The beneficial effects of omega-3 polyunsaturated fatty acids have been widely described in the literature in particular those on cardiovascular system. In the last decade there has been an increased interest in the role of these nutrients in the reduction of articular inflammation as well as in the improvement of clinical symptoms in subjects affected by rheumatic diseases, in particular rheumatoid arthritis (RA).

While the typical diet in the United States has a much greater ratio of omega-6 fatty acids compared with omega-3 fatty acids, research is showing that shifting this ratio-by increased consumption of fatty fish or fish oil supplements-may provide significant health benefits. Reductions in cardiovascular risk, depression, and rheumatoid arthritis symptoms have been correlated with omega-3 fatty acid intake, and there is increased interest in the use of omega-3 fatty acid supplementation for other psychiatric illnesses and prevention of Alzheimer’s disease.

The beneficial properties of fish oil are well known and are related to its fatty acid composition rich in omega-3 polyunsaturated fatty acids. A variety of epidemiological and clinical studies have demonstrated the efficacy of fish oil supplementation in rheumatoid arthritis (RA). The anti-inflammatory effects of fish oil are linked to the production of alternative eicosanoids, to the reduction of proinflammatory cytokines, to the inhibition of the activation of T lymphocytes and of catabolic enzymes. Fish oil supplementation could represent a valuable support to the traditional pharmacological treatment of rheumatoid arthritis.

A study by Berbert AA et al (Nutrition Feb 21 (2): 131-6, 2005) evaluated whether supplementation with olive oil could improve clinical and laboratory parameters of disease activity in patients who had rheumatoid arthritis and were using fish oil supplements.

Forty-three patients were investigated in a parallel randomized design. Patients were assigned to one of three groups. In addition to their usual medication, the first group received placebo (soy oil), the second group received fish oil omega-3 fatty acids (3 g/d), and the third group received fish oil omega-3 fatty acids (3 g/d) and 9.6 mL of olive oil.

Disease activity was measured by clinical and laboratory indicators at the beginning of the study and after 12 and 24 wk. Patients’ satisfaction in activities of daily living was also measured. There was a statistically significant improvement in relation to group 1 with respect to joint pain intensity, right and left handgrip strength after 12 and 24 wk, duration of morning stiffness, onset of fatigue, Ritchie’s articular index for pain joints after 24 wk, ability to bend down to pick up clothing from the floor, and getting in and out of a car after 24 wk. Group 3, but not Group 2, in relation to Group 1 showed additional improvements with respect to duration of morning stiffness after 12 wk, patient global assessment after 12 and 24 wk, ability to turn faucets on and off after 24 wk, and rheumatoid factor after 24 wk. In addition, Group 3 showed a significant improvement in patient global assessment in relation to Group 2 after 12 wk.

Ingestion of fish oil omega-3 fatty acids relieved several clinical parameters used in the present study. However, patients showed a more precocious and accentuated improvement when fish oil supplements were used in combination with olive oil.

More convincing data support the efficacy of omega-3 PUFA in reducing pain, number of tender joints, duration of morning stiffness, use of non-steroidal anti-inflammatory drugs and improving physical performance in RA patients. Kolahi et al (Clin Biochem Dec 23, 2009) from the Biotechnology Research Center in Tabriz University of Medical Sciences conducted a clinical trial to prove that fish oil supplementation decreases serum soluble receptor activator of nuclear factor-kappa B ligand in female patients with RA.

Soluble receptor activator of nuclear factor-kappa B ligand (sRANKL) to osteoprotegerin ratio is designated as a bone metabolism equation in many rheumatologic disorders and would be modified with fish oil (FO) supplementation. Eighty-three females with rheumatoid arthritis were divided randomly to 40 and 43 patients treated with (1 g/day) or without FO for 3 months accompanied with conventional drugs, respectively. Osteoprotegerin, sRANKL, tumor necrosis factor alpha (TNFalpha) serum levels were measured before and after treatment. Serum levels of osteoprotegerin increased, although sRANKL, TNFalpha and sRANKL/osteoprotegerin ratio decreased with FO therapy. A significant positive correlation was observed between sRANKL/osteoprotegerin ratio and TNFalpha levels (r=0.327, p=0.040) in the FO-treated group. CONCLUSIONS: FO could decrease the inflammatory response by lowering of serum TNFalpha levels and sRANKL/osteoprotegerin ratio.

