YouTube Ban Lifted in Pakistan, for 3 Minutes

ISLAMABAD, Pakistan — A ban on YouTube, which Pakistan imposed after an anti-Islam video caused riots in much of the Muslim world, was lifted Saturday, only to be reinstated — after three minutes — when it was discovered that blasphemous material was still available on the site.

After months of criticism of the ban, the government decided to allow Pakistanis to have access to YouTube again, saying steps had been taken to ensure that offensive content would not be visible. But those efforts apparently failed, and the authorities quickly backtracked.

The ban was imposed on Sept. 17 following violent protests in response to the video, which was made in the United States and ridiculed the Prophet Muhammad. The government then ordered all telecommunications companies to block Internet material deemed offensive to Muslims and urged people to report such material.

But the ban on YouTube came to be seen as censorship, and a growing number of the estimated 25 million Internet users in the country complained.

“This is purely a naked power play by the government and one that we should resist,” an editorial in The Express Tribune, an English-language daily newspaper in Karachi, Pakistan, said Friday. “This is about controlling our behavior and denying us access to the Internet.”

“We need to make it clear that we do not wish to regress to a dark age when a centralized authority controlled all access to information,” the editorial, observing the 100th day of the ban, went on to say. “Retreating to such an era would essentially mean that we were longer living in a democracy.”

By Friday evening, Rehman Malik, the country’s interior minister, indicated that the ban would be lifted over the weekend. Mr. Malik said firewalls by government technicians were being installed to block pornographic and blasphemous material.

On Saturday, the Pakistan Telecommunication Authority directed local Internet service providers to make YouTube accessible. But by the afternoon, Geo, a private television news network that wields immense influence, reported that anti-Islam and blasphemous material was still available on YouTube. The criticism was led by Ansar Abbasi, a right-leaning journalist who often speaks out on morality and religion.

Yielding to the criticism, Prime Minister Raja Pervez Ashraf then ordered providers to again block access to the video-sharing site.

The flip-flop drew an immediate rebuke from users and led to a flurry of jokes on Twitter about the government’s dithering and backtracking.

“YouTube is a huge convenience for users, who benefit from it for educational as well as entertainment purposes,” Zubair Kasuri, the editor of Flare, a Karachi-based telecommunications magazine, said in a telephone interview. Mr. Kasuri expressed surprise over the government’s failure to install an effective firewall mechanism despite having months to do so.

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Elwood V. Jensen, Pioneer in Breast Cancer Treatment, Dies at 92

Tony Jones/Cincinnati Enquirer, via Associated Press

Elwood V. Jensen in 2004.

Elwood V. Jensen, a medical researcher whose studies of steroid hormones led to new treatments for breast cancer that have been credited with saving or extending hundreds of thousands of lives, died on Dec. 16 in Cincinnati. He was 92.

The cause was complications of pneumonia, his son, Thomas Jensen, said.

In 2004 Dr. Jensen received the Albert Lasker Basic Medical Research Award, one of the most respected science prizes in the world.

When Dr. Jensen started his research at the University of Chicago in the 1950s, steroid hormones, which alter the functioning of cells, were thought to interact with cells through a series of chemical reactions involving enzymes.

However, Dr. Jensen used radioactive tracers to show that steroid hormones actually affect cells by binding to a specific receptor protein inside them. He first focused on the steroid hormone estrogen.

By 1968, Dr. Jensen had developed a test for the presence of estrogen receptors in breast cancer cells. He later concluded that such receptors were present in about a third of those cells.

Breast cancers that are estrogen positive, meaning they have receptors for the hormone, can be treated with medications like Tamoxifen or with other methods of inhibiting estrogen in a patient’s system, like removal of the ovaries. Women with receptor-rich breast cancers often go into remission when estrogen is blocked or removed.

By the mid-1980s, a test developed by Dr. Jensen and a colleague at the University of Chicago, Dr. Geoffrey Greene, could be used to determine the extent of estrogen receptors in breast and other cancers. That test became a standard part of care for breast cancer patients.

Scientists like Dr. Pierre Chambon and Dr. Ronald M. Evans, who shared the 2004 Lasker prize with Dr. Jensen, went on to show that many types of receptors exist. The receptors are crucial components of the cell’s control system and transmit signals in an array of vital functions, from the development of organs in the womb to the control of fat cells and the regulation of cholesterol.

