Family Caregiving During Vacation

My family and I are winding up a whirlwind 14-day prospective-college tour throughout the southeast and mid-Atlantic and begin our journey home. As soon as we land back home, I will barely get our travel clothes into the washer when I will climb back into the car and head over to my mother’s house to continue my role as family caregiver. And vacation has ended.

I was a bit reticent to take such a long break. I haven’t been away for such a long stretch of time since I became, along with my brother, my elderly mother’s primary caregiver so many years ago. But sometimes circumstances arise (or—dare I say it—sometimes even family caregivers need a break) that take us away from our senior loved ones for an extended period.

Respite care for family caregivers

Just because a family caregiver is gone doesn’t mean the senior needs any less help. No one is advocating that a senior “goes it alone” for the duration. However, that will be a  great fear for the senior who may be worried, “Who will take care of me?”

Planning respite care should be a part of your trip planning itself. To help alleviate any anxieties, discuss your travel plans with your loved one and assure them that together, you will work out the details necessary for whatever care they will need and with which they will be comfortable. Discuss the options based on level of care needed.

In-home care

Most times your elderly loved one will be most comfortable staying at home. If the senior is relatively independent, sometimes part-time caregiving can be be cobbled together from a variety of sources. You can enlist friends and neighbors, church volunteers or other willing family members to provide companionship during your absence (make sure they know how to reach you while you are away.) Fill the pantry and fridge so store trips won’t be necessary. If your elderly loved one doesn’t feel comfortable cooking hot meals, you can hire a  meal service. Check  to see if Meals on Wheels is available in your area. Make sure all medication prescriptions are filled. A medical alert system is not a bad idea if the senior is sometimes home alone, even if you are not on vacation.

If a higher level of care is necessary, you can hire a professional caregiver through a reliable senior home care agency. Caregiverlist works with only the most quality home health agencies to provide non-medical professional caregivers to assist with ADLs and C.N.A.s who can provide some basic medical care. These caregivers go through a rigorous screening  process that includes criminal background check. They are insured and bonded and are actively managed by a direct supervisor or manager. In-home care costs can range from $15 - $25 per hour for hourly care and $150 - $350 per day for 24-hour live-in care.

Off-site care

There are many assisted living communities that can provide furnished apartments for temporary senior care on-site. Temporary residents enjoy the same level of available care as permanent residents and have access to all the available amenities such as meals, medication management, transportation, activities, and security.  $15 - $25 per hour for hourly care and $150 - $350 per day for 24-hour live-in care. According to 2012 Genworth.com data ,temporary care respite stays are usually less than one month long, and can cost between $75 to $200 per day. A Geriatric Care Manager can help you navigate all your available options, as well as inform you on how best to pay for respite care.

As summer winds down, your family vacations are probably behind you. However, family caregiving, while rewarding, can be highly stressful and lead to caregiver burnout. A family caregiver should take much needed time off and, while perhaps furloughs will be shorter in duration, the need for respite care will be no less. Consider following the same guidelines for abbreviated breaks. And remember, ski season will be soon upon us!

Seniors and Suicide: Depression Drives Decision

The world lost a comedic genius earlier this week when Robin Williams was found in his home in California, dead of an apparent suicide. It’s been reported that Mr. Williams had been battling severe depression as of late. When I heard the sad news I thought, Here’s a man who had everything—wealth, fame, the love of a good family, the adoration of the world. How could someone who had so much decide to take his own life? And if his depression could drive him to commit such a final act, what chance do those with less—less money, fewer loved ones, failing health, have?

That’s the misinformation we as a nation have about depression—that it’s a choice, a moral failing. But depression is a disease, like cancer or heart disease. Although some seniors will have battled depression all their lives, many experience their first onset late in life, in their 80s and 90s. And because depression is the primary risk factor in most suicides, left undiagnosed and untreated, the elderly are a high-risk demographic. 

According to the National Institute of Mental Health (NIMH), older Americans comprise 13 percent of the population but account for 18 percent of all suicides. In the U.S., elderly white males, especially the old-old (over the age of 85), have the highest risk of suicide in the nation. In a fact sheet produced by the American Association of Suicidology, the 2010 suicide rate for these men was 47.33 per 100,000, or 2.37 times the current rate for men of all ages (19.94 per 100,000).

