Tuesday, February 21, 2017
One of my friends has had a number of ministrokes. As we sat down for lunch he told us that the previous problems, which we had attributed to mixing medication and booze, was in fact due to a miinistroke. He said the Doctor told him that he had a mini-stroke, or a Transient Ischemic Attack (TIA) as the Doctors call it, and so he was not too concerned. This is the third mini stroke that he has had in the past two years.
A Transient-Ischemic Attack or “mini-stroke” is when a blood clot stops blood from flowing to the brain for a short time. Effects are short-term, or transient. The brain returns to normal.
I am worried about my friend because the stats are not good: More than 1/3 of people who have a TIA are expected to eventually suffer a stroke although studies may vary, up to 20% of these people will suffer a stroke within 90 days.
What happens in a TIA?
Part of the brain can not receive blood anymore, so it becomes starved of oxygen and nutrients. This is called ischemia. It caused my friends’ abnormal behaviours.
The brain needs blood to survive as blood contains oxygen and nutrients needed by the brain. Th blood flows from the heart, up through lots of arteries, which branch out into the brain.
How a blood clot can form
Over many years, fat and cholesterol in the blood can stick to the artery wall, gradually building into a plaque. The artery becomes increasingly stiff and narrow This process is called atherosclerosis. Part of the plaque can break off forming a blood clot, this blood clot flows through the artery towards the brain, where it gets stuck in one of the smaller arteries.
As part of the brain cannot receive blood anymore, so it becomes starved of oxygen and nutrients. This is called ischemia. This is what caused my friend`s abnormal behavior’s. For my friend the world flipped upside down, and everything he saw was upside down. It took a few minutes for his world to right itself, but when it did, he did not go seek medical help. He continued on as normal. It was only at his next regular visit to his doctor that he told the her about this event. He was tested and it was determined that he had a stroke.
What should you do if you suffer a mini-stroke
Never drive yourself or the person having a stroke or TIA to the hospital. CALL AN AMBULANCE. Ask to be taken to the closest hospital that provides expert stroke care. You should be seen quickly after arriving at the hospital. If possible you should receive a brain scan to find out if your symptoms were caused by a blood clot or bleeding into your brain.
Who is at risk factors for a mini-stroke?
Here are risk factors cannot be controlled:
· Age – most occur over age 65
· Gender – after menopause women have a higher risk than men
· Ethnicity – First Nations, African, Southeast Asian
· Family history – higher if others in the family have experienced TIAs or strokes
· History of stroke or TIA – you have had a previous incident
Risk factors you can do something about:
· High blood pressure (hypertension)
· High blood cholesterol
· Heart disease atrial fibrillation
· Being overweight
· Excessive alcohol consumption
· Physical inactivity
Like my friend, the symptoms and signs of a TIA will have gone away by the time you get to the hospital or see your doctor, so the TIA diagnosis may be made based on your medical history alone.
If you have had a TIA within the last 48 hours, you will likely be admitted to the hospital so that doctors can search for the cause and observe you.
A complete neurological examination involves testing your language and memory skills; your behaviour, alertness, vision, and eye movements; your muscle control; your ability to walk (gait); and your sense of touch.
An abnormal sound called a bruit may be heard when listening to the carotid artery in the neck or other artery. A bruit is caused by irregular blood flow which could mean a blockage in the artery
Blood tests are done to learn whether there is anything in your blood that would tell your doctor what caused your TIA. Your blood may be tested for cholesterol and triglyceride levels, blood sugar level, and abnormalities in blood clotting.
The good news for my friend is that TIAs do not cause lasting damage to the brain. However, they are a warning sign that he may have a true stroke someday. He can reduce your chances of a future stroke by following-up with his health care team to manage his risk factors.
In addition, he can do the following to help himself. He can stop eating at McDonalds and lose some weight, exercise more, the recommended amount for our age is 150 minutes per week. Start eating well and follow the Canada Food Guide. He is starting to drink less alcohol. The recommended amount is 9 drinks a week for women, 14 for men. Lucky, he does not smoke, but if he did he could quit smoking. All of want him to retire, as he is still working albeit part time, to reduce his stress. And finally he should make a plan with the doctor to monitor and hopefully prevent him having a major stroke.
Monday, February 20, 2017
The following is a report done by the Social Concerns Committee of the Retired Teachers Association. In BC when a person reaches 80, they are required to take a test to determine their ability to drive. This test is done every two years and there is no standard fee for the test. As a result, some seniors have paid over $300 for the test by the Doctor and some have paid $50.00.
The Province's DriveABLE program tests drivers with a computer touch screen and has resulted in people having their drivers' licence cancelled. We believe recent efforts to improve the DriveABLE program's image and accessibility are simply wrongheaded.
The program is not "misunderstood" – it is simply wrong: poorly conceived, unsupported by current science, a violation of our charter rights and tainted by conflict of interest. Improved access will only bring more harm.
