State John Kerry - In America, "you have a right to be (as)
stupid (as) you want to be."
(But too many Americans are abusing the privilege)
Why did our systems fail and why
will they continue to do so? From Paul Volcker
"our economics are based on “an
unjustified faith in rational expectations, market efficiencies
and the techniques of modern finance"
You must not believe everything you think
Great spirits have always encountered violent opposition from mediocre minds
Huntington's Disease: A
To the uninitiated, a first read-through of the symptoms of Huntington’s disease is reminiscent of the behaviors of very early childhood. Those afflicted with what is sometimes also called Huntington’s chorea eventually can’t walk or communicate the way they once did. They need help eating and drinking and even toileting and become dependent on others for almost everything. But a deeper read promises heartbreak that only the caregivers of those with this hereditary disorder and the patients themselves can truly understand; for in spite of the fact that those living with Huntington’s disease are as needy as our own young, they are also completely coherent all the way to the end of life. They know what’s happening but there’s nothing they can do about it. Whole inside but prisoners of their own bodies, they yearn to communicate but can’t. They understand what’s being said but can’t always reply. They try to walk and carry on but instead stumble or fall or even become confined to wheelchairs. The indignity of the disease can cancel out pride, self-esteem and joy, and it is the wise caregiver who learns early-on the importance of compassion, of reaching out to another who is intellectually an equal but physically, verbally and emotionally has once again been relegated to infancy.
First described by Dr. George Huntington in 1872, Huntington’s disease is now considered a fairly common genetic disorder. Passed from parent to child in a genetic mutation of a normal gene discovered in 1993 called the Huntington gene, the disease is egalitarian, affecting as many men as women and no more prevalent in one race or ethnicity than another. While onset is most common between the ages of 30 and 45, some are afflicted as early as age two. (Children living with Huntington’s disease rarely live to adulthood.) The sobering facts are these – children of parents who carry the gene have a 50/50 chance of inheriting it, and those who have the gene will develop the disease. There is no question or possibility otherwise, and the disease is fatal. Over time, Huntington’s disease affects the afflicted person’s ability to walk, talk, think and reason. Its impact is felt in three major areas – emotional, physical and cognitive.
Early symptoms affect cognition and mobility. Other indicators include depression, mood swings, forgetfulness, clumsiness, involuntary twitching and lack of coordination. As the disease advances, concentration and short-term memory are affected and involuntary movements of the head, trunk and limbs increase. Walking, speaking and swallowing skills decrease. Eventually the patient becomes totally dependent. Death is often caused by choking, infection or heart failure. While there is currently no cure, those living with with the disease must learn to live with it, for life after diagnosis can last as long as 20 or 30 years. Physical fitness is very important – those who are fit handle the disease’s progression better than those who are not.
Caregivers of those living with Huntington’s disease know as perhaps not many others do the complexities of lending support to someone who is involuntarily traveling backwards emotionally while continuing to relate to them on a level intellectual playing field for as long as possible. Faced with behavioral problems, particularly those of dementia, an altered perception of the world and changes in family dynamics, the caregiver must learn to speak a new language, one whose vocabulary is not verbal but behavioral. Learning to look beyond unwanted behaviors to see what the patient is trying to say or demonstrate is a pre-requisite to successful caregiving, for it is up to the helper to see through, interpret, analyze and deliver while still preserving the patient’s dignity and self worth. Imagine if you will the difficulty of knowing what you want to say or do but being unable to follow through. It is this difficult truth that becomes the new reality of those living with Huntington’s disease. Caregivers function as life preservers, helping love ones hold onto a remnant of the life they once knew. There is absolutely no doubt that it takes a special person with a heart of gold who can look beyond, understand, translate and accomplish what is needed in the face of the disease and debilitation of a loved one. It is an ability to translate the language of disability into productivity that will enable a caregiver to observe and see what he or she is capable of and still interested in doing and adjust expectations accordingly. It is in helping to find things he or she can still do that self worth is saved and confidence restored. Aggression, depression, obsessions and compulsions, hallucinations and paranoia are all behaviors the caregiver may have to confront. Add to that irrevocably changed family dynamics, and it becomes clear that families must work together to learn new, unfamiliar terrain. The imbalance is that the lion’s share of the work will fall to the caregiver. Following are some tips that should be helpful:
Because Huntington’s disease is progressive, the symptoms exacerbate as the disease advances. Late stage symptoms of the disease include dystonia, sustained abnormal postures that include facial grimaces, twisted neck and arched back; chorea or choreoathetosis, a condition in which involuntary movements like jerking, twisting and writhing become more pronounced; a slowness of voluntary movements to include abnormal eye movements and gait disturbances; an inability to regulate the speed or force of movements; an inability to initiate movement; slowed reactions; difficulty speaking and swallowing due to involvement of the throat muscles; localized or generalized weakness and impaired balance ability; and rigidity. In most patients, chorea peaks and then declines while rigidity and slowness in movement may become more significant. Rigidity and spasticity are late stage problems that can affect gait, lead to falls and eventually lead to the need for a wheelchair. While an enumeration of these complications paints a bleak picture and must illustrate the feeling of helplessness faced by caregivers, it is important for others to understand not only what the patient is living but what their caregivers face daily.
