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Caregiver Burden

It was a straightforward phone message (names changed): “Hey Dr. S., this is Bobbie Jones, April Dixon’s granddaughter. I was calling to inform you that April passed away today at City Hospital. They said she was bleeding in her stomach or something. I’m not quite what sure what happened, but she got real sick. But she’s gone, so, thanks so much. You’ve been a real neat doctor, and it’s been good working with you through the years taking care of my grandmother. Take care. Bye.”

Bobbie Jones is a saint. Pure and simple. She took care of her 88-year-old grandmother with tender, loving care. I am certain if left to the vagaries of the “healthcare system” that her grandmother would have died at least three years ago, maybe earlier.

Ms. Jones will get no recognition. No income. No honors, save this blog post which she’ll never see. She will get a letter from me, expressing my condolences and appreciation for the love and care that she provided her grandma. She singlehandedly advocated for an octogenarian with advanced dementia and probable cancer (we were never able to get a definitive diagnosis of it) and gave her a quality of life that I would want were I in her grandma’s shoes. Read more »

*This blog post was originally published at ACP Internist*

Feeding Tubes In The Elderly Demented?

An article in [last] week’s New York Times entitled Feeding Demented Patients with Dignity suggests that hand feeding dementia patients may be a better option than tube feeding them.

My God, are we really putting feeding tubes in the elderly demented? When did this happen?

During college, I worked as a nurses aide in a nursing home outside Philadelphia. For 20 hours a week (40 hours in the summer) for two years, I cared for patients in all stages of dementia, from the walking confused through to the end stage, stiffened victims confined to wheelchairs or beds. But in all that time, I never, ever saw anyone with a feeding tube. Read more »

*This blog post was originally published at The Blog that Ate Manhattan*

Dr. Val Tells ABC News How To Stave Off Memory Loss

Did you know that physical activity can reduce your risk for memory loss and dementia? I had the chance to speak to ABC’s Let’s Talk Live team about important lifestyle choices that can keep the mind healthy and active. The good news is that you really can teach an old dog new tricks, and those new tricks can stimulate growth of new brain cells. Watch the video and check out the Alzheimer’s Association website for more information about dementia prevention:

New Research On Alzheimer’s Disease

Data presented at the International Conference on Alzheimer’s Disease in Honolulu this week indicated that exercise and adequate vitamin D levels could help reduce risk for the disorder. Framingham Heart Study researchers found that risk for dementia was halved in “moderate to heavy exercisers” compared with more sedentary people, while researchers on a separate study found that vitamin D deficiency can greatly increase risk for mental impairment.

Another study found that injecting the compound florbetapir into the brain of patients with dementia and then performing a PET scan could help pinpoint the size and location of plaques.

Researchers also reported that tea consumption was linked to a slower rate of cognitive decline in older adults without cognitive impairment, but there was no dose response and more studies will need to be done to determine a definitive link. (CBS News, Wall Street Journal, Medscape)

*This blog post was originally published at ACP Internist*

Personalized Medicine: A Bait And Switch

Mark Hyman, a proponent of so-called “functional medicine” promoting himself over at the Huffington Post (an online news source that essentially allows dubious medical infomercials to pass as news) has posted a particularly egregious article on personalized medicine for dementia.

In the article Hyman distorts the modern practice of medicine, the current state of genetic science, and the very notion of “disease.” It is, as usual, a fine piece of medical propaganda sure to confuse many a reader. Hyman starts with some standard epidemiology of dementia –- it’s a common and growing disorder –- but then descends quickly into distortion and pseudoscience. Read more »

*This blog post was originally published at Science-Based Medicine*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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