Dr. Jensen’s work also led to the development of drugs that can enhance or inhibit the effects of hormones. Such drugs are used to treat prostate and other cancers.

Elwood Vernon Jensen was born in Fargo, N.D., on Jan. 13, 1920, to Eli and Vera Morris Jensen. He majored in chemistry at what was then Wittenberg College in Springfield, Ohio, and had begun graduate training in organic chemistry at the University of Chicago when World War II began.

Dr. Jensen wanted to join the Army Air Forces, but his poor vision kept him from becoming a pilot. During the war he synthesized poison gases at the University of Chicago, exposure to which twice put him in the hospital. His work on toxic chemicals, he said, inspired him to pursue biology and medicine.

Dr. Jensen studied steroid hormone chemistry at the Swiss Federal Institute of Technology on a Guggenheim Fellowship after the war. While there, he climbed the Matterhorn, one of the highest peaks in the Alps, even though he had no mountaineering experience. He often equated his successful research to the novel approach taken by Edward Whymper, the first mountaineer to reach the Matterhorn’s summit. Mr. Whymper went against conventional wisdom and scaled the mountain’s Swiss face, after twice failing to reach the summit on the Italian side.

Dr. Jensen joined the University of Chicago as an assistant professor of surgery in 1947, working closely with the Nobel laureate Charles Huggins. He became an original member of the research team at the Ben May Laboratory for Cancer Research (now the Ben May Department for Cancer Research) in 1951, and became the director after Dr. Huggins stepped down.

He came to work at the University of Cincinnati in 2002, and continued to do research there until last year.

His first wife, the former Mary Collette, died in 1982. In addition to his son, Dr. Jensen is survived by his second wife, the former Hiltrud Herborg; a daughter, Karen C. Jensen; a sister, Margaret Brennan; two grandchildren; and three great-grandchildren.

Dr. Jensen’s wife was found to have breast cancer in 2005. She had the tumor removed, he said in an interview, but tested positive for the estrogen receptor and was successfully treated with a medication that prevents estrogen synthesis.

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Elwood V. Jensen, Pioneer in Breast Cancer Treatment, Dies at 92

Tony Jones/Cincinnati Enquirer, via Associated Press

Elwood V. Jensen in 2004.

Elwood V. Jensen, a medical researcher whose studies of steroid hormones led to new treatments for breast cancer that have been credited with saving or extending hundreds of thousands of lives, died on Dec. 16 in Cincinnati. He was 92.

The cause was complications of pneumonia, his son, Thomas Jensen, said.

In 2004 Dr. Jensen received the Albert Lasker Basic Medical Research Award, one of the most respected science prizes in the world.

When Dr. Jensen started his research at the University of Chicago in the 1950s, steroid hormones, which alter the functioning of cells, were thought to interact with cells through a series of chemical reactions involving enzymes.

However, Dr. Jensen used radioactive tracers to show that steroid hormones actually affect cells by binding to a specific receptor protein inside them. He first focused on the steroid hormone estrogen.

By 1968, Dr. Jensen had developed a test for the presence of estrogen receptors in breast cancer cells. He later concluded that such receptors were present in about a third of those cells.

Breast cancers that are estrogen positive, meaning they have receptors for the hormone, can be treated with medications like Tamoxifen or with other methods of inhibiting estrogen in a patient’s system, like removal of the ovaries. Women with receptor-rich breast cancers often go into remission when estrogen is blocked or removed.

By the mid-1980s, a test developed by Dr. Jensen and a colleague at the University of Chicago, Dr. Geoffrey Greene, could be used to determine the extent of estrogen receptors in breast and other cancers. That test became a standard part of care for breast cancer patients.

Scientists like Dr. Pierre Chambon and Dr. Ronald M. Evans, who shared the 2004 Lasker prize with Dr. Jensen, went on to show that many types of receptors exist. The receptors are crucial components of the cell’s control system and transmit signals in an array of vital functions, from the development of organs in the womb to the control of fat cells and the regulation of cholesterol.

Dr. Jensen’s work also led to the development of drugs that can enhance or inhibit the effects of hormones. Such drugs are used to treat prostate and other cancers.