There is great reason for hope in combating Huntington’s, however. Since 1991, Columbia University’s HDSA Center for Excellence has been working tirelessly to provide help to those who have the disease (www.hdny.org). And recently, Sirna Therapeutics and the University of Iowa announced groundbreaking results in a preclinical study for the treatment of Huntington’s disease through RNA Interference Therapy. One day at a time, with the help of people who care and want to find answers, through the courage of those living with the disease and because of the 24/7 dedication of caregivers, there will be answers. Those who live it know that Huntington’s disease does not have to have the last word. It can be a statement of victory from those who learn in each moment to overcome overwhelming odds.
Helpful Hints for Caregivers
Fresh infection detected in Liberia as Guinea and Sierra Leone report steady stream of new cases
The group, which represents 11,000 investment professionals, says their valuations index, which has been running for three years, is in effect flashing red over the high valuations of bonds.
Brad Crombie, head of fixed income at Aberdeen Asset Management, said: “You only know you’re in a bubble when it pops. But this market could pop. There is more tension and anxiety over valuations than for a long while.
Even with respect to some of the most liquid markets in the world (S&P500 equities) and with respect to the weakest possible version of the hypothesis (so-called “weak form” — the hypothesis that there is no information in the past history of share prices which can be used to predict the future), it doesn’t work…. Momentum effects exist and can’t be rationalised away as statistical noise; fund companies like AQR have been offering funds based on them, and generally outperforming, for ages. And when you get to anything stronger than the very-weak form versions, the performance is really quite embarrassing….
Market prices are… in some sense a weighted average of the views of a large group of well-resourced and intelligent people with an incentive to get things right. But nobody would build a theory of politics around the infallibility of opinion polls — business schools certainly wouldn’t let any other department get away with claiming that it’s definitionally impossible to improve on the current state of affairs. All that’s really left of market efficiency is a sort of woolly idea that “it’s difficult to make money in the stock market”. Which it is, but it’s pretty difficult to make money in any other way too…. Efficient markets theories have the advantage for economics academics that they provide a useful response to an often-asked question by class smart-alecs (“If you’re so smart, why aren’t you rich?”), and… provide… sensible advice for personal finance (tracker funds). But this really isn’t a reason to keep them on the syllabus3/22:
|Long Distance Caregiving - A Growing Phenomenon|
By Liza Berger, Staff Writer
It usually starts with a call: A father casually informs you he’s been diagnosed with congestive heart failure. Your mom’s neighbor says she’s noticed that Mom hasn’t been herself lately. A sibling tells you it’s about time you came down South to visit Dad.
Caregiving is often triggered by a crisis. And all of
a sudden, an adult child is forced to come to grips
with a newfound new role as a long-distance caregiver.
Approximately seven million adults, including more than three million Baby Boomers, provide or manage care for a relative or friend over the age of 55 who lives at least an hour away. That is according to the “Handbook for Long-Distance Caregivers” from the Family Caregiver Alliance and its partner, the National Center on Caregiving. Like the changing patterns of living, gender roles have evolved too. Men now represent more than 40 percent of caregivers, the National Institute on Aging reports. Meanwhile, a study by MetLife Mature Market Institute in conjunction with the National Alliance for Caregiving indicated that 23 percent of long-distance caregivers are the sole primary caregiver.
Whether primary or secondary, man or woman,
caregiving from afar is loaded with anxiety-producing
questions: How do I make sure Mom or Dad receives the
proper care? Where do I find the necessary care
services? How do I balance my life here with caring
for him there?
Assessing your family member’s condition is the first step toward getting a handle on the situation, caregiving organizations say. It should include both a medical diagnosis and an evaluation of the individual’s need for assistance, according to the guide “Long Distance Caregiving” from MetLife in cooperation with the National Alliance for Caregiving. Making regular visits is probably the best way to appropriately determine a loved one’s limitations and needs. Ask such questions as: Is there a change in personal hygiene? Does he or she appear unsteady when getting up or down from a chair? And does he or she seem to be increasingly forgetful? These help to determine the type and amount of care that a loved one may require. Also, a caregiver shouldn’t forget to always spend some quality time with a loved one during a visit. Research is key in learning about the types of services that are available in your loved one’s community. One good idea is to use the phone or computer to find out what the resources and options are before a visit. Then a caregiver can set up appointments to meet providers during the visit. Caregivers should make a point of meeting their family member’s doctors and others who help their family member.
Services in the community to consider include: meal delivery, adult day care, in-home aides, transportation, help with Medicare claims and telephone check-ins. A long-term care facility, such as an assisted living facility or nursing home, may also be an option. The Administration on Aging’s Elderare Locator helps find aging services in a particular community. To find out more, call 800-677-1116, or visit www.eldercare.gov. (More resources for long-distance caregivers are at the end of the story.)
