Dementia and voting

seniors%20vote

This seems like an apt article to share today, this 2016 election day in the US. It touches on an issues that isn’t discussed too often, even among people who dedicate their lives to understanding, preventing, and treating dementia.

Dementia and voting.

This article and video discuss Rob and Margaret and their process of navigating voting after Rob’s diagnosis of moderate Alzheimer’s disease 2 years ago. Read the full article and watch the video at:  https://www.statnews.com/2016/11/07/alzheimers-voting-dementia/

In practice, whether they cast a vote often gets left to the discretion of a caregiver. Many geriatricians and ethicists who study the issue say there’s one key question to determine whether someone with Alzheimer’s should vote: Can they express their choice? It doesn’t matter if they’re confused about what day it is. Or whether they can physically fill out the ballot. What matters is that they’re able to state, write, point at, or otherwise cogently indicate who they want to vote for. And for many people with dementia, especially in the early and middle stages of the disease, that’s entirely doable.

vote-wisely

I have mixed feelings on this. Of course, there is no cognitive testing for someone to be allowed to vote. There is no IQ testing. You have to be 18 and registered. This also includes people with developmental (and other) disabilities.

In general, I would agree with the above quote, that as long as they can express their preference, they should retain their right to vote. We may not always agree with people’s reasons, but if they can clearly express their decision, they should be encouraged to exercise it. What is especially touching in the story about Rob and Margaret, above, is that Rob had a lifelong, active interest in politics and seemed to understand the issues and his (perhaps formerly expressed) opinions on them when Margaret explained them. It really would be a disservice to take away his right to vote.

However, it gets trickier when the person has been declared legally incompetent, such as when someone else takes over managing the finances, and health and legal decisions. At this point, it is very reasonable to think that the person with dementia can no longer understand complex topics and use their reasoning skills to arrive at a decision which is based on cognitive thought. And I also think that by this point, the care partner will know that and not put the person with dementia in the stressful position of trying to navigate voting anyway.

Here’s what Alzheimer’s Society has to say:

Question: Can a person with dementia vote in the UK general and local elections.

Answer: Yes, a person with dementia can vote regardless of their capacity.

It is clearly stated in the Electoral Commission’s guidance for Electoral Registration Officers that mental health conditions do not constitute a legal incapacity to vote, so a person would not be stopped from voting at the polling station.

However, it is important to note that the guidelines also state that the decision as to whether and how to vote at an election must be made by the elector themselves, and not by a carer or a person making decisions on behalf of the elector.

I also found a 2011 research article which looked at the capacity to vote in older adults and people with dementia. They conducted their research with people diagnosed with dementia and people of the same age with no presence of dementia. Categories they rated were:  understanding of the nature of the vote, understanding of the effect of the vote, vote choice, comparative reasoning, consequential reasoning, and appreciation. They found:

We observe that patients with dementia understand the nature and eect of the vote (53% and 44%, respectively), and appreciate its consequences (66.2%) but do not do as well when it is time to make a voting choice (25%) and to consequential reasoning (35.3%)…The criteria of understanding and appreciation are easier for the patients, but not those of vote choice and reasoning. Cognitive deterioration, but not age, influences the capacity to vote.

What are your thoughts on this issue? Please share them in the comments!

 

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eHealth: Combining Psychology, Technology and Health

Guess who has been browsing online courses to join 🙂

Source: eHealth: Combining Psychology, Technology and Health (FutureLearn) | MOOC List

Free webinar on advanced Alzheimer’s

From the Alzheimer’s Prevention Registry. They are offering a free webinar on advanced Alzheimer’s disease.

We call the final phase of Alzheimer’s the “advanced” stage of the disease. By this point, someone with Alzheimer’s has become completely dependent on others to care for them. This is also the hardest time for many caregivers.

Free Webinar: Advanced Alzheimer’s – Sign up to join the live webinar OR view recording at your convenience!

Join this Dementia Dialogue webinar via computer to learn the nuances of advanced Alzheimer’s and about powerful tools you can use to ensure comfort.

For those who prefer to join by phone, we also offer an audio version of the Dementia Dialogues. Sign up here or email bannerresearch@bannerhealth.com for details.

  • Wednesday, October 19, 3-4 PM Eastern (12-1 PM Pacific, 1-2 PM Mountain, 2-3 PM Central)
  • Sign up now

In order to receive the link to the recorded webinar, you should follow the registration process in the same way you would as if you were planning to attend the live webinar. Everybody who registers, whether or not they attend, will receive a link to the recorded version after the event on the 19th. Please disregard reminders to join the live webinar if you cannot attend.