Not to be confused with normal (and relatively temporary) sadness and grief which can be caused by the loss of a loved one, changes in one’s environment, or deteriorating health, depression doesn’t go away by itself and needs professional intervention. In short, the senior needs treatment.

If you are a senior caregiver, be on the lookout for these signs of depression. Symptoms of depression in the elderly can include:

  • memory problems and confusion
  • social withdrawal and isolation
  • loss of appetite, weight loss
  • complaints of pain where there are no apparent physical causes
  • inability to sleep
  • irritability
  • delusions or hallucinations
  • also, heavy alcohol consumption is a known risk factor for depression and suicide.

Like many other diseases, depression is treatable and, according to experts, suicide can be prevented. If you suspect your senior loved one or elderly client shows signs of depression, the first step is to seek medical help. Some simple tests performed by their primary care physician can help determine a course of action to treat the disease and thereby, help prevent suicide. If more immediate action is needed, The National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) operates a 24-hour confidential suicide hotline.

We at Caregiverlist extend our sincere condolences to the family of Robin Williams, as well as to the families of all the victims of suicide. We can only hope that his passing will open the discussion of depression and suicide, help remove its stigma, and encourage sufferers to seek help.

Clorox Hosts Special Chicago Caregiver Event

Senior caregivers based in or near Chicago, Illinois should consider taking some time for themselves and enjoy a little TLC care of Clorox®.

Caring for the elderly, especially in their own homes, can be a relentless and stressful endeavor. Those of us who take care of our senior loved ones know that there is little time left over to care for ourselves. Clorox® CareConceptsTM recognizes that fact and is planning a series of evenings in cities around the country to celebrate and honor those who care for others.

Chicago’s caregiver event takes place on Wednesday, August 20, and will provide some pampering activities, along with hors d'oeuvres, drinks, and the opportunity to meet others in the caregiving community who experience all the joys and frustrations that you do.

There will also be a screening of the documentary “A Sacred Journey” by filmmaker Ernesto Quintero and a panel discussion among experts and caregivers on the topic: When Care Comes Home, exploring the challenges and inspirational moments of in-home caregiving.

If you bring along a photo submission of you with the person for whom you are caring, along with a brief description (i.e., “Caring for my mom since 2001”), Clorox® CareConceptsTM will donate $5 on your behalf to the REST Program.

Date: Wednesday, August 20
Time: 6:30 p.m.
Location: The Logan Theater 2646 N Milwaukee Ave., Chicago, IL 60647
Transportation: Car: Complimentary valet parking
Nearest CTA: Blue Line at Logan Square 


RSVP by Thursday, August 14 to RSVP@pdcpr.net or 708.305.5075
For more information: Visit WhenCareComesHome.com

Caregiverlist® has long been a champion of the family and professional caregiver. A few years ago, we held our own “Caregiver Day” and can attest to its popularity. Senior caregiving can be such an isolating experience—sometimes it’s just you and your senior. We highly recommend taking advantage of any and all opportunities to take some time and connect with others who know exactly what you are experiencing as a caregiver. We think the Clorox® CareConceptsTM special night out on August 20 will be a hit in Chicago. Look for other Clorox® CareConceptsTM caregiver night off events in Los Angeles on October 1 and Washington DC on November 13.

 

 

South Carolina "Senior Plan" Touted by Lt. Governor Hopeful

Bakari Sellers, South Carolina Representative (D) and candidate for lieutenant governor, has made issues affecting South Carolina’s senior population his primary concern.

Rep. Sellers has been traveling the state discussing his proposed South Carolina “Senior Plan” to improve the life of its aging population.

In his Sellers for South Carolina blog, he outlines a six point plan focusing on the needs of the elderly which includes:

  • Expanding the state’s investment in senior transportation.
  • Advocating for tax relief packages for caregivers and long-term care insurance premiums.
  • Leading the Senior Fraud Taskforce.
  • Expanding the senior homestead exemption.
  • Strengthening the continuum of care.
  • Transforming the Office on Aging into a driving force for advocacy on behalf of Alzheimer’s patients and their families and increasing Alzheimer’s research

Representative Sellers is also proposing a $500 annual tax credit for family caregivers.