In another study, Adam et al ( Rheumatol Intl Jan;(1):27-36) investigated the effects of both dietary measures, alone and in combination, on inflammation, fatty acid composition of erythrocyte lipids, eicosanoids, and cytokine biosynthesis in patients with RA.

Sixty-eight patients with definitive RA were matched into two groups of 34 subjects each. One group was observed for 8 months on a normal western diet (WD) and the other on an anti-inflammatory diet (AID) providing an arachidonic acid intake of less than 90 mg/day. Patients in both groups were allocated to receive placebo or fish oil capsules (30 mg/kg body weight) for 3 months in a double-blind crossover study with a 2-month washout period between treatments.

Clinical examination and routine laboratory findings were evaluated every month, and erythrocyte fatty acids, eicosanoids, and cytokines were evaluated before and after each 3-month experimental period. Sixty patients completed the study. In AID patients, but not in WD patients, the numbers of tender and swollen joints decreased by 14% during placebo treatment. In AID patients, as compared to WD patients, fish oil led to a significant reduction in the numbers of tender (28% vs 11%) and swollen (34% vs 22%) joints Compared to baseline levels, higher enrichment of eicosapentaenoic acid in erythrocyte lipids (244% vs 217%) and lower formation of leukotriene B(4) , 11-dehydro-thromboxane B(2) (15% vs 10%, P less than 0.05), and prostaglandin metabolites (21% vs 16%, P less than 0.003) were found in AID patients, especially when fish oil was given during months 6-8 of the experiment.

A diet low in arachidonic acid ameliorates clinical signs of inflammation in patients with RA and augments the beneficial effect of fish oil supplementation.

Dr. Jack Haddad, MD, MBA is the founder and owner of King of Home Care, an independently owned non-medical In-home care agency. In addition to his compassion and dedication to the home care industry, Dr. Haddad’s expertise and knowledge with hospice care is evident by the clinical research trials that he has conducted over the years.

Caring for a family member inflicted with symptoms of Alzheimer\’s disease is both debilitating and a challenging task. Each day brings new demands as the caregiver copes with the rapid progression of the new patterns of behavior of the Alzheimer\’s patient.

In preparing and setting up an effective home care for an Alzheimer\’s patient, a compassionate caregiver must make the following changes in a new home environment:

1. As the disease progresses, adjusting your communication style to the patient\’s changing needs.

2. Scheduling visitors to avoid surprises and have something to look forward to. Even if the elder with dementia does not recognize those who visit, the contact is nonetheless valuable for them.

3. Establishing routines in activities of daily living. Be accepting of the increasingly limited capabilities of the person with dementia and implement care strategies accordingly. Do your best to be patient, kind, flexible, supportive, and calm. This disease is no one\’s fault, although it is very aggravating and disappointing.

By the same token, don\’t take problem behaviors (like aggressiveness or wandering) personally. Accept the symptoms of the disease and proceed from there. Remember that the person is not behaving this way on purpose.

Plan activities that the patient is interested in, such as art, cooking, walking, swimming, or gardening. Focus on enjoyment, not achievement. If the person is lucid enough, involve them in making music, doing puzzles or crosswords, or playing memory games, card or board games. Or, the patient may passively enjoy hearing music, contact with pets, or sitting outside in the garden.

Go for walks in the neighborhood, go for a drive, or spend time at a park. Walking is often therapeutic, although the pace may not be as vigorous as you might like. Develop a style of paying more attention to the beauty and novelty of your surroundings as you walk.

4. Maintaining social contacts and fun. During the early stage of the disease, caregivers can promote the patient\’s sense of well being by providing emotional support and by helping to maintain familiar activities and social contacts.