Dementia: investing against the trillion dollar disease

research*eu results features highlights from the most exciting EU-funded research and development projects. It is published 10 times per year in English. The August/September 2016 issue is a special feature on ‘Dementia: investing against the trillion dollar disease’.

research*eu results magazine - August 2016/September 2016

Issue 55 – August 2016/September 2016

Interviews:

  • Julie Wadoux of AGE Platform Europe in Belgium on ‘Stakeholders join forces to create age-friendly environments across Europe’
  • Hubert Martens of Medtronic in the Netherlands on ‘Brain pacemakers without side effects’
  • Dr. Mark Isalan of Imperial College London in the United Kingdom on ‘The long sought cure to Huntington’s disease’

Other highlights:

  • Chest pain treatment offers hope for the fight against neglected fungal diseases
  • What knowledge societies can learn from foraging societies
  • Disrupting the solar energy status quo
  • A deeper understanding about the causes of sea-level rise
  • New interactive app encourages users to adopt healthier lifestyles
  • EU Scientists use silver to make lights shine more brightly
  • New tools and methods to protect Europe’s Critical Infrastructure
  • Innovative stacking technique results in highly detailed images of Mars

 

You can download it for free here:  http://bookshop.europa.eu/en/research-eu-results-magazine-pbZZAC16007/;pgid=GSPefJMEtXBSR0dT6jbGakZD0000VCTF9fYd;sid=a9NobXoofeZodS3fMVj2yhgNyRAUPX37bQA=?CatalogCategoryID=Yriep2Ix6ucAAAEvxusQ_v3E

And check out other issues from research*eu results here:  http://cordis.europa.eu/research-eu/magazine_en.html

Digital Health Care Design: Coursework for Innovative Solutions for Aging Populations

I am participating in an massive online open course (MOOC) from the University of Copenhagen and Copenhagen Business School on the topic of Innovating Solutions for Aging Populations.

The free course is offered through Coursera; it started June 6th and runs until July 17th. You can read more about the course and sign up for future offerings at: https://www.coursera.org/learn/health-care-innovation

Week 5:  Digital Health Care Design

In this final module you will be introduced to digital design methods and how to explore the solution and the problem during the innovation process. You will learn how to frame the design problem through field studies and collaboration, and how to apply prototypes in your work.

This week’s lectures focused on digital design and how it plays a role in the innovation process. How to identify a (design) problem, how to explore the problem through studying and collaborating with others (including stakeholders), and analyze and reframe design problems into a useful product or service.

If we look at the My Day case example from Steno Diabetes Center, the overall purpose is to develop an e-health solution that supports people with diabetes in maintaining a diet that is healthy for their condition by mobilizing Steno’s specialist knowledge within the field. At first, the problem may appear as very clear. People with diabetes need help with managing their diet. But once you start looking into it, the roots of the problem are more complex. Why is it that many people with diabetes struggle with their diet? Is it because they don’t know what is healthy for them? Is it because they get tempted? Or forget about healthy diets when they eat? Or there is something completely different at stake. 

Participatory design (involving stakeholders in the design process), ethnographic studies (how will the innovation be perceived, used, and beneficial to populations), and re-framing the design problem are useful tools for innovating health care technology design.

There are also different design techniques which can be used to develop and test the eHealth prototype. First, a paper mock-up is used to outline and describe the eHealth innovation. Second, a fully functional software prototype is developed where the interface (how the user interacts with the technology) is made to look and feel like the final product. These allow for sketching out the initial design and consulting with others, usually leading to some changes in the design and improving the initial idea. The functional prototype allows for demonstrations and testing – where users can interact with the product/service and provide feedback on various aspects (usability, look and feel, functionality, etc.). These two types of prototyping are tools used to create the design and to test the design.

Quiz

Q1. Different types of prototypes can be distinguished by their resolution (the level of detail by which they represent the final design) and their technical fidelity (how closely the prototype technically resembles the final product). In relation to this framework, what is a mock-up prototype and what is the purpose?

 A1. A simple (low resolution and low fidelity) prototype made out of e.g. paper and cardboard to visualize a concept and facilitate discussion between users and designers

Q2. Different types of prototypes are typically used at different stages in a digital project to serve different purposes. When and why is a high resolution and high fidelity prototype typically used?

A2. Towards the end of the project to evaluate the outcome of the design process, e.g. through a field study or a usability test

Q3. What is a wireframe prototype?

A3. A visual model, for instance developed using an IT tool, mainly used to communicate, but also to run initial tests of a design

Q4. Why is problematization important in a digital design process?

