The Best of…Seniors Turn to Acupuncture to Treat Age-Related Illness

Published April 30, 2001, Pawtucket Times

            New lifestyle changes are taking hold of age 50-plus seniors.  Many are dropping junk foods, soft drinks, and coffee from their daily diets in favor of following microbiotic recipes, buying only organically grown foods and drinking spring water.

             A growing number of older Rhode Islanders are also combining visits to their personal physicians with nonconventional healing practices, from chiropractic care to Chinese medicine, herbs, homeopathy, acupuncture, biofeedback, message, and reflexology.

            This trend is reflected as far back as 1993 when a study published by the New England Journal of Medicine noted that about 34 percent of 1,539 people surveyed used one alternative therapy in the past year, one-third had even seen an alternative therapy provider.

And Speaking of Acupuncture…

           Acupuncture stands out as a uniquely effective treatment modality for ailments effecting older persons.

          Acupuncture needs stimulate specific acupuncture points lying on identified meridians or pathways for energy or Qi (pronounced “chee”) that are located on the head, body or ears.

          Stimulation is accomplished by inserting and then manipulating very think sterile single-use needles.  This alternative therapy can also include heat, electro-stimulation, low intensity lasers or magnets, each applied to selected acupuncture points.

         According to Nancy Emerson Lombardo, Ph.D., senior research scientist at Wellesley College Center for Research and Women, acupuncture treats the whole body rather than its isolated symptoms and may be particularly useful for a disease caused by the aging process, such as Alzheimer’s disease.

         Dr. Emerson Lombardo states that her study, the first of its kind in the nation, found that acupuncture is definitely feasible for American elderly with Alzheimer’s disease and vascular dementia.

         Moreover, acupuncture relieves symptoms of anxiety and depression in most of the patients in her study.  Succesful relief of severe anxiety and depression in four study participants also improved cognitive functioning in three of the four.

         Various research studies reveal just how acupuncture works, Emerson Lombardo said, noting that researchers have found that acupuncture can: release certain neurotransmitters and hormones (including endorphins, which relieve pain and elevate mood).

          Acupuncture can also increase blood circulation, release substances known to reduce inflammation in tissues, and/or boost the immune system.

          Furthermore, the internationally recognized Wellesley College researcher added that “acupuncture has proven effective for many mental and physical complaints afflicting the elderly.”

         These include pain and arthritis; stroke; headaches and back aches; inflammations; insomnia; allergies and asthma, nausea and constipation; and postoperative pain.

         “Acupuncture is as effective as conventional drugs and has fewer side-effects for improving emotions, and helping with symptoms of anxiety, sleep disturbance, and irritability,” Dr. Emerson Lombardo said.

          In treating major depression, acupuncture has shown improvement rates comparable to those of psychotherapy or pharmacotherapy, she adds.

         Dr. Emerson Lombardo stated that acupuncture therapy should be considered a safe treatment.

          The unconventional medical treatment has been approved and is recognized as a safe and effective therapy for treating various conditions by both the World Health Organization, the U.S. Federal Drug Administration and the National Institute of Health.

Finding the Best Acupuncturist

           When shopping around for the best acupuncturist, Dr. Emerson Lombardo suggested that seniors should interview the acupuncturist briefly on the telephone, requesting information about training, licensing, and experience in treating the particular ailment(s).

          Call the American Association of Oriental Medicine (AAOM) at (888) 500-7999 or (610) 266-1433 to obtain a list of local licensed acupuncturists who have had an average of 2,400 hours of study.  Or get this list from AAOM’s web site, (www.aaom.org).

           Herb Weiss is a Pawtucket-based freelance writer that covers aging, health care and medical issues.  This article appears in the April 30, 2001 issue of the Pawtucket Times.

The Best of…Little Things Count When Deciding on a Nursing Home

Published April 23, 2001, Pawtucket Times          

           It isn’t easy operating a nursing facility these days.

           The high turn over rate of certified nursing assistants has drastically impacted the quality of care provided in facilities.  And this direct care staffing shortage is also financially hurting facilities too, reducing their financial stability, even pushing many towards bankruptcy.

