THURSDAY, APRIL 27, 2017
A special supplement to the AUSTIN DAILY HERALD
Joanne and Ken Jensen are two of about 70 Mayo Clinic Health System Auxiliary volunteers who fill a variety of assistance roles at Mayo Clinic Health System in Austin. Photos by Michael Stoll/mike.stoll@austindailyherald.com
Servant hearts Volunteers keep giving to clinic auxiliary By Michael Stoll
mike.stoll@austindailyherald
Ken and Joanne Jensen sat at the information desk at the main entrance of Mayo Clinic Health System in Austin, answering visitor questions and providing assistance where they could. They volunteer every other Monday and Friday and are two of 70 volunteers who are part of the Mayo Clinic Health System Auxiliary. “The role of our auxiliary is to help people,” said Ken, a sentiment shared by his wife, Joanne. “We feel that this is a good use of our retirement time,” she said. The Jensens, who are retired teachers from the Austin Public School system, have volunteered with the auxiliary for 22 years. They got involved at the insistence of their friend, Janet Borchardt. “Janet was working here and she said we would be a good addition to the auxiliary,” Joanne said. “We knew that after we retired from teaching, we
Joanne and Ken Jensen offer a helping hand at Mayo Clinic Health System in Austin.
“We feel that this is a good use of our retirement.” — Joanne Jensen Mayo Clinic Health System Auxiliary volunteer
couldn’t just sit around,” Ken added. “We volunteered and we are very happy we did.” Volunteers for the auxiliary fill a number of roles
at the medical center , from pushing wheelchairs to delivering newspapers to patients.
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For more on the Mayo Clinich Health System Auxiliary, visit https://mayoclinichealthsystem.org/locations/austin/volunteer
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APRIL 27, 2017
Senior Living
AUSTIN DAILY HERALD
A diet soda a day might affect dementia risk, study suggests By American Heart Association News
One or more artificially sweetened drinks a day was associated with higher risk of stroke and dementia, a new study suggests. T he research, published Thursday in the science journal Stroke, examined consumption of beverages sweetened with sugar and artificial sweeteners but did not find that same association with sugary beverages. The results, however, come with a host of caution flags raised by exper ts. They say the study does not even hint that regular sugary drinks are better for you, or even that artificially sweetened drinks were associated with higher risk of strokes or dementia. The study’s lead author said the observational study shows an association or trend in a group of people and not a direct cause-and-effect link. It’s more “hypothesis-generating.” “The jury is still out, and this just shows people need to be cautious,” s a i d M a t t h e w P a s e, Ph.D., a fellow in the department of neurology at Boston University School of Medicine and an investigator at the Framingham Heart Study. Previous studies have looked at artificial sweeteners’ impact on stroke risk. Pase believes this is the first study to look at its association with risk of dementia — and he hopes the work will spur more research into the effects of these sweeteners on the brain. Researchers analyzed the self-reported diets of two sets of people participating in the Framingham Heart Study, the longest-running heart study in the U.S., funded by the National Heart, Lung, and Blood Institute and run in partnership with Boston University. The study examined beverage intake of 2,888 people over the age of 45 for its stroke analysis and 1,484 people over the age of 60 for the study’s dementia analyses. Over seven years, re-
searchers used food frequency questionnaires up to three dif ferent points in time. They then followed up for the next 10 years to deter mine who developed stroke and dementia. At the end of the follow-up period, researchers counted 97 strokes, or 3 percent of the participants in the stroke analysis arm of the study. Of those, 82 were ischemic. The study found 81 cases of dementia, or 5 percent of the participants in the dementia arm of the study. Of those, 63 were diagnosed as Alzheimer’s disease. The study found that people who re por ted drinking at least one artificially sweetened drink a day compared with less than one a week were 2.96 times as likely to have an ischemic stroke, caused by blood vessel blockage, and 2.89 times as likely to be diagnosed with dementia due to Alzheimer’s disease. The results were adjusted for variables such as age, sex, caloric intake, diet quality, physical activity and smoking. Pase and other researchers say the work points clearly to the need to investigate the possible biological reasons