A geriatric care manager (GCM) may be just the person
a long-distance caregiver is looking for to help
assess a loved one’s needs and coordinate services.
Often trained as gerontologists, social workers or
nurses, they can suggest care options, provide
referrals to local resources and help guide you
through the complex system of long-term care.
It’s also important to involve the loved one in the decision-making process.
It’s important that caregivers tend to their own physical and emotional health. Recognize what you can and can’t do. Forgive yourself for not being perfect, according to the “Long-Distance Caregiving” guide. Don’t become isolated from your friends, families and activities. Support groups may offer a way for caregivers to share their feelings with others who are in similar situations. If a caregiver is experiencing signs of depression, sleeplessness or feelings of helplessness, it may be a good idea to seek help, experts say.
It takes a special person to be a caregiver. Those who are doing it should recognize that they are doing a valuable, loving and caring act—and for this they should be proud.
There are many places long-distance caregivers can
turn to for help. Here are a few:
Family Caregiver Alliance
National Council on Aging Benefits Check-Up.
This interactive tool tells you a little about what is behind the tax forms. What does each line mean? How many people make an entry? How does it affect revenues and the distribution of tax burdens across income categories?
This year’s version covers the 2014 Form 1040—the most common return—and Schedule A, where taxpayers tally up itemized deductions. The biggest change from 2013 is the addition of three lines related to the Affordable Care Act that reconcile subsidies used to purchase health insurance on the federal or state exchanges or collect penalties from people who failed to obtain required coverage.
the Federal Open Market Committee said it anticipated lifting rates when it had seen further improvement in the labour market and was “reasonably confident” that inflation would move back to its 2 per cent target over the medium term. This new language did not mean the committee has made up its mind when to raise rates, however, the statement added.
The biggest market reaction was seen in US equities, where the broad S&P 500 index erased losses to rise 1.1 per cent. Investors bought up US Treasuries, pushing yields on the benchmark 10-year note 6 basis points lower and back below 2 per cent.
Obesity increases cancer risk by around 40 percent in women, according to new figures from Cancer Research UK.
the list of obesity-related
short. The data show that obesity increases the risk of at least
seven different kinds of the disease: bowel (colon) cancer, womb
(uterine) cancer, post-menopausal breast cancer, gallbladder
cancer, kidney cancer, esophageal cancer, and pancreatic cancer.
EFM- This is not an esoteric comment. When dealing with long term care, life insurance, actuarial lifetime, health factors change how to plan for retirement.
While being a caregiver to unusual or so-called “difficult” behaviors, it is quite common for persons with dementia to display these types of behaviors and while many of these behaviors are predictable, like repetitive questioning, pacing, forgetting how to use common objects, etc., there are others that are more upsetting to both the caregiver and the individual with dementia. Agitation in the form of shouting, pushing, resisting care; spitting out food; urinating in inappropriate places, disrobing; wandering, etc., are the kinds of behaviors that are truly unsettling and should prompt investigation. Special note should be made of the fact that medication in the form of sedatives, tranquilizers, and other “behavior” medications like antipsychotics need not be the first step. Many of the medications given to help control these behaviors can cause more harm than good. It is true that in certain instances these types of medications are warranted, but far too often these medications are prescribed as a knee-jerk response when no or few other strategies have been attempted to reduce the problem or are continued for far too long without attempts to reduce the dosage or discontinue the drug.
Current thought on best practices with regard to understanding difficult behaviors in persons with dementia focuses on the concept of unmet need. As human beings, we all have certain, basic physical and emotional needs: air, food, water, sleep, comfort, love, safety, security, belonging, etc. Individuals with dementia continue to have these needs despite their disease; their disease, however, may make it more difficult for them to express or satisfy these needs. For example, if I no longer am capable of explaining an abstract concept like insecurity due to the cognitive impairment I have related to Alzheimer’s disease, yet I feel that way, how can I express it? If I have physical discomfort due to arthritis pain in my hips and lower back but cannot articulate the words to describe it due to the language impairment I have related to Alzheimer’s disease, how can I tell you that I am in pain when you try to get me out of my chair? I may “show” you by resisting, or withdrawing, shouting, striking out or any number of other ways that seem like difficult behavior. When in fact, I am trying to “tell” you that I have an unmet need: I am in pain; I need comfort.
As caregivers, you know your loved one well. You may be surprised when he or she does something out of character or behaves unusually. You may be tempted to respond abruptly or seek strong medication to curb the problem. Better strategies would include an analysis of the potential causes of the behavior focusing on unmet need. Some common themes related to physical need: Is your loved one in pain? Many older adults have chronic pain that research tells us is inadequately or even un-treated. The addition of a regularly scheduled mild analgesic may be of tremendous benefit. Could your loved one have an infection? The most common infections that we see in older adults with dementia are urinary tract infection, pneumonia, and skin infections from scratches or open wounds. This can be very uncomfortable for the individual and definitely contribute to exaggerated behaviors. You would need to see a physician for treatment of these. Could your loved one be dehydrated? As we get older, we have a diminished thirst response and coupled with common medications that older adults take, like diuretics (“water pills”) that further dehydrate them, you could see increased confusion. Is your loved one uncomfortable due to constipation? Again related to poor fluid intake and certain medications (add calcium supplements to the list), lack of exercise, and limited dietary fiber, older adults are at risk for constipation which can be very uncomfortable. Simple strategies like providing regular liquids throughout the day, adding fiber to the diet and a daily walk can help.