Elwood Vernon Jensen was born in Fargo, N.D., on Jan. 13, 1920, to Eli and Vera Morris Jensen. He majored in chemistry at what was then Wittenberg College in Springfield, Ohio, and had begun graduate training in organic chemistry at the University of Chicago when World War II began.

Dr. Jensen wanted to join the Army Air Forces, but his poor vision kept him from becoming a pilot. During the war he synthesized poison gases at the University of Chicago, exposure to which twice put him in the hospital. His work on toxic chemicals, he said, inspired him to pursue biology and medicine.

Dr. Jensen studied steroid hormone chemistry at the Swiss Federal Institute of Technology on a Guggenheim Fellowship after the war. While there, he climbed the Matterhorn, one of the highest peaks in the Alps, even though he had no mountaineering experience. He often equated his successful research to the novel approach taken by Edward Whymper, the first mountaineer to reach the Matterhorn’s summit. Mr. Whymper went against conventional wisdom and scaled the mountain’s Swiss face, after twice failing to reach the summit on the Italian side.

Dr. Jensen joined the University of Chicago as an assistant professor of surgery in 1947, working closely with the Nobel laureate Charles Huggins. He became an original member of the research team at the Ben May Laboratory for Cancer Research (now the Ben May Department for Cancer Research) in 1951, and became the director after Dr. Huggins stepped down.

He came to work at the University of Cincinnati in 2002, and continued to do research there until last year.

His first wife, the former Mary Collette, died in 1982. In addition to his son, Dr. Jensen is survived by his second wife, the former Hiltrud Herborg; a daughter, Karen C. Jensen; a sister, Margaret Brennan; two grandchildren; and three great-grandchildren.

Dr. Jensen’s wife was found to have breast cancer in 2005. She had the tumor removed, he said in an interview, but tested positive for the estrogen receptor and was successfully treated with a medication that prevents estrogen synthesis.

Read More..

Senate Leaders Racing to Beat Fiscal Deadline

WASHINGTON — Senate leaders and their aides spent Saturday searching for a formula to extend tax cuts for most Americans that could win bipartisan support in the Senate and final approval in the fractious House by the new year, hoping to prevent large tax increases and budget cuts that could threaten the fragile economy.

As part of the last-minute negotiations, the lawmakers were haggling over unemployment benefits, cuts in Medicare payments to doctors, taxes on large inheritances and how to limit the impact of the alternative minimum tax, a parallel income tax system that is intended to ensure the rich pay a fair share but that is increasingly encroaching on the middle class.

President Obama said that if talks between the Senate leaders broke down, he wanted the Senate to schedule an up-or-down vote on a narrower measure that would extend only the middle-class tax breaks and unemployment benefits. The Senate majority leader, Harry Reid of Nevada, said he would schedule such a vote on Monday absent a deal.

If Congress is unable to act before the new year, Washington will effectively usher in a series of automatic tax increases and a program of drastic spending cuts that economists say could pitch the country back into recession.

The president and lawmakers put those spending cuts in place this year as draconian incentives that would force them to confront the nation’s growing debt. Now, lawmakers are trying to keep them from happening, though it seemed most likely on Saturday that the cuts, known as sequestration, would be left for the next Congress, to be sworn in this week.

“We just can’t afford a politically self-inflicted wound to our economy,” Mr. Obama said Saturday in his weekly address. “The housing market is healing, but that could stall if folks are seeing smaller paychecks. The unemployment rate is the lowest it’s been since 2008, but already families and businesses are starting to hold back because of the dysfunction they see in Washington.”

The fear of another painful economic slowdown appears to have accelerated deal-making on Capitol Hill with just 48 hours left before the so-called fiscal cliff arrives. Weeks of public sniping between Mr. Reid, the Democratic leader, and Senator Mitch McConnell of Kentucky, the Republican leader, ebbed on Friday evening with pledges of cooperation and optimism from both.

On Saturday, though, that sentiment was put to the test as 98 senators waited for word whether their leaders had come up with a proposal that might pass muster with members of both parties. The first votes in the Senate, if needed, are scheduled for Sunday afternoon.