artificial sweeteners might affect the brain and the need for more experimental and clinical trials. “We need to be cautious in the interpretation of these results,” said Rachel K. Johnson, Ph.D., past chair of the American Heart Association’s Nutrition Committee and professor of nutrition at the University of Vermont. “It doesn’t prove cause and effect. When you see these kinds of associations, you want to always ask what is the biological plausibility, what is the mechanism that might be causing this?” But, Johnson said, there is a part of the issue that is “settled science.” “We have a robust body of literature on the adverse effects of sugary drinks. Absolutely the message is not to switch to sugary drinks,” she said. Studies linking added
sugars and conditions that lead to cardiovascular disease – the No. 1 cause of death in the world – have been around for years. Diets high in added sugars have been connected to heart risk factors such as obesity and high blood pressure. In 2012, the AHA and the American Diabetes Association issued a scientific statement on the use of artificial sweeteners, saying “that when used judiciously, [artificial sweeteners] could facilitate reductions in added sugars intake.” The statement called for further research on non-nutritive sweeteners and cardiovascular risk but noted that “limiting added sugars is an important strategy for supporting optimal nutrition and healthy weights.” Consumers shouldn’t “overinterpret” the latest study’s results, said Christopher Gardner, Ph.D., director of Nutrition Studies at the Stanford Prevention Research Center and a professor of medicine at Stanford University. Gardner was lead author on the 2012 statement. “It’s a tricky thing,” said Gardner, who leads research into how people can optimize their diets. “Nobody ever said diet sodas were a health food.” For many people, such as people with diabetes or obesity, he said, diet sodas can be part of the gradual switch from sugary drinks. “So, the bottom line is, ‘Have more water and have less diet soda,’” he said. “And don’t switch to real soda.” Pase, who studies how people can change behavior or diet to prevent dementia, said people need to be skeptical when deciding whether to select something with artificial sweeteners or real sugar. “Just because a beverage is advertised as being healthy because it doesn’t have any sugar doesn’t mean that it is healthy,” Pase said. “Artificial sweeteners may have effects in the body that we haven’t begun to explore.”
A special supplement to the AUSTIN DAILY HERALD
Senior Living
THURSDAY, APRIL 27, 2017
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Hearts: Volunteers keep auxiliary going strong From Page 1-SL They also sit at the information desk to answer questions and direct patients and visitors. “The hardest part is when someone comes in and says, ‘I have an appointment,’ and we ask, ‘Who are you supposed to see?’ and they say, ‘I don’t remember,’” Ken said. “We don’t always have an answer right out of our mouths,” Joanne said with a laugh. The Mayo Clinic Health Systems Auxiliary does not just provide volunteers to fill various duties, but also provides funding for various projects, such as building the chapel on the hospital’s second floor. “[The auxiliary] purchased the very first ambulance for the hospital in 1908,” said Ken, who also serves at the auxiliary historian. “We did not include the purchase of the horses.” The hospital staff appreciates the work done by the auxiliary volunteers. “The auxiliary delivers coffee in the morning to various stations and sometimes they appreciate it so
much, they ask, ‘Where’s the tip jar?’” Ken said with a laugh. He said that, although they don’t take tips, any money they receive goes to the auxiliary. The patients, however, are the most appreciative of all. “I think we need to help make the patients comfortable as much as we can because they’re afraid some of the times,” Joanne said. “Sometimes we get them to laugh and sometimes we get them to sing. It makes their day and our day better. “ The auxiliary is run solely by volunteers and, according to the Jensens, they are always looking for more. “The other volunteers do what works for them, so there is always someone here,” Joanne said. “They are here because the feel they are needed, and this allows them give as well as receive. It is absolutely Joanne and Ken Jensen are two of about 70 Mayo Clinic Health System Auxiliary volunteers who fill a variety of assistance roles at Mayo Clinic Health System in Austin. Michael Stoll/mike.stoll@austindailyherald.com rewarding.” “It gives you a warm feeling knowing that you’ve helped people,” Ken said. “It’s just a service that we feel we’re doing to the community, in particularly to the hospital.”
