A new study published in the Journal of the American Geriatrics Society examined the relationship between poor oral health and older male adults' risks of increased frailty, reports EurekAlert . The researchers invited 1,722 surviving participants of the British Regional Heart Study when they were 71 to 92 years old, with subjects deemed frail if they had to deal with at least three issues that included exhaustion, weak grip strength, slow walking speed, weight loss, and low physical activity levels. The team determined 20 percent of surviving participants had no teeth, 64 percent had fewer than 21 teeth, 54 percent had gum disease, 29 percent had at least two symptoms of dry mouth, 34 percent rated their oral health as "fair to poor," and 11 percent reported trouble eating. The researchers concluded that men with such dental issues were more likely to be frail than men that did not have dental issues. They team also observed a strong association between complete tooth loss, dry mouth, and additional oral health concerns and developing frailty. They suggest these findings emphasize the importance of oral health for older adults.

Although persons with dementia frequently need hospital care, few hospitals are prepared to care for them, reports the Boston Globe . "Hospitals were never designed to accommodate people with dementia," says Susan Antkowiak with the Massachusetts/New Hampshire Chapter of the Alzheimer's Association. A panel established in 2016 by the Massachusetts state legislature recently urged hospitals to develop, within three years, a comprehensive plan for addressing the needs of people with dementia, about 60 percent to 80 percent of whom have Alzheimer's. Composed of senior-care specialists, government officials, and caregivers, the panel has made voluntary recommendations for setting protocols for identifying people with dementia, training staff, and changing the surroundings to be more conducive. Concord-based Emerson Hospital has taken steps to accommodate people with dementia, according to Care Management Director Margaret Foley. She notes staffers work to help hospitalized people maintain the abilities they came with. In attempts to avoid sedating medications, the hospital seeks other ways to calm down individuals with dementia, such as a family photo or a familiar blanket. The Alzheimer's Association says Massachusetts stands out from other states in having established a committee focused exclusively on hospitals. A September report from the committee offered 70 pages of resources and suggestions. Patricia M. Noga with the Massachusetts Health & Hospital Association says the association has organized a working group to identify ways hospitals can change and share knowledge about practices that are known to work.

The AARP and North American Securities Administrators Association (NASAA) have rolled out an online interview tool to help investors quickly get to the most salient issues when interviewing prospective investment advisers, reports Financial Advisor . The "Interview An Adviser" tool supplies a script for investors to use to focus on an adviser's experience, licensing, education, services and products offerings, compensation, and standard of care to determine whether the candidate is mandated to act as a fiduciary who is "obligated to act in the investor's best interest." The new tool effectively concentrates investors' attention on whether or not a financial professional functions as a fiduciary using a client best-interest standard, or is registered as a broker, using the looser suitability standard. "While registered investment advisers serve as fiduciaries who are required to provide advice that is in their clients' best interest, many other financial advisers operate under different requirements that obligate them only to make recommendations that are 'suitable,'" says the AARP's Jean Setzfand. "AARP's new interactive guide will help investors avoid confusion about a financial professional's standards and qualifications." The absence of a fiduciary rule for any financial professional who is not a registered investment adviser is the motivator for the new tool. "The U.S. Department of Labor DOL approved a fiduciary duty rule in 2016 requiring that advisers managing retirement savings accounts meet the 'best interests' standard," note the AARP and NASAA. "However, last year DOL announced a delay until 2019 in implementation of major provisions of the rule."

The Financial Industry Regulatory Authority (FINRA) has published a set of frequently asked questions on its rules concerning financial exploitation of seniors that go into effect on Feb. 5, reports Think Advisor . FINRA Rule 2165 allows members to impose provisional holds on disbursements of funds or securities from the accounts of specified customers "where there is a reasonable belief of financial exploitation of these customers." Revisions to FINRA Rule 4512 stipulate that members make reasonable efforts to secure the name of and contact information for a trusted contact person for a customer's account. According to the Q&A, a member firm may not place a temporary hold on a securities transaction pursuant to Rule 2165, as the rule is inapplicable to transactions in securities. However, Rule 2165 says a firm with a reasonable belief of financial exploitation of a client may place a temporary hold on a disbursement from one account to another at the firm. FINRA notes in such a situation, "a member may place a temporary hold on a request to disburse funds or securities from an account to another account at the member (e.g., where a member receives a request to move funds from a customer's account to his friend's account at the member but the member reasonably believes that the customer is being financially exploited)." The FAQ also explains when a firm may disclose to the trusted contact information about a customer's account.

A new survey estimates that almost 66 percent of Americans older than 50 think all nursing community employees should get annual flu vaccinations, reports HealthDay News . More than 60 percent of poll respondents said all nursing and/or assisted living community residents also should get vaccinated, while 70 percent said if they knew that 33 percent of the staff at a nursing community was not vaccinated it would make them less likely to live there. In addition, a majority of respondents said the flu vaccine should be offered to workers at no cost, and those who do not avail themselves of the vaccine should be required to stay at home whenever they become ill. These results suggest that care communities should protect vulnerable individuals — or potentially risk losing business, says the University of Michigan Professor Preeti Malani. "I encourage everyone to ask nursing communities and other long-term care communities about their vaccination policies," she said. However, the U.S. Centers for Disease Control and Prevention calculates that less than 70 percent of long-term care workers are routinely vaccinated against the flu, despite the agency's recommendation that everyone older than six months do so. By comparison, about 90 percent of hospital staffers get flu vaccinations every year.