Some common themes related to emotional need: Is your loved one bored? Are they wandering or trying to leave your home to find something more interesting to do? Conversely, is the day too busy or too overwhelming and they are looking for more quiet time? The best days for persons with dementia are when they have balance between sensory stimulating and sensory calming activities. Is your loved one frightened of being left at home alone? Are they feeling sad or depressed? The research tells us that the rate of un or under-treated depression is quite high in older adults with dementia. Providing social times and opportunities for continued belonging are important; consider a pet, plant or an indoor garden to offer care responsibilities and purpose to the individual with dementia.
It may take some time before you are able to identify the potential causes of the challenging behavior, but understanding that it may be the result of an unmet need is an important first step. Unfortunately, there are behaviors that we may never be able to understand as they are part of the mystery of this challenging illness. Finally, it is very important to have a care team that accepts this approach to behaviors as well. Understanding challenging behaviors is key to meeting your needs as a caregiver!
Why has there been very little price change in the explicit fees consumers pay for managed accounts?
“Within the managed accounts practice at Cerulli, the questions most frequently asked by our clients relate to fees,” explains Tom O'Shea, associate director at Cerulli. “Since 2008, there has been very little price change in the explicit fees that consumers pay for subadvisory separate accounts, mutual fund accounts, rep-as-portfolio-manager services, and rep-as-adviser accounts.”
According to Cerulli, the explicit costs of all types of managed account programs varied only three to six basis points between 2008 and 2014
female labour force participation rate in India at around 33 per cent of the workforce, well below the global average of 50 per cent and the east Asian level of 63 per cent.
In contrast to trends elsewhere, the proportion of women working in India has declined over the past decade, while the 50 per cent gender gap — the difference between male and female participation rates — is second only to Saudi Arabia’s among the G20 economies.
Linda Thunström (HUI Research AB) ; Jonas Nordström (Department of Food and Resource Economics, University of Copenhagen) ; Jason F. Shogren (Department of Economics and Finance, University of Wyoming)
We examine consumer certainty of future preferences and overconfidence in predicting future preferences. We explore how preference certainty and overconfidence impact the option value to revise today’s decisions in the future. We design a laboratory experiment that creates a controlled choice environment, in which a subject's choice set (over food snacks) is known and constant over time, and the time frame is short -- subjects make choices for themselves today, and for one to two weeks ahead. Our results suggest that even for such a seemingly straightforward choice task, only 45 percent of subjects can predict future choices accurately, while stated certainty of future preferences (one and two weeks ahead) is around 80 percent. We define overconfidence in predicting future preferences as: the difference between actual accuracy at predicting future choices and stated certainty of future preferences. Our results suggest strong evidence of overconfidence. We find t hat overconfidence increases with the level of stated certainty of future preferences. Finally, we observe that the option value people attach to future choice flexibility decreases with overconfidence. Overconfidence in future preferences affects economic welfare because it says people have too much incentive to lock themselves into future suboptimal decisions.
Traditional academic literature has relied on so-called "limits to arbitrage" theories to explain why investment managers are unable to eliminate the effects of investor "irrational" preferences (either the asset-pricing anomalies or the behavioral finance literature) on asset pricing. We demonstrate, however, that investment managers may not eliminate the observed asset-pricing anomalies because they may contribute to their existence. We show that if managers face constraints such as a "tracking-error constraint," coupled with the need to hold liquidity to meet redemptions or to actively-manage investments, they optimally hold higher-volatility securities in their portfolios. Investment constraints, such as tracking-error constraints, however, reduce the principal-agent problems inherent in delegated asset management and serve as effective risk-control tools. Liquidity reserves allow managers to meet redemptions or redeploy risks efficiently. We prove that invest ment managers will combine a portfolio of active risks (a so-called "alpha portfolio") for a given level of liquidity with a hedging portfolio designed to control tracking error. As the demand for either liquidity or active management increases presumably because of confidence in alpha, the cost of maintaining the tracking-error constraint increases in that the investment managers must finance these demands by selling more lower-volatility securities and holding more higher volatility securities. With more demand for the "alpha" portfolio, managers are forced to buy more of the tracking-error control portfolio. Investment managers and their investors are willing to hold inefficient portfolios and to give up returns, if necessary, to control the tracking-error of their portfolios. Given the liquidity and tracking-error constraints, investment managers concentrate more of their holdings in higher volatility (higher beta) securities. And, we show that it is optimal for investors to lim it their manager's use of leverage, which implies that leverage has a different cost other than the cost of borrowing exceeding the return from lending. Empirically, we show that active investment managers, such as mutual funds, hold portfolios that concentrate in higher volatility securities. Moreover, when they change their holdings of their "alpha" portfolios (reduce or increase their tracking error by choice), the relative prices of higher volatility stocks change according to the predictions of the model. That is, if investment managers move closer to a market portfolio, the prices of lower-volatility stocks rise more than the prices of higher-volatility stocks given changes in the prices of other market factors.
