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Posts Tagged "Dementia"

23Jan

Living near major traffic routes increases risk of dementia and other conditions: UBC study

by admin

VANCOUVER —
People who live less than 50 metres from a major road or less than 150 metres from a highway are at a higher risk of developing dementia or Parkinson’s disease, according to new research from UBC.

Researchers looked at 678,000 adults living in Metro Vancouver between 1994 and 1998, and then followed up with them once again from 1999 to 2003. They used postal code information to assess each person’s closeness to the road and their exposure to air pollution, noise and green spaces. They ended up identifying 13,170 cases of dementia, 4,210 cases of Parkinson’s disease, 1,277 cases of Alzheimer’s, and 658 cases of Multiple Sclerosis (MS). Researchers classified the different categories of roads based on the traffic volume and the width of the lanes.

The study’s lead author and UBC PhD candidate Weiran Yuchi told CTV News Vancouver the research found living near a major traffic route increased the risk of dementia by 14 per cent, and increased the risk of Parkinson’s by seven per cent.

“We believe that the air pollution associated with traffic actually contributes to the onset of these neurological disorders,” she said.

Due to the relatively low number of Alzheimer’s and MS cases identified, researchers were not able to link an increased risk of those diseases to air pollution, specifically. They are now studying information from across the country to try and get a better understanding of any potential connection.

There was one thing researchers found could mitigate the effects of air pollution: living within 100 metres of a green space.

“There could be several reasons,” Yuchi said. “We believe that maybe the visual presentation … actually is one possible reason. Or, you know, people who live near green space, they’re more physically active, and they pay more attention to their health, and as a result they are at less risk of developing certain neurological disorders.”

Increasing access to parks is one of the goals the City of Vancouver set in its “Greenest City Action Plan,” but according to the Park Board, it hasn’t quite hit its stated target of having everyone within a five-minute walk of a green space by this year.

Senior environment and sustainability planner Chad Townsend said in an email to CTV News Vancouver: “99 per cent of people are within a 10-minute walk of a park or green space (80% are within a five-minute walk). However, distribution is uneven and some neighbourhoods are underserved.”

He singled out Grandview-Woodland and Fairview as areas which have less park land per 1,000 residents, comparatively.

Another goal was to plant 150,000 more trees between 2010 and 2020. Townsend said the Park Board expects to achieve that goal by the end of this year.

Yuchi said in light of Canada’s aging population, the study’s authors are hoping that city planners will take their findings to heart and find ways to increase access to green spaces while reducing traffic.

“The number of cases of neurological disorders are forecast to increase dramatically,” Yuchi said. “Neurological disorders (are) actually one of (the) leading causes of death and disability globally, and we know little about the risk factors of neurological disorders, so therefore we think that it’s necessary for people to pay more attention to neurological health.” 

27Feb

Dementia law report recommends better oversight on health care consent

by admin

Jim Mann wants everyone to know that he’s more than his dementia.

He was diagnosed with Alzheimer’s 12 years ago, but that doesn’t mean he can’t be involved in making decisions about his health.

The distinction is important for Mann — and many others living with dementia. The Surrey resident is thinking a lot about consent these days after being part of an advisory committee on health care consent for people with dementia. Their report, Conversations About Care, was released Feb. 27.


Surrey resident Jim Mann was diagnosed with Alzheimer’s 12 years ago.

Arlen Redekop /

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Mann, 70, said professionals in health care still make assumptions about people with dementia.

He recalled an emergency room incident when a nurse yelled his name and added “patient only.”

“My wife and I stood up and walked over. Halfway there, she (the nurse) yelled again ‘patient only.’ I got up to her and said ‘my wife needs to be with me. I have Alzheimer’s.’ She turned around and looked me up and down and said ‘well, you look fine.’ “

Mann said that while the public might not always understand that dementia is a cognitive impairment not a physical one and therefore not visible, he believes that kind of language isn’t acceptable in a health care environment.

“Within the medical system, I’m sorry, you should really know this by now,” he said.


Jim Mann says professionals in health care still make assumptions about people with dementia.

Arlen Redekop /

PNG

The two-year collaborative research project that Mann was a part of was undertaken by the Canadian Centre for Elder Law and the Alzheimer Society of B.C. Funding included a $40,000 grant from the Law Foundation of B.C.

The goal of the project’s Conversations About Care report is to ensure that the legal framework in B.C. remains strong enough to protect people living with dementia as well as those named as their legal substitutes.

In 2018, about 70,000 people in B.C. were living with dementia. By 2033, that number is estimated to increase to almost 120,000.

Krista James, national director of Canadian Centre for Elder Law at the University of B.C., said the report is intended to start a conversation about the rights of people with dementia.

“I feel that we’re missing that rights-based lens that recognizes the rights of older people to make choices about what happens to them,” she said.

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“Although the law is different in each jurisdiction, and this report applies specifically to the experience in B.C., we need to open up that conversation to think about the citizenship rights of older people in a health care context. It’s really urgent.”

The report’s 34 recommendations were developed through a process that included consultation with people living with dementia, family caregivers, health care professionals, and others who deal with consent on a regular basis.

James said the origins of the report came from phone calls she received from family caregivers who felt frustrated that decisions were being made without consultation.

B.C. is ahead of many other provinces because of our comprehensive health care consent statute called the Health Care (Consent) and Care Facility (Admission) Act.

“From our perspective, the health care consent law in B.C. is super robust and I think fairly clear,” James said.

“It says if it’s not an emergency, you need to get that prior informed consent. The care facility regulations that govern long term care don’t seem to be consistent. There is a lot more wiggle room.”

That means some physicians, licensed practical nurses and care aids don’t understand the concept of prior informed consent for non-emergency care.

“I have talked to a few people who think that if the person is in the care facility they have consented to all the care that the people who work there think is the right care for them,” she said.

“Some of the staff don’t understand they have to get consent. They confuse admission to the care facility with consent to all the meds.”

One of the report’s recommendations calls for all licensed long-term care facilities to set out rules on restraints, including chemical restraints (medications such as antipsychotics used to control aggressive behaviour).

Other big concerns include the challenge of sorting out situations where family members making decisions about care for someone with dementia can’t agree on what to do. One way to address that, James said, is to have social workers involved in helping families find a solution.

James said the report recognizes that health care providers are never going to be experts on the law.

“They’re not lawyers,” she said. “We shouldn’t expect them to be experts on the finer details of the law. They need to have support so they can properly interpret the law.”

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Recommendations of the report

• Improving health care decision-making laws in B.C. by adding language to recognize that people’s capacity to make health care decisions can vary from day to day and decision to decision, and that they be involved to the greatest degree possible in all case planning and decision-making.

• Address barriers to informed consent experienced by Indigenous people and people who need language interpretation, and create financial incentives to support physicians so they can spend time to talk with patients and families.

• Create a review tribunal to allow people living with dementia to review health care decisions made by substitute decision makers.

kevingrififn@postmedia.com

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