To describe the challenges faced by rural caregivers in providing assistance to older family members with Alzheimer's disease and closely related conditions. Procedure: Preliminary focus group findings from a new grant initiative, Alzheimer's Rural Care Healthline, that assesses the efficacy of telephone-based cognitive-behavioral intervention for rural dementia caregivers. Groups identified specific caregiver educational and skills-training requirements and best methods for soliciting referrals from rural health providers, community elder care agencies, and churches. Results: Trust emerged as an overarching theme, along with family and community privacy issues and the stigma associated with dementia. Conclusions: Future studies should consider the educational priorities, technological requirements, and sociocultural context of rural caregivers in designing telehealth-based interventions, including issues of privacy, stigma, and trust. Recognition of these factors may lead to increased acceptability, frequency of use, and sustainability of rural telehealth programs.
Nonadherence within the schizophrenic population is a challenge for both the patient and the clinician. This problem not only causes an increase in health care use and cost but also places the patient at risk of relapse and dissatisfaction with medical care. Nonadherence is influenced by several factors including disease, treatment, and psychological and social factors. All of these factors must be addressed if the clinician hopes to reduce nonadherence within this patient population. This article will attempt to identify factors that contribute to nonadherence and review strategies that can be implemented to address each of these factors.
Numerous trials have been conducted evaluating the efficacy of ginkgo biloba in memory disorders. The active constituents of ginkgo biloba are antioxidants that scavenge free radicals, which have been implicated in the pathogenesis of memory disorders. These studies suggest that ginkgo biloba in doses up to 120 mg/day when taken for 2 years may halt the progression of the disease for at least six months. The biggest concern of using ginkgo biloba is associated with its effects on platelet activating factor, which may result in bleeding disorders. Additional studies are needed to evaluate ginkgo biloba in combination with other medications.
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