Taking thyroid meds? You might just be tired MPR News Staff
When older folks go to the doctor saying they’re tired or having trouble losing weight, a common response is to test the thyroid gland. The gland produces hormones that have many regulatory effects on the body — fatigue, weight gain, feeling cold, dry skin, constipation and more. So, if tests indicate the thyroid is slowing down, doctors often turn to a synthetic thyroid hormone called levothyroxine, or Synthroid. But that might be ineffective, according to a new study published in the New England Journal of Medicine. In the study, researchers conducted a randomized trial of people over age 65 who had what’s called subclinical hypothyroidism. People with subclinical hypothyroidism essentially
have mild symptoms of hypothyroidism, or fatigue, depression or feeling cold. They were treated with levothyroxine, which researchers found to have no apparent benefit. “This really raises the question of, should we be doing this?” said MPR News medical commentator Dr. Jon Hallberg. “And I’ll tell you, a lot of us in primary care are prescribing this kind of thyroid hormone.” One danger of overprescribing this medication is that it can create an opposite problem: hyperthyroidism. What’s behind these symptoms then? “At the end of the day, a lot of times we are just tired, and we just can’t explain it,” Hallberg said. He joined All Things Considered host Tom Crann to discuss thyroids, the study and what it all means.
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Senior Living
THURSDAY, APRIL 27, 2017
Scams push foreclosure fraud to limit, taking victims’ homes Associated Press
NEW YORK — The phone call came as Raymond Murray neared the bottom of his luck. His wife had died, his career had been ended by injuries, and struggling to get by on his disability check, he had scraped together just enough to pay a lawyer to avoid imminent foreclosure on his modest Brooklyn home. The man on the phone offered a godsend: The foreclosure could be averted, the legal fees could be eliminated and the monthly mortgage payment he could no longer afford could be trimmed. Soon, Murray was sitting at a conference room table in the man’s office, finalizing the fix he believed would keep him in his home. It didn’t take long for the sad truth to become clear: This aging immigrant was scammed out of his home. Around the U.S., deed theft has emerged as one of the most sophisticated and devastating frauds ever to menace homeowners. Foreclosure “rescue” scams that have stolen thousands of dollars from individual homeowners in the years since the housing collapse have been pushed by savvy perpetrators to their limit. They use lies to convince the desperate to sign over their title, then force them into homelessness or a yearslong legal battle. “The scammers are no longer content with stealing $5,000. Now they want the whole house,” said Dina Levy, who heads the Homeowner Protection Program in the New York attorney general’s office, which has spread word about deed theft and prosecuted culprits. Deed theft has been reported around the U.S., from San Diego, where prosecutors recently netted a guilty plea and six-year prison sentence for a man involved in deed thefts of at least 15 homes, to Detroit, where the register of deeds hopes to expand his fraud unit to keep up with a crush of cases. The problem has been most severe in gentrifying neighborhoods quickest to rebound from the housing crisis, nowhere more so than ever-pricier blocks of New York. The New York sheriff ’s office has taken a lead on the cases and since 2014, the office has amassed more than 1,700 complaints, with hundreds under investigation, and some 32 arrests already tallied. Sheriff Joseph Fucito ticks off the ways the thefts happen, from opportunists cobbling together
documents on vacant properties to those transferring the home of an unwitting family member into their name, to fake housing assistance businesses that prey on those in financial crisis. “You can just wake up,” Fucito said, “and it happened on a piece of paper.” Murray came to New York in 1989 from his native Guyana, working as a telephone technician and then a police traffic control agent. He and his wife Desrie, a teacher, lived in a relative’s basement, then rented a home before saving enough to buy. It wasn’t much — a two-story brick house with a white metal gate, on a quiet, tree-lined Brooklyn street — but he felt like he finally could see what he’d been working for. “It was an American dream,” the 67-year-old says. After two on-the-job accidents, Murray was forced to retire. Money became tighter, but after his wife died suddenly of ovarian cancer in early 2009, Murray’s real financial pinch set in. He cut back on food, kept the house darkened and found other ways to scrimp. His savings disappeared, he fell behind on the mortgage and a default notice alerted him that he was being referred for foreclosure. He had already spent $5,000 on an attorney to try to restructure his debt when that chance call came in January 2014, from a man named Mario Alvarenga. Murray said Alvarenga told him his mortgage could be modified, and the fix wouldn’t even cost anything, so long as he fired his attorney. Because of his poor credit, Murray said he was told, his home would need to go in the name of another company Alvarenga was tied to, Launch Development, for 90 days; then the loan modification would be finalized and the property could be put in the name of one of his children or, as he’d remarried, his new wife. After signing a stack of papers at Alvarenga’s office, Murray left awash in relief. But, soon after, Alvarenga phoned to tell him the loan modification wasn’t approved, pleading for patience. Murray grew worried and suspicious, and Alvarenga became impossible to reach. It all climaxed with Murray finding a man on his property taking pictures and informing him the house now belonged to him. Later, an eviction notice on his door ordered him to vacate.
