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By Jim Gibson,                                   Times Colonist                                   July 29, 2010

Jim Wiebe conducts a bell choir for the members of the music therapy program at the Oak Bay Kiwanis Pavilion. He says music helps people with dementia connect with the here and now, something many can’t do on their own.

Photograph by: Darren Stone, Times Colonist, Times Colonist

Music therapist Jim Wiebe is in full voice at the Oak Bay Kiwanis Pavilion, home to 122 residents with varying degrees of dementia.

This morning’s group consists of six people — five of whom are in wheelchairs — in a semi-circle around him. None appear to be even mouthing the words to Side by Side along with Wiebe. Two men, however, are attempting a tentative beat with their bodhran-like drums. Two of the women appear asleep, tambourines idle on their laps.

Wiebe is unfazed.

After 22 years in music therapy, he knows what counts: the small glimmers of a connection between the individual and the music.

“We’ve got to look for the small changes,” he used to tell his music therapy students at Winnipeg’s Canadian Mennonite University.

Pavilion acting director Penny Donaldson is a big fan of music therapy for those slipping away through dementia, or “the long goodbye” as she sometimes terms it.

“Even though they have dementia, there’s still an opportunity to use the brain. Music brings a lot of pleasure, a flood of happy hormones that help fight depression and make the brain work better,” she says.

Research supports music therapy, according to Wiebe. It calms agitation and stimulates the brain. It’s also a social activity.

If we just warehoused people, they’d sleep or stare out into space, he says. That’s what happens if we don’t intervene with music therapy.

The goal of music therapists with seniors is to maintain their functions at a given level for as long as possible, he says. It also improves their quality of life.

Wiebe comes three days a week to the pavilion, working with small groups such as this morning’s. Occasionally, it’s one-on-one, as he did with a former professional guitar player who became musically alive whenever handed the instrument he mastered decades ago. It helped him organize his brain, Wiebe says. Eventually he slipped too far for the guitar to bring him back even briefly in sessions with Wiebe.

Wiebe has a larger group, the Blue Bells, who use tonal bells to create music as they learn to focus and follow direction.

“They turn out a neat sound, but it’s a group activity, building a sense of community for them so that they are not alone,” Donaldson says. They also have a brief sense of accomplishment.

The program costs $26,000 annually. It’s funded by the Oak Bay Kiwanis Health Care Society, the pavilion’s owner and operator. The society raises the money in part through events such as its Greater Victoria Garden Party,

Aug. 15, at the pavilion.

Donaldson speaks longingly of expanding the music therapy program to five days, but knows the pavilion hasn’t the funding. Wiebe, employed by the Victoria Conservatory of Music, also does music therapy at two other locations offering services similar to the pavilion’s.

“I love the work,” he says.

While at the University of Kansas, he studied with one of the pioneers researching music and dementia. The last part of the brain to go is that which responds to music, Wiebe says.

Through music he tries to help the individual connect with the here and now, something many can’t do on their own.

“Music is in the moment. It cuts through the fog of dementia and they’re here with me,” Wiebe says.

Invariably, some of the lyrics the residents once knew drift up through the fog. Wiebe has an inkling what songs to try from his past work with them and from family interviews.

The rest of this morning’s sessions are given over to favourite songs. There’s no reaction when he asks one woman for her favourite. Wiebe re-phrases the question: What song did her father whistle on his way home from work?

Barely audible, she says It’s a Long Way to Tipperary. Wiebe keeps the sparse conversation alive by asking if her father was a better whistler or singer. Whistler, she responds.

Wiebe starts singing Tipperary, urging her “to sing it for dad.” He softens his voice, allowing her scratchy whisper to be heard singing.

“Way to go,” he says at the finish, later telling a visitor that what put the smile on her face were the memories of her dad.

Wiebe makes his way around the others, singing such individual favourites as Rose Marie, It Don’t Mean A Thing and Loch Lomond. He has one more favourite to sing before his session ends. It’s Que Sera Sera for the woman at the far end of the group.

Wiebe begins singing, but the woman’s eyes are closed as though soundly asleep. Suddenly, they snap open as though startled. After a pause, she begins to sing Que Sera Sera in a weak but pleasant soprano.

“Oh, you have a wonderful voice,” Wiebe tells her.

Her face lights up; not only does she sing now, she taps the beat out on her thigh.

“You’re our own Doris Day, you know,” Wiebe says.

jgibson@tc.canwest.com

© Copyright (c) The Victoria Times Colonist

The Greater Victoria Garden Party

By Dennis Thompson
HealthDay Reporter

WEDNESDAY, May 26 (HealthDay News) — Osteoarthritis used to be thought of as an older person’s condition. 

The joint disease occurs over time as the cartilage between bones breaks down and wears away, allowing the bones to rub together and causing pain, swelling and loss of motion. 

“If you live long enough, it’s like death and taxes — you will likely get osteoarthritis,” said Dr. Todd Stitik, an associate professor of physical medicine and rehabilitation at the University of Medicine and Dentistry of New Jersey. 

But these days, doctors have been seeing osteoarthritis more frequently in younger people, particularly osteoarthritis of the knee joints. Researchers are trying to figure out why. 

The most promising avenues of study have tied early onset knee osteoarthritis to serious knee injuries, such as anterior cruciate ligament (ACL) tears. 

One study found that impact-related ligament tears inside the knee can play havoc on the surrounding cartilage cells. Impacts that were hard enough to tear ligaments but not fracture bone or cartilage still caused cartilage cells to die off in a cascade that reached well away from the impact zone. 

“If you have injury to the cartilage, that can weaken the cartilage and make it less durable over time,” said the study’s lead author, Dr. Constance R. Chu, an associate professor of orthopedic surgery at the University of Pittsburgh and director of its Cartilage Restoration Center. “What we’re looking at is an impact injury that wasn’t sufficient to fracture the cartilage, but I still would consider it a major impact.” 

The damage done to the cartilage cells by that type of injury would be invisible on a typical MRI scan, Chu said. Nonetheless, she guessed that about half of the people who sustain an ACL tear could develop osteoarthritis within five to 10 years. The findings were reported in the December issue of the American Journal of Sports Medicine. 

Most early onset osteoarthritis appears to be tied to exercise and sports. People are playing harder at younger ages and potentially doing themselves harm by not protecting their joints. 

Another study, this one presented at the 2009 annual meeting of the Radiological Society of North America, found that people engaged in high levels of physical activity sustained more severe knee injuries, including such damage as fluid buildup in bone marrow and lesions on their cartilage and ligaments. Such injuries drastically increase the chances of developing osteoarthritis, according to the researchers. 

Stitik cited as an example a college student he treated. She was in her early 20s, had been doing a lot of exercises, such as squats and lunges, that are hard on the knees, and she had been doing them improperly, he said. 

“An MRI showed arthritic changes already taking place under her kneecap,” Stitik said. “She was doing exercises improperly and was overdoing it. She was with a personal trainer and also exercising on her own — just doing too much.” 

However, Chu suspects there also is a connection between early onset osteoarthritis and the growing obesity epidemic. 

“If someone is overweight or obese, they put more stress on cartilage that has been weakened by injury,” she said. “It is chronic overload [and] a very likely cause of osteoarthritis.” 

People who injure a knee should approach their recovery with great care if they want to reduce their chances of osteoarthritis, Chu said. 

“Give the joint some time to recover,” she said. “How long, we don’t really know — but for sure until any pain or swelling goes away. Then they should gradually return to their activity.” 

Active adults can better protect their knees from injury by strengthening their thigh and leg muscles through exercise, Chu said. These muscles provide crucial support to the knee joint. People also should be careful about the amount of high-impact exercise they do and should try to drop some pounds if they are overweight, she said. 

“I actually advise my patients that the same types of things we think are good for their heart — regular exercise, eating well — are likely to be the healthiest for their joints as well,” she said. “We can’t control our genetics. Some people are literally born with tougher cartilage. It’s the lifestyle factors that are under people’s control that absolutely factor into whether a joint injury translates into early osteoarthritis. There are things people can do to reduce their chances of having terrible knees at a very, very young age.” 

Copyright © 2010 HealthDay. All rights reserved.SOURCES: Todd Stitik, M.D., associate professor, physical medicine and rehabilitation, and director, musculoskeletal/occupational medicine, University of Medicine and Dentistry of New Jersey, Newark, N.J.; Constance R. Chu, M.D., Albert B. Ferguson associate professor of orthopedic surgery, and director, Cartilage Restoration Center, McGowan Institute for Regenerative Medicine, University of Pittsburgh; Nov. 30, 2009, presentation, Radiological Society of North America annual meeting, Chicago; December 2009, American Journal of Sports Medicine

The Oak Bay Kiwanis Pavilion is asking you to make a difference to the lives of some of Greater Victoria’s most vulnerable seniors.