Meryem Duygun (School of Management, University of Leicester, UK) ; Juan Carlos Matallín-Sáez (Department of Finance & Accounting, Universitat Jaume I, Castellón, Spain) ; Amparo Soler-Domínguez (Department of Finance & Accounting, Universitat Jaume I, Castellón, Spain) ; Emili T ortosa-Ausina (IVIE, Valencia and Department of Economics, Universitat Jaume I, Castellón, Spain)
This paper analyses the relationship between active management and performance in US equity mutual funds over the period 2001-2011 for both gross and net returns. Mutual funds achieve nonzero abnormal performance through strategies that produce differentiated results which are not captured by risk factors. Active management is measured by time-varying parameters, idiosyncratic risk and turnover. The results show a negative aggregate performance close to zero. Performance is worse for non-survivor mutual funds. A U-shaped relation is found between active management and performance, thus both the best and the worst mutual funds show a higher level of active management. This behaviour is also found in the relationship between expenses and performance. Active management therefore implies selecting different strategies or investment bets with higher expenses and an unequal performance is achieved. However some level of persistence in the success of these bets is only f ond for the best mutual funds. Moreover the results of these bets show a low level of similarity in terms of herding between the best funds. In contrast, the failures of the worst mutual funds are not persistent before expenses are considered, but there is a higher level of herding among these funds. In sum, the best funds reflect persistence and particular skills, whereas the worst present non-persistence and common failures.
The tables and charts below provide yield rates for AAA, AA and A rated bonds in 10, 20 and 30-year maturity ranges. These rates reflect the approximate yield to maturity that an investor can earn in today's tax-free municipal bond market as of 3/13/2015.
Mike BushnellJust 2% of all gainfully employed respondents in a recent survey said they would cash out their DC plan’s balance if they switched jobs, but in reality, 45% of all transitioning workers do so. In the Winter issue of NAPA Net the Magazine, Warren Cormier examines why so many people take the money and run. READ MORE
the market has been rising despite a barrage of corporate reports that might suggest that stock prices are overextended. After all, growth in both revenue and earnings for the last quarter has decelerated. For the 440 companies in the Standard & Poor’s 500-stock index that had reported by Wednesday, revenue for the fourth quarter rose only 1.5 percent over the period a year ago, compared with a 4.1 percent growth rate for the third quarter at the same point in the previous earnings season, Mr. Yardeni said.
Comparable numbers for earnings were an annual increase of 5.9 percent in the fourth quarter, versus a 10.4 percent rise at the same point in the previous earnings season. The strong dollar, falling oil prices and a sluggish global economy have all taken their toll.
worse, guidance for future earnings turned extremely
EFM- so should you care that much? Well, how are you invested? To
gain assets, quite obviously. But on the other side you are
terribly concerned about a major drop. But you can only have a
major drop in your equities if you want to. If you don't want to,
then don't. You have to know how much a true correction is
(percentage) and then DCAD. Pretty simple actually.
|Drug Dispensing and the Caregiver|
By M. Simon
One of the common issues that caregivers have to deal with on a daily basis is the need to dispense their care recipient’s medication in a safe and timely fashion. Navigating the dangerous waters of different pill sizes, colors and dosages can be an intimidating experience as most family members and home care workers possess neither an in-depth knowledge of these medications nor the ability to discern when a problem with the pills may be developing. Elderly and infirm clients often seem to be on a never ending slew of pills that need to be doled out on a regular basis. It doesn’t matter that the clients have accumulated them honestly, usually a few at a time during each hospital admission; but the sum total is what the home care worker, family member or employee, must face every day on the job.
In past years, medications were often dispensed
three or four times per day or worse. Thankfully, in
our modern day, each medication only has to be taken
once or twice every twenty-four hour period. The
downside is that there are a lot more diseases we
can treat and consequently a lot more pills people
First of all, it’s a good idea to keep all medications in a safe and secure place. Playful grandchildren, nosey visitors and even confused patients will get into the pill bottles if they’re left unattended. Some medications have to be refrigerated, but most can be safely stored in a secure cupboard. Pharmacies, in an effort to keep your business, have developed blister packs that link the pills with specific days of the week. So, in the middle of a busy day, if the caregiver suddenly wonders “Did I give him his morning pills?” all it takes is a quick look at the package to confirm that, yes, it was given. In the same vein, all medications should be administered at the same time every day. Modern pills have been designed for specific durations and maintaining a regular dosing schedule will decrease the risk of adverse reactions.
Not to overstate the obvious, but dosages of drugs should not be changed without first consulting the client’s physician. The old adage “If one is good, two is better” does not apply in these situations. Playing with the dosages of blood thinners, heart pills and pain killers can easily have unforeseen and unfortunate side effects.