“It’s a little like playing Russian roulette with the economy,” said Senator Mark Warner, Democrat of Virginia. “The consequences could be enormous.”

Members of Congress were mostly absent from the Capitol on Saturday, after two days of Senate votes on other matters and a day before both chambers were to reconvene. However, senior aides were working on proposals in their offices or at their homes.

Speaker John A. Boehner stopped by the Capitol briefly to see his chief of staff on Saturday afternoon. Mr. McConnell spent much of the day in his office.

Aides to Mr. Reid were expecting to receive offers from Mr. McConnell’s staff, but no progress was reported by midday. Even if the talks took a positive turn, Senate aides said, no announcement was expected before the leaders briefed their caucuses on Sunday.

The chief sticking point among lawmakers and the president continued to be how to set tax rates for the next decade and beyond. With the Bush-era tax cuts expiring, Mr. Obama and Democrats have said they want tax rates to rise on income over $250,000 a year, while Republicans want a higher threshold, perhaps at $400,000.

Democrats and Republicans are also divided on the tax on inherited estates, which currently hits inheritances over $5 million at 35 percent. On Jan. 1, it is scheduled to rise to 55 percent beginning with inheritances exceeding $1 million.

The political drama in Washington over the weekend was given greater urgency by the fear that the economic gains of the past two years could be lost if no deal is reached.

Some of the consequences of Congressional inaction would be felt almost at once on Tuesday, in employee paychecks, doctors’ offices and financial markets. Analysts said the effect would be cumulative, building over time.

An early barometer would probably be the financial markets, where skittish investors, as they have during previous Congressional cliffhangers, could send the stock market lower on fears of another prolonged period of economic distress.

In 2011, the political battles over whether to raise the nation’s borrowing limit prompted Standard & Poor’s to downgrade its rating of American debt, suggesting a higher risk of default. The Dow Jones industrial average fell 635 points in a volatile day of trading after the downgrade.

This month, traders have again nervously watched the political maneuvering in Washington, and the markets have jumped or dropped at tidbits of news from the negotiations. Two weeks ago, Ben S. Bernanke, the chairman of the Federal Reserve Board, predicted that if lawmakers failed to reach a deal, “the economy will, I think, go off the cliff.”

Immediately — regardless of whether a deal is reached — every working American’s taxes will go up because neither party is fighting to extend a Social Security payroll tax cut that has been in place for two years.

Robert Pear and Jennifer Steinhauer contributed reporting.

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IHT Rendezvous: European Union Plans to Accentuate the Positive in 2013

LONDON — With the prospect of more troubles ahead for the European Union in 2013, officials have launched a campaign to remind its 500 million citizens of the benefits of belonging to the 27-nation alliance.

Next year has been designated the European Year of Citizens by the decision-makers in Brussels, who have highlighted a range of advantages, from freer cross-border travel to cheaper cross-border phone calls, to convince a sometimes skeptical public that membership has been worthwhile.

It might seem like a hard sell after a year in which the Union limped from crisis to crisis over a debt mountain that threatened the survival of the euro, the currency shared by 17 E.U. states.

Action by European leaders eventually succeeded in keeping Greece within the eurozone amid fears that a Greek exit — a “Grexit” — could spark the collapse of the single currency.

But that is only partial consolation for a European population facing another year of the kind of tough austerity programs that sparked strikes and protests in the most indebted states in 2012.

The Brussels bureaucrats offer a longer-term view, pointing out that tangible progress has been made in the 20 years since the creation of European Union citizenship that has improved the lives of millions.

“Nowadays traveling abroad entails cheaper travel costs, hassle-free border crossings, package holiday guarantees, access to healthcare systems and cheaper calls when you phone home,” according to the European Commission. “These are just some of the benefits derived from E.U. citizenship.”

Large numbers of Europeans have certainly taken advantage of free movement between member states to improve their job prospects outside their home nations. More than 12 million Europeans lived in a member state other than their own, according to data from 2010, before austerity began to bite.

Anecdotal evidence is that growing numbers of Europeans are now on the move, including French millionaires escaping tax hikes at home and young jobless Spaniards heading to find work in Germany.

Europe may have escaped a “Grexit” in 2012 but a new crisis is looming with the prospect of a “Brexit”, as Britain’s Conservative-led government prepares to spell out its position on its future relations with its European partners.