Even when Alzheimer\’s patients no longer have the cognitive ability to understand your humor, they can still appreciate it. They may still smile or laugh and sharing that laughter can be a relief to both you and your charge. Use the same modes of humor as you always have: teasing, nonsense, clowning. Be even more silly than usual!

To counteract isolation and loneliness, encourage family and friends to stay involved. Take the patient to family gatherings if it\’s comfortable to do so. Schedule visitors, to avoid surprises and have something to look forward to. Even if the elder with dementia does not recognize those who visit, the contact is nonetheless valuable for them.

Sometimes the caregiver will want to join the patient in family gatherings or stay in the home when visitors are present. Caregivers can start feeling isolated and lonely themselves as more and more of their time is built around the elder\’s needs. If the patient feels safe with the visitors, the caregiver can use the visiting time as an opportunity for relief and respite. Adult day care has similar benefits: social stimulation for the patient and free time for the caregiver.

5. Promote comfort and safety. As problems with memory and judgment increase, the patient becomes more vulnerable to accidents and injuries. There will be times when you\’ll want to remind the person that they have Alzheimer\’s. At other times it might be better to refer to a \”memory problem.\” Even if you repeatedly tell the elder that they have Alzheimer\’s disease, they may not remember that you told them. Be prepared to patiently repeat the information at times when you\’re trying to help the person understand why they can\’t do something or why you are taking over a task the person used to do.

Carefully screened and compassionate caregivers regard their responsibility as a way of being involved with their loved one. Their caring is based on unconditional love, and they do not consider it a burden. Dementia patients are able to read body language and to respond to the positive attitudes of the caregiver. Where patient and caregiver have had problems in their past relationship, it can be especially challenging to empathize and be kind, so a support system for the caregiver is most important.

6. Communicate with an Alzheimer\’s patient. A good home care service trains caregivers to acknowledge requests and respond to these patients. Don\’t argue or try to change the person\’s mind, even if you believe the request is irrational. Be affectionate with the patient, if this feels natural. Try not to set up a cycle of paying attention only when the person displays problem behaviors. Break this negative cycle by being supportive of positive behavior.

Jack Haddad, MD, MBA
Portfolio Manager
MD Capital Management
Affiliated Hospitals
Sutter-Roseville Medical Center, Roseville, CA
San Francisco General Hospital, San Francisco, CA
San Jose Orthopedic Medical Group, San Jose, CA
Highland Hospital, Oakland, CA

Dr. Jack Haddad, MD, MBA is the founder and owner of King of Home Care, an independently owned non-medical In-home care agency. In addition to his compassion and dedication to the home care industry, Dr. Haddad\’s expertise and knowledge with In-Home Care is evident by the clinical research trials that he has conducted over the years.

Researches from Germany conducted a study to evaluate the significance of home care patients suffering from advanced cancer. Results were published in Med Klin, 15;95(3): 136-42.

Analysis of the study was derived from interviews with relatives of patients with terminal cancer diseases. They had participated in the home care of 50 consecutively treated patients 2 years previously.

The value of home care was evaluated on the basis of the personal experience of those concerned. Data showed that the holistic concept of palliative home care could be implemented by a specialized team at a high quality level.

Under the favorable conditions of the familiar surroundings, an atmosphere of trust developed as a result of the cooperation with the family members, people close to the patients and with family doctors. It contributed to a relatively high quality of life and to alleviate the emotional stress. Most of those involved were able to accept the hand of fate. On this basis, the terminal phase could be satisfactorily arranged and preparations made for a good quality of death.

During the home care, appreciation of the value of the family increased. The intensified family relations were mostly sustained after the patient\’s death. The results document the great personal importance of home care for patients, their caretakers and families. The positive experience and the awareness of having contributed substantially to coping with the life crisis made it easier for the bereaved to grieve and to rearrange their life. Stepwise discriminant analysis was performed using admission, discharge, and combined variables. In our final model of the predictors of discharge disposition, the use of admission functional variables, age, and sex correctly classified 100% of the NH group and 91% of the other group, with IADL, ADL, and mobility defining the function that discriminated the groups.