Despite what the infomercials say, don’t start
using over-the-counter products, herbs, vitamins and
supplements without first discussing it with a
physician. Not only is quality control for these
products somewhat lacking (as compared to
prescription medications), but they may interact
with the client’s normal medications by increasing
or decreasing the medicinal concentration in the
There are also options to consider if the condition of the person you are caring for begins to deteriorate. For example, if problems develop with his or her ability to swallow, there may be some pills that can be changed to a liquid or even given through a small butterfly needle in the skin. Some newer medications are actually a combination of two or three different drugs and using them could decrease the total number of pills consumed daily.
Another aspect to consider, especially if his or her condition is worsening, is whether they really require all those medications. If grandmother, who is well into her ninth decade, is truly failing, does she really need that cholesterol pill or that Alzheimer’s drug? Maybe it’s time to have a family discussion with the physician and ask the question, “Have we reached the point where we are treating the disease instead of the patient?” One of the benefits of modern medicine is that we have so many wonderful drugs to combat the detrimental aspects of aging and disease. However, just because these drugs now exist doesn’t always mean it’s in the best interest of the client to use them.
The use of medicines is one aspect of caregiving that will not disappear in the foreseeable future. It is a complicated and precise job that requires concentration and adherence to a rigorous schedule. The aforementioned tips are meant to simplify this task and make life that much easier for the caregiver in your family.
is Brain Injury Awareness Month
Traumatic Brain Injuries can Result from Senior Falls
Traumatic brain injuries due to falls caused nearly 8,000 deaths and 56,000 hospitalizations in 2005 among Americans 65 and older, according to a new report from the Centers for Disease Control and Prevention released in the June issue of the Journal of Safety Research.
Traumatic brain injuries, or TBIs, are caused by a bump or blow to the head; however, they may be missed or misdiagnosed among older adults. TBI often results in long-term cognitive, emotional, and/or functional impairments. In 2005, TBIs accounted for 50 percent of unintentional fall deaths and eight percent of nonfatal fall-related hospitalizations among older adults.
Falls are not an inevitable consequence of aging, but they do occur more often among older adults because risk factors for falls are usually associated with health and aging conditions. Some of these conditions include mobility problems due to muscle weakness or poor balance, loss of sensation in feet, chronic health conditions, vision changes or loss, medication side effects or drug interactions, and home and environmental hazards such as clutter or poor lighting.
“Most people think older adults may only break their hip when they fall, but our research shows that traumatic brain injuries can also be a serious consequence,” said Dr. Ileana Arias, director of CDC′s National Center for Injury Prevention and Control. “These injuries can cause long-term problems and affect how someone thinks or functions. They can also impact a person’s emotional well-being.”
Each year, one in three older Americans (65 and
older) falls, and 30 percent of falls cause injuries
requiring medical treatment. In 2005, nearly 16,000
older adults died from falls, 1.8 million older adults
were treated in emergency departments, and 433,000 of
these patients were hospitalized. Falls are the
leading cause of injury deaths and nonfatal injuries
for those 65 and over.
Key findings are:
Arias also points out that as more baby boomers reach retirement age, these types of injuries will increase demands on the health care system unless action is taken to prevent the injuries. “CDC has developed tips and suggestions for older adults, their caregivers, health care providers, and communities to help prevent falls,” Arias said.
For older adults, their children, caregivers, and health care providers, CDC recently developed the “Help Seniors Live Better, Longer: Prevent Brain Injury” initiative. Developed in collaboration with 26 organizations, it features easy-to-use English- and Spanish-language materials in a concise question-and-answer format to help prevent, recognize, and respond to TBI. For more information and materials, visit www.cdc.gov/TraumaticBrainInjury/seniors.html.
CDC has also created resources for practitioners and community-based organizations. “Preventing Falls: What Works. A CDC Compendium of Effective Community-based Interventions from Around the World” and “Preventing Falls: How to Develop Community Based Fall Prevention Programs for Older Adults” can be downloaded or ordered at http://wwwdev.cdc.gov/HomeandRecreationalSafety/Falls/preventfalls.htm.
A healthy 55-year-old man can now expect to pay, on average, $2,075 per year for $164,000 in initial benefits, up from $1,765 last year,
The cost for a healthy, single woman of the same age is higher: Her average premium is $2,411, up from $2,307. Insurers take gender into account when pricing long-term care policies, since, statistically, women live longer and are more likely to need long-term care.
Couples generally get a discount if they buy a joint policy; the rationale is that one or the other is likely to provide some care for a spouse initially, Mr. Slome said. A married couple, both age 60, would now pay $3,930 combined, up from $3,840, for $328,000 of initial coverage.
The numbers assume a “three-year” policy that uses a daily benefit of $150 to compute a maximum payout, and includes inflation protection — a 3 percent compounded annual increase in benefits. Eliminating inflation protection greatly reduces the cost — the average premium for a single man would be cut roughly in half — but that means you will probably have to pay more out of pocket if you eventually need care. A middle option, which costs more than the base premium, allows the choice of adding inflation protection later.3/10: India rape
ine months after India was rocked by the gang rape and murder of a young physiotherapist on a Delhi bus, popular Bollywood actress Kalki Koechlin made a satirical video called “Rape: It’s your fault”.
