White Coat Notes

Driving and dementia

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November 5, 2007

A diagnosis of Alzheimer's disease does not automatically mean an end to driving, experts on aging said at an MIT conference last week, but because there is no test to determine when people with dementia should no longer get behind the wheel, families need help deciding when to take away the keys.

"All people with Alzheimer's will eventually be unable to drive," said Robert Stern, co-director of Boston University's Alzheimer's Disease Clinical and Research Program. "That does not mean they can't drive early on in the disease. Everyone has a different course. It steals cognitive skills at a different pace."

Caregivers say their loved ones with Alzheimer's are driving an average of 10 months longer than they think is safe, gerontologist Jodi Olshevski of The Hartford said. The insurance company collaborated with MIT's AgeLab and BU to find ways to help caregivers spot - and then deal with - the warning signs of trouble.

Uninsured veterans
You might think that veterans automatically have healthcare from the government, but one in eight working-age veterans is uninsured, a study from Cambridge Health Alliance reports.

Healthcare at Veterans Health Administration hospitals and clinics is limited to veterans who have service-related conditions or who have incomes of less than about $30,000 a year, depending on where they live. That leaves many middle-income veterans under 65 without coverage of any kind, mirroring the situation of other uninsured groups, Dr. Steffie Woolhandler, author of the study in the American Journal of Public Health, said in an interview.

"I - and I think a majority of Americans - had assumed that all veterans were automatically eligible for healthcare, and this in fact was true in the late 1990s," she said. Now "the majority of middle-income veterans are excluded."

Compassionate caregiver
Barbara Moscowitz thinks older adults are overlooked by people who can't see past their walkers and hearing aids, their illnesses and infirmities to the human beings inside.

"I want to live in a universe that will see me not as a long list of chronic diseases but as an individual first who might have to cope with illness," Moscowitz, 54, said in an interview.

For her work at Massachusetts General Hospital with people with Alzheimer's and their families, she received the Kenneth B. Schwartz Center's Compassionate Caregiver of the Year Award on Thursday at a dinner attended by 1,700 people.

MGH best place to work
Massachusetts General Hospital is the best place to work in academia, according to a survey of scientists by The Scientist. Beth Israel Deaconess Medical Center ranked 10th, and Dana-Farber Cancer Institute came in 34th in the magazine's list of top 40 US academic institutions.

Mass. General scored high in job satisfaction, peers, management, infrastructure and environment, the magazine reports in its November issue.



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