In conclusion, other studies have been conducted on predictors of bereavement outcomes in family caregivers of persons who have died of cancer. The literature has been divided into common themes of predictors: characteristics of the deceased person, characteristics of the bereaved person, comparisons of bereaved and non-bereaved persons, well-being of the bereaved person prior to the death, prior interpersonal relationships, characteristics of the illness, characteristics of the caregiving experience, and characteristics of terminal care.

A number of recurring patterns point the way to identifying persons who may be at increased risk for poor adjustment during bereavement. It is apparent that men and women express their grief somewhat differently. Whether men or women are at greater risk for poor adjustment, however, remains to be determined.

There is some empirical evidence to suggest that lower socioeconomic status and linguistic barriers interfere with adjustment during bereavement. There is a dearth of culturally relevant services to help palliative-care patients and their family members make the required adjustments. The literature makes apparent the need for open awareness of the impending death and for careful and thoughtful planning for where and how the death ought to occur.

The regular and frequent presence of professional caregivers contributes to family caregivers\’ satisfaction with care. Discrepant findings point to the need to explore the issues that underline them. Older bereaved caregivers appear to have some advantages over younger ones, but this finding is not universally found in the results of these studies. Methodological problems include small sample sizes and large variations in the particular bereavement outcomes studied.

Jack Haddad, MD, MBA Portfolio Manager MD Capital Management

Affiliated Hospitals Sutter-Roseville Medical Center, Roseville, CA San Francisco General Hospital, San Francisco, CA San Jose Orthopedic Medical Group, San Jose, CA Highland Hospital, Oakland, CA

Dr. Jack Haddad, MD, MBA is the founder and owner of King of Home Care, an independently owned non-medical In-home care agency. In addition to his compassion and dedication to the home care industry, Dr. Haddad\’s expertise and knowledge in hospice care is evident by the clinical research trials that he has conducted over the years.

The touch screen technologies you see in modern electronics is something seen as entertaining- certainly not something that increases the functionality of devices by a significant amount. For hearing aids, touch screens have opened up a new door to usability and costs for the elderly.

The touch screen technology seeks to replace the mechanical technology put in place by most hearing aids on the market today. Using a knob or potentiometer is fine in most cases, but it isn\’t as functional when you are preoccupied with other matters. With a touch screen, you are able to simply swipe the top of the hearing aid and instantly have a higher or lower volume level.

One of the big topics to address with hearing aids was to make the controls adjustable even when you have other commitments with your hands. If you are driving down the road, and desperately need to operate your hearing aid for whatever reason, you\’ll find it hard to do so without swerving. Touch screen hearing aids only need a quick touch- meaning you can modify them while multitasking within the blink of your eye.

Due to the \”closed\” architecture that is used by digital hearing aids with touch screen functionality, there is greater protection from moisture. Previously, users of hearing aids had to be particularly careful when in humid environments such as a bathroom after hot water has been run. Digital hearing aids have much more leeway in the moisture levels they can operate under.

The life span of a touch screen enabled hearing aid is greater, as they are less susceptible to mechanical breakdown. Mechanical devices can be affected by dirt, grime, and moisture. Digital hearing aids don\’t have the exterior parts that conventional hearing aids do, and so, they are less susceptible to the elements. That means they will last longer on average when considering terms of mechanical wear and tear.

The cost of digital hearing aids has plummeted, despite the reasoning that newer technologies are usually more expensive. Technologies that are easily produced and manufactured are sold at lower prices, and this is just the case for the digital hearing aids with touch screen technologies. Manufacturers can churn out a great number of the devices at a lower cost, which then gets passed onto the consumer when he or she goes to but it from a retailer.

In Conclusion

Digital hearing aids are the new standard for hearing aids. It\’s hard to go back to a mechanical-based design after having experienced the glories of a hearing aid with little maintenance. Talk to your doctor to see if you can obtain a touch-enabled hearing aid for your own solution to hearing loss woes.

Learn more on digital hearing aid and hearing aids.