A4. To ensure that the project solves a relevant problem and to ensure sustained interest among the stakeholders of the project

Q5. When does problematization ideally take place in digital design?

A5. Mainly in the early phases but in principle throughout the project, to ensure that new insights into the problem produced by the project will be taken into account

Q6. Which method is particularly useful in a problematization process?

A6. Ethnographic studies of the actual problem settings to observe how the problems unfold in practice, and workshops, where the problems are discussed thoroughly with stakeholders of the project

The Business Case: Coursework for Innovative Solutions for Aging Populations

I am participating in an massive online open course (MOOC) from the University of Copenhagen and Copenhagen Business School on the topic of Innovating Solutions for Aging Populations.

The free course is offered through Coursera; it started June 6th and runs until July 17th. You can read more about the course and sign up for future offerings at: https://www.coursera.org/learn/health-care-innovation

Week 4:  The Business Case

Continue reading

Rehabilitation: Coursework for Innovative Solutions for Aging Populations

I am participating in an massive online open course (MOOC) from the University of Copenhagen and Copenhagen Business School on the topic of Innovating Solutions for Aging Populations.

The free course is offered through Coursera; it started June 6th and runs until July 17th. You can read more about the course and sign up for future offerings at: https://www.coursera.org/learn/health-care-innovation

Week 3:  Rehabilitation Continue reading

Diabetes: Coursework for Innovative Solutions for Aging Populations

I am participating in an massive online open course (MOOC) from the University of Copenhagen and Copenhagen Business School on the topic of Innovating Solutions for Aging Populations.

The free course is offered through Coursera; it started June 6th and runs until July 17th. You can read more about the course and sign up for future offerings at: https://www.coursera.org/learn/health-care-innovation

Week 1 included short introduction videos covering the growth in life expectancy, reductions in childhood mortality rates, and the shift from healthcare focusing on infectious diseases to focusing on chronic and noncommunicable diseases.

Week 2:  Diabetes

In this module you will be presented with the physiology, complications, prevention and treatment of diabetes. Also, you will be introduced to self-management tools designed to help people with diabetes choose healthy meal plans.

Lecture 1:  Diabetes/metabolism

This week’s video lectures focused on a brief introduction to diabetes (what it is, how many people have it, what can cause it, and tools to manage and treat diabetes), and a strong focus on using diet as a self-management tool. They report that a healthy lifestyle (including exercise and healthy eating with at least 30% of meals consisting of vegetables) has a higher success rate than using medications alone. They also reported that cancer medications and diabetes medications are the two most sold drugs worldwide (big pharma makes BIG money!!)

highest selling drugs worldwide

Quiz

Q1. Which physiological mechanism is impaired when insulin sensitivity is reduced in type 2 diabetes? 

A1. The insulin-stimulated glucose uptake, primarily by muscle cells

Q2. Based on the lecture, which of these persons have the highest risk of developing insulin resistance?

A2. Both John’s parents have type 2 diabetes, John is obese and doesn’t exercise much

Q3. How should type 2 diabetes be prevented?

A3. By early identification and by changing lifestyle

 

Lecture 2:  Diet self-management

The lectures also talked about tools (two apps for smart phones) called My Plate and My Day. These seem to still be under development, but focus on helping people to track their daily habits, especially around eating and nutrition and living an active lifestyle.

Quiz

Q1. What is hard for Eva in relation to her treatment?

A1. Accepting her diabetes

Q2. What does self-management mean in relation to diabetes?

A2. Taking responsibility for managing the treatment

Q3. What is the purpose of the “plate models”?

A3. The T-shaped plate model to loose weight. The Y-shaped plate to maintain weight

Q4. Which macronutrients provide humans with energy?

A4. Carbohydrates, fat, protein and alcohol

Q5. What affect does fat have on blood glucose levels?

A5. High fat foods can delay a rise in blood glucose level

Q6. What macronutrient have highest impact on blood glucose?

A6. Carbohydrate

Course Review! Innovating Solutions for Aging Populations

Currently, I am participating in an massive online open course (MOOC) from the University of Copenhagen and Copenhagen Business School on the topic of Innovating Solutions for Aging Populations.

The free course is offered through Coursera; it started June 6th and runs until July 17th. You can read more about the course and sign up for future offerings at: https://www.coursera.org/learn/health-care-innovation

This course will introduce you to health care innovation within the theme of ‘healthy living and active aging’, covering both the medical and the commercial aspects of innovations. Following two cases on diabetes and rehabilitation, this interdisciplinary course will present the key theories, tools, and concepts within health care innovation, and teach you to analyse and develop solutions to some of the great health care challenges of our time. This master-level online course is created by leading experts from Denmark and the Netherlands and is directed at students and practitioners from different fields, including public health and business economics. This course is supported by the European Institute of Innovation and Technology (EIT Health).