Citing the statistics of a greatly expanding senior population which is expected to double by the year 2030, this younger member of the General Assembly bemoans the fact that South Carolina “seniors have been neglected too long” and proposes to reach across the aisle and seek cooperation from Democrats and Republicans alike.

South Carolina’s victorious lieutenant governor will also lead the state’s Office on Aging.

In AARP’s recent State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers, South Carolina ranked in the third quartile in 34th place nationally. Caregiverlist’s® Nursing Home database includes 195 South Carolina Nursing Homes, with a private-room cost average of $185.76 and an average Star Rating of 2.9.

The majority of senior issues and concerns are addressed on a state level. It’s nice to see a young representative like Mr. Sellers tackle the well-being of his elder constituency. If you’d like to learn more about South Carolina senior services and resources, Caregiverlist® offers by-state information such as SC Drivers License Laws, caregiver training requirements and a link to the South Carolina Department on Aging.

Sellers South Carolina Nursing Home

(95-year-old Dolly Sparks meets Rep. Bakari Sellers during a campaign stop at Agape Senior Assisted Living North Charleston. Wade Spees/Staff. http://sellers2014.com/ )

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Shots for Seniors: Vaccines Recommended for Older Adults

There’s a national debate going on questioning whether vaccines are safe.

Vociferous anti-vaccine activists link vaccines with rising numbers of children with autism, although studies have shown no correlation between the two. Nor has it been proven that vaccinations cause childhood leukemia, as previously thought. Despite scientific findings (or, in the opinion from the other side of the aisle, pharmaceutical company propaganda),  the anti-vaccine movement continues its rally against childhood vaccinations due to their proposed dangerous side effects while public-health experts contend that high rates of non-vaccination are the cause of recent contagious disease outbreaks.

But what about the elderly? Are they in danger of vaccine complications?

August is National Immunization Awareness Month (NIAM). Sponsored by the Center for Disease Control, the purpose of the campaign is to “provide an opportunity to highlight the value of immunization across the lifespan”.  The CDC recommends that the elderly (those 60 years +) receive the following vaccines to promote good health:

Seasonal flu (influenza) vaccine
The CDC estimates 90 percent of seasonal influenza-related deaths and more than 60 percent of seasonal influenza-related hospitalizations in the U.S. each year occur in people 65 years and older.

Tetanus, diphtheria, and pertussis (Td or Tdap) vaccine
Everyone, including the elderly, should have booster shots for tetanus and diphtheria every 10 years.

Pneumococcal  (pneumonia) vaccine
Pneumonia, which often starts as a simple viral respiratory disease, and can develop into a severe inflammation of the lungs, often cited as the fifth leading cause of death in the elderly and frail.

Zoster vaccine, to protect against shingles
The risk of getting shingles increases as one ages. Not only that, but shingles can be extremely painful in the elderly. The persistent pain, called postherpetic neuralgia (PHN), can last for months or years.

This is not to say that vaccines for seniors have been without their own controversy. Several years ago, “Fluzone High-Dose”, a flu vaccine manufactured by Sanofi Pasteur especially for those over 65 years old. And although Sanofi Pasteur reported finding the vaccine 24.2% more effective in preventing influenza in the aged, some believe the vaccine, which contains four times the amount of antigen compared to the regular flu vaccine, brought with it stronger side effects.

You can learn more about the vaccines you or your senior client or loved one may need at vaccines.gov. Their Adult Immunization Scheduler tool offers personalized vaccine suggestions based on your age (and other factors.)

How do you feel about immunization and vaccines? Do you believe them necessary to continued well-being or is it a dangerous scam perpetrated by big pharma? Is it part of your job as a senior caregiver to influence the decision of the elder in your charge whether to get that shot or not? We’d love to hear you opinions in the comment section. Regardless of where you stand on the issue, Caregiverlist® continues to believe in utilizing everything in one's health toolkit in order to age well.

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Minnesota Leads the Way in Senior Care

Minnesota’s comprehensive senior care programs may well become the nation’s standard. In addition to scoring a first-place position in AARP’s 2014 State Long-Term Services and Supports (LTSS) Scorecard (also in 2011), Minnesota’s Department of Human Services announced in a July 1 press release a plan to award $3.5 million to providers of services to older Minnesotans, as well as for people with disabilities. The money is specifically earmarked for innovative projects designed to improve quality for home and community-based services.