BC Motor Vehicles Fitness to Drive
A member’s bitter experience led us to look into the DriveABLE program. His wife's driving licence was revoked after failing a computer-based test. We did some digging and "put out the word". Our members and others are really angry. Rather than a scientific breakthrough in public safety, we have a program based on out of date research. We have privatized public policy developed by consultants, delegated to clerks and computers and outsourced to independent contractors.
On March 19, 2016 Shirley Bond, Minister of Justice and Attorney General, announced changes to the DriveABLE program: "… a decision regarding a person’s ability to continue driving will not be made solely from an in-office computer assessment. People who fail the computer assessment will be offered a DriveABLE road assessment. The results of the in-office assessment combined with the on-road evaluation and medical information will ensure licence decisions are made in the fairest manner possible. The Province will pay for the cost of both assessments."
Our efforts, and those of others advocating for seniors have had some impact. Drivers' licences will no longer be suspended "on the spot" as a result of a screening test.
Are we there, yet? No.
We believe that efforts to improve the program's PR and accessibility are simply wrongheaded. The program is not "misunderstood" – it is wrong. It should be cancelled. Improving access will only result in more people's lives being damaged.
There are two programs under the Office of the Superintendent of Motor Vehicles (OSMV) that affect seniors' driving: the 80+ medical assessment and DriveABLE.
• After the age of 80, accident free or not, drivers are required to get a doctor’s assessment of their medical fitness to drive. While most receive a positive report, others may be referred for further assessment. (DriveABLE)
• Under the DriveABLE program, a report from the police, health care provider or "concerned citizen" may result in having to take a DriveABLE test. The purpose of the test is to assess cognitive fitness.
The DriveABLE program is based on an out-of-date view of the world. Twenty years ago, there was what amounts to a moral panic about aging and driving; an apocalyptic vision of a "grey wave" of demented "wrinklies" careening down the roads. It was not hard to convince funding agencies and academic journals of the risks inherent in the rising tide of demented drivers. Clever entrepreneurs have used fear, uncertainty and doubt to promote their agenda and their products.
The real world, thank goodness, has not cooperated. Seniors' accident and death rates have gone down, not up. Cooler heads have prevailed in the academic world. Where mass screening of drivers for cognitive fitness was sliced bread in the '90's, a respected voice in health care now says:
…the available literature fails to demonstrate the benefit of driver assessment for either preserving transport mobility or reducing motor vehicle accidents."
adding their reasons:
the cognitive test that most strongly predicted future crashes would … prevent six crashes per 1000 people over 65 screened, but at the price of stopping the driving of 121 people who would not have had a crash.
Attitudes about senior drivers are changing but we still have work to do. Too many conversations about aging drivers include words like these:
"No one wants unsafe drivers on the road"
thus justifying almost any level of heavy-handed intervention into seniors' lives.
This is unhelpful. We will always need to strike a balance between mobility and safety. The only way to have no unsafe drivers on the road is to have no drivers or close the roads. Drawing neat little lines in the sand isn't possible.
Our Continuing Concerns
• The harm caused by the DriveABLE program far outweighs the benefits. The program casts too wide a net, damaging people's lives. We have seen little acknowledgement of the impact of driving cessation. We need a balanced, thoughtful review of this program with community input. The review must exclude those who have an institutional bias or business interest in the outcome. • The driving record should be the "gold standard" not the DriveABLE road test.
• The over 80 medical exam should be discontinued. In reviewing European experience, the UK Transport Research Laboratory stated: "There is no evidence that any licence renewal procedure or requirement for a medical examination has an effect on the overall road safety of drivers aged 65+"
• Since the fatal crash rate for 70-74 year olds, 75 - 79 year olds and 80+ year olds is now less than that of 35-54 year olds there is no justification for discriminating against seniors.
• Retraining and remediation are absent from the OSMV's program. The belief seems to be that cognitive impairment is incurable, decline inevitable and remediation impossible. This doesn't square with modern science. One cognitive factor which modern research has found to be strongly predictive of crashes is the Useful Field of View - UFOV. Training is readily available which remedies UFOV problems and would undoubtedly reduce risks and promote independence. There are likely other remedial approaches. OSMV relies solely on driving cessation.
• Our doctors have been misled into believing that they are liable for damages under case law if they don't report on those they believe unfit to drive. A professional development document for BC doctors cites a 1973 precedent that was overruled in 2003. A minor quibble, you say? Ask your doctor how she feels about being misled and bullied into reporting. We believe this program damages the doctor-patient relationship; patients becoming guarded about disclosing information to doctors; doctors reluctant to bring up the subject of driving. Medicine doesn't work on a "don't ask, don't tell" basis. We support the Neurologists position; physicians should be free to report or not report based on their assessment of the needs of the individual, the family and the community.
• If seniors must be screened and assessed, then individual and community needs must be taken into consideration. We believe that physicians - people we trust - should be the major players in the complex decisions about driving restriction, retraining, remediation or cessation. We need the "meaningful and trusted consultation" that only our doctors can provide, not a heavy-handed approach with all of the decisions being made by clerks, computers and contractors.