Prime Minister David Cameron, under pressure from the Euroskeptic wing of his party, is expected next month to reaffirm that he will seek to claw back powers that have been passed to Europe and that he is prepared to hold a national referendum on continued E.U. membership after the next British election.

Herman Van Rompuy, president of the European Council, which brings together the alliance’s political leaders, has warned that the British move threatens the future of the Union.

“If every member state were able to cherry-pick those parts of existing policies that they most like, and opt out of those that they least like, the union in general, and the single market in particular, would soon unravel,” he told The Guardian.

Is Europe over the worst? Or will continuing economic weakness and a potential “Brexit” threaten its prospects in 2013? Tell us what you think. And, if you’re a European, let us know if E.U. membership has proved to be a benefit or a hindrance.

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Senate Leaders Set to Work on a Last-Minute Tax Agreement

Luke Sharrett for The New York Times

In a televised statement at the White House after meeting with Congressional leaders on Friday, President Obama said he was “modestly optimistic” that an agreement could be reached.

WASHINGTON — At the urging of President Obama, the Democratic and Republican leaders of the Senate set to work Friday night to assemble a last-minute tax deal that could pass both chambers of Congress and avert large tax increases and budget cuts next year, or at least stop the worst of the economic punch from landing beginning Jan. 1.

After weeks of fruitless negotiations between the president and Speaker John A. Boehner, Mr. Obama turned to Senator Harry Reid, the majority leader, and Senator Mitch McConnell of Kentucky, the Republican leader — two men who have been fighting for dominance of the Senate for years — to find a solution. The speaker, once seen as the linchpin for any agreement, essentially ceded final control to the Senate and said the House would act on whatever the Senate could produce.

“The hour for immediate action is here. It is now,” Mr. Obama said in the White House briefing room after an hourlong meeting with the two Senate leaders, Mr. Boehner and Representative Nancy Pelosi, the House Democratic leader. He added, “The American people are not going to have any patience for a politically self-inflicted wound to our economy, not right now.”

Senate Democrats want Mr. McConnell to propose an alternative to Mr. Obama’s final offer and present it to them in time for a compromise bill to reach the Senate floor on Monday and be sent to the House. Absent a bipartisan deal, Mr. Reid said Friday night that he would accede to the president’s request to put to a vote on Monday Mr. Obama’s plan to extend tax cuts for all income below $250,000 a year and to renew expiring unemployment compensation for as many as two million people, essentially daring Republicans to block it and allow taxes to rise for most Americans.

Bipartisan agreement still hinged on the Senate leaders finding an income level above which taxes will rise on Jan. 1, most likely higher than Mr. Obama’s level of $250,000. Quiet negotiations between Senate and White House officials were already drifting up toward around $400,000 before Friday’s White House meeting. The two sides were also apart on where to set taxes on inherited estates.

But senators broke from a long huddle on the Senate floor with Mr. McConnell on Friday night to say they were more optimistic that a deal was within reach. Mr. McConnell, White House aides and Mr. Reid were to continue talks on Saturday, aiming for a breakthrough as soon as Sunday.

“We’re working with the White House, and hopefully we’ll come up with something we can recommend to our respective caucuses,” said Mr. McConnell, who has played a central role in cutting similar bipartisan deals in the past.

The emerging path to a possible resolution, at least on Friday, appeared to mirror the end of the protracted stalemate over the payroll tax last year. In that conflict, House Republicans refused to go along with a short-term extension of the cut, but Mr. McConnell reached an agreement that permitted such a measure to get through the Senate, and the House speaker essentially forced members to accept it from afar, after they had left forChristmas recess.

This time, the consequences are more significant, with more than a half-trillion dollars in tax increases and across-the-board spending cuts just days from going into force, an event most economists warn would send the economy back into recession if not quickly mitigated. With the House set to return to the Capitol on Sunday night, Mr. Boehner has said he would place any Senate bill before his chamber and let the vote proceed and the chips fall. The House could also change the legislation and return it to the Senate.