The program comes on the heels of the state’s successful 2006 Performance-based Incentive Payment Program (PIPP) that provides nursing homes with additional funds for proven quality improvement projects. In 2013, an article published in the journal Health Affairs determined that PIPP facilities showed significantly increased quality after PIPP funding and continued to have higher overall quality scores than nursing homes not in the program.

In fact, Good Samaritan Society - Albert Lea (Private), which rates over 4 stars in Caregiverlist's® Nursing Home Star Ratings, used its PIPP money to implement a nursing assistant mentorship program to increase its C.N.A. retention rate with great success.
 
The Minnesota Department of Health and Human Services is hoping to see a similar outcome by funding 27 projects in 39 Minnesota counties. Recipients must put policies in place to improve quality of life or deliver better service more efficiently.

For example, Knute Nelson Home Care will receive funding to implement GrandCare technology, an interactive touchscreen used as a communication portal between the older person and family caregivers. The Lutheran Home Association will use funds to decrease staff turnover in its in-home services, and the grant will help Tealwood Senior Living to develop and apply dementia care culture change in its assisted living facilities.

“Home and community-based service providers are key to helping people with disabilities and olderadults live independently, which is what most people prefer,” Human Services Commissioner Lucinda Jesson said in a written statement. “We have found that initiatives like this promote greater, lasting quality and efficiency and a better overall experience for people being served.”

Caregiverlist salutes Minnesota for taking a proactive approach to improving the quality of care for its elderly citizens. Minnesota’s initiatives are proving to set the bar for the best senior care in the U.S.  Now if they could just do something about those winters!

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Dawn of the Planet of the Caregiverlist Blogger: My Top 5 Posts

I went to see Dawn of the Planet of the Apes this past weekend and it occurred to me that my maiden Caregiverlist blog post was about the first Planet of the Apes movie (James Franco, not Charlton Heston, thank you very much): Rise of the Planet of the Apes.

In August of 2011, that movie was the subject of my blog post because its premise dealt with the search for a cure for Alzheimer’s disease (and please don’t let the ensuing movie’s cluster-franchise discourage future Alzheimer’s and dementia research.) This sequel bypassed the whole Alzheimer’s angle but for one sentence in the exposition, so I can’t use this movie for blog fodder. However, I thought I’d look back on my last three years of contributions and highlight my top five posts, out of the hundreds I've written, based on number of eyeballs.

#5 Does Your Power of Attorney Include a HIPAA Release?
15. July 2014 19:17
This is a recent post in which I discuss the importance of legal due-diligence as it applies to medical issues. It all boils down to the fact that information is power. When it comes to the ones we love, we want to make sure no one tells us they can’t give us pertinent medical information because necessary paperwork wasn’t processed. Process that paperwork!

#4 Become a Certified Senior Caregiver
2. July 2014 16:09
Who doesn’t love a good infographic? Caregiverlist provides an at-a-glance look at the growing need for caregivers for an elderly population, caregiver skills and senior caregiver job descriptions, and caregiver salary and benefits. It also outlines the steps to becoming a professional senior caregiver. And it’s pretty.

#3 Caregiver Pay: Are You Living Paycheck to Paycheck?
19. April 2014 11:18
It sure is nice to know you are not alone, especially when you feel like you are living at the end of your rope. C.N.A.s are essential to society in helping the elderly age with comfort and dignity. Unfortunately, those who help others often find themselves on the short end of the recompense stick. HBO’s Paycheck to Paycheck: The Life and Times of Katrina Gilbert spoke to many of you who are trying to make a life while making a difference.

#2 Alzheimer's Disease and Dementia: What's the Difference?
24. June 2014 08:18
I’m not above admitting it—Bradley Cooper’s face would make me click on any link too. When I wrote about Alzheimer’s and dementia awareness as a cause celebre, the popularity of the post was proof. It just goes to show that these diseases touch all, regardless of wealth or station—no one is immune to memory loss devastation.

BradleyCooper

Bradley Cooper proudly promotes purple to #ENDALZ.


