to veins in the chest, avoiding needle sticks.

Catherine told PA Media that chemotherapy was “really tough.”

“It is a relief to now be in remission and I remain focused on recovery,” she wrote on Instagram.

Advertisement

Her announcement “certainly is good news and is reassuring,” said Dr. Kimmie Ng, associate chief of the division of gastrointestinal oncology at the Dana-Farber Cancer Institute in Boston.

But cancer experts like Dr. Ng say that the meaning of remission in a patient can vary.

In general, when doctors and patients talk about remission, they mean there is no evidence of cancer in blood tests or scans.

The problem is that a complete remission does not mean the cancer is gone. Even when a cancer is “cured” — defined as no evidence of cancer for five years — it may not be vanquished.

That makes life emotionally difficult for patients, who have to have frequent visits with oncologists for physical exams, blood tests and imaging.

Advertisement

“It’s really scary,” Dr. Ng said. “The amount of uncertainty is very very hard,” she added.

But that ongoing surveillance is necessary, despite the toll it takes on patients.

“Different cancers have different propensities of returning or not returning,” said Dr. Elena Ratner, a gynecologic oncologist at the Yale Cancer Center.

As many as 75 to 80 percent of ovarian cancers, she noted, can come back in an average of 14 to 16 months after a remission, depending on the stage the cancer had reached when it was found and on the cancer’s biology.

“Once the cancer returns, it becomes a chronic disease,” Dr. Ratner said. She tells her patients: “You will live with this cancer. You will be on and off chemotherapy for the rest of your life.”

Advertisement

Dr. Ratner’s gynecological cancer patients have to come back every three months for CT scans to keep an eye out for evidence that the cancer has returned.

“The women live CT scan to CT scan,” she said. “They say that for two and a half months, they have a wonderful life, but then, in time for the next CT scan, the fear returns.”

“It costs them — it costs them a lot,” she said.

“It’s awful, yet I am amazed every day by their strength,” she said of her patients.

Advertisement
Continue Reading
Advertisement

Trending