If the Senate is able to produce a bill that is largely bipartisan, there is a strong belief among House Republicans that the same measure would easily pass the House, with a large number of Republicans. While Mr. Boehner was unable to muster enough votes for his alternative bill that would have protected tax cuts for income under $1 million, that was because the measure lacked Democratic support, and was roughly a few dozen votes shy of passage with Republicans alone.

Helene Cooper and Ron Nixon contributed reporting.

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China Toughens Its Restrictions on Use of the Internet

HONG KONG — The Chinese government issued new rules on Friday requiring Internet users to provide their real names to service providers, while assigning Internet companies greater responsibility for deleting forbidden postings and reporting them to the authorities.

The decision came as government censors have sharply stepped up restrictions on China’s international Internet traffic in recent weeks. The restrictions are making it harder for businesses to protect commercial secrets and for individuals to view overseas Web sites that the Chinese Communist Party deems politically sensitive.

The new regulations, issued by the Standing Committee of the National People’s Congress, allow Internet users to continue to adopt pseudonyms for their online postings, but only if they first provide their real names to service providers, a measure that could chill some of the vibrant discourse on the country’s Twitter-like microblogs. The authorities periodically detain and even jail Internet users for politically sensitive comments, such as calls for a multiparty democracy or allegations of impropriety by local officials.

Any entity providing Internet access, including over fixed-line or mobile phones, “should when signing agreements with users or confirming provision of services, demand that users provide true information about their identities,” the Standing Committee ordered.

In recent weeks, Internet users in China have exposed a series of sexual and financial scandals that have led to the resignations or dismissals of at least 10 local officials. International news media have also published a series of reports in recent months on the accumulation of wealth by the family members of China’s leaders, and some Web sites carrying such reports, including Bloomberg’s and the English- and Chinese-language sites of The New York Times, have been assiduously blocked, while Internet comments about them have been swiftly deleted.

The regulations issued Friday build on a series of similar administrative guidelines and municipal rules issued over the past year. China’s mostly private Internet service providers have been slow to comply with them, fearing the reactions of their customers. The Standing Committee’s decision has much greater legal force, and puts far more pressure on Chinese Internet providers to comply more quickly and more comprehensively, Internet specialists said.

In what appeared to be an attempt to make the decision more palatable to the Chinese public, the Standing Committee also included a mandate for businesses in China to be more cautious in gathering and protecting electronic data.

“Nowadays on the Internet there are very serious problems with citizens’ personal electronic information being recklessly collected, used without approval, illegally disclosed, and even traded and sold,” Li Fei, a deputy director of the Standing Committee’s legislative affairs panel, said at a news conference in Beijing on Friday. “There are also a large number of cases of invasive attacks on information systems to steal personal electronic information, as well as lawbreaking on the Internet through swindles and through defaming and slandering others.”

Mr. Li denied that the government was seeking to prevent the exposure of corruption.

“When citizens exercise these rights according to the law, no organization or individual can use any reason or excuse to interfere, and cannot suppress them or exact revenge,” he said. “At the same time, when citizens exercise their rights, including through use of the Internet, they should stay within the bounds of the Constitution and the laws, and must not harm the legitimate rights and interests of the state, society, the collective or of other citizens.”

A spokesman for the National People’s Congress said that that 145 members of the Standing Committee voted in favor of the new rules, with 5 abstaining and 1 voting against them.

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TIMESCAST: New Year’s in Times Square Goes Digital

December 26, 2012By Fritzie Andrade, Krishnan Vasudevan and David Gillen

TimesCast Media+Tech: Song apps to keep the party going. | A conversation with Allure’s 85-year-old plastic surgery editor, Joan Kron. | A look at the social media tied to the ball drop.

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The New Old Age Blog: United States Lags in Alzheimer's Support

This month, the United States Senate Special Committee on Aging released a report examining how five nations — the United States, Australia, France, Japan and Britain — are responding to growing numbers of older adults with Alzheimer’s disease and dementia.

Every country has a strategy, but some are much further ahead than others. Notably, France began addressing Alzheimer’s disease and dementia in 2001 and is in the midst of carrying out its third national plan. (Scroll down at this link to find the English version of the 2008-2012 French plan.)

By contrast, the United States released its first national plan to address Alzheimer’s in May.

The Senate report highlights several trends under way in all five countries, including efforts to coordinate research more effectively, diagnose Alzheimer’s disease more reliably and improve training in dementia care by medical practitioners.