#1 Inspirational Quotes for Caregivers
24. August 2013 06:22
Caregivers, especially caregivers for the infirm and seniors, experience a tremendous amount of stress. It’s why Caregiverlist has made it’s mission to "care for the caregiver" especially. It’s no wonder then that my preeminent blog post was one that gave inspiration to the senior caregiver. Culled from a variety of sources, these inspirational quotes speak to why caregiving is the ultimate humanitarian calling. The takeaway: “They may forget your name, but they will never forget how you made them feel.” —Maya Angelou

If there is any topic that you would like to see me tackle in future, feel free to drop me a line at renata@caregiverlist.com. Thanks for reading!

Does Your Power of Attorney Include a HIPAA Release?

Seniors and family caregivers often find it difficult to discuss plans of action for when the elderly family member is incapacitated or no longer able to speak for themselves. It’s a challenging subject, but one worth tackling before it’s needed. If you don’t, the circumstances can be dire.

The Health Insurance Portability and Accountability Act of 1996, better known as HIPAA, was designed to protect a patient’s right to privacy by penalizing doctors and other healthcare providers who disclose "protected health information" about their patients. Whenever you go to the doctor, you’ll be prompted to fill out a federally-mandated form that reads, "HIPAA Notice of Privacy Practices." Patient confidentiality is generally a good thing. No one has the right to know my medical prognoses, see my prescriptions, or discuss my medical treatments unless they have my written approval. But what if a person can’t give that approval?

There are plenty of HIPAA horror stories out there. Imagine the story of the woman whose mother wound up in the ER after suffering a stroke. She approaches the nurse’s station, frantic about her mother’s condition and is met with a sympathetic shrug of the shoulders and, "I am sorry, I am not authorized to give you that information." By law, unless the woman and her mother had a Power of Attorney for HIPAA release, no one in that hospital can discuss her medical condition with outside parties—even the woman’s own daughter.

Caregiverlist®, in it’s ongoing mission to care for the caregiver and make life just a little easier for seniors and their families, has worked with Law Depot to provide you access to senior care legal documents to help facilitate elder care.

In the case of Power of Attorney for HIPAA Release, it is imperative to have all legal documents in place as, in most cases, the patient is not a position to give their verbal instructions. Do it in order to lessen the burden on family members during an already stressful time. In addition to the providing all medical professionals the “release of information” paperwork, it’s also important for the senior and their proxy to discuss and fill out a Last Will and Testament and a Living Will for end-of-life medical treatment requests.

Learn more about HIPAA at the Department of Health and Human Services’ Office for Civil Rights website at www.hhs.gov/ocr/hipaa.

States React to AARP Scorecard

Much has been made of AARP’s released report 2014 State Long-Term Services and Supports (LTSS) Scorecard. In fact, I covered the results in a recent blog.

Since the report’s release, state politicians and policy makers have been scrambling to either issue statements strongly urging for their state’s commitment to long term care improvement or stridently patting themselves on the back for a job well done.

Louisiana’s Times-Picayune article on nola.com about its senior population being over-institutionalized. Louisiana ranked 37th of the 50 states and Washington, D.C. in its overall long-term care policies. In that state, aging seniors are (predominantly) either placed in nursing homes or cared for at home by unpaid family members. And it ranked dead-last in effective transitions—meaning that a high number of nursing home residents are hospitalized because they’re not receiving the care they need. Funny, the same report found that there are a high number of nursing home residents with low-care needs. No doubt it is because of the lack of alternatives such as adult day care and other home and community-based services.

Not surprisingly, vociferous Louisiana AARP advocates call for increased funding of alternate care choices in an attempt to acquiesce to the majority of older Louisiana residents who wish to age in place, at home. Ironically, despite the article pointing to so many calls-to-action, they conclude optimistically, pointing out that “Louisiana's ranking in 2014 improved slightly from the 43rd slot, when scorecard was last issued in 2011.”

On the flip-side, Minnesota’s Office of the Governor Mark Dayton was quick to issue a press release extolling their number one spot on the scorecard for long term care access, choice, quality, and caregiver support. The release also pointed out that Minnesota ranked in first place on the 2011 Scorecard as well.

In the release, Gov. Dayton cited the following efforts that assist Minnesotans in “providing our parents, grandparents, and people with disabilities the best possible care.”