EIT Health develops talents, drives innovative business ideas forward and boosts the global competitiveness of European industry through three key programmes that will offer a vibrant ecosystem for future entrepreneurs, academics and businesses.

Sometimes, I get a bit too excited about taking online courses. I like to watch the videos on the weekends or in the evenings during my yoga time. I think I have completed over 25 courses in the past 18 months, which actually adds up to quite a bit of time commitment. But, I really do love learning and the variety of topics offered on Coursera and edX really makes it interesting. Anyway, as I was wrapping up the Re-thinking Ageing course last week (read my posts about the course here), of course I decided to sign up for 4 more courses 😛

I am particularly interested in this course on Innovating Solutions because of the content (being a specialist in gerontechnology – technologies for and to benefit aging adults – and having an entrepreneurial spirit) and because it is hosted by the University of Copenhagen and Copenhagen Business School – both some 15 minutes by bike away from my home. I am hoping not only to brush up on what is happening in the field and future opportunities and trends, but also to make some connections in Copenhagen where I could hopefully take my work in this field further.

I will be making weekly posts about the course content, and hope that it gets you thinking, inspired, and even excited enough to share your thoughts in the comments!

Week 2:  Diabetes

Week 3:  Rehabilitation

Week 4:  The Business Case

Week 5:  Digital Health Care Design

Ageing well: Coursework for Re-thinking aging

Currently, I am participating in an massive online open course (MOOC) from the University of Melbourne on the topic of Re-thinking aging:  are we prepared to live longer?

The free course is offered through Coursera; it started the last week in April and runs for 5 weeks. You can read more about the course and sign up for future offerings at: https://www.coursera.org/learn/ageing/home/welcome

We were encouraged to keep a journal or blog about our journey through the course, particularly to note where our opinions and ideas have changed from the beginning of the course to the end. I thought this would be a great opportunity to share the course information and my opinions with you – a little something different than my usual posts 🙂 As such, this will be a work in progress over the next 5 weeks. Continue reading

How Climate Change Affects the Health of Older Adults

Climate change and its consequences are an impending reality, ones that have both socio-emotional and physical effects on older adults. Our lives, livelihoods and health are intrinsically tied to that of the planet, so it is crucial to look at how we can improve resilience to climate change, especially in vulnerable populations like the elderly. Not all older people are the same as they react differently to the effects of climate change. However, there are a few trends that have been sighted to have a disproportional effect on older adults.

Read the full article on Global Health Aginghttps://globalhealthaging.org/2016/03/10/how-climate-change-affects-the-health-of-older-adults/

Good and Bad Foods for Your Brain

22 Best & Worst Foods for Your Brain

From tea to tuna, take a look at 22 of the best and worst foods to feed your brain.

Flip through the slideshow and read the full article on MSN.comhttp://www.msn.com/en-us/health/nutrition/22-best-and-worst-foods-for-your-brain/ss-BBr20Wc?ocid=spartanntp#image=1

Economics of ageing: Coursework for Re-thinking aging

Currently, I am participating in an massive online open course (MOOC) from the University of Melbourne on the topic of Re-thinking aging:  are we prepared to live longer?

The free course is offered through Coursera; it started the last week in April and runs for 5 weeks. You can read more about the course and sign up for future offerings at: https://www.coursera.org/learn/ageing/home/welcome

We were encouraged to keep a journal or blog about our journey through the course, particularly to note where our opinions and ideas have changed from the beginning of the course to the end. I thought this would be a great opportunity to share the course information and my opinions with you – a little something different than my usual posts 🙂 As such, this will be a work in progress over the next 5 weeks. Continue reading

Differentiating dementia, delirium and depression

Nursing Times Learning has launched a new unit on how to tell the difference between dementia, delirium and depression in older people, to ensure they receive the right care.

Dementia, delirium and depression are all serious conditions that are particularly common in older people. Their similar symptoms mean the conditions can go undetected and untreated. However, although they may present in similar ways, there are differences in the treatment and support approaches used for each. It is vital that health and care professionals can identify key risks, signs and symptoms associated with all three conditions so that appropriate support, treatment and management can be given.

Read the full article with symptoms, causes, treatments and a quiz to test how well you can differentiate at:  http://www.nursingtimes.net/roles/mental-health-nurses/differentiating-dementia-delirium-and-depression/5084104.fullarticle