Most relevant to readers of this blog is another trend with increasing international scope: an accelerating effort to keep patients with Alzheimer’s disease and other forms of dementia at home and arrange for care and treatment there, rather than in institutions.

Anyone who’s followed reader response to Jane Brody’s column this week on aging in place knows the burden that this can place on families, especially if government support for home-based services (companions or home health aides who help with bathing, dressing, toileting and other tasks), adult day care or respite care is scarce or nonexistent, as is the case for most middle-class families in the United States.

Is care at home for patients with Alzheimer’s necessarily more humane? Only if caregivers have the resources — financial, physical and emotional — to handle this draining, exhausting, immeasurably difficult job. And only if the institutions that serve people with more advanced forms of Alzheimer’s disease and other types of dementia are so poorly financed, staffed and operated that we wouldn’t feel comfortable leaving loved ones in their care.

Three charts in the new Senate report underscore the extent to which the United States differs from other countries in what is expected of family caregivers. The first, on Page 60, shows countries’ support for paid long-term care services for residents age 65 and older. This includes all residents who need long-term care, including those with Alzheimer’s disease, other forms of dementia and other disabling chronic illnesses. Not included are services provided by unpaid family caregivers.

Look at where the United States ranks compared with Australia, Japan, France and the 30 other developed countries that belong to the Organization for Economic Cooperation and Development. Paid support for long-term care is much less in our country than in theirs.

The second chart, on Page 64, gives a sense of how much paid support for long-term care is provided in people’s homes. Again, the data is not specific to Alzheimer’s disease or dementia, although these are primary reasons older adults need long-term care.

And again, the United States falls short in terms of the amount of paid care it provides in home settings, even though older people tend to prefer these settings over institutions.

The third chart, on Page 75, brings results in the other two down to the level of families. When paid long-term care support is scarce or unavailable, you would expect a heavier load to fall on unpaid caregivers, and this is what the chart shows. Look at the number of caregivers in the United States who put in 10 to 19 hours a week (34.2 percent) or 20 hours or more a week (30.5 percent), and compare those with similar figures for France, Australia and Britain, all of which provide more paid long-term care than we do. Where are informal caregivers working the hardest? Right here at home in the United States.

For me, the take-away is clear. Other countries with which the United States is closely aligned have embraced long-term care as an essential social responsibility while we have not. Unless and until we do so, caregivers here will be among the most harried, stressed and burdened among wealthy, developed countries in the world.

Read More..

The New Old Age Blog: United States Lags in Alzheimer's Support

This month, the United States Senate Special Committee on Aging released a report examining how five nations — the United States, Australia, France, Japan and Britain — are responding to growing numbers of older adults with Alzheimer’s disease and dementia.

Every country has a strategy, but some are much further ahead than others. Notably, France began addressing Alzheimer’s disease and dementia in 2001 and is in the midst of carrying out its third national plan. (Scroll down at this link to find the English version of the 2008-2012 French plan.)

By contrast, the United States released its first national plan to address Alzheimer’s in May.

The Senate report highlights several trends under way in all five countries, including efforts to coordinate research more effectively, diagnose Alzheimer’s disease more reliably and improve training in dementia care by medical practitioners.

Most relevant to readers of this blog is another trend with increasing international scope: an accelerating effort to keep patients with Alzheimer’s disease and other forms of dementia at home and arrange for care and treatment there, rather than in institutions.

Anyone who’s followed reader response to Jane Brody’s column this week on aging in place knows the burden that this can place on families, especially if government support for home-based services (companions or home health aides who help with bathing, dressing, toileting and other tasks), adult day care or respite care is scarce or nonexistent, as is the case for most middle-class families in the United States.

Is care at home for patients with Alzheimer’s necessarily more humane? Only if caregivers have the resources — financial, physical and emotional — to handle this draining, exhausting, immeasurably difficult job. And only if the institutions that serve people with more advanced forms of Alzheimer’s disease and other types of dementia are so poorly financed, staffed and operated that we wouldn’t feel comfortable leaving loved ones in their care.

Three charts in the new Senate report underscore the extent to which the United States differs from other countries in what is expected of family caregivers. The first, on Page 60, shows countