Cutting edge News on the globe　　海のむこうの　いまどきニュース

　

With Independence Day approaching, it’s important to remember that maintaining your independence is important if you have Alzheimer's disease. Doing so for as long as possible can be beneficial to your quality of life and self-esteem. People with Alzheimer’s can remain independent during the early stages by making simple adjustments, taking safety precautions and relying on the support of caregivers.

シンプルなことで、自立を維持しよう

独立記念日独立記念日を前に、もしあなたがアルツハイマー病ならば、自立を維持することを思い起こすことは大切だ。

HHS News 　　4/15
US Department of Health and Human Services　　アメリカ合衆国　ヘルス・ヒューマンサービス省

Coordinated Care for People with Medicare and Medicaid
メデイケア／メデイケイド　（高齢者向け／低所得者向け医療制度）　利用者のための、コーデイネイト・ケア

　◆15州に、予算各100万ドルーー全米900万人の重複サービスを調整

The U.S. Department of Health and Human Services (HHS) today announced four initiatives to give states more flexibility to adopt innovative new practices and provide better, more coordinated care for people with Medicaid and Medicare while helping reduce costs for states and families. The initiatives support the Obama administration’s work to make Medicaid more flexible and efficient and to address long-term cost growth. Several of the announcements also help implement provisions of the Affordable Care Act. Today HHS announced:

“Medicaid programs provide health coverage for millions of low-income Americans who otherwise would lack access to health care,” said HHS Secretary Kathleen Sebelius. “With these new resources and flexibilities, states will have new options to make their Medicaid programs work better for the people they serve, while helping lower their costs.”

Under a new initiative funded by the Affordable Care Act, 15 states will receive up to $1 million each to develop new ways to meet the often complex and costly medical needs of the approximately nine million Americans who are eligible for both the Medicare and Medicaid programs, known as “dual eligibles.”
The goal of the program is to eliminate duplication of services for these patients, expand access to needed care and improve the lives of dual eligibles, while lowering costs. The new Federal Coordinated Health Care Office, or the Duels Office, at the Centers for Medicare & Medicaid Services (CMS), was created by the Affordable Care Act to improve care for dual eligibles and will work with the states to implement the top strategies to coordinate primary, acute, behavioral and long-term supports and services for dual eligibles, improving quality and lowering costs.

The 15 states that will receive these funds are :

California, Colorado, Connecticut, Massachusetts, Michigan,
Minnesota, New York, North Carolina, Oklahoma, Oregon,
South Carolina, Tennessee, Vermont, Washington and Wisconsin.

“Beneficiaries who are in both Medicare and Medicaid can face different benefit plans, different rules for how to get those benefits and potential conflicts in care plans among providers who do not coordinate with each other,” said Donald M. Berwick, M.D., administrator of CMS. “This can be disastrous for those beneficiaries who are most vulnerable and in need of help.”

CMS proposed new rules today giving states new flexibility for their programs to help people with disabilities choose to live in their communities rather than in institutions. The proposed rules reduce administrative barriers for states seeking to help multiple populations, which may include seniors and/or people with different types of disabilities. They will also allow individuals to participate in the design of their own array of services and supports, including such things as personal care and respite services for caregivers.

“These long awaited rules will help people living with disabilities realize the promise of the ADA to live in the least restrictive environments possible for them—like their own homes,” said Henry Claypool, director of the Office on Disability at HHS. “With these new tools as well as incentives included in the Affordable Care Act, states, working closely with advocacy groups, beneficiaries, and other stakeholders, can more easily develop effective plans to improve options for people with disabilities. We hope states will take advantage of this new flexibility.”

New rules issued today will provide 90-percent of the cost for states to develop and upgrade their IT systems to help people enroll in Medicaid or the Children’s Health Insurance Program (CHIP) – and
75-percent of ongoing operational costs. This increase over the previous federal matching rate of
50-percent will help states prepare for the Medicaid improvements and expansion that will come in 2014 from the Affordable Care Act, when many more Americans will be eligible for these programs, and to coordinate enrollment with the Exchanges. The rules establish performance standards for the improved eligibility systems to promote greater efficiency and a more consumer-friendly enrollment process.

Note: All HHS press releases, fact sheets and other press materials are available at http://www.hhs.gov/news.

National Alliance for Caregiving // 　

　　flyer 'The caregiving Exchange 　April 2011
　「ケアを与えあうこと」　２０１１　4月号より抜粋　4/12

Legislative Update　　法制化　　現状

12州の新法案のうち、カリフォルニア州のもののみ抜粋　

California: Sponsored by Assemblywoman Yamada, this bill would enact the Community Care Modernization Act of 2011. A. 594 would establish the California Department of Adult and Aging Services in the California Health and Human Services Agency, for the purpose of maintaining individuals in their own homes, or the least restrictive homelike environments for as long as possible, by integrating services under a single agency, to establish stronger, more focused leadership for home- and community-based services for all older adults and persons with disabilities.
The bill would provide for the appointment of the director of the department by the Governor, and would specify the director's duties and it would require the department to convene a stakeholder committee to assist the department in coordinating with other state agencies. A. 594 is now in the hands of the Human Services, Aging and Long Term　Care Committee.

カリフォルニア：　コミュニテイーケア近代化法２０１１：　A. 594
障害を持つすべての高齢者が「在宅、あるいは家に近い環境」　にできるだけ長く暮らせることを目的に、ヘルス・ヒューマンサービスエージェンシーの
カリフォルニア成人・高齢者サービス部　が強く、集中したリーダーシップを発揮し、家とコミュニテイーを基盤としたサービスを作り上げていくための法案。

法案により、知事は部門デイレクターを任命し、他のエージェンシーとの協力で、部門を支えるための　株主委員会を　開催、運営することがもとめられる。
Ａ594は現在、ヒューマンサービス・　高齢・長期ケア　委員会に委ねられている

National Alliance for Caregiving ／全米ケアする同志の会
4720 Montgomery Lane
Bethesda, MD 20814

　　For Immediate Release　緊急報告　　e-flyer from NAC 　　National Alliance for Caregiving 　3/31

NEW STUDY REVEALS BALANCE OF POSITIVE AND NEGATIVE ASPECTS
FOR CAREGIVERS OF INDIVIDUALS WITH ALZHEIMER’S DISEASE OR DEMENTIA

新しい研究結果：　アルツハイマー病や認知症の誰かをケアする人の　プラス面マイナス面のバランス均衡

Caregivers’ Views Related to Stage of Loved One’s Illness
and
Whether Caregiver Had a Choice in Assuming Responsibility

ケアを与える人が、愛する人の病の進行と、責任を選択するかどうかを考える視座

WASHINGTON, DC, March 31, 2011— One-half of caregivers of individuals with Alzheimer’s disease or dementia surveyed for a new caregiver study find an equal balance of positive and negative experiences in their caregiving. One-third (33 percent) say their caregiving experience is more positive than negative.

ワシントンＤＣ　２０１１年３月１１日　　—アルツハイマー病あるいは認知症の誰かをケアしている半数が新しい介護者調査に答えた。
プラス、マイナスの体験のバランス均衡で、　３３％は、マイナスよりプラス面が多いと感じていると答えている

The 2011 report, “Caregivers of Individuals with Alzheimer’s or Dementia,” which was presented at a briefing on Capitol Hill today, examines both positive and negative feelings associated with caregiving for individuals with progressive deterioration of their abilities and faculties. Conducted by the National Alliance for Caregiving and sponsored by Pfizer Inc., the study found that:

「アルツハイマー病あるいは認知症のケアを与える人」　２０１１　報告／首都ワシントンＤＣで発表：　
病気の進行とともに、ケアを与える人の感じ方についての調査・ＮＡＣ　米国ケアを与える人の会／Pfizer Inc· ファイザー製薬

　　　　·　Two out of three caregivers feel that caring for their loved one gives them the opportunity to “give back” (65 percent)
　　　　　　　　　　３分の２（６５％）は、愛する人をケアして　「与え返す」　機会を得たと感じている

· Nearly one-half of caregivers feel they now have a closer personal relationship with the person to whom they provide care (46 percent)
　　　　約半数（４６％）は、ケアを与えている人と、人として、より近い関係を持てていると感じている

· More than four in 10 feel they now live more “in the moment” than they did before (44 percent)
　　　　１０人に４人以上（４４％）は、以前より、「その瞬間」に生きていると感じている

When asked how they have been changed by their caregiving experience, 67 percent are more grateful, 60 percent are more accepting, 56 percent are more patient and 51 percent are more assertive.

Emotional stress appeared as one of the prevalent negative feelings associated with caregiving. In fact, 61 percent of caregivers reported feeling highly stressed. Forty (40) percent indicated feelings of guilt that they were not doing more to help their loved one and 39 percent reported anger with themselves for becoming frustrated with their loved one.

When looking at the initial signs of the disease, the study found that nine of 10 caregivers observed events and situations that led them to believe their loved one probably had Alzheimer’s or dementia. Only three in 10 say a doctor’s examination or questioning was one of the events that initially contributed to their thought that Alzheimer’s or dementia was present (31 percent).

“I think that it’s revealing that 70 percent of family caregivers recognized the symptoms of Alzheimer’s on their own, without a doctor’s questioning,” says Gail Hunt, CEO and president of the National Alliance for Caregiving. “This shows me that the public is beginning to understand the signs and symptoms of Alzheimer’s. Primary care physicians may need more education to help in screening older patients.”

The study looked at the care recipients’ condition, diagnosis of the illness, actions taken and information sources used, the impact of the caregiving situation, profiles of caregivers and background on the caregiving situation. Results found that caregivers’ views of their situations were related to two factors: the stage of their loved one’s illness and the choice they felt they had in assuming their caregiver role.

“Patients with dementia rely on caregivers every day,” says Warachal Faison, Pfizer’s Director of Primary Care Medical Affairs. “It’s imperative that we support these caregivers, so they can balance their work and the needs of their loved ones. As the number of dementia patients grows, we need to be attentive to family caregivers who are making significant sacrifices for the good of others.”

The “Caregivers of Individuals with Alzheimer’s or Dementia 2011” report is based on a quantitative survey of 1,000 family caregivers, age 18 or older, who provide unpaid care to an individual with Alzheimer’s, dementia or age-related mental confusion or forgetfulness. Respondents were screened to ensure their care recipient was at least 40 years old. The on-line questionnaire was fielded from September 14 to September 27, 2010.

At Pfizer, we apply science and our global resources to improve health and well-being at every stage of life. We strive to set the standard for quality, safety and value in the discovery, development and manufacturing of medicines for people and animals. Our diversified global health care portfolio includes human and animal biologic and small molecule medicines and vaccines, as well as nutritional products and many of the world's best-known consumer products. Every day, Pfizer colleagues work across developed and emerging markets to advance wellness, prevention, treatments and cures that challenge the most feared diseases of our time. Consistent with our responsibility as the world's leading biopharmaceutical company, we also collaborate with health care providers, governments and local communities to support and expand access to reliable, affordable health care around the world. For more than 150 years, Pfizer has worked to make a difference for all who rely on us. To learn more about our commitments, please visit us at www.pfizer.com.

Copyright © 2010, CarePages, Inc.
Everyday Caring : Eating Healthy Meals When Stress Strikes

When stress seems to have taken over your life,
healthy meals and snacks are better for body and mind
than that sugary brownie.
Find out how good food can help you cope.

By Linda Foster, MA
Medically reviewed by Pat F. Bass III, MD, MPH

It’s natural to crave chocolate cake, ice cream, and other foods that seem to improve your mood when you’re feeling stressed, even though you know they’re not healthy snacks. The problem is, they may temporarily lift your mood, but they can also send you crashing when the sugar high goes away, and if the extra calories cause you to gain weight, you may have a whole new source of stress.

There’s no need to soothe your nerves with empty calories when you can be eating healthy meals and snacks that can help your body and mind fight the harmful effects of stress and improve your health in general.

Calming Your Brain and Body With Healthy Foods

“Ever wonder why you’re calm and somewhat sleepy after eating a big turkey dinner?,” asks Karen Hutton, RD, MA, LDN, patient services manager of food and nutrition services at Methodist Medical Center of Illinois in Peoria. It’s because turkey contains tryptophan, an amino acid found in many protein-based foods that can have a calming effect on the body.

Foods containing tryptophan, complex carbohydrates (not simple sugars, including fructose found in fruit), and vitamin B6 are all known for their positive effects on serotonin production. Serotonin is a chemical in the brain that has a positive effect on mood.

“It is commonly known as the ‘good mood’ chemical, and increased levels of serotonin can induce a sense of relaxation,” says Melissa Mietzner of the Illinois State University Graduate Dietetic Program. She says there are many healthy meals that may positively affect mood during times of stress. “Some of these foods can help with serotonin levels, while others help with muscle relaxation.”

What Foods Should You Eat to Decrease Stress?

“Good sources of tryptophan include milk, soy, animal proteins such as lean beef and poultry, and cottage cheese,” says Mietzner. Whole grains, such as oatmeal, whole-wheat pasta, and popcorn are some of the best sources of serotonin-boosting carbohydrates.

Good sources of vitamin B6 are spinach, avocado, wheat germ, bananas, tuna, and some fortified cereals — choose whole-grain cereals with a high fiber content, not a high sugar content.

Want a tryptophan-packed breakfast to start your day? Hutton recommends eating two eggs fixed however you like, and having a cup of soy milk and one serving of oatmeal or high-fiber, whole grain bread.

Mietzner says eating foods that contain magnesium and calcium have also been shown to have a relaxing effect on the muscles; getting too little calcium can cause muscle tension and spasms. The best sources are low-fat or fat-free dairy foods, like milk, yogurt, and cottage cheese. Good sources of magnesium include almonds, green leafy vegetables like spinach, oatmeal, soy, dairy products, and whole grain cereals.

Easy to make, healthy snacks that combine these foods include low-fat cottage cheese on whole-grain crackers, a layered yogurt and banana parfait, a simple smoothie made with low-fat milk or yogurt and your favorite fruit, and oatmeal topped with sliced almonds.v

When Eating Better Doesn’t Help Enough

While we all have had certain foods make us feel better or even worse, most of the scientific evidence for the mood-food relationship has been done in the lab rather than on people, so your response to these foods and specific nutrients may vary. If you feel that you’re experiencing significant stress or possibly depression, talk to your doctor about other treatments, such as medication, that may help get you through stressful times.

「もしあなたが、　より良いケアがより利用しやすく　なるために

この　「利用可能なケア・アクト」（ケアの法律）　を改善するためのアイデアがあるなら、

是非一緒に改善したい。　必要な修正をして、ぜひ前進しよう。」

Now, all week long, you have a great opportunity to keep the conversation going.

そして今、一週間ずっと、この件の会話を継続する方法媒体がある。

We encourage you to get involved and use one of these channels to speak out.

あなたに、これらのチャンネルを利用して、声を上げるよう是非呼び掛けたい。

This is a great opportunity to voice your support for the Campaign for Better Care and to ask critical follow-up questions about how health care reform can be implemented in ways that provide the care coordination and improved communication we all need.

これは、ベターケアキャンペーンをサポートすることに　「あなたが」　声を出していただく好機だ。
医療ケアの調整とコミュニケーションの向上ができるような医療改革について、
重要なフォローアップの質問をぜひしてほしい。　

それを必要としている我々すべてのために。

Debra Ness, President, National Partnership

＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝

村田裕之／スマートシニア・ビジネスレビュー　11.1.24 Vol. 147

＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝

私は今から11年以上前にスマートシニアというコンセプトを提唱しました。
当時のスマートシニアの定義は、「ネットを縦横に活用して情報収集し、
積極的な消費行動をとる先進的なシニア」というものでした。

スマートシニアの増加で、多くの市場が変わったことを
これまで本レビュー、拙著や講演等で何度もお話してきました。

しかし、ネットの進化は、11年前の予想を超えた
本人の知恵を「賢く社会に貢献するシニア」という
新たなスマートシニア像を生み出しつつあります。

アメリカ・ロスアンジェルス在住の94歳の女性、
バーバラ・クーパーさんによる「Ask Grandma Anything」
（おばあちゃんの人生相談）がその一例です。

これは、ネット上で寄せられるさまざまな相談に
バーバラおばあちゃんが動画で答えるというものです。

興味深いのは、相談が世界中から寄せられること。
これはネットが世界の多くの地域に普及し、
生活インフラになったがゆえに可能となったことです。

それ以上に興味深いのは、
とりわけ若者から多くの相談が寄せられることです。

様子を見ていると、多くの若者が彼女に相談するのは、
単に知識としての助言を求めているだけでないようです。
彼女の言葉や身振りを通じて、彼女の人柄が伝わり、
それに癒されているのが理由のようです。

こうした深いコミュニケーションが可能になったのは、
ブロードバンド、動画、デジタル・ビデオという
過去10年間における道具の進化のせいです。

一方、彼女の知恵を動画に収め、ネットで伝えているのが、
彼女の二人の孫娘だという点も見逃せません。
バーバラおばあちゃんがいくら知恵を持っていても、
彼女らなしに、世界中に伝わることはないからです。

また、喜ばしいのは、彼女らが、
おばあちゃんから頼まれてやっているのではないことです。

自慢のおばあちゃんの知恵をネットで伝えると、
世界中から反応があることが自分たちの発見でもあり、
本人たちのやりがいになっているのがいいのです。

豊かな高齢社会とは、
高齢者だけが豊かになる社会ではありません。

豊かな高齢社会とは、
高齢者と若者という異なる世代が互いに仲良く、協調し、
双方の世代の関係性が豊かになっていく社会なのです。

バーバラおばあちゃんと孫娘の協働作業は、
このことを改めて実感させてくれます。

Wanted: A National Respite System KAREN STABINER　　求められる国家的息抜きのシステム

Jill Kagan, who has chaired the National Respite Coalition since 1994, hopes to change all that — not household by household, but at the policy level. She is determined to help caregivers who can’t afford private options find a way to catch their breath.

Respite advocates face a Goliath-sized challenge on a decidedly David-sized budget. Authorized by Congress in 2006, the Lifespan Respite Care Program was intended to support and expand the delivery of respite services nationwide. In each of the last two years, the federal Administration on Aging has provided $2.5 million to the program, the bulk of it granted to individual states to develop their own initiatives.

“Each state has a $200,000 grant over three years,” she said. “They are doing some incredible things to identify, streamline and coordinate services, do public awareness and maybe leverage some other federal, state and private funding sources. But very few will actually be able to provide services to very many people directly at this time.”

Respite care is in desperate need of a systematic solution, Ms. Kagan believes. The Lifespan program is a first step. The immediate goal for state grantees is the creation of what Ms. Kagan calls “model infrastructures” ending the duplication of services and bringing about some coordination. Progress varies by state: Those with more active existing respite programs should be able to fund services more quickly than those only starting to address the issue.

The respite program covers caregivers “across the lifespan” — that is, people who care for disabled children as well as for parents and spouses.

According to studies by The Commonwealth Fund and Evercare, a subsidiary of the insurer United Healthcare, these caregivers are less likely to be employed, likelier to miss work if they are employed, and often don’t have medical insurance. They are less healthy as a group than people who aren’t caregivers.

Ms. Kagan says there is a particular need among those who care for the elderly, especially if the caregiver is older as well. Among those older than 66 and experiencing stress related to caregiving responsibilities, there is a 60 percent higher mortality rate, compared to non-caregivers who are in the same age group.

“Meaningful quality respite is the first thing I would make sure every caregiver has access to,” said Ms. Kagan. “It is what most caregivers have on the top of their lists. There is a continuum of other services that caregivers desperately need, but without just a moment to step back and take a rest, how are they supposed to figure out what they need, let alone have the energy, time, and resources to seek it out?”

The A.R.C.H. National Respite Network’s “The ABCs of Respite” is a primer on what kind of help is available and how caregivers might avail themselves of various services. The network’s locator service helps families find and pay for respite services regardless of the age of the person being cared for. The National Caregiver Support Program, administered through local Area Agencies on Aging, focuses specifically on funding respite for those caring for aging friends or relatives.

There are also volunteer and faith-based programs that provide occasional respite.

None of it comes near to making a dent in the needs of the caregiver population, according to Ms. Kagan. The goal of the National Respite Coalition is “to keep respite policy and funding alive,” Ms. Kagan said. “The grassroots movement has grown, and we have formed over twenty active state respite coalitions.”

The coalition hopes to see funding for the Lifespan program raised to at least $5 million next year. But with the economy still in the doldrums and a new Congress reluctant to fund new social programs, Ms. Kagan said, the prospects seem increasingly unlikely.

With Alzheimer’s Patients Growing in Number,
Congress Endorses a National Plan

アルツハイマー病の患者数増加、米国下院は国家プラン承認　　12/23

By PAM BELLUCK

Published: December 15, 2010　 On Politics, 　Ｔｈｅ　Ｎｅｗ　Ｙｏｒｋ　Ｔｉｍｅｓより

Congress has voted unanimously to create, for the first time, a national plan to combat Alzheimer’s disease with the same intensity as the attacks on AIDS and cancer.

下院国会は、満場一致で、初めて、アルツハイマー病と対峙する国家プラン策定を可決した。これは、エイズやがんと同等のレベルのプランになる

The bill, expected to be signed by President Obama, would establish a National Alzheimer’s Project within the Department of Health and Human Services, to coordinate the country’s approach to research, treatment and caregiving.

法案は、オバマ大統領による署名で、ヘルス・ヒューマンサービス省庁において、全米アルツハイマープロジェクトを創設するだろう。
これは、国家の研究、治療、ケアを与えるためのアプローチを調整するための企画になる

Its goal, the legislation says, is to “accelerate the development of treatments that would prevent, halt or reverse the course of Alzheimer’s” and “improve the early diagnosis of Alzheimer’s disease and coordination of the care and treatment of citizens with Alzheimer’s.”

法律の目的は、「治療を向上させ、アルツハイマー病の機序を予防、反転させ、」　「アルツハイマー病に関わる国民のために、
病気の初期診断の可能性を高め、ケアや治療の調整をはかること」　とされている。

The project would include an advisory council of representatives from agencies like the Centers for Disease Control and Prevention, the National Institutes of Health, the Department of Veterans Affairs, the Food and Drug Administration, the Indian Health Service and the Centers for Medicare and Medicaid Services. Scientific experts, health care providers and people caring for relatives with Alzheimer’s would also be included.

“If you go to war, you have planning, planning, planning,” said Representative Christopher H. Smith, Republican of New Jersey, who co-sponsored the bill. “Well, this is a war on a dreaded disease. We need to bring all the disparate elements together for the greatest possible result.”

プロジェクトは、病気のコントロールと予防委員会、全米ヘルス研究所、軍総務省、食・薬品運営健康サービスなどの組織から代表を集めた諮問委員会を発足させ、
また、インドヘルスサービス、メデイケア・メデイケイドサービスセンター、科学者、医療者、また、アルツハイマー病患者をケアする介護者も含む

もし戦争に行けば、計画、計画、計画である。代表のクリストファー・スミス氏、（ニュ―ジャージー州選出の共和党議員で、
共同法案スポンサーである）　は言う。　「これは悲惨な病気との戦争だ。すべての差し迫ったケースの情報を集めて、最も可能性のある成果を生み出す　必要がある」

While the act itself does not authorize more money, one of the recommendations of the national plan “is likely to be for an increase in research money for Alzheimer’s,” said another co-sponsor of the bill, Senator Susan Collins, Republican of Maine.

“We spend one penny on research for every dollar the federal government spends on care for patients with Alzheimer’s,” she said. “That just doesn’t make sense. We really need to step up the investment.”

The legislation was driven by the rapidly rising number of people with Alzheimer’s — about 5.3 million now, and expected to triple by 2050. The cost of their care to Medicare and Medicaid was about $170 billion last year. By 2050, Ms. Collins said, it will grow to $800 billion a year, more than the military budget.

法案は金銭をもたらすものではないが、国家プランの追い風は、
「アルツハイマー病への研究費増大を見込める」　　メイン州共和党で、同じく共同スポンサーのスーザン・コリンズは言う。

私たちは、連邦政府がアルツハイマー患者に費やす1ドル中の１セントを研究につかう。「これでは意味がない。投資を促進しなくては」

この法案は、アルツハイマー罹患者数の急増により成り立った。５３０万人の患者数は、２０５０年までに３倍になるといわれる。
高齢者医療保険に相当するメデイケア・メデイケイドのコストは　２００９年１７００億ドルだった。

２０５０年までに、この医療費は８０００億ドル、軍のための予算を超える規模になるといわれる。　　とコリンズ氏はいう。

The House passed the bill on Wednesday, and the Senate last Thursday.

上院は先週木曜日に、下院は今週水曜日に法案を承認、法律制定となった。

Alzheimer’s experts said the effort could make a significant difference.

“What really makes this so powerful is that it takes us from a lot of small efforts going on locally to doing something in a coordinated way,” said Dr. Kenneth Kosik, a neuroscientist at the University of California, Santa Barbara. “If there’s one thing we know in science it is that to draw conclusions we need numbers, large-size populations to study.”

The national plan will reinforce efforts to detect brain changes that occur years before people develop symptoms of dementia, and to develop drugs to prevent or substantially delay symptoms.

“Dealing with symptoms only after the fact is not going to solve the problem,” said Dr. Zaven Khachaturian, a former director of Alzheimer’s research for the National Institutes of Health. Delaying symptoms for just five years, he said, “we will cut down tremendously” on the number of people who live long enough to develop Alzheimer’s.

アルツハイマー病の専門家は、この努力は、意義のある変化をもたらすことができる　という。

「これで、沢山の小さな努力が、まとめられた方法で地域に波及できる。」　　神経科学者のケネス博士（ＵＣサンタバーバラ）　はいう。
「もし科学で我々の知っていることがあるとすれば、数のサンプル、大人数の研究から成果をを引き出すことが必要なのです。」

国家認知症上プランは、脳の変化を察知し、認知症状を引き起こす何年も前にこれを発見し、予防や遅延のための薬をつくるための努力を確かなものにする.
「発症の後で、その症状に取り組んでも解決にならない。」　全米ヘルス研究所のアルツハイマー研究所前所長の　Dr. Zaven Khachaturian はいう。

「５年発症を遅らせるせるだけで」　「長生きして、アルツハイマー病を患う人口はものすごく減らせる」

Representative Edward J. Markey, a Massachusetts Democrat who co-sponsored the bill, said his mother had had Alzheimer’s. “We’re trying to create a sense of urgency so that we’re developing multiple pathways that ultimately might be successful,” he said. “We’ve done it with polio, we’ve done it with AIDS.

“It’s a unique disease to the extent that patients can’t lobby for themselves, and the person close to them cannot lobby because they’re home taking care of that person. There are no Alzheimer’s survivors.”

A better you　もうすこしいいあなたに　　　　11/25

7 tips to curb emotional eating
感じながら食べる7つのコツ

There are times when everyday problems get the best of us and all we want to do is reach for a bag of chips, a tub of ice cream or a box of chocolates. Here are ways you can get in touch with what’s really going on and stop the mindless eating before it gets out of control.

毎日の問題がともかくポテトチップスを食べたい、アイスクリームが食べたい、チョコレートが食べたいとこんなことばかりになる時がある。
現状をみつめ、コントロールができなくなる前に、意味もなく食べることをやめる方法とは

Listen to your body. Tune into physical cues that tell you whether you’re really hungry or just letting your emotions take over. Is your stomach rumbling? Do you feel dizzy or light-headed? These are signs of true hunger. On the other hand, if you ate less than two hours ago, you’re probably not really hungry. Give the craving at least 10 minutes to pass.

身体の声を聴く　　　身体の感覚を研ぎ澄まし、お腹が本当にすいているか、ただ感情を満たしたいのか、問いかける。
お腹がなっているのか、めまいや軽い頭痛がするのか、空腹のサインはあるのだ。さもなければ、2時間以内に食べたのならば、
お腹はすいていないのだ。少なくとも、10分は経過を待ってみる。

Identify your emotions. The key is to find other ways to express your emotions rather than eating. Start writing down the emotions you’re feeling when a craving hits. Are you sad, lonely, angry or bored? Starting to recognize patterns can help you anticipate and avoid triggers.

Distract yourself. Call a friend. Go for a walk. Clean out the cabinets. Get up and move around to take your mind off your craving.

Avoid sitting in front of the TV. Studies show that people who eat while watching TV consume considerably more calories. Have your regular meals at the kitchen table without the TV on. Sit down. Savor every morsel.

テレビの前に座らない　　研究では、テレビを見ながら食べる人は、かなりカロリーオーバーだという結果がでている。
テレビなしで、台所のテーブルで食事を規則的に取ろう。座って、一口一口の味とにおいを楽しもう

Eat at regular intervals. Eating smaller meals every four hours can help you avoid feeling deprived.

Try to make a healthier choice. All too often, we reach for foods that are high in calories and unhealthy fats when we are stressed (nobody ever reaches for a carrot!). Try an apple instead of apple pie or unbuttered popcorn instead of potato chips.

Be patient. If you do succumb to emotional eating, don’t beat yourself up. Go back to the suggestions above and resolve to start anew tomorrow.

忍耐強く　　もし感じるに任せて食べているのなら、自分を責めないこと。　上記のアドバイスにそって、解決のために、新しい明日をはじめること。

　The New York Times
The New Old Age 　　
caring and coping 　　　

新しい高齢時代　　ケアと対応
November 10, 2010, 8:53 am New York 　　　11/12　LIA Posted

Families Struggle to Care for Veterans 　　陸・海・空軍　退役者をケアする家族の大変さ

When Jim Hewes, a San Diego painter and Vietnam veteran, received the diagnosis of colorectal cancer in February 2008, his wife, Libby, suddenly became his aide, therapist, homemaker and advocate — his everything. Through long months of chemotherapy, radiation and surgery, she dressed wounds, changed colostomy bags and tried to hold onto her own equilibrium.
Courtesy Libby Hewes Libby and Jim Hewes in the summer of 2005, before learning he had cancer.
“That first year, I was on the verge of a nervous breakdown, asking the social worker for a support group, some help, anything,” she said.

ジム・ヒュース、サン・デイエゴ塗装工でベトナム帰還兵が、2008年2月に直腸がんだと診断された時、妻のリビーは、たちまち、彼の世話人、セラピスト、家庭人、そして運動家――彼の全てになった。長い月日の化学療法、放射線、外科手術で、傷を手当てし、人工肛門の処理をし、彼女は自分の平衡を保とうとした。2005年の夏に、彼が癌だと分かり、「その最初の一年は、神経がどうにかなりそうでした。。ソーシャルワーカーに、サポートグループでも何でも、ともかく助けを求めたのです。」

Spouses caring for cancer victims endure such trials. But a new report suggests the job can grow still more complicated and demanding when the people they care for are combat-era veterans with service-connected illnesses or disabilities.
“Because of the stresses during this period, his P.T.S.D.” — post-traumatic stress disorder — “came to the fore,” Mrs. Hewes said. “The anger, the road rage — it got scary for me at times.”
And frustrating. After she’d spent months in polite, protracted discussions with the Social Security Administration trying to get disability coverage for her husband, “They called here one day while I was at work, asking for paperwork, and Jim blasted them. They hung up.”
He stalked out of a clinic, too, when the wait got too long. “He’d get angry and explode, and I had to mop up the damage,” Mrs. Hewes said. Both had severe depression.

癌患者をケアする配偶者は、決まってそのような憂き目にあう。しかし、この患者が、戦闘軍の帰還兵であった場合は、
この大変さはさらに複雑でやりきれないものになると報告されている。
「戦闘中のストレスのために、ＰＴＳＤ－－心的外傷後ストレス症候群ーーが前面に出ました」　ヒュース夫人は言う。「怒り、長々と続く憤怒、時として、私にも非常に恐ろしいものでした。」
「そして、障害保険の認定を受けようと、数か月のどうしようもなく長い、社会保険局との取り決められた話し合いの後、ある日私が働きに行っている間、電話がかかってきて、書類を求められて、ジムは荒れ狂い、そして相手は電話を切りました。　彼はクリニックに行き、長く待たされすぎると、怒って爆発したのです。私はすべて、後始末をしなければなりませんでした。」　夫婦とも、ひどく落ち込んでいた。

Gail Hunt, director of the National Alliance for Caregiving, knows plenty about the sacrifices caregivers make, in part because the organization regularly conducts nationwide research. But she was startled by the results of “Caregivers of Veterans: Serving on the Homefront,” an online survey of people caring for veterans with service-related disabilities suffered from the World War II era through Iraq and Afghanistan.

ＮＡＣのゲイル・ハントは、特に、ＮＡＣは全国規模の調査を頻繁にしているため、介護者の犠牲について多くを知りぬいている。
しかし、最前線に立った退役軍人の介護者は、第二次世界大戦からイラクとアフガニスタンまで、戦闘に起因する障害のある人たちの介護者の調査結果には驚愕した。

Of the 462 caregivers of veterans responding to an online questionnaire, 30 percent said they’d filled that role for a decade or more, and 68 percent called their situation “highly stressful.” The proportion of veterans’ caregivers who reported a high level of physical strain, who left their jobs or devoted more than 40 hours a week to caregiving — all were several times higher than figures reported in the past by caregivers of adults whose disabilities are not related to military service.

462名の退役軍人の介護者のうち、30％は、10年以上、介護につきっきりで、68　％が「非常にストレスを感じる」と言っていた。
身体的にきついと感じている介護者たちは、仕事をやめ、介護に週40時間以上費やしていた。
－－すべての項目について、軍の任務とは関係なく障害を抱えている人の介護者よりも、軍人の介護者の辛さの数値は何倍も高かった。

In part, this difference stems from the long duration of caregiving for veterans, who may be injured while young and then require decades of help.
But it also reflects what medical professionals call “co-morbidities.” High rates of depression, anxiety and other mental illnesses accompany vets’ physical injuries and disabilities, the caregivers reported.

退役者は、若い時に傷を負っていて、介護が長期にわたることもあるが、医療者の言ういわゆる　「付帯的な病」であり、身体的外傷や障害に加えて
鬱、不安、其の他の心の病の率が高いことがと報告されている。

While we may think of P.T.S.D. and traumatic brain injury as contemporary injuries (President Obama called them “the signature wounds of today’s wars”), more than half the vets in this sample who served in Vietnam or earlier conflicts also had P.T.S.D. and 14 percent had a traumatic brain injury, in addition to more common diseases like diabetes, cancer and Parkinson’s.

ＰＴＳＤや、一時的脳の外傷　（オバマ大統領は、「今日的戦争の傷跡」というが）　を考えた時、半数以上のベトナム帰還兵がＰＴＳＤを抱え、
14％が脳外傷、また、通常人と同じように、糖尿病、癌、パーキンソン病などにかかっている。

On Capitol Hill on Wednesday 10th, , representatives from the National Alliance for Caregiving and the United Health Foundation, which underwrote the survey, and from veterans’ organizations will hold a lunchtime briefing for Congressional staff members. “We want to let Congress know what we found,” Ms. Hunt said.

国会では、この10日水曜日に、ＮＡＣとヘルス財団の代表が、こうした調査結果を下院議員に昼食会で報告した。
「調査結果を知ってもらう必要がある」とゲイル氏は語った。

The recommendations the alliance and its partners will make, based on the survey and also on focus groups and phone interviews, are fairly modest: immediate training for caregivers, even while injured veterans are still in hospitals, so that they will know what to expect and what to do; mentoring programs and support groups, online and offline, that will connect veterans’ caregivers with others in similar situations; and legal advisers for families.

グループごとの電話聞き取りやアンケート調査をもとにした請願では、介護者の早急なトレーニングが必要であること、そして、傷ついた患者がまだ病院にいたとしても、
このようなトレーニングをすれば、介護者はどうすればよいか予測がつき、対応ができること、
また、傾聴、サポートプログラム、同じ状況の人たちと繋がること、家族への法的アドバイスなどの提供を求めている。

Compared with the medical costs of caring for veterans, these are not big-ticket items.
“I’d like to see an advocate, someone to walk us through the system,” said Betty Sullivan of Texas, who for three years cared for her husband, Charles, a Vietnam vet in the late stages of Parkinson’s disease at 71, in their home in San Antonio. “Everything with the government is overwhelming.”
Mrs. Sullivan reluctantly moved her husband into a residential center when she was no longer able to lift him or physically care for him. He is now in hospice care.

医療費と比べれば、このようなトレーニングは大きなコストではない。
「私は、活動している人、この仕組みを通して私たちに近寄ってきてくれる人に会いたい」　テキサスのベテイー・サリバンはいう。
彼女の夫のチャールズは、71歳で、パーキンソン病の最終段階にいるベトナム帰還兵だ。
「政府のする全てはやりすぎだ」　サリバンは、もはや身体介護に限界が来て、気は進まないながら、夫を入居者センターに移した。

But Jim Hewes is cancer-free, his doctors say. And slowly he and Libby have regained their footing, in part because of a caregivers class she finally found this year — the kind the report recommends for any veteran’s caregiver.
“I learned so much,” Mrs. Hewes said. “It was life-changing for me. I could get off the roller coaster.”

しかし、ジム・ヒュースは、もう癌の心配はいらないとドクターはいう。　すこしづつ、夫婦は立ち直ってきた。
理由の一つには、リビー・ヒュースが今年介護者の講義クラスを受けたこと。　軍人の介護者のために報告書からおこした今回の請願内容もこのようなトレーニングだ。
「すごく勉強になった」　ヒュース夫人は言う。　「このおかげで、私の人生を変えられた、ジェットコースターからおりられたの」

How will you Stop Diabetes®? The future is in your hands　　　11/10
どう糖尿病をストップするか？　　未来はあなたの手に　　　

e-news from American Diabetes Association　アメリカ糖尿病協会e-flyer より

During American Diabetes Month®, become one of the thousands of Diabetes Advocates who stand up for the rights of people with diabetes.
Meet Tracy and Jared Milligan, two Diabetes Advocates who stood up against school discrimination in Florida.

アメリカ糖尿病月間に、糖尿病の人々の権利のために立ち上がる数千人の糖尿病活動家のひとりになりませんか
フロリダで、入園差別に立ち上がった二人の糖尿病活動家、トレイシーとジェアード・ミリガンに会おう

When our son Jared went to enter kindergarten, we were told he could not go to his neighborhood school unless a parent came every time he needed insulin.

If a parent couldn't be on call constantly, then Jared (like every other child with diabetes who couldn't yet self-manage his disease) was going to be sent to 1 of only 5 specified schools in the district. That meant the school district refused to help children with diabetes at 98 elementary schools in my district, reserving just a few for kids with diabetes (what we came to call "diabetes schools").

We knew it wasn't right.

We turned to the American Diabetes Association and together with diabetes health care professionals, attorneys, and grassroots advocates, fought for fairness for Florida's kids.

糖尿病である、私たちの息子ジェアードが幼稚園に入る時、
インシュリンを打つ時にいつも親が来られなければ、近所の園には行けないと言われました。

もし、親がコンスタントに来られないならば、(自分の病気の管理が自分でできない他の糖尿病の子と同様）
地域にある指定の５か所のうちの１つの園に入るしかないといわれました。
つまり、地域の９８校の園では、糖尿病の子供を拒絶している、
そして、糖尿病の子供たちだけが行くところ　(いわゆる糖尿病園）にいけということです。

間違っていると思いました

アメリカ糖尿病協会に入り、糖尿病医療専門家、弁護士、
そして、草の根活動家たちと、フロリダの子供たちの公平・公正　のために闘いました

The result was passage of a state law that protects students with diabetes
including ending the discrimination that Jared faced. And for this little five-year-old,
Jared was able to go to school with other children in his neighborhood.

その結果、ジェアードの直面していた差別撤廃を含む糖尿病の子供たちを守る州法が成立し、
この小さな５歳の少年、ジェアードは今、
近所の子供たちと共に幼稚園に通うことができるようになりました。

This November, become a Diabetes Advocate and take action to find a cure, improve access to health care,
end discrimination and Stop Diabetes.

１１月は、糖尿病月間です
活動家になり、治療法を見つけ、医療をよりよくし、差別をなくし、
糖尿病をストップするために、行動を起こしましょう

American Diabetes Association | 1701 North Beauregard Street Alexandria, VA 22311 | 1-800-DIABETES
Please add news@diabetes.org to your address book to ensure you receive all future emails.
Copyright 1995-2010. American Diabetes Association. All rights reserved.

Real-life stories from our activists help us all understand the importance of the Campaign for Better Care’s work to ensure that health reform is implemented in ways that really help patients and their families. They offer inspiration to get involved, stay involved, and work even harder.

私たちの活動家からの本当の生活ストーリーは、
ベターケアキャンペーンが、両親や家族を助けるような医療改革を本当に実践できているかを
確認するのに役立つ。参加し、継続し、さらに努力するためのインスピレーションを提供してくれる。

Take, for example, Joann from Washington, DC.
例えば、ワシントンDCのジョアンから

Last spring, Joann’s 79-year-old mother, who suffers from moderate stage dementia, fell and broke her hip. At the hospital, Joann discovered that most staff members were not properly trained to handle a patient with dementia. She also realized that there was no communication between her mom’s doctors: "I love her doctors but, surprisingly, they never talked with one another during this entire ordeal!"

昨春、79歳の母が、中度の認知症にかかり、転んで腰の骨を折った。
病院でジョアンは、ほとんどのスタッフが認知症の患者を扱う訓練をきちんと受けていないこと、
また、母を見ている医師同士のコミュニケーションは皆無であると分かった。
「私は先生たちが好きだったけれども、驚くことに、彼らは、この入院中一度もお互いに話をしていなかったのです」

For Joann, like so many other family members and caregivers, dealing with this breakdown in coordination, communication, and care was "physically and emotionally draining," she said. "I felt I always had to keep on top of her care and remind staff she had dementia. I have a lot of energy, but there is a limit."

ジョアンにとって、また他の家族や介護者同様、医療の調整、コミュニケーション、そしてケアは、
「身体的にも、そして感情的にも、護られていないと感じるばかりでした。」　「私は母のケアを一番に考え、
認知症を患っていることをスタッフに言い続け、自分はエネルギーが多い方ですが、限界がありました。」

Since then, Joann has become a hard-working Campaign for Better Care activist dedicated to making sure others don’t have to go through what she did. Unfortunately, stories like hers are all too common. Every day patients and their families struggle in a fragmented health care system that doesn’t provide quality, coordinated care.

それ以来、ジョアンはベターケアキャンペーンの活動家になり、
彼女が経験したことを他の人が経験しないよう運動しています。
不幸なことに、彼女のようなストーリーは決してめずらしいことではなく、
毎日毎日、家族や患者は、まとまりのない医療システムと格闘している。
医療は、質の良い、調整されたケアを提供できるシステムになっていないのだ。

That’s why the Campaign for Better Care is helping to build a system that provides quality, coordinated care for all Americans — especially vulnerable older adults with multiple chronic health conditions.

ここに、ベターケアキャンペーンの意味がある。質の良い、調整された医療ケアを
すべてのアメリカ人に　―――特に脆弱な高齢者たち、複合的、慢性的健康問題を抱えた方々を助けるために
システムをつくることだ。

The very foundation of this Campaign rests on activists like Joann, and you, who help spread the word, share stories, and encourage others to join us. And we’ve been working hard to make sure you have the tools and resources to make an impact. Now, we’re excited to introduce a new resource — the activist toolkit.

ジョアンのような活動家は、キャンペーンの基礎・土台である。
そして、言葉を通じて、ストーリーを語り、励まし、仲間になるように励ましてくれる活動家たち。
あなたが手立てや方法を手中にしているかを確認するのが私たちの仕事だ。
今日の新しい方策は――活動家のツールキットである。

We invite you to take a sneak peek at the toolkit — it is chock full of everything from Conversation Starters to tips for how to talk about the Campaign and work with the media. We hope you enjoy it!

このツールキットは、会話の始まりから、キャンペーンについてどう語るか、
メデイアをどう使うかを網羅している。　楽しめるといいと思います。

Over the next few weeks, we’ll be highlighting different pieces of the toolkit and inviting your feedback as you try out these new skills and actions. So why not get started today by finding a new way to bring the Campaign for Better Care to your community?

来週から、違うツールキットを用いて、新しいこの道具をどう用いたかをフィードバックしてもらいよう呼びかけます。
今日からはじめて、地域にベターケアキャンペーンを浸透させる方法を見つけてみませんか

Thanks for everything you do.

Sincerely,

Cecili Thompson Williams

For those of you who understand even minimal French, check out www.journeedesaidants.fr. Yesterday was the first national Caregivers' Day in France. There were specific recognition celebrations at 45 sites around the country, speeches by four national ministers and a Sarkozy speech. On the very easy-to-use website, you will also see short video clips of people thanking the family caregivers in their families. The website presents an interesting model for anyone planning a caregiver recognition day.

10月6日は、フランスで初めての　「ケアを与える人の日」　でした。
フランス中の45か所で、特別の　「お祝い」　があり、国家の省長官や、サルコシ大統領のスピーチがありました。　
ホームぺージも使いやすく、ビデオクリップでは、家族で「ケアを与える人」に感謝する場面がみられます。　
ホームページは、　「ケアを与える人の日」　にプランを立てるひとにとって、わくわくするひとつのモデルを与えてくれます。

_____________________
Gail Hunt
President & CEO
National Alliance for Caregiving
gailhunt@caregiving.org

+++++++++++++++++++++++++++

When someone you care about needs to talk, one of the best ways you can show compassion is to offer a supportive ear.
Good listening skills build social support and connect you deeper with the world around you.
Try these five tips to sharpen your listening IQ.

あなたの大切な人が話したいとき、一番いいのは、耳を傾けてあげること。　
傾聴は、社会的サポートになり、あなたの周りの政界とあなたを、より深く結ぶ。　「リスニングIQ」　を磨く5つの鍵とは...?

１．Be present. Now’s the time to really listen, not wait to talk. Completely surrender to the moment as being your friend’s time to vent. Maintain eye contact. Pay attention to nonverbal clues, like tone of voice and body language.

１．そこにいること。話す時を待つのではなく、その瞬間を友人が解き放てる時間に。視線を合わせて。
言葉にならない表現に注意して。声のトーンとか、しぐさとか。

２．Reframe what you hear. One of the best ways you can show your friend she’s being heard is to summarize and repeat back your understanding of what she’s feeling. For example, if your friend is depressed because of health issues, you might try saying, “Things definitely seem pretty overwhelming right now. You sound like you’re feeling really lost.”

２．聞いたことを形にする。あなたの友人が聞いてもらっていると思えるのは、彼女の感情を理解した部分でまとめて、
あなたが繰り返してみること。例えば、健康問題で落ち込んでいたら、
「今は相当な落ち込みって様子ね、ひどく滅入っている話し方だもの」

３．Ask questions. Your questions reflect how closely you’ve been listening and show your true interest. Open-ended questions like “How did that make you feel” can deepen and further the conversation.

３．質問する。どのくらい聞いてもらっているか、関心を持ってくれているかを相手に感じさせる。　
こたえの決まっていない質問　「それでどう感じたの?」　などは、会話を深めていける。

４．Try not to give advice. It’s tempting to immediately offer your take on how to “fix” the problem. But unless she directly asks for your opinion, your friend just probably wants to feel heard and understood first.

４．アドバイスをしない。すぐに何とかしたくなるが、相手が意見を求めてくるまでは、ただ聞いてもらいたくて、最初に理解してもらいたいだけなのだ。

5.Stay focused on them. Try not to relate a story of your own (“That’s just like the time I…”), unless you can quickly bring the conversation back to your friend. That way, she will feel genuinely cared for and loved.

5. 相手の集中する。すぐに相手が話せる間の取り方以外には、自分のストーリーにしない　（「それってあの時みたい。。。」など）　
集中して聞いてもらってこそ、大切にされている、愛されていると感じられるものだ。　

　　◆　National Grandparents Day! 　　　 9/12 　2010
the 2nd Sunday, September

US 祖父母の日　　◆ 「祖父母の日に」　　9月第二日曜日　　e news from 　全米女性と家族のパートナーシップ　

Debra Ness, President ,
Campaign for Better Care
President, National Partnership

全米パートナーシップ法人　会長
ベターケア・キャンペーン
デブラ・ネス

This year, we can do more than send candy or flowers. Let’s take action to improve the health and economic security of our grandparents — and all of America’s grandparents. Here are five things you can do to show grandparents that you care:

今年は、キャンデイーや花を贈る以上のこと、できるのではないでしょうか。

自分の祖父母―――そしてすべてのアメリカの祖父母のために、健康やや、経済的保障をよりよくする行動をしましょう。　　
　5つの提案です

１．社会保障を守ろう　
Protect Social Security. Our grandparents have worked for a lifetime and they deserve to retire in dignity. Taking away their economic security by pushing back the retirement age — or cutting the benefits they count on — will hurt seniors and all families. Let the Deficit Commission know that our budget shouldn’t be balanced on the backs of hard-working seniors. Sign the petition »署名　

２．男女平等報酬の法律をサポートしよう
Support the Paycheck Fairness Act. Too many women in this country have worked hard all their lives, and taken home lower wages because of discrimination. Pay discrimination costs women for a lifetime, reducing wages as well as the savings, pensions and Social Security benefits that we rely on in old age. Tell the Senate that it’s time to vote for equal pay. Send a message »メッセージを送る

３．ベターケアのキャンペーに参加しよう
Join the Campaign for Better Care. More than three in four Americans age 55 or older (78 percent) are dealing with at least one chronic health condition like diabetes, heart disease or arthritis. The Campaign for Better Care is working to ensure that health reform is implemented in ways that will give the older patients who rely on the system most the coordinated, quality care they deserve.
Join the Campaign »キャンペーンに参加

４．祖父母はケアを与えるキーパーソで、時に自分のことも大切にする必要があると気付こう
Recognize that grandparents are key caregivers, and often need care themselves. Grandparents are a vital link in strong families and increasingly, they help care for our nation’s children. Their role has only increased during this recession, as more grandparents are serving as primary caregivers and more grandchildren are living with their grandparents. But too often our laws fail to recognize grandparents’ central role. The Department of Labor has taken important steps that will help some families, but we need laws that give workers the time they need to care for their seriously ill grandparents or grandchildren. It’s time for our country to do more! Read our fact sheet »　家族がする重要なステップ、現状と事実を知ろう

５．差別をなくし、恒例の働く人を守る法律を制定しよう
Pass the Protecting Older Workers Against Discrimination Act. The Supreme Court has made it harder for older workers who face discrimination on the job to prove they’ve been discriminated against because of their age. Learn more

Thank you!

Sincerely,

Debra Ness, President

　◆ cornel choronicle, April 30 2010 　　コーネル通信　２０１０年４月３０日　　update 8/5

Volunnteer　future　ボランテイアの未来　

New interests and hobbies

Sometimes we do get locked into the “rat-race” of life and volunteering can give that escape to everday routine and create a balance in our lives. Finding new interests and hobbies through volunteering can be fun, relaxing and energizing. Help run a youth radio station or website for a few hours a week or assist in publishing a charity newsletter. The energy and sense of fulfilment can carry over to a work situation and sometimes helps to relieve tensions and foster new perspectives for old situations. Sometimes a volunteer experience can lead you to something you never even thought about or help you discover a hobby or interest you were unaware of. You can strengthen your personal/professional mission and vision by exploring opportunities and expanding your horizons.

新しい関心事と趣味

ときどき、我々は、人生のハツカネズミレースのようなものに巻き込まれる。ボランテイアは、そのようなお決まりの日常から私たちを解き放ち、生活の中のバランス感を創出することができる。ボランテイアで新たな関心事や趣味を見つけることは楽しく、それは、緊張感もなく、エネルギーを与えてくれる経験でもある。一週間に一度、立ち上げのラジオ局やホームページの運営を助けるとか、チャリテイーのニュースレターを出版することを手伝ってみよう。エネルギーや充足感は、仕事の閉塞感や緊張感を吹き飛ばし、定まりきった現状に、新しい考え方をもたらしてくれたりする。ボランテイア経験は、今まで考えもしなかったことに自分を導いてくれたり、知らなかった趣味や関心事を発見させてくれたりする。　新しい機会を探求したり、視野を広げたりすることによって、個人的な、また専門的な使命やビジョンををより強く感じるようになることもできる。

New experiences

Volunteering is a brilliant way to get life experience. Whether you build a library or mail flyers to raise awareness for a local charity, you will experience the real world through hands-on work. This guide section has established that volunteers can do almost anything and with the new millenium has dawned an era of infinite volunteer opportunities. For example, it is possible to volunteer in developing countries and see the direct impact of your actions on some of the most vulnerable people of the world. You could skydive for charity, a chance to experience the ultimate thrill and raise funds to help the charity continue its work.

新しい経験

ボランテイアは、生活体験を得るための、輝かしい方法だ。図書館をつくるなり、、地方のチャリテイーイベントに意識付けを行ったりするメール通信をおくるなり、どちらにせよ、手作業を通じた現実の世界を体験する。このセクションでは、ボランテイアは何でもできること、そして、ボランテイアが、無限の機会の時代の到来を告げている新しい世紀に入ったことを述べたい。例えば、発展途上国のボランテイアをして、貴女の経験のインパクトを直接に世界の最も弱い人にもたらすことができるし、チャリテイーのためにスカイダイビングをして、究極のスリルを味わうと同時に集めた基金を活動継続のためにもちいることもできる。

Volunteering brings together a diverse range of people from all backgrounds and walks of life. Both the recipients of your volunteer efforts and your co-workers can be a rich source of inspiration and an excellent way to develop your interpersonal skills. Volunteering also offers an incredible networking opportunity. Not only will you develop lasting personal and professional relationships but it is also a great way to learn about people from all walks of life, different environments, and new industries. Networking is an exciting benefit of volunteering and you can never tell who you will meet or what new information you will learn and what impact this could have on your life.