A survey of more than 400,000 U.S. workers in the past year found when people believe promotions are managed effectively, they are more than twice as likely to make an extra effort at work and to plan a long-term future with their company, reports the Harvard Business Review . Furthermore, they are five times as likely to believe leaders act with integrity. Among the Fortune 100 Best Companies to work for, 75 percent of employees think promotions go to those who most deserve them. A good promotion process lets leaders elevate each employee to their full potential and demonstrate the kind of results and behaviors they value. Poorly managed promotions can foster feelings of jealousy and resentment in others, and the career goals of employees across the company can be left unreached. Leaders can bolster the effectiveness of their promotion process by re-concentrating on the people the process is meant to support, at every stage. Prior to a promotion, each team member's long-term aspirations should be clarified so leaders know both how they will contribute as the business expands and how they can best support them. Leaders also should encourage, support, and coach employees to pursue new positions as soon as they are posted. Once the promotion decision is made, leaders should generate buy-in by explaining to others the reason behind the decision. Following the announcement, leaders should follow up with the people who were not promoted to recalibrate.

Male nurses working in the Pacific Northwest — where recruitment efforts have focused on bringing men into nursing — say the profession is reliable, pays well, and is one they take pride in, reports the New York Times . Although men form a minority in the nurse occupation, they earn higher salaries than women. Older adults particularly attach a stigma to male nurses, but the General Social Survey found progressive views of gender roles were associated with more men who entered nursing, according to a recent working paper published by the Washington Center for Equitable Growth. "This narrative that men can't provide care in the way that women can is part of that broad cultural narrative that misunderstands what nursing's about," says VA hospital student nurse Adam White. "We need to talk with young people about caring as a gender-neutral idea, but also as something that's rooted in skills, in expertise." Economic forces have contributed, including growth in jobs and pay in healthcare. Nursing is growing faster than the average profession, with salaries increasing steadily since 1980. The survey found the increase in male nurses was largely consistent across the U.S., although black and Hispanic men and those in rural regions were less likely to enter the profession. Men also report liking nursing because of the variety of roles they can fulfill, including bedside caregivers, surgery assistants, educators, technicians, and administrators.

Dr. Bill Thomas is seeking to restore a sense of independence to seniors while relieving them of the burden of maintaining bigger homes, reports STAT . Thomas' Minka initiative is a simple 330-square-foot, plywood-boned home through which the physician hopes to change the senior housing model. The warm, light, and roomy residence features oversize windows, a shed-style roof, a bathroom compliant with the Americans with Disabilities Act, a full-size bed, and an Ikea-furnished kitchen and countertop. On the Minka's ceiling is a detachable mechanical lift to help people get out of bed and move more safely around the bathroom. The small size of the structure makes heating and cooling clean and inexpensive. Thomas mainly plans to build Minkas in clusters, which provide built-in community and offer economies of scale to builders. In some instances, they could be built on a homeowner's existing property, although that could involve the headache and cost of a local zoning board appeal for many aspiring residents. Tioga County, N.Y., official LeeAnn Tinney says Minkas are better suited to retirees than people with children. A Minka costs about $200 per square foot to build, and Thomas intends to refine the manufacturing process to get the cost down to $150 per square foot to attract local homebuilders to either purchase prebuilt Minka kits or customized CNC machines to fabricate their own. In keeping with his vision of sustaining senior independence, Thomas plans to add ancillary services and technologies to encourage social engagement, healthy eating, and physical activity.

As Vietnam veterans age and develop terminal illnesses, the U.S. Department of Veterans Affairs' (VA) palliative care staff are facing more challenges, reports Kaiser Health News . Some veterans become stoic and less willing to admit they are afraid or in pain, and less willing to take treatment. Others with post-traumatic stress disorder (PTSD) are even more resistant to taking pain-relieving opioids because the drugs can exacerbate their symptoms. The VA's National Center for PTSD estimates about 70 percent of Vietnam vets have had PTSD in their lifetime, the highest rate among veteran groups, while various studies found this higher rate is attributable to the unusual combat conditions vets faced and the negative reception many of them got when they returned home. "They're so distracted trying to cope with their physical symptoms that they might have flashbacks," notes VJ Periyakoil at the VA Palo Alto Health Care Center. "War memories start coming back; they start having nightmares." Some vets also refuse pain-relieving medication because they feel as if they deserve the pain, says University of California-San Francisco Professor Eric Widera. He notes the VA has been attempting to implement end-of-life care earlier for vets in order to resolve their moral distress or PTSD years before they end up in hospice.