Requiring the use of diapers or other assistance pads is embarrassing and uncomfortable. They can cause chafing or other uncomfortable conditions. Adult incontinence is a serious medical condition that can be treated!

While incontinence is usually a problem for the elderly, any adult can experience the same problems. Understand the condition and knowing how to treat it is the best way to cope with the condition. Obviously it isn’t easy to fix the problem, especially if you cannot afford treatment.

Treating adult incontinence is fairly simple. There are a number of ways to remedy the weakened muscle tissue and return it to normal, or close to normal. Women that have given birth are at a higher risk for developing adult incontinence due to the extensive pressure and damage done to the bladder during pregnancy.

A few simple tests for diagnosis can treat adult incontinence. You do not have to live your life depending on diapers, pads, or medications to control your problem. Surgery or even weight loss and certain exercises can help treat or relieve the condition. Usually a health problem is to blame and can be treated so that you do not have to live with the condition any longer. Even bladder muscle repair can stop the incontinence altogether.

If you are unable to afford any expensive surgery, you can cope with the difficulty of adult incontinence by utilizing the benefit of free treatments. Kegel exercises are a popular way to strengthen the pelvic floor and provide extra support for the bladder. You simply squeeze the muscle slightly and hold for a few seconds. The motion can be repeated as often as you would like. There are even special tools designed to help the exercise become more effective. This exercise is free, can be done anywhere, and makes a significant different. If you are overweight then losing weight will relieve pressure on the bladder so that you may live normally again!

Even though pads and diapers help stop the urine from wetting your clothing, they do not help your bladder. Adult diapers never provide any support for the bladder, nor do they fix the problem. This is why seeking treatment is so very important for those that want to avoid the embarrassment of living with adult incontinence. Yes, treatment can become pricey, but insurance may cover some of the costs. It is truly worth it to seek out help if you do not want to live with such an embarrassing condition.

Closing Comments

No one deserves to live with this condition. It can completely change your life once you seek a permanent treatment solution. Opting for surgery can also ensure that you will remain incontinence free for many years to come! Exercises and weight loss are free solutions that help relieve most of the uncontrollable bursts.

Learn more on Poise and Incontinence Products.

Despite all the information available about nocturnal enuresis there are still lots of rumors and half-truths that persist about the condition. While the causes of adult bed wetting at night are largely understood by the medical community it’s still a medical malady that often confuses victims who suffer from it. It’s been estimated that approximately 25 million people suffer from some form of adult nocturnal enuresis in the United States alone. Here are a few myths about adult bed wetting at night and follow by the real story.

You Can Control Adult Bedwetting If You Truly Want To: Wetting the bed as an adult is not enjoyable and willpower alone will not alleviate the problem. Most adult bed wetting problems are a result of some sort of physical issue and not necessarily caused by a certain thought process. It’s easy for a non-bedwetter to dismiss the problems of wetting the bed at night, but it truly is something that’s out of a person’s conscious control most nights.

Nocturnal Enuresis Only Affects Elderly Men and Women: It is true that many men and women first start to suffer from adult bed wetting when they are more mature, but that is not always the case. Bed wetting is a malady that can strike any person at just about any age – including teenagers and even preteens. The kind of adult nocturnal enuresis will often determine when a person will first suffer from a bed wetting incident.

Adult Bed Wetting Has No Treatment: Even without medical treatment adults can prevent nighttime urination with easy-to-use bed wetting alarms and behavior modification techniques. While simple mind-over-matter exercises might not prevent adult nocturnal enuresis, there are many actions which can be done to solve the problem. There are drug treatments and medical procedures which can be prescribed for adult bed wetting problems.

With the right treatment adult bed wetting can almost always be prevented and treated safely. It’s very important to remember that adult bed wetting may be a sign of a serious medical problem. Men and women who suffer from adult bed wetting should meet with a doctor as soon as possible.

Need to learn more about the causes and treatments of middle-aged bed wetting issues? Visit our site to learn about treatments, medical procedures and to get the latest news about bed wetting breakthroughs and discoveries.