We appeal to your generosity to help us provide resources so necessary to the comfort and well-being of residents of the Oak Bay Kiwanis Pavilion and their families.

We are requesting your generous support in helping fund Physical Therapy Services to maintain resident’s independent mobility throughout the complex care and dementia disease process. Every opportunity to help our residents be active brings a taste of joy to people at all stages including end of life. Strengthening exercises are central to this goal. Currently we do not have access to the equipment needed for this type of exercise program.

The Pavilion’s primary funding for basic care comes largely from the Vancouver Island Health Authority (VIHA). The funding received covers direct care, but little else. The Kiwanis Pavilion Foundation works hard to find funding for resources that provide Pavilion residents with a quality of life that you and I may take for granted.

If we are fortunate to receive more funds than is necessary for this item, any extra will be put towards Art Therapy and other resident support programmes or the growth of The Kiwanis Pavilion Endowment Fund.

Please mark your calendar and join us for a Summer Garden Party on August 15.

We would like to take this opportunity to invite you to a special afternoon that includes auctions, food, games, live entertainment and a celebration of summer in a spectacular garden setting. The event will also increase awareness of Pavilion programs. More information will be coming on the Foundation website, http://www.obkp.org/foundation.

The Kiwanis Pavilion is owned and operated by the Kiwanis Club of Oak Bay through the Oak Bay Kiwanis Health Care Society. Since its launch in 1982 as a seniors care facility, the role of the Pavilion has changed considerably. It has adapted and grown with the challenge of caring for seniors with complex care needs, including dementia, surrounding them with understanding and love.

Sincerely,

Brian H Beckett,

Foundation Chair

www.obkp.org

NEWS RELEASE

For immediate release:

March 17, 2010

KIWANIS PAVILION BOARD SEEKS ALTERNATIVES

TO OPERATIONS FOR KIWANIS PAVILION

VICTORIA – The Oak Bay Kiwanis Health Care Society has informed its residents, their

families and employees that it will be seeking alternatives for the operations of the Kiwanis Pavilion.

The Health Care Society has successfully operated the Pavilion for almost 30 years.

However, declining Kiwanis Club memberships and increasing complexities in the delivery of health care have led to the decision to look at other options for managing the facility which include finding a new operator to assume responsibility of the Pavilion.

“The Kiwanis Pavilion is an excellent facility and we are very proud of the quality care we

deliver to residents,” said Barbara Gies, Vice-Chair of the Board of Directors. “We understand  that this has been a difficult announcement for employees, residents and their families to hear but we felt it was important they know the situation. This process will likely take about 18 months to complete – and I want to emphasize that throughout this process we will operate business as usual.”

The Pavilion is home to 122 residents who suffer from dementia or are either physically frail or suffer mild cognitive impairment. Gies reiterated that communication with both residents and their families would be regular, with all parties kept abreast of progress.

“We are committed to our employees, to the comfort and care of our residents and to continuing to provide a trusted community service,” said Gies. “Our ultimate goal is to achieve a seamless transition with as little disruption as possible to employees, residents and their families.”

The board has initiated discussions with the Vancouver Island Health Authority in regards to finding a suitable operator for the Pavilion. “It is our desire that Kiwanis Pavilion will continue to operate as it does today for years to come under the direction of a new operator,” said Gies. “We made a difficult but responsible decision intended to ensure the future well-being of the Kiwanis Pavilion’s many employees and residents.”

-30-

For more information contact:

Kim Van Bruggen

250-727-7464

 An undated image of the human brain taken through scanning technology. Credit: Reuters/Sage Center for the Study of the Mind, University of California, Santa Barbara/Handout

CHICAGO (Reuters) – People with a family history of Alzheimer’s disease often have clumps of a toxic protein in their brains even though they are perfectly healthy, researchers said on Monday. Health They said the findings could lead to new ways to identify people most likely to develop Alzheimer’s disease, when there is still time to do something about it.

“The hope is to one day be able to diagnose very clearly the Alzheimer’s disease process before any symptoms occur, when the brain is still healthy. Then the treatments would have the best chance of success,” said Lisa Moscone of New York University Langone Medical Center, whose study appears in the Proceedings of the National Academy of Sciences.

The team wants to continue to follow the people in the study to see whether they develop dementia, and they want to replicate the findings in a much larger study.

Several teams have been working on better ways to detect early-stage Alzheimer’s disease in hopes of developing drugs that can fight it before it causes too much damage.

Current treatments cannot reverse the course of Alzheimer’s, a mind-robbing form of dementia that affects more than 26 million people globally.

Moscone’s team used an imaging technique called positron emission tomography or PET with a fluorescent dye called Pittsburgh Compound B that lights up clumps of a protein called beta amyloid that are a hallmark of Alzheimer’s disease.

The team imaged the brains of 42 people with an average age of 65, all with healthy brain function. Of these, 14 people had mothers who had Alzheimer’s; 14 had fathers with the disease; and 14 had parents with healthy brain function.

Brain scans of all 42 showed that those whose parents — either fathers or mothers — had Alzheimer’s were more likely to have amyloid plaques in their brains. This was especially true of people whose mothers had Alzheimer’s. “They have pretty much 20 percent more amyloid beta deposits in their brains.

In other words, they had an almost four times greater risk for amyloid beta pathology,” Moscone said in a telephone interview. The finding confirms other studies that suggest having a mother with Alzheimer’s may be a greater risk factor.

“It looks like if you have maternal history of Alzheimer’s disease, the risk of amyloid beta plaque and a reduction in brain activity is much greater as compared to having a father affected,” Moscone said. After advanced age, a family history of Alzheimer’s is the single biggest risk factor for developing the disease. Not everyone who has beta amyloid plaques in their brain develops Alzheimer’s disease, but Moscone said having the plaques does increase the risk. (Editing by Eric Walsh)

Budget likely to ignore impact of aging population

Baby boomers’ incomes helped once helped chop away at the federal deficit, and they will be missed once they start vanishing from the tax rolls. 

Chris Wattie, CTV.ca News 

Date: Wednesday Mar. 3, 2010 8:45 AM ET 

Most of the substance of Thursday’s federal budget will centre on spending cuts and the growing deficit, but experts say the government is ignoring the demographic elephant in the room: the looming effect of an aging Canadian population on federal finances. 

“It’s a little like seeing a great big glacier coming down the valley,” says William Robson, analyst with the C.D. Howe Institute. “It doesn’t seem particularly urgent because it isn’t moving very quickly … but once it arrives it sure changes the landscape.” 

The national fertility rate has fallen from a peak of 3.9 children per woman at the tail of the baby boom to 1.5 children per woman now. 

Meanwhile, life expectancy has risen to 80.7 years in 2006, from 58 years in 1926. By 2019, individuals over the age of 65 are expected to account for more than a quarter of the population; and by 2029, more than a third. 

Tina Kremmidas, chief economist for the Canadian Chamber of Commerce, says the recession and rising unemployment has diverted attention from the population shift those figures represent and the coming shortages in the labour market they will create. 

In a pre-budget report, entitled “Recession, Recovery and the Future Evolution of the Labour Market,” she warns that Canada’s aging population created shortages before the recession and those will resurface when the economy recovers. 

“Labour shortages are not a huge issue now, but as the recovery progresses they will return,” she says. “Before the recession hit, 36 per cent of businesses in Canada reported some kind of labour shortage … that’s only going to get worse.” 

Robson says that this year represents the peak of Canada’s percentage of 18 to 64 year olds — the prime age group for the workforce. “This is the highest this age group has ever been and it’s as high as it ever will be,” he said. 

“It’s all downhill after this year.” 

Having such a large percentage of the population in the workforce, especially with the baby boomers in their prime wage and salary earning years, helped drive up government revenue in the late 1990s. That, in turn, helped eliminate the federal deficit. 

“Now we’ve hit the high point and we’re going to fall down the other side a lot faster than we rose,” says Robson. 

Yet Kremmidas does not expect such issues to be a major, or even minor theme of this year’s federal budget. “There are some key structural problems that have to be addressed that haven’t been addressed … and there’s no guarantee that the budget will begin to address them.” 

She says governments have so far been slow to react to the challenges posed by demographic changes in the workforce. “Governments, and not just the current government, tend to focus short term,” she says. 