A special supplement to the AUSTIN DAILY HERALD
What the Trump team should consider before axing Meals on Wheels funds By David Campbell
Binghamton University, State University of New York via the Conversation and Associated Press
To justify President Donald Trump’s aim to spend less on social services, Office of Management and Budget Director Mick Mulvaney declared, “We can’t spend money on programs just because they sound good.” Who can argue with that? Not us. Like anyone else, we want our taxpayer dollars spent wisely. Funding programs that “sound good” but don’t accomplish much seems foolish. Still, this principle is way too broad to apply to complicated budget decisions. Our research suggests that identifying the best spending choices is a lot harder than it sounds.
Assessing social service programs
Mulvaney brought up Meals on Wheels, a program that delivers meals to 2.4 million homebound seniors a year, while trying to give a good example of something funded through the Community Development Block Grant program that Trump is seeking to eliminate altogether. The grants “were just not showing any results,” he said in mid-March. The federal government spends about $3 billion annually on block-grant funds that states, counties and cities use to meet local needs as they see fit. This money helps make housing more affordable for low-income people, subsidizes child care and, in many communities, covers part of the cost of Meals on Wheels and other programs serving the elderly. As public administration professors, we have studied how social service programs get assessed. In our research at Binghamton University, we have surveyed and interviewed funders as well as providers of these programs to learn how they measure results and how they use that information once they get it. We found that each defines results in different ways and uses them in different ways, making it hard to prove whether government funded programs like Meals on Wheels “work.” In one study, for example, we asked 20 funders and 20 providers the open-ended question, “Why do you collect performance information?” In a number of cases, interviewees provided more than one response. What we learned is that providers often are more interested in improving their
programs and becoming more responsive to the people who benefit from them. Funders such as the federal government, on the other hand, tend to prioritize making sure that the programs have the intended outcomes. However, there are risks to placing so much emphasis on results. This mindset can lead policymakers to a binary choice: Programs work or they don’t. Fund them if they do and defund them if they don’t. To further complicate matters, social service organizations like Meals on Wheels must provide different kinds of performance-related information to each funder that supports them. Imagine the challenge, let alone confusion, these requirements create. For any one program, there is no single desired result. Each funder can judge a program’s success based on its own standard.
Meals on Wheels
Research about Meals on Wheels’ benefits supports our point. Should it improve nutrition? Provide companionship? Enable seniors to remain in their homes? Reduce health care costs? Without agreement on this program’s goals, there’s no single way to evaluate its results. Mulvaney, for example,
may care about one kind of result and the senior eating a delivered meal could care about another. The volunteer who delivered it and the local entity that handled the meal’s logistics might value yet other priorities. Since the budget director made this assertion, reporters and op-ed writers have countered what Mulvaney said about Meals on Wheels, citing studies about the program’s effectiveness. Brown University professors Kali Thomas and Vincent Mor, for instance, found that a mere one percent increase in the number of adults over age 65 receiving home-based meals could save Medicaid $109 million annually by making it easier for the elderly to age in place. Other studies find that having volunteers visit the home-bound makes them less lonely, less likely to suffer falls and less prone to depression — positive outcomes that trim health care costs. If Meals on Wheels generates these benefits, why cut spending on it? Troublingly, if the government scraps Meals on Wheels or other programs, there may not be a replacement. If that happens, the problems the program addresses persist but there’s no longer a plan to address them. Isn’t improving pro-
grams a better option? Social service providers are on the ground and mission-driven. Results matter to them, but not as ends in themselves. Instead, they are motivated to learn how to make good programs more effective and more responsive to the people they serve. Yes, funders must worry about results, but in many cases, they should use them to learn how to improve programs, not as an excuse to end them.
Budgetary confusion
Since Meals on Wheels gets far more federal cash from the Department of Health and Human Services than from block grants, it’s unclear whether the program is in jeopardy even if Congress backs Trump’s plan to scrap the Community Development Block Grant and the Community Services Block Grant programs. But the underlying issue remains: Mulvaney seemed to assume that everyone agrees what it means to say that Meals on Wheels does or does not work, that he’s looked into the matter and has decided that the program doesn’t work. His confusing comments raised a question at the heart of our research. What does it mean when someone claims a program “doesn’t work”?