          According to the Rhode Island Health Care Association, eight out of the state’s 105 nursing homes have filed for Chapter 11 Bankruptcy, two are currently in state receivership and two more were recently ordered closed by the Department of Health.

         In these difficult financial times for nursing facilities, especially with a state-wide shortage of certified nursing assistants, youmusts become a better shopper when seeking the most appropriate nursing facility to place your loved one.

       “Until there is a health crisis, families don’t often think about nursing facility care until it’s too late,” states Roberta Hawkins, executive director of the Alliance for Better Long Term Care who serves as the state’s ombudsman on the behalf of 10,000 Rhode Island nursing home residents.  “If  it’s possibly, just plan ahead,” Hawkins recommends.

      “Your state health department provides a comprehensive list of nursing homes and their survey results to help you determine if the facility is reputable,” states Hawkins.

       According to Hawkins, word of mouth or personal recommendations from family, friends, neighbors, hospital discharge planners, and her nonprofit advocacy group about a nursing home’s care are key bits of information to determine if the facility is well managed.

        “The Alliance also offers a free phone help line to assist matching the particular needs of a person with a specific facility,”  Hawkins adds.

       With more than 20 years of experience under her belt in assisting families find the right nursing facility for the loved ones, Hawkins gives simple tips on selecting a facility.

        Hawkins suggested that a need for upgraded services for residents requiring intensive medical care, special rehabilitation therapies and dietary requirements, along with religious and cultural needs should also be taken into account before selecting a facility.

       Location should not always be a deciding factor in selecting a nursing facility.  Carefully choose a facility that meets your loved ones medical, personality and social needs.

       In many cases, this critical decision is made only for convenience of family members or visitors.  If an elderly spouse can not drive, make sure that the selected facility is on a bus line.  Keeping a married couple close together is very important for their psychological well-being.

       Always have the older person in need of skilled nursing care, actively participate in choosing a facility even if they can’t physically visit the site.  Family members can also provide this person with brochures and admission materials.

      Don’t choose a facility on the basis of a beautiful physical exterior, fancy rugs, or glittering chandeliers, Hawkins says.  When visiting a nursing facility, always observe how staff members interact with residents and each other — look for laughter, a pleasant environment, and a strong activity program.

       For those frail residents who are bed bound, look for a stable nursing staff.

       Ask yourself, is the facility’s environment cheerful in appearance and clean?

        Are the bedrooms warm looking and do they reflect the residents individuality?  Or do they all look the same, like hotel rooms.

        Find out if residents are allowed to bring in personal belongings such as chairs, tables, lamps or even a television set into their rooms.

        For those persons who always loved nature and being outdoors, find out if the nursing facility has an outside area for sitting or walking.  Determine if this area is accessible to a wheelchair bound person who might want to roll outside to listen to the birds.  This simple amenity is very important.

        When touring a facility determine if a dining room is available for eating meals and space to allow residents to socialize with each other and participate in activities.

         Is there a real working activities room?  A resident who has always been involved in crafts and enjoys participating in group activities will want to select a facility with a well-run activities program.

         Also, be aware of how the nursing facility smells.  Sometimes you may smell strong odors of deodorants.  This might be covering up unpleasant odors.

        Listen for sounds of buzzers, rung by residents in need of help, and observe how quickly staff responds.

         When walking the halls, say “hello” to the staff you meet.  Do the staff pleasantly respond to you?  IF not, consider that they may not respond           well to your loved one.

         Walk in and talk with residents gathered in a community room.  In conversation, find out how long they have lived at the facility.  Ask if they like the facility and are they respected as individuals by staff.

         If you see residents in restraints lying or sleeping in a chair or wheelchair, this may be a red flag for poor care.  The facility may not have enough staff to allow the residents to lay down in bed for a nap in the afternoon.

         After you locate your facility, “put your name on the waiting list,” Hawkins recommends, even if the nursing facility admissions will occur months later.

         For those afflicted with Alzheimer’s and related dementia, it is wise for these individuals to be admitted earlier in the disease process to get them acclimated to the facility and for the staff to learn more about the resident’s habits, likes and dislikes.

        Herb Weiss is a Pawtucket-based freelance writer covering aging, health care and medical issues.  This Column appeared in the Pawtucket Times on April 23, 2001.

The Best of…New Strategies are Needed to Work with Hispanic Seniors

Published April 16, 2001, Pawtucket Times 

           As expected, the U.S. Census Bureau’s 2000 census data reveals that the United States of America has truly become a “tossed salad” of races and ethnic groups.Rhode Island’s growing minority population reflects this national trend.  Minority groups represent about 25 percent of the state’s total population.  In Providence, minority groups are now in the majority.

            The Hispanic population in Rhode Island, now representing 8.7 percent of the state’s total population, has doubled in the past ten years, climbing from 45,752 in the 1990 census to 90,820 in the latest census figures.  Eighty percent of this increase has occurred in Providence, Pawtucket and Central Falls.

            Aging service providers will need to adopt new strategies and ways to enhance access to programs and services to a growing Hispanic senior population.     

            Census data does not always give us an accurate demographic snap shot of the nation’s population, warned Edgar E. Rivas, Vice President for Policy at the National Hispanic Council on Aging.  “We really don’t know how many Latino elders are out there because of the potential undercount of immigrant Latino elders,” he stated.            

            Oftentimes, Hispanic families are not accurately reflected in census data because of their own distrust of the U.S. Census Bureau, Rivas told The Times.  . “Even those aging service providers who have a knowledge base of serving this population will have a very hard time if the undercounted seniors come out of the wood work,” he said.

            “Aging service providers will have to relearn how to conduct culturally appropriate outreach and to provide services in ways that are comfortable to their Hispanic clients,” Rivas added.  To often Latino elders may be eligible for services but because of the way the services are delivered, they don’t feel welcome to the services, he noted, ultimately the choose to rely on informal caregivers or just go without services.

            According to Rivas, informational materials about programs and services will have to be rewritten to reflect the specific needs of older Hispanics.  For instance, the Health Care Finance Administration offers bilingual materials to explain federal programs, like Medicare and Medicaid.  Even with this material written in Spanish, many aging Hispanic elders are intimidated by the way the information is presented.  This problem can easily be corrected if Hispanic aging advocates develop more user-friendly materials (e.g., using Spanish language videos, peer educators or literature using pictures to illustrate issues).

              Ann Hill, former director of the Providence-based Saint Martin de Porres Senior Center and well-known aging advocate, states that with a more ethnically diverse population, nonprofit agencies must hire personnel that can reach out, understand and meet the needs of various ethnic groups.  She calls for more public dollars to be provided to the agencies to help them accomplish this goal.

             ,Joan Crawley, Senior Center Director at the Leon Mathieu Senior Center, agrees.   With interpreters who speak Spanish and Cape Verdian Creole at Pawtucket’s senior center, non-English speaking CapeVerdian and Hispanic seniors can now come in to see a primary care physician, with a social worker on hand to interpret their medical complaints and to explain treatment plans.  The social work is also available to case manage any of the other social service needs that the Hispanic or CapeVerdian client may have.

             “We’re always trying to increase the trust level between our staff and the ethnic seniors who come to our senior center,”Crawley added, noting that she wants them to feel comfortable bringing their problems to her staff.  

             Susan Sweet, Chairperson of the Rhode Island Elder Minority Task Force and a consultant for minority and nonprofit agencies, commented that she applauds “the efforts of agencies serving elders to diversity their staff and services to serve all the elders in their communities.  However, it is extremely important to acknowledge, support, and strengthen those agencies that have been and continue to be the basic resource for minority elders, such as Progreso Latino, Cape Verdian Community Development Association (CACD), and Projecto Esperanza, to name a few in the Pawtucket/Central Falls area.”

             “No longer can we do business as in the past.  We must update our strategies of delivering programs and service to meet the new century of diversity,” Sweet said. 

             Herb Weiss covers health, medical care and aging issues.  This article appeared in The Pawtucket Times in April 16, 2001.  He can be reached at hweissri@aol.com.