多様な人々に出会うこと

ボランテイアは、様々なバックグランド、人生経験を持つ多様な人々を結びつける。ボランテイアをしてもらう人も、する人にとっても、ボランテイア体験は、インスピレーションの豊かな源泉であり、人との交流スキルを磨くこの上ない方法であるし、また、信じられないくらいのネットワーク機会をもたらす。人間関係、専門的関係を継続するだけでなく、人生経験を持つ人々のことを知ることができる。新しくネットワークができることは、ボランテイアの非常にエキサイテイングな産物だし、この経験が、どのくらい自分の生き方に影響するか、新しい情報を知り、自分がどのようにインパクトを受けるかは未知数である

◆ The new health IT regulations
released by the Obama administration on July 13/ HHS Secretary Sebelius made the announcement at HHS.

　新しい　「健康　情報テクノロジー」　法案　成立
　ＵＳ７月１３日　オバマ政権・国民健康サービス省　長官発表　

Health providers who take advantage of federal health IT dollars will be held accountable
— ensuring they use health IT in a way that improves the care you receive.
Thank you for helping us get here, and thanks in advance for your continued support.
Today we celebrate, and tomorrow we forge ahead.

連邦政府予算を、健康を担う人が使えるようにーー　
あなたが受けるケアを改善するために、、連邦政府予算で健康情報を用いる案が可決されました。
協力をしてくれた皆様　感謝します。継続支援をお願いします。今日はお祝いし、あすゆっくり前進しましょう

Sincerely,

Debra Ness

Campaign for Better Care
President, National Partnership

全米パートナーシップ法人　会長
ベターケア・キャンペーン
デブラ・ネス

P.S. Share this success with your friends and family, and urge them to get involved in our ground-breaking campaign,
the Campaign for Better Care.

ノーベル平和賞受賞者アルベルト・シュヴァイツァー博士の名言
"Happiness is nothing more than good health and a bad memory"

を噛みしめ、愚かな者こそ幸せになれるのではないかと、
少しだけ良い気分になった

「健康な体」と多少「不確実な記憶力」　は、

「幸せの必要条件」 　になりうるのである
　　　　　　　　

　　　　　　　　　　　――この地上で自分を生かしてくださるのが誰であるか　に気づいてさえいれば――

President Obama Signs Elder Justice Bill into Law
オバマ大統領、高齢者正義立法案に署名

March 24, 2010 - As part of the new US health care system plan, Congress and President Obama have approved the Elder Justice Act and the Patient Safety Abuse Prevention Act. This will include Adult Protective Services (APS) funding that will provide $400 million in first-time dedicated funding for adult protection services. It will also provide $100 million in state demonstration grants in order to test many different methods that will improve APS.
３月２４日、新しい合衆国医療システムプランの中で、下院とオバマ大統領は、高齢者正義立法案と患者安全侵害予防法案を通過させた。　これは、成人のための予防サービス（ＡＰＳ）であり、成人擁護のサービスとして初めて４兆ドルの資金が投じられたことになる。　ＡＰＳを改善する多くの諸方法を検証するために、州にはデモンストレーションのための助成金１兆ドルも投じられる。

The bill will provide $32.5 million in grants to support long-term care ombudsman programs. Ombudsman are vital to nursing homes because they are many times the first responders to nursing home abuse and neglect. For instance, the Illinois Long-Term Care Ombudsmen program helps to protect the safety and well-being of nursing home residents in Illinois by investigating complaints on behalf of residents and their families and also educating these groups on residents' rights. There will also be an additional $40 million given to training programs for national organizations and State long-term ombudsmen programs.
法案によって、３兆２５００億ドルの資金が長期ケア　オンブスマン（問題解決者）プログラムを支援するために遣われる。ナーシングホームにとって、オンブスマンは欠かせない。というのは、多くの場合、ナーシングホームにおける虐待や無視などの問題に最初に応えてきたのは、オンブスマンであったからだ。　たとえば、イリノイの長期ケアオンブスマンプログラムは、入居者や家族に代わって不満を調査して、ナーシングホームに住む高齢者の安全や健康を守ってきているし、また、高齢者の権利について、当人や家族に教育をしたりしている。　国家や州の長期ケアオンブスマンプログラムのトレーニングプログラムにも、４０００万ドルの追加資金が投じられることになる。

The Elder Justice Bill will establish what is being referred to as the Elder Justice Coordinating Council that will make recommendations to the Secretary of Health and Human Services on the coordination of activities of federal, state, local and private agencies. They will also work with entities who relate in elder abuse, neglect and financial exploitation. Recently, this country has seen a great rise in the amount of elder financial exploitation cases.
高齢者正義立法法案によって、その調整委員会が、連邦政府、州政府、地方行政や民間の組織活動への提言として、
健康と人的サービス省庁の長官に対して進言する事柄を確定することになるだろう。

The Patient Safety Abuse Prevention Act will help keep nursing home patients from abusive employees. It creates a national program of criminal background checks for those seeking to work in nursing homes and other long-term care facilities. The Chicago nursing home abuse lawyers of Levin & Perconti are extremely pleased with the passage of this legislation and believe that it will go a long way to combat nursing home abuse.
患者の安全・虐待予防法案は、ナーシングホームの患者を、虐待する職員から引き離す上で機能する。ナーシングホームやその他の長期ケア施設で働きたいと言ってくる人の犯罪歴をチェックする国家プログラムを作成することになる。　シカゴのナーシングホーム虐待を取り扱う弁護士であるLevin　と　Pelconti ｉはこの法制化を非常に喜んでおり、ナーシングホームの虐待と闘うのはまだまだ遠く長い道のりになると考えている。　

It’s often said that staying positive when you’re grappling with a serious disease like cancer is important. But experts say that’s not necessarily the best approach for surviving cancer in good emotional health.
“Getting a diagnosis of cancer is devastating,” says Timothy C. Birdsall, ND, a doctor of naturopathic medicine and vice president of integrative medicine at the Cancer Treatment Centers of America in Goodyear, Ariz. “A normal human response is to be devastated and sad, and to grieve.”
So how do you survive cancer in good emotional health? Here’s his advice.

あなたがたとえば癌のような重病だと知らされた時、「前向き」に生きられるかどうかが重要だとは、よく言われることだ。けれども
専門家は、癌でありながら、感情的によい精神状態でいようとすることは、必ずしもベストアプローチというわけではないという。
癌の診断は破滅的だ、と自然生理学・内科医であり、アリゾナのアメリカ癌治療センターの副所長であるTimothy Birdsall 医師は言う。
正常な人間としての反応は、「破滅的、悲痛そのものである」と。では、そんなとき、どう感情的に穏やかでいられるのだろうか？

Cancer Survival and Your Mental Health
癌に打ち勝つこととあなたの心の健康

Stress is cumulative, he says. A little bit is fine but building it up can do more damage to your mental health.　
ストレスは溜まってくる。少しならいいが、積もり積もると、心の健康にそれだけダメージが増える

Taking steps to relieve stress and anxiety can help clear your mind and maintain good emotional health when you're being treated for cancer — and after you’ve beat it.　
ストレスや不安を解放するステップを踏むことで、あなたの心が明確になり、感情的にも健康を保つことになる。　癌の治療をしているとき、そしてそれを克服してからも、ストレスを解き放つことだ。

　2010年1月　ＩＦＡ　ｅ－news　より

Disaster in Haiti　ハイチにおける災害
Beyond the Devastation　荒廃の向こうに　

The devastation in Haiti is unimaginable.
Estimates suggest that more than 200 thousand people have died and millions are without proper shelter,
clean drinking water, or medical care.
Many NGOs are keeping close tabs through various information sources for status updates
- including the arrival of aid (pictured above), the saving of someone trapped beneath the rubble and what the future aid requirements may be.
But with each passing day, the death toll rises. Haitians are proud and resilient people but an earthquake of this magnitude will push
even the strongest among them to the limit. We all hope that one day Haiti will be rebuilt,
but in the meanwhile they need the help of everyone who has the ability to " give".

Already people of all backgrounds, of all cultures and all ages are giving what they can to help the relief effort in Haiti.