In three-and-a-half minutes of very black humour, the actress mocked pervasive patriarchal attitudes — expressed openly by Indian public figures — that blamed urban women and their conduct for the rising violence against them
In the film India’s Daughter , aired in the UK on Wednesday night, Mukesh Singh, who has been sentenced to death for his role in the attack, expresses no remorse, and blames the young woman for her own fate, saying she should have neither been out at night nor resisted the assault.
“A girl is far more responsible for a rape than a boy,” the convict told Leslee Udwin, the British director, in a chilling interview filmed in New Delhi’s Tihar jail. “A decent girl won’t roam around at 9 o’clock at night.” Calling her death an “accident,” Singh added, “when being raped, she should not fight back. She should just be silent and allow the rape”.
On average, chief market strategists' forecasts are worse than those made by a guy I call the Blind Forecaster. He's a brainless idiot who assumes the market goes up 9% -- its long-term historic average -- every year, regardless of circumstances.
Some quick math shows the strategists' forecasts were off by an average of 14.7 percentage points per year.
How about the Blind Forecaster? Assuming the market would rise 9% every year since 2000 provided a forecast that was off by an average of 14.1 percentage points per year.
Underperforming the Blind Forecaster isn't due to 2008, which forecasters like to write off as an unforeseeable "black swan." Excluding 2008, the strategists' error rate is 12 percentage points per year, versus 11.6 percentage points per year for the Blind Forecaster.
More than a third of staff at the Department for Work and Pensions are expected to lose their jobs in the next five years as Whitehall leaders brace themselves for more sweeping cuts across the civil service after the general election
New rules forcing fund supermarkets to reveal their pricing structures have prompted more wealthy self-directed investors to move their money, research shows.
Direct-to-consumer fund supermarkets that charge flat fees, an arrangement that benefits those with large amounts of money to invest, have seen a steep increase in the average size of customer accounts, according to research by The Platforum, a business information company.
February 13th marked the 25th anniversary of the bankruptcy of Drexel Burnham Lambert. I remember driving to work at Drexel’s Beverly Hills office that morning having no idea what was about to happen. My years at Drexel in the late 1980s and those I spent managing the firm’s private equity holdings in the 1990s were an intensive education in credit and human nature. Twenty-five years after Drexel’s demise and seven years after a crisis that pushed the global economy to the brink of collapse, the world is drowning in debt and derivatives. As a point of reference, when Drexel filed for bankruptcy, it had a balance sheet of $3 billion. When Lehman Brothers filed for bankruptcy in 2008, its balance sheet was two hundred times larger at $600 billion. As Figure 1 below illustrates, debt has grown exponentially while the global economy has crept along at a petty pace. Six years after the financial crisis, interest rates have been driven below zero in much of the developed world,2 a sign that policy makers have failed to create sustainable economic growth. (The latest tally is that $1.9 trillion of European sovereign debt is trading with negative yields.) They have managed to inflate financial assets but left the real economy behind. For example, U.S. equity prices have gained 122% since 2009 while US nominal growth has grown by only 18% over the same period. Having exhausted their ability to employ interest rates as a policy tool, policy makers are now shifting their sights to currencies to stimulate growth. But currencies are themselves nothing more than a form of debt, a promise by a sovereign. And those promises are being actively debauched in a series of currency wars that are certain to end badly for those who depend on fiat money for their daily bread...3/9:
We estimate the equity risk premium (ERP) by combining information from twenty models. The ERP in 2012 and 2013 reached heightened levels—of around 12 percent—not seen since the 1970s. We conclude that the high ERP was caused by unusually low Treasury yields.
The Labour leader’s latest market intervention reflects concerns that people exercising new freedoms over their pension savings could be exploited by companies offering new products.
A market survey of drawdown products by Which? found big variations in annual charges between companies and even with the same pension provider. “Our research uncovered several high-charging drawdown products, including one that charges 2.76 per cent,” said Which?. “We think this is too high for the mass market and want to see a cap introduced on products sold to customers by their existing provider.”
Which? said a saver with a typical £36,000 pension pot, taking £2,000 a year in income drawdown, would save £10,300 over their retirement if charges were capped at 0.5 per cent instead of 2.75 per cent.
3/8:Falling Marriage Rates Reveal Economic Fault Lines
72.2% in 1960
68.6% in 1970
62.3% in 1980
50.5% in 20123/8: Generational differences force re-examination of workplace retirement education
In the past five years, employers have realized just how precarious a position their employees are in when it comes to retirement and they have begun to put plans in place to help get them moving in the right direction.
A report released this week by Financial Finesse, a provider of financial wellness programs, shows just how ill-prepared baby boomers, Gen Xers and millennials are for retirement.
In the case of baby boomers, they are generally doing well financially but “those who are unprepared for retirement have little time to save, and even those who are prepared face some financial risks.”
Employers are becoming more aware of their employees’ financial situations, particularly when it comes to older workers.
“We’ve seen an increase in their urgency and willingness to dedicate teams to this by building financial wellness programs,” said Liz Davidson, CEO of Financial Finesse. “People are designing and monitoring these programs and the budget dollars have gotten much larger. They are also doing much more analysis on behavioral change and what is triggering the behavioral change.”EFM- None are teaching risk cause they have never been taught it. Nor how to mitigate almost all major losses.
Can employees stressed out about their personal finances be as productive as those who are not? Not likely. Survey data supports the intuitive answer. For example, 41% members of the Society for Human Resource Management responding to a poll last year reported that an “overall lack of monetary funds to cover personal expenses” took a toll on some of their employees’ output levels.
The assumption seems to be not that employees aren’t paid a living wage, but that they have some shortcomings in their personal financial management skills.
The government of Brazil’s President Dilma Rousseff is being forced to allow energy and fuel prices to rise after earlier subsidising them in a bid to boost consumption and spur the country’s slowing economy.
This has fuelled inflation, which grew at a monthly rate of 1.24 per cent in January compared with December, or an annualised rate of 7.14 per cent — exceeding the central bank’s target range of 4.5 per cent plus or minus two percentage points.
EFM- I gave up on Mexico and South America years and years ago. Huge graft and terrible economics.
|What to look for in a
Yes, it is long but it's necessary for you or your parents.
Use the following checklist to assist you in assess nursing homes. If possible, both the caregiver and care recipient should be involved in the decision making process. The more an older person participates in the planning process, the easier it will be to adjust to the new environment.
Staff and Care
(c)Senior Living Alternatives, which, publishes FREE semi-annual guides to senior housing in the Detroit, Chicago, Cleveland, Cincinnati, Columbus and Toledo areas, and Milwaukee and Madison, Wisconsin. Call toll-free for free copy: 1-888-SLA-7276. For Nationwide Information, visit http://www.senioralternatives.com
What to Look for in Assisted Living Communities
Using the following checklist to assist you in assesses assisted living communities. If possible, both the caregiver and care recipient should be involved in the decision making process. The more an older person participates in the planning process, the easier it will be to adjust to the new environment.
Assessing an Assisted Living residence as you tour the facility:
Is staff available to provide 24-hour assistance with activities of daily living (ADL) if needed?
ADLs include: __Dressing __Eating __Mobility __Hygiene and grooming __Bathing, __toileting __incontinence __Using the telephone __Laundry __Housekeeping in unit __Transportation to doctor, hairdresser, activities, etc. __Shopping __ walking/caring for pets. others:______________
Features of individual units
Social and recreational activities
Senior Living Alternatives(c), which, publishes FREE semi-annual guides to senior housing in the Detroit, Chicago, Cleveland, Cincinnati, Columbus and Toledo areas, and Milwaukee and Madison, Wisconsin. Call toll-free for free copy: 1-888-SLA-7276. For Nationwide Information, visit http://www.senioralternatives.com
We have concluded that we did not have adequate controls designed and in place to ensure that we correctly implemented changes made to one of our methodologies as part of our comprehensive long-term care insurance claim reserves review completed in the third quarter of 2014. As a result, we failed to identify a $44 million after-tax calculation error. Although this control deficiency did not result in a material misstatement in the consolidated financial statements, we have concluded a material weakness exists in the controls over the implementation of our long-term care insurance claim reserves assumption and methodology changes because such a misstatement could have occurred. We are currently working to remediate the material weakness ... We cannot be sure when we will successfully remediate the material weakness or whether compensating controls will be effective b efore then in preventing or detecting material errors.
EFM- now I wonder what will happen
to all the other companies selling any form of their policies.
In periods when the markets do not change dramatically, most investors get it right most of the time but it does not make them any money. It is very valuable to forecast radical changes, as in the case of oil prices, but most people don’t get this right and this makes forecasting so unavailing. When something radical happens, someone gets it right, but Marks asks himself did this person get anything else right before or after, or do they just take extreme positions?
“It’s not what you don’t know that gets you in trouble but what you know for certain that just ain’t true.”
If you think the same as everybody else, you will act the same as everybody else. If you act the same as everybody else, you will perform the same as everybody else. If you want to outperform, then you have to think differently and act differently with higher level thinking.
With first-level thinking, an investor thinks that a company is great and buys the stock. With second-level thinking the investor thinks that the company is great but not as great as everyone thinks and therefore sells the stock. Marks described first-, second- and third-level thinking in the context of Maynard Keynes’ observations in predicting winners in newspaper beauty contests in London in the 1920s. With first-level thinking, you pick the winner based on your opinion. However to win the contest you need to have at least second-level thinking and pick the girl who you think will get the most votes.
Hunt provided further details on Keynes’ observations of
third-level thinking on his Epsilon
Hunt stated that to win the contest you have to make a
third-level decision and pick “who will get the most votes when
all the voters are basing their votes on who they think will get
the most votes”.
I'm not sure the liquor makes