  • New incentives for providers to increase quality
  • More help for people who want to move from nursing homes and other congregate settings to homes of their own
  • More comprehensive information and referral services for individuals and family caregivers
  • Support for core community services that help people stay in their homes
  • More flexibility for consumers in choosing supports tailored to their needs
  • Promotion of competitive employment for people with disabilities
  • A stronger adult protection system; and
  • Own Your Future, an initiative that encourages Minnesotans to plan for their long-term care and is now exploring new ways Minnesotans can finance this care.


We at Caregiverlist® not only care for the caregiver, we advocate for seniors and their families. I hope that the Long-Term Care Scorecard elicits more than one-upmanship between states. It’s a great opportunity to see where your own system may be lacking and examine and adapt those state policies and approaches to long term senior care that appear to be working best.

Alzheimer's Disease and Dementia: What's the Difference?

It happens almost imperceptibly — a misplaced wallet, a forgotten word or name, short-term memory loss. These incidents can be normal blips in memory, but sometimes they can be indications of a more serious cognitive degeneration. The fear of being diagnosed with Alzheimer’s disease can keep a person in the state of denial. In fact, new figures show half of those who are diagnosed with dementia waited at least six months before seeing their doctor.

The Alzheimer’s Association says that of more than 6000 people surveyed, nearly a quarter of list Alzheimer’s disease as the second most frightening condition they most fear getting, behind cancer. More than 80% believe that the disease is a normal part of aging, and nearly 40% of people believed that only those with a family history of the disease could be affected.

But Alzheimer’s disease is not a normal part of aging. It's a disease that causes brain cells to malfunction and ultimately die. Neurons are the chief type of cell destroyed by Alzheimer's disease. That causes memory changes, erratic behaviors and loss of body functions. It’s a sad fact that Alzheimer’s has no survivors. The disease is the 6th leading cause of death in the United States.

June is Alzheimer’s and Brain Awareness Month. The Alzheimer’s Association is asking everyone affected by the disease to show their commitment to the cause by wearing purple and posting to social media sites like Facebook. As they say on their website, “Everyone who has a brain is at risk to develop Alzheimer's—but everyone can help to fight it.”

A number of celebrities have banded together to support Alzheimer’s awareness. Recently, actor and Alzheimer’s activist Seth Rogan spoke to congress about the need to allocate more funding to research and eradicate the disease that strikes so many, including his mother-in-law.

BradleyCooper

Bradley Cooper proudly promotes purple to #ENDALZ.

All Alzheimer’s disease is dementia but not all dementia is Alzheimer’s. Dementia is an overall term that describes a wide range of symptoms. Although Alzheimer’s is the most common form of dementia, there are a variety of other dementia types. These include Vascular dementia, or post-stroke dementia, which accounts for about 10% of all dementia cases. Dementia with Lewy bodies (DLB) sufferers are more likely than people with Alzheimer's to have early symptoms such as visual hallucinations and muscle rigidity. Parkinson's disease, frontotemporal dementia, normal pressure hydrocephalus are also types of dementia. Some of these diseases are treatable. Unfortunately, no cure or treatment slows or stops some of these progressive dementia diseases, like Alzheimer’s. But there are drug treatments that may temporarily improve symptoms.

Mild Cognitive Impairment (MCI) is often, but not always, a precursor to dementia. If you’ve been diagnosed with MCI, or are caring for a senior with Mild Cognitive Impairment, there’s a lot you can do to ease the ease and reduce the signs of MCI. For example, it’s been found that, coupled with a healthy diet, regular exercise can have a very positive impact on the brain and cognitive function.

Caregiverlist® urges if you are a senior caregiver whose family member or client presents any symptoms of memory loss, to seek the counsel of a doctor. Early detection is key in order to benefit from treatment and to plan for the future. Some dementia disorders are treatable — such as depression, drug interactions, thyroid problems, excess use of alcohol or certain metabolic disorders, such as a vitamin B12 deficiency .

If you or your beloved senior has Alzheimer’s disease or dementia, share your story with the world. Reach out to us on Twitter @Caregiverlist and don't forget to use #gopurple and #endalz to join the conversation. It’s time we destigmafy Alzheimer’s and other memory loss diseases.

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