ハイチにおける荒廃は想像を絶する。20万人以上の人々が命を落とし、数百万人が適切な避難所もない。清潔な水、医療もない。多くの非営利法人ＮＧＯが、支援の到着、混乱に陥っている人々が救助されたか、これから必要な支援は何か、など状況の現状把握で協力しているが、死亡者統計は日々増えるばかりだ。
ハイチの人々は誇り高く沈黙しているが、この規模の地震は、彼らのうちの最も強い人ですらも限界を感じるほどの痛みを伴う。
この災禍の渦中にも、「与える」ことのできる力のあるすべての人の助けが必要だ。

すでに、ハイチにおける救済の努力を支援するために、文化、年齢、背景の違う多くの人々が、「与えること」を始めている。

Best Practices for Emergency Response for Older People in Emergencies
非常事態における高齢者のための緊急対応ベスト実践

The stated aim of most humanitarian organisations is to provide emergency relief to whole communities in a crisis, if possible targeting the most vulnerable. Research carried out by HelpAge International shows clearly that older people tend not to be considered among the most vulnerable. However, as an international community committed to humanitarian advancement we need to adopt attitudes, policies and programmes that protect and support older people's rights and contributions at all times. Reducing the vulnerability of older people is not primarily about creating special services for them. It is about ensuring that they have equal access to vital services

最も人道的な組織としてできるあ、こと、それｈ危機にある地域全体に緊急支援を提供することだ。
HelpAged International高齢者支援国際組織の研究によると、高齢者は災害時、
最も弱い、救われなければならない人たちであるとはみなされていない。
しかし、国際コミュニテイーとして我々は、高齢者の権利と貢献度をいつ何時もサポートし、守っていく姿勢、
政策、プログラムをとりいれていくことが求められよう。
高齢者の弱さを問題にするのではないーー高齢者にだけ特別なサービスを創りだすことではなく、
なくてはならないサービスに、高齢者も一国民として手が届くようにすることが必要なのだ。

International Federation on Ageing |
4398 Boul. St Laurent, Suire 302 | Montreal | Quebec |
H2W 1Z5 | Canada

ーーーーーーーーーーーーーーーーーーーーーーーーーーーーーー

The below analysis is taken from Congressional Quarterly and Kaiser Family Foundation:
US下院議会報告とカイザー家族財団　分析資料

source from National Alliance for Caregiving ／全米ケアする同志の会 e-news 12月より

Senate Majority Leader Reid Unveils Final Package of Changes to Senate Health Care Reform Bill:
上院t多数派院内総務　医療改革最終草案提示

Senate Majority Leader Harry Reid (D-NV) unveiled the manager’s amendment to the Senate health reform bill, H.R. 3590. As expected the plan would drop a new government-run insurance plan, or public option, that progressives in both chambers had fought for. In its place, the amendment would create a new system of national, private insurance plans supervised by the Office of Personnel Management, which already administers health benefits for federal employees. The bill also slightly increases penalties for individuals who do not purchase insurance, a change that Senator Olympia Snowe (R-ME) has described as "difficult to support." Therefore, the final bill is unlikely to garner any GOP support.

Medicaid Expansions Won in Bill:
メデイケイド（低所得者医療保障）拡大提示

A key feature of the bill is an expansion of Medicaid to cover many more low-income families. Medicaid is normally a shared federal-state program in which the federal government picks up, on average, 57 percent of the cost. Under the amendment, the government would pay 90 percent of the cost, on average, to cover people who otherwise would not be eligible for Medicaid. In addition, the manager's amendment provides additional Medicaid payments to three states -- Nebraska, Vermont, and Massachusetts -- to help them people newly eligible for the program. Nebraska would receive 100 percent federal financing for new Medicaid beneficiaries in perpetuity. Vermont would get a 2.2 percentage-point increase in federal payments for six years, and Massachusetts a 0.5 percentage-point increase for three years. In addition, the manager's amendment includes an additional $10 billion for an expansion of Medicaid to community-health centers, and in the National Health Service Corps, which provides
doctors for underserved areas.

Chronic Care Coordination and Help for Medicaid Beneficiaries and their Caregivers:
慢性疾患ケア調整、そしてメデイケイドサービスとケアする人へのヘルプ

The manager's amendment also includes a new section, Incentives for States to Offer Home and Community-Based Services as an Alternative to Nursing Homes. Under these provisions, the states must agree to use new federal dollars to expand support and services for home and community-based care for Medicaid population. The amendment makes it easier for Medicaid beneficiaries and their caregivers to access supports and services by requiring states to streamline and develop an easy "single-point of entry/no wrong door" policies that will enable consumers and caregivers to access long-term services and supports at the local and community level. The new provisions also include requirements for states to evaluate the functional and financial needs of Medicare beneficiaries to determine what types of support and services are needed.

Abortion Language Tightened:
中絶許容範囲は厳格化

In order to secure the vote of Senator Ben Nelson (D-NE), the last member of the Democratic party to commit to the bill, the manager's amendment tightens restrictions on insurance coverage for abortion, and weakens new nonprofit insurance co-operatives established under the bill to compete with private insurers. The manager's amendment also provides additional funding to assist rural hospitals.

The Congressional Budget Office and the Joint Committee on Taxation estimated that the changes in the manager’s amendment would raise its cost over 10 years to $871 billion, from $848 billion. The manager’s amendment drops a provision of the bill that would have stopped a 21 percent cut in Medicare fees for physicians scheduled to take effect Jan. 1. Reid said the Senate will pass a separate bill in January to avert the cut for the entire year; in the meantime, a defense appropriations bill, H.R. 3326, that the Senate cleared Saturday would stave off the cut for two months.

New Financial Requirements for Insurers
企業管掌保険に対し支払いレベル上昇要求

The Reid amendment also includes new financial requirements for private insurers. Beginning in 2011, insurers covering employees of large businesses would have to spend at least 85 of their revenue from premiums on medical claims, a metric known in the industry as “medical loss ratio,” or MLR. Insurers covering employees of small businesses, or selling policies to individuals, would be required to meet an MLR of 80 percent. That change had been advocated by Senator Jay Rockefeller (D-WV).
In addition,

Insurance Exchange Plans
保険サービス交換オプション

The manager’s amendment requires the Office of Personal Management (OPM) to recruit at least two entities to participate in the new system of national health insurance plans, and one must be a nonprofit. It also requires that one of the national plans not cover most abortions, a nod to abortion opponents such as Nelson. OPM would be able to negotiate a medical loss ratio, profit margins and premiums for the national plans. The plans would also have to meet state requirements across the country.

The amendment specifies that OPM cannot divert resources from the health benefits program for federal employees that it already supervises, and that people covered by the new national plans would not be included in the same risk pool as federal employees. That is a concession to unions representing federal employees, who are concerned that the employees’ insurance premiums might rise if many sick people were to join their risk pool as a result of the changes.

Under the amendment, some individuals who can get coverage through their employers could go into the exchange to buy coverage instead. Workers with “cafeteria” plans who can choose between company-provided insurance or a voucher to go elsewhere would be able to use that voucher to buy exchange coverage.

Mandate Penalties
義務遵守ペナルテイー

The manager’s amendment also slightly changes the penalty on people who do not get insurance coverage, which they would be required to do by the bill. The result is a slightly stiffer penalty on higher income people. The penalty is determined by a formula based on how many months a person or family is without insurance. Some high-income families that did not buy insurance would be penalized the cost of premiums for a “bronze” plan offered through the exchange.

Low-income families would pay a smaller penalty based on how many months they were without insurance. The maximum penalty would top out at $750 per uninsured person by 2016, after starting at $95 in 2014 and going up to $495 in 2015. There would also be a penalty based on a percentage of income that some uninsured people might end up paying, instead of the flat amount. These people would face a fine of 2 percent of their income in 2016, but only if it created a larger penalty than paying the flat rate. The changes put slightly more pressure in higher income people to buy insurance.

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When stress seems to have taken over your life,
healthy meals and snacks are better for body and mind
than that sugary brownie.
Find out how good food can help you cope.

With Alzheimer’s Patients Growing in Number,
Congress Endorses a National Plan

アルツハイマー病の患者数増加、米国下院は国家プラン承認　　12/23

By PAM BELLUCK

Published: December 15, 2010　 On Politics, 　Ｔｈｅ　Ｎｅｗ　Ｙｏｒｋ　Ｔｉｍｅｓより

Copyright © 2009, CarePages, Inc.
Everyday Caring 　November 25, 2010

A better you　もうすこしいいあなたに　　　　11/25

7 tips to curb emotional eating
感じながら食べる7つのコツ

Copyright © 2010, CarePages, Inc.
Everyday Caring　　September 30, 2010

Debra Ness

When stress seems to have taken over your life, healthy meals and snacks are better for body and mind than that sugary brownie. Find out how good food can help you cope.

With Alzheimer’s Patients Growing in Number, Congress Endorses a National Plan アルツハイマー病の患者数増加、米国下院は国家プラン承認 12/23

By PAM BELLUCK

Published: December 15, 2010 On Politics, Ｔｈｅ Ｎｅｗ Ｙｏｒｋ Ｔｉｍｅｓ より

Copyright © 2009, CarePages, Inc. Everyday Caring November 25, 2010

A better you もうすこしいいあなたに 11/25

7 tips to curb emotional eating 感じながら食べる7つのコツ

Copyright © 2010, CarePages, Inc. Everyday Caring September 30, 2010

Debra Ness

When stress seems to have taken over your life,
healthy meals and snacks are better for body and mind
than that sugary brownie.
Find out how good food can help you cope.

With Alzheimer’s Patients Growing in Number,
Congress Endorses a National Plan

アルツハイマー病の患者数増加、米国下院は国家プラン承認　　12/23

Published: December 15, 2010　 On Politics, 　Ｔｈｅ　Ｎｅｗ　Ｙｏｒｋ　Ｔｉｍｅｓより

Copyright © 2009, CarePages, Inc.
Everyday Caring 　November 25, 2010

A better you　もうすこしいいあなたに　　　　11/25

7 tips to curb emotional eating
感じながら食べる7つのコツ

Copyright © 2010, CarePages, Inc.
Everyday Caring　　September 30, 2010