If you or anyone you know has lost a drivers' licence through taking a DriveABLE test, you should write to:
Office of the Superintendent of Motor Vehicles
Attn: Driver Fitness Unit
PO Box 9254 STN PROV GOVT Victoria, BC V8W 9J2
and request a road test.
Sunday, February 19, 2017
The information listed here is for seniors in BC but if you do a Google Search with your location in the search, you may find your community, state or province has similar services
Information here was taken from Office of the BC Seniors Advocate website at: https://www.seniorsadvocatebc.ca/
The Office of the Seniors Advocate monitors and analyzes seniors’ services and issues in BC, and makes recommendations to government and service providers to address systemic issues. The OSA was established in 2014 and is the first office of its kind in Canada. Isobel Mackenzie, the BC Seniors Advocate, has over 20 years’ experience working with seniors in home care, licensed care, community services and volunteer services.
Health Care: Resources for Seniors
There are three main provincial websites detailing programs and services for seniors’ health care.
View the B.C. Health website to learn more about:
§ Financial assistance for Medical Services Plan coverage
§ Financial assistance with the cost of prescription drugs and medical supplies through Fair PharmaCare
§ Accessing health care services including assisted living, residential care, and home & community care.
View the Seniors’ Health website to learn more about:
§ Specific health concerns such as cataracts, dementia and heart disease
§ Advanced care planning
§ Emergency preparedness
View the Planning for Healthy Aging website to learn more about:
§ Healthy lifestyle choices
§ Protection from elder abuse and neglect
§ Lifelong learning and community participation
Housing: Resources for Seniors
There are two main sources of information on provincial government housing programs and services for seniors.
View the provincial government’s seniors’ housing website for information on:
§ Home Improvement Assistance Programs
§ Rental and affordable housing
§ Supportive housing
View BC Housing’s seniors’ services website to learn more about:
§ Home Adaptations For Independence
§ Shelter Aid for Elderly Renters (SAFER)
§ Assisted living
§ Seniors’ supportive, rental and subsidized housing
Income Supports: Resources for Seniors
Both the federal and provincial governments have income support programs for seniors. The federal government runs the Canada Pension Plan, Old Age Security and Guaranteed Income Supplement programs.
View the Government of Canada’s seniors’ website for information on:
§ The Canada Pension Plan
§ Old Age Security
§ Guaranteed Income Supplement
The provincial government runs programs for low-income seniors to access medical services and supplies, transportation and housing. It also contains legal information on protecting yourself and finances.
View the Province of B.C.’s website to learn more about:
§ MSP and Fair PharmaCare programs for low-income seniors
§ Subsidies for housing and transportation
§ Legal information on protecting yourself and your finances
Personal Supports: Resources for Seniors
Personal supports help seniors live as independently as possible. These supports are complimentary to the medical services provided by Home & Community Care programs in B.C.
There are three key websites with information about personal supports:
§ Visit the B.C. Personal Supports website for services and programs to assist people with disabilities, including mobility, hearing and communication challenges.
§ Visit the Better at Home website to learn more about the services that might be offered in your community, including housekeeping, home maintenance and repairs, and friendly visiting.
§ Visit the BC211 website, or dial 2-1-1, to find community, social or government services in your area.
Transportation: Resources for Seniors
View the provincial government’s seniors’ transportation website for information on:
§ Driving your own vehicle, carpooling and car-sharing
§ Public transit, including HandyDART
§ Walking and cycling
§ Volunteer driver programs
§ Medical travel assistance
The Seniors Transportation Access and Resources (STAR) website also has useful information for seniors and their families. Click here to visit the STAR website.
Saturday, February 18, 2017
Information taken from an Infographic by Sparc BC (Social Planning and Research Council of BC) and United Way of Lower Mainland
· Between 2001-2011, the seniors’ population increased from 70,335 to 81,930. (an increase of 16%)
· Between 2001-2011, the number of people over the age of 100 increased from 95 to 165 seniors. (an increase of 74%)
· Between 2001-2011, the number of seniors living alone increased from 20,030 to 21,575. (an increase of 8%)
· In 2011, the Vancouver Health Service Delivery Area found that 26% of seniors had per-ceived their health as fair to poor.
· Between 2000-2010, 3,345 new immigrant seniors settled in Vancouver.
· One-third senior households spend 30% or more of their income on housing. Between 2006-2011, this number rose from 12,635 to 14,025 seniors. (an 11% increase in seniors at risk of losing their homes.)
· Between 2009-2012, the number of seniors and persons with disabilities (PWD) on BC Housing’s social housing waitlist in-creased from 1,575 to 2,172 people. (a 38% increase)
· In 2011, 15,190 seniors lived on a low income. Seniors living alone had after-tax incomes of approximately $19,500 or less. Seniors living in couples had after-tax incomes of approximately $27,250 or less. (one in five seniors live on a low income)
· Between 2001-2011, the number of seniors who could not speak English increased from 15,755 to 17,740 seniors. (23% of seniors cannot speak English)
· In 2011, Cantonese (12,305) and Mandarin (9,410) were the most commonly spoken languages among seniors other than English. (63% of seniors do not speak English as their first language)