“Their focus is on winning the next election. This is a very long-term issue … [and] governments need to think more long-term.” 

With the birth rate falling, governments at every level need to start coming up with ways to expanding participation in the workforce by seniors, aboriginals, the disabled and immigrants, Kremmidas says. 

“We need to expand Canada’s labour force if we want the Canadian economy to continue to grow.” 

Sylvain Schetagne, of the Canadian Labour Congress, agrees that more needs to be done to address the problems caused by a slow in the growth of the labour force and the aging of our population. 

“Governments have to start doing something about this, not only at the federal level, but also at the provincial level,” he says. “There’s going to be some major challenges.” 

He says the federal budget should recognize this by introducing measures to improve access to education and retraining and to better absorb immigrants into the workforce. But it must also work on improving pensions, which will be of greater importance every year that the percentage of Canadians hitting retirement age increases. 

“Their focus has been on balancing the books; balancing the books,” he says. “Unfortunately that doesn’t do much to address these problems.” 

The parliamentary budget watchdog has already warned the government that it faces a battle with the provinces over health-care spending because of Canada’s greying population. 

“The major demographic transition that is underway in Canada will strain governments’ finances over the next several decades,” states a report issued last week by Parliamentary Budget Officer Kevin Page. 

“Aging will move an increasing share of the population out of their prime working-age years and into their retirement years. With an older population, spending pressures in areas such as health care and elderly benefits are projected to increase. At the same time, slower labour force growth is projected to restrain growth in the economy, which will slow the growth of the general tax base.” 

The report suggested the resulting strain on federal finances will be most pronounced in health care, as services for Canadian seniors account for a larger and larger share of federal spending. 

If transfer payments to the provinces to pay for this health-care are allowed to grow at their current rate, the federal government will have to raise taxes or cut spending by nearly $30 billion in the next budget to keep the deficit in check. 

In addition to health transfers, a number of other federal programs are expected to face cost pressures, including Old Age Security and the Guaranteed Income Supplement. 

(AP) — c ()-2010, The Washington Post

If you think that getting older is the beginning of the end, think again. Sure, skin loses some elasticity and joints get creaky, and maybe you can’t keep your eyes open past 9:30 p.m. But even people well into their 80s are going to yoga and Pilates classes, volunteering, having sex and taking college courses. In short, getting older has its upside.

Don’t believe it? Then listen to these experts: John Murphy is a Brown University Medical School professor and expert on geriatrics; Cheryl Phillips is chief medical officer of On Lok, a nonprofit organization in San Francisco that advocates for the elderly and for long-term care. Here’s what they had to say about aging, in separate interviews:

What gets better as you age?

Murphy: Memories and stories get better. I think that past recollections, which are so much richer than in my younger patients, can really flavor how (older people) respond to new occurrences in life. Seniors generally identify quality of life as good. As we age, we each start to develop a sense of perspective that makes us more valuable in contributing to society.

A couple of weeks ago, I spoke with two seniors who recalled the 1918 influenza outbreak; one was in New York, one was in Berlin. To hear them, what it was like then, certainly they put the panic … and the H1N1 (flu) in perspective. I also think the wisdom that people bring to every encounter is significantly enhanced when you get older.

Phillips: Very often, as people age, they will describe a much broader network of family and friends. There is an opportunity to expand that network, adding new friends and family.

If you look at aging as a series of losses-strength, hearing, eyesight, friends, time-people will get depressed and see it as a negative. If they see it as new opportunities-historian of family experiences and a new opportunity to travel-they will embrace it. Really, it starts with the framework and perspective. Many 80 year olds say, “There’s no way I’d want to go back to that way of life (in their younger years). Now I get to sit back and watch others work.”

Language skills continue to improve into our 40s and 50s. Skills that depend on strategy and learning get better in our middle ages. Not only do we have experience to build from, but our brains store learned patterns. We know, for example, that people are better drivers in their 30s and 40s than in their teens and early 20s: Just ask the insurance companies.

Many sports that require repetitive actions and thus learned muscle responses also get better. Peak athletic performance is in the late 20s and early 30s, but it is often later than that when we best learn how to discipline ourselves, use better thinking and strategy planning and be more observant.

What about sex

For the rest of this article, go to http://www.nj.com/newsflash/index.ssf?/base/lifestyle-1/1265749238102690.xml&storylist=health&thispage=2