The shooters often acted during bouts of confusion, paranoia, delusion or aggression, common symptoms of dementia. The victims were spouses, children and caregivers. The takeaway was that healthcare providers they talked to said they received little or no guidance on how to talk to families about gun safety.

Most patients refuse to answer if they have guns at home and doctors rarely ask if the patient has guns at home. Healthcare professional are trying to figure out how to ask patients if they have guns at home.

Dr. Altaf Saadi, a neurologist at UCLA who has been practicing medicine for five years, said the investigation revealed a “blind spot” in her clinical practice. After reading it, she looked up the American Academy of Neurology’s advice on treating dementia patients. Its guidelines suggest doctors consider asking about “access to firearms or other weapons” during a safety screen, but they don’t say what to do if a patient says they do.

Research bears this out. A 2014 study found, 58 percent of internists surveyed reported never asking whether patients have guns at home.

Dr. Colleen Christmas, a geriatric primary care doctor at Johns Hopkins School of Medicine and member of the American Neurological Association told Kaiser, “One of the biggest mistakes that doctors make is not thinking about gun access. Firearms are the most common method of suicide among seniors, she noted. Christmas said she asks every incoming patient about access to firearms, in the same nonjudgmental tone that she asks about seat belts, and “I find the conversation goes quite smoothly.”

Momentum has been building among health professionals to take a greater role in preventing gun violence. In the wake of the Las Vegas shooting that left 58 concertgoers dead last October, over 1,300 health care providers publicly pledged to ask patients about gun ownership and gun safety when risk factors are present.

Volunteers with Alzheimer’s San Diego, a nonprofit group, became alarmed when they visited people with dementia and found 25 to 30 percent of those homes had guns, said Jessica Empeño, the group’s vice president.

“We made a decision as an organization not to send volunteers into the homes with weapons,” she said.

But, for health professionals, navigating this politically fraught issue can be difficult. Here are the leading issues according to Kaiser:

Is it legal to talk to patients about guns?

Yes. No state or federal law bars health professionals from raising the issue.

Why don’t doctors do it?

The top three reasons are lack of time, being unsure what to tell patients and believing patients won’t heed their advice about gun ownership or gun safety, one survey of family physicians found.

“There’s no medical or health professional school in the country that does an adequate job at training about firearms,” Wintemute argued. He said he is now working with the American Medical Association to design a continuing medical education course on the topic.

Polling conducted by the Kaiser Family Foundation for the story suggested that few Americans are concerned about the potential dangers of elders and firearms. Nearly half of people queried in a nationally representative poll in June said they had relatives over 65 who have guns. Of those, more than 80 percent said they were “not at all worried” about a gun-related accident.”

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A health care proxy is a way to eliminate confusion among your loved ones and health care providers about your health care wishes should you no longer b able t make those decsions yourself. Hospitals, doctors, and other medical providers must follow the agent’s decisions as if they were your own.

Here are a some common questions and answers about health care proxies:

Who can be your health care agent?

Anyone 18 years of age or older, including a family member or close friend can be your health care proxy.

A doctor can act either as your proxy or your attending doctor, but not as both simultaneously. A number of special rules apply to patients or residents of a nursing home, hospital, or mental health facility who want to name a staff member as an agent.

What powers do health care proxies have?

Your proxy can decide how your wishes apply as your medical condition changes, but he or she is legally obligated to always act in your best interest.

The person you select as your health care agent will have as little or as much authority as you want. You may allow your agent to make all health care decisions or only certain ones.

A health care proxy is different from a living will because it does not require that you know in advance all the decisions that may arise. Nevertheless, you may give your agent instructions that he or she must follow and specify on the form the treatments you do or do not want.

Also, note that you can continue to make health care decisions for yourself as long as you’re able. You can also cancel the authority given to your agent by informing him or her or your health care provider orally or in writing.

To appoint a health care proxy, you and your agent must sign a New York health care proxy form in the presence of two adult witnesses. This is best done in an attorney’s office like the Law Offices of Jeffrey Weinstein. Mr Weinstein is an estate professional and can guide you through what you need to do to insure your wishes are carried out.

Here are some instances when you would need a proxy:

• You are in a coma from an accident or illness.
• You are terminally ill and not expected to recover.
• You have Alzheimer’s or another form of dementia.
• You are under general anesthesia, when something unexpected occurs.
• You are in a persistent vegetative state.
• You suffered from an illness that left you unable to communicate.

Wherever the truth lies, what is happening to Aldrin is becoming more and more common and not just to the rich and famous. The exploitation of the elderly is growing and is vastly underreported.

Julie Schoen of the National Center on Elder Abuse told AARP, “It’s such a hidden crime. Within families, victims don’t want to prosecute. There’s a huge gap in our system when it comes to recording these crimes. We need better research. Ninety percent of perpetrators are family members or other people the victim knows well, such as caretakers, neighbors or friends.

Schoen suggests some ways to help protect you and your aged loved ones.

• When a person is still mentally sharp, help him or her make a plan that designates power of attorney and health care directives. “We tend to want to keep financial matters private, but if we don’t have those discussions, that’s what blows things apart.”
• Stay connected with older loved ones through regular phone calls, visits or emails.
• Develop a relationship with your parent’s caregiver. “They’ll be less likely to financially exploit Mother because they know you’re paying attention.”
• Become a “trusted contact” to monitor bank account and brokerage activity.
• Sign up for a service such as EverSafe to track financial activity and notify an advocate of unusual withdrawals or spending.
• Set up direct deposit for checks so others don’t have to cash them.
• Do not sign any documents that you don’t understand.

If you need legal help protecting an aging loved one, please call us here at the Law Offices Of Jeffrey Weinstein. (212) 693-3737.

Alzheimer’s is the most common form of dementia and affects more than 5 million Americans. People suffering from Alzheimer’s develop a buildup of two proteins that impair communications between nerve cells in the brain, plaques made of amyloid beta proteins and neurofibrillary tangles made of tau proteins.

Curiously, researchers were at a loss to explain why not all people with those signs of Alzheimer’s ever develop any cognitive decline. The question then became, what sets these people apart from those with the same plaques and tangles that develop dementia?

Giulio Taglialatela, director of the Mitchell Center for Neurodegenerative Diseases said

“In previous studies, we found that while the non-demented people with Alzheimer’s neuropathology had amyloid plaques and neurofibrillary tangles just like the demented people did, the toxic amyloid beta and tau proteins did not accumulate at synapses, the point of communication between nerve cells. When nerve cells can’t communicate because of the buildup of these toxic proteins that disrupt synapse, thought and memory become impaired. The next key question was then what makes the synapse of these resilient individuals capable of rejecting the dysfunctional binding of amyloid beta and tau?”

To answer this question, researchers used high-throughput electrophoresis and mass spectrometry to analyze the protein composition of synapses isolated from frozen brain tissue donated by people who had participated in brain aging studies and received annual neurological and neuropsychological evaluations during their lifetime. The participants were divided into three groups, those with Alzheimer’s dementia, those with Alzheimer’s brain features but no signs of dementia and those without any evidence of Alzheimer’s.

Results showed that resilient individuals had a unique synaptic protein signature that set them apart from both demented AD patients and normal subjects with no AD pathology. Taglialatela said this unique protein make-up may underscore the synaptic resistance to amyloid beta and tau, thus enabling these fortunate people to remain cognitively intact despite having Alzheimer’s-like pathologies.

Taglialatela sai they still didn’t understand the mechanisms responsible for this protection,” but “understanding such protective biological processes could reveal new targets for developing effective Alzheimer’s treatments.”

Research has found that dementia has various risk factors such as high blood pressure, lack of sleep and lack of physical exercise. Now research has found alcohol may play a role. A new study followed 9,000 people over a 23-year period to draw conclusions on the link between alcohol consumption and dementia risk.

The researchers assessed their alcohol consumption and potential dependence regularly using standard questionnaires and by looking at alcohol-related hospital admissions.

The combination of French and English reasearchers also examined hospital records for cases of dementia, as well as for any diagnoses of conditions, such as heart disease or diabetes.

In the UK anything over 14 standard U.K. alcohol units per week counted as heavy drinking. In the U.K., a standard glass of wine counts as 1 unit of alcohol, and 14 weekly units is the maximum threshold for what is considered harmful drinking.

In the U.S., the Dietary Guidelines for Americans recommend that men should not drink more than two drinks per day and women should not exceed one drink per day.

The average follow-up period for the study was 23 years. During that time, 397 people developed dementia. The researchers team took into account for various sociodemographic factors that may have influenced the results.

The study was published in the BMJ (Britsish Medical Journal) and in an editorial comment, Sevil Yasar, from the Johns Hopkins School of Medicine in Baltimore, MD, weighed in on the findings.

“[A]lcohol consumption of 1-14 units/week may benefit brain health; however, alcohol choices must take into account all associated risks, including liver disease and cancer.”

Everyone over age 18 should have a healthcare proxy. Situations that may require a proxy:

• You are in a coma from an accident or illness.
• You are terminally ill and not expected to recover.
• You have Alzheimer’s or another form of dementia.
• You are under general anesthesia, when something unexpected occurs.
• You are in a persistent vegetative state.

Appointing the right person to be your healthcare proxy can be difficult. Here are some steps to guide you:

Clarify your values and beliefs

Consider what’s important to you. What contributes to the quality of life you want? How do you want to spend your final years, weeks or days? What activities are essential to having a quality life? What role does your faith play in making these decisions?

Frame your medical wishes around these values and priorities. Determine which treatments you are willing to accept. Figure out which treatments you would never want. How much medical care are you willing to have to stay alive? What kind of medical risks are you willing to take? When would you want to shift from treatment to comfort care?

Have an honest conversation

Talk to family members and friends about what you want. During those conversations, look for someone who is most likely to represent your wishes.

Once you choose a proxy, continue to share your wishes, thoughts and opinions with that person. It’s impossible to predict every scenario that may present itself. But explaining your views will give your agent the information to make decisions on your behalf.

Discuss your wishes with providers

It’s important to share your wishes with your providers, particularly your primary care provider. This information will enable them to care for you in a manner that is consistent with your wishes. You should also let them know you have a healthcare proxy.

Once you have a healthcare proxy, complete the New York Health Care Proxy form. Instructions are available in several languages:

• English Fillable PDF with Instructions – Revised 11/2017
• Chinese (PDF)
• Spanish (PDF)
• Haitian Creole (PDF)
• Italian (PDF)
• Korean (PDF)
• Russian (PDF)

1. There are three different types of strokes: Ischemic, Hemorrhagic, and TIA (Transient Ischemic Attack). Ischemic occurs as a result of an obstruction within a blood vessel supplying blood to the brain. It accounts for 87 percent of all stroke cases. Hemorrhagic occurs when a weakened blood vessel ruptures. Two types of weakened blood vessels usually cause hemorrhagic stroke: aneurysms and arteriovenous malformations(AVMs). But the most common cause of hemorrhagic stroke is uncontrolled hypertension (high blood pressure). TIA is caused by a temporary clot. Often called a “mini stroke”, these warning strokes should be taken very seriously.
2. During a stroke, nearly 120 million brain cells die every hour. Compared with the normal rate of cell loss in brain aging, the brain ages 3.6 years each hour without treatment. The sooner the patient gets medical care, the better their chances of recovery.
3. About 66 percent of the time, someone other than the patient makes the decision to seek treatment – recognizing the warning signs and sudden symptoms of stroke to receive treatment fast, could help save a life.
4. F.A.S.T. is an acronym used to teach the most common warning signs and sudden symptoms of stroke. F.A.S.T. stands for (F) face drooping, (A) arm weakness, (S) speech difficulty, (T) time to call 9-1-1. Less than half of the population is aware of the signs.
5. Stroke symptoms can also include sudden numbness, sudden trouble seeing in one or both eyes, sudden severe headache with no known cause and sudden trouble walk
6. Calling 9-1-1 and arriving at the hospital in an ambulance is the fastest way to get treated quickly during a stroke emergency. Driving to the hospital is a common mistake people make, that can result in longer wait times before the patient receives medical care.
7. Patients who have an ischemic stroke, may have a treatment window for mechanical clot removal within six hours to up to 24 hours in certain patients with clots in large vessels.
8. Alteplase (also known as tPA) is a drug used to dissolve a blood clot that causes stroke. Stroke patients who arrive at a hospital within 90 minutes of symptom onset and qualify to receive tPA are almost 3 times more likely to recover with little or no disability.
9. Nearly half of all adults in the U.S. (an estimated 103 million) have high blood pressure.
10. High blood pressure is the most common controllable cause of stroke. Recent guidelines redefined high blood pressure as a reading of 130/80 mm Hg or higher. A normal reading would be any blood pressure below 120/80 mm Hg and above 90/60 mm Hg in an adult.

To read more about strokes please visit National Stroke Association

In the report called, “They Want Docile,” the group claims 179,000 residents of long-term nursing homes across the country are given anti-psychotic drugs each week that are not appropriate for their condition. They claim the drugs are used for their sedating side effects, which make patients with dementia and Alzheimer’s disease easier to manage.

Hannah Flamm, an NYU law school fellow at Human Rights Watch told the Guardian, “People with dementia are often sedated to make life easier for overworked nursing home staff, and the government does little to protect vulnerable residents from such abuse.”

The report is based on publicly available data and visits to 109 nursing facilities from October 2016 to March 2017 in California, Florida, Illinois, Kansas, New York and Texas. They also interviewed 323 people living in nursing homes, nursing facility staff and long-term care and disability experts.

An attorney for AARP, Kelly Bagby, which has been involved in several court cases challenging nursing home medication practices, told Fox News “given the dire consequences” of antipsychotics, the number of elderly people with dementia taking the drugs “should be zero.”