There are around 48 million people caring for adult friends and family members in the United States. These loving individuals do so without pay but with all of the responsibilities of a paid care provider. And sometimes, they need a break or support in ways that their current network can’t offer. This is where you come in. Caregiver support is a crucial service that can help those who help our nation’s most vulnerable.

Today’s quick guide from Patient Talk will cover several topics, including general business formation, where to find workers for your family support endeavors, the types of services you might offer, and how you can ensure that your clients are well taken care of.

Business Formation

In any business, you want to make sure that you have the right protections in place. If you’re going into people’s homes and dealing with individuals on a one-on-one level, a limited liability company is a smart choice as it reduces your personal liability in case of legal issues with your company. An LLC is not difficult to form, and if you don’t mind reading local formation regulations and following best practices, you can establish your LLC online using a formation service instead of paying for an expensive attorney.

Next, it’s time to market your services! You should spread the word via social media, of course, but it’s also a good idea to put together a kind of newsletter or digital pamphlet that contains all the information a prospective client might need. Your best bet is to start in Word, then save it as a PDF. If you need to make changes later, the best solution is to use this free PDF editing tool.

Finding The Right Staff

If your future business (more on that later) needs healthcare workers, a staffing agency can help you find the right certified care specialist, or you can search for them yourself. Make sure you request and check references, since your workers are crucial to your success. Get Smarter suggests that you can look for characteristics such as honesty, professionalism, dependability, and innovation to identify your best candidates.

In Demand Services

The act of supporting family caregivers typically falls under the respite care category. This could be any number of services, from companion care to housekeeping to assistance with skilled nursing needs. You can start a business doing any or all of these programs, each of which is highly in demand and much needed across the US.

Exceptional Customer Service

Regardless of your industry, customer service is crucial. However, when you’re dealing with overworked, underpaid, and overwhelmed individuals, customer service must be handled delicately. In addition to knowing your customers, listening to them, and providing the support they need, you and your employees must be compassionate caregivers, great listeners, and friends. For this reason, you have to make a point to get to know the personality of each employee to ensure they are the right fit for today and in the future.

Supporting Your Staff

You expect your staff to support your customers, but you also have to support your staff, especially those in the medical field. As American Nurse explains, nurses and other medical professionals today experience anxiety, burnout, and other mental health problems at an exceptional level. Make sure that you give your employees plenty of time off and benefits, such as gym memberships, paid vacation time, and mental health services, that can help them live their best life both on and off the clock.

Starting a business supporting caregivers is a great way to secure your future income. But you have to have the right employees, set up your business structure, offer the right services, and support both your customers and your staff if you want to be successful. The above tips can help you get going, but it’s your care and compassion that will help you meet your goals.

Patient Talk is a place for patients and caregivers to discuss the issues that matter most to them. If you have any questions, don’t hesitate to reach out!

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 People with multiple sclerosis (MS) who follow a Mediterranean diet may have a lower risk for problems with memory and thinking skills than those who do not follow the diet, according to a preliminary study released today, March 1, 2023, that will be presented at the American Academy of Neurology’s 75^th Annual Meeting being held in person in Boston and live online from April 22-27, 2023.

The Mediterranean diet includes a high intake of vegetables, legumes, fruits, fish and healthy fats such as olive oil, and a low intake of dairy products, meats and saturated fatty acids.

“It’s exciting to see that we may be able to help people living with MS maintain better cognition by eating a Mediterranean diet,” said study author Ilana Katz Sand, MD, of the Icahn School of Medicine at Mount Sinai in New York, New York, and a member of the American Academy of Neurology. “Cognitive difficulties are very common in MS, and they often get worse over time, even with treatment with disease-modifying therapies. People living with MS are very interested in ways they can be proactive from a lifestyle perspective to help improve their outcomes.”

The study involved 563 people with MS. People completed a questionnaire to show how closely they followed the Mediterranean diet. They were assigned a score of zero to 14 based on their responses with higher scores given to those who more closely followed the diet.

Researchers then divided participants into four groups based on their diet scores, with the lowest group having scores of zero to four and the highest group having scores of nine or higher. 

Participants also took three tests assessing their thinking and memory skills. Cognitive impairment was defined as scoring less than the fifth percentile on two or three of the tests.

A total of 108 people, or 19%, had cognitive impairment.

The researchers found that people who more closely followed the Mediterranean diet had a 20% lower risk for cognitive impairment than people who did not follow the diet.

Among those in the lowest diet score group, 43 of 133 people, or 34%, had cognitive impairment compared to 13 of 103 people, or 13%, of people in the highest diet score group.

The relationship was stronger among people with progressive MS, where the disease steadily worsens, than among those with relapsing-remitting MS, where the disease flares up and then goes into periods of remission.

Importantly, Katz Sand noted, the results were the same when researchers rigorously adjusted for other factors that could affect the risk of cognitive impairment, such as socioeconomic status, smoking, body mass index, high blood pressure and exercise.

“Among health-related factors, the level of dietary alignment with the Mediterranean pattern was by far the strongest predictor of people’s cognitive scores and whether they met the study criteria for cognitive impairment,” Katz Sand said.

She noted that longer studies that follow people over time and well-designed interventional clinical trials are needed to confirm the results. A limitation of the study was that tests were taken only once.

Disabilities were underreported in clinical trial data and commonly used as a basis for exclusion from trial participation in an analysis of 80 recent trials involving cardiovascular outcomes, according to a study being presented at the American College of Cardiology’s Annual Scientific Session Together With the World Congress of Cardiology.

Reports estimate that over half of people with heart disease have one or more disabilities related to cognition, mobility, vision, independent living, self-care or hearing as defined by the Centers for Disease Control and Prevention (CDC). However, the new study found that 38% of clinical trials listed a disability among their exclusion criteria and only 8% of trials reported disability status as part of their baseline data. Researchers said these gaps in both inclusion and reporting suggest clinical trial designers are missing an opportunity to ensure studies adequately represent the patient populations they intend to benefit.

“We were surprised that there was this lack of reporting for disabilities, simply because doing so is CDC guideline recommended, and it would be a valuable data point for clinicians,” said Roy Lan, MD, an internal medicine resident at Stanford University and the study’s lead author. “I hope our study can jump-start an effort to increase reporting of disabilities, both in baseline patient demographics and also outcomes.”

The study is the first to specifically examine reporting and inclusion of people with disabilities within cardiovascular clinical trials. Across all 80 trials, only six included data on disabilities in published baseline participant characteristics, an omission that may be due to a lack of data collection, a lack of data reporting or both.

“There is an abundance of literature within cardiovascular trials on race, ethnicity and gender, but people with disabilities are another population that can be vulnerable,” Lan said. “As we become more advanced in targeting therapies to different population groups, this is one that we really can’t forget and need to serve well. If we aren’t even reporting disabilities in clinical trials, how can we best serve and take care of these patients?”

Researchers analyzed the 20 most recently published clinical trials in each of four major areas: atrial fibrillation, coronary artery disease, hypertension and diabetes. Only trials for which full published data were available were included in the sample, and all studies were published between 2014 and 2022. The researchers assessed disabilities reporting and exclusion criteria based on each trial’s published data as well as records from the clinical trials database (ClinicalTrials.gov).

Overall, 38% of the trials listed at least one type of disability among their exclusion criteria. Of the different types of trials, disabilities were cited in exclusion criteria most often in hypertension trials (55%) and least often in diabetes trials (15%).

Disabilities related to cognition or psychiatric issues (such as Alzheimer’s disease or other forms of dementia) were the most common type of excluded disability with one-third of trials citing this in the exclusion criteria. Between 3%-8% of trials excluded disabilities related to mobility, vision, independent living, self-care or hearing. Although the CDC provides specific criteria for defining six categories of disability, researchers noted that many clinical trials established their own definitions of disability, potentially leading to greater exclusion and making it difficult to compare results across studies.

Future studies could help to elucidate why people with certain types of disabilities are often excluded from clinical trial participation and guide efforts to design trials that are more inclusive, researchers said. They suggest it would also be useful to more routinely include information about disability status in clinical trial data, as well as capture the degree of disability at baseline to allow researchers to track any changes over the course of the trial.

In a separate study being presented at the meeting, researchers found that people with intellectual disabilities (limitations in the ability to learn at an expected level and function in daily life) who were hospitalized for acute coronary syndrome were significantly less likely to receive coronary angiography or revascularization and more likely to die in the hospital than people without intellectual disabilities. The findings point to a need to address disability-related disparities in patient care in addition to clinical trial design and practice. The trial, “Outcomes of Acute Coronary Syndrome in Patients with Intellectual Disabilities: Insights from the National Inpatient Sample,” will be simultaneously published in Cardiovascular Revascularization Medicine.

Satisfying relationships in mid-life with partners, friends, or work colleagues are linked to a lower risk of accumulating multiple long-term conditions in older age—at least among women—suggests research published in the open-access journal General Psychiatry.

The less satisfying these relationships were, the greater was the risk, with the findings only partially explained by influential factors, such as income, education, and health behaviours, the study shows.

Mounting evidence indicates a link between strong social networks and good health/wellbeing in older age, but it’s not known if these connections might lower the risk of multiple long term conditions (multimorbidity), which many older women, in particular, face. 

In a bid to assess to what extent a women’s level of satisfaction with their relationships—partner, family, friends, work colleagues, and other social connections—singly and collectively might influence this risk, the researchers drew on 13,714 participants of the Australian Longitudinal Study on Women’s Health (ALSWH).

The ALSWH is an ongoing population-based study looking at factors associated with the health and wellbeing of women who were aged 18–23, 45–50, and 70–75 in 1996.

All the women in the current study were aged 45-50 in 1996. Their health and wellbeing was tracked roughly every three years via questionnaire up to 2016.

They were asked to rank their levels of satisfaction with each of their 5 categories of  relationships on a 4-point scale, with each response scored up to a maximum of 3 points.

And they were asked to indicate if they developed any of the following: diabetes; high blood pressure; heart disease; stroke; chronic obstructive pulmonary disease (COPD); asthma; osteoporosis; arthritis; cancer; depression; and anxiety.

Accumulating 2 or more of these from a starting point of none, or additional conditions from just 1, or from 2 or more, was defined as having multiple conditions (multimorbidity).

Information was collected on potentially influential demographic, lifestyle and hormonal factors: country of birth, marital status, area of residence, educational attainment and the ability to manage income; weight (BMI), physical activity, alcohol intake and smoking; and menopausal status. 

The final analysis included 7694 women, 58% (4484) of whom accumulated multiple long term conditions over 20 years of monitoring.

Those who did so, were more likely to have lower educational attainment, find it difficult to live off their income, be overweight/obese, physically inactive, smokers and to have had a surgically induced menopause.

Overall, relationship satisfaction was associated with the accumulation of multiple long term conditions: the greater the levels of satisfaction, the lower were the risks.

Compared with women reporting the highest level of satisfaction (score of 15), those who reported the lowest (score of 5 or less) were more than twice as likely to accumulate multiple long term conditions after fully adjusting for potentially influential factors. 

The strength of the association was comparable with that of well established risk factors, such as overweight/obesity, physical inactivity, smoking and alcohol intake, say the researchers.

When all 5 types of relationship were included in the analysis, the association weakened, but still remained significant for all except friendships. Similar results were observed when individual conditions were analysed separately.

Well established risk factors, such as socioeconomic position, health behaviours, and menopausal status, together explained less than one-fifth of the observed association.

This is an observational study, and as such, can’t establish cause. It also relied on personal recall, and didn’t capture information on social relationships in early adulthood. And as it included only Australian women, the findings might not be applicable to men or other cultures, say the researchers.

Further research is needed to explore other specific effects of relationships on the accumulation of multiple long term conditions, such as intimacy, quantity, and emotional and practical support, they emphasise. 

Nevertheless, they conclude: “Our findings have significant implications for chronic disease management and intervention. First, at the individual level, these implications may help counsel women regarding the benefits of starting or maintaining high quality and diverse social relationships throughout middle to early old age.

“Second, at the community level, interventions focusing on social relationship satisfaction or quality may be particularly efficient in preventing the progression of chronic conditions.

“Third, at the country and global levels, social connections (eg, social relationship satisfaction) should be considered a public health priority in chronic disease prevention and intervention.”

Urban gardens, like this one in California, have been found to benefit local ecosystems and humans. CREDIT University of California

Traditionally, it has been assumed that cultivating food leads to a loss of biodiversity and negative impacts on an ecosystem. A new study from researchers at multiple universities, including The University of Texas at Austin, defies this assumption, showing that community gardens and urban farms positively affect biodiversity, local ecosystems and the well-being of humans that work in them.

The study, published in Ecology Letters, looked at 28 urban community gardens across California over five years and quantified biodiversity in plant and animal life, as well as ecosystem functions such as pollination, carbon sequestration, food production, pest control and human well-being.

“We wanted to determine if there were any tradeoffs in terms of biodiversity or impacts on ecosystem function,” said Shalene Jha, an associate professor of integrative biology who was lead author on the paper. “What we found is that these gardens, which are providing tremendous nutritional resources and increasing well-being for gardeners, are also supporting incredibly high levels of plant and animal biodiversity. It’s a win-win.”

A green sweat bee on a native wildflower. CREDIT University of California

Previous assumptions by scientists about the negative effect of food production on biodiversity have been almost entirely based on intensive rural agriculture enterprises that tend to grow only one or two types of crops, often at a massive scale. Urban community gardens, private gardens, and urban farms and orchards tend to grow more types of plants in smaller areas. This new study is the first to explore the effects of urban gardens across a wide range of biodiversity measures and ecological services.

“It’s estimated that by 2030, about 60% of the world’s population will live in cities,” Jha said. “And urban farms and gardens currently provide about 15%-20% of our food supply, so they are essential in addressing food inequality challenges. What we’re seeing is that urban gardens present a critical opportunity to both support biodiversity and local food production.”

The study also found that the choices that gardeners make can have a large impact on their local ecosystem. For instance, planting trees outside crop beds could increase carbon sequestration without limiting pollinators or decreasing food production from too much shade. And mulching only within crop beds could help improve soil carbon services, while avoiding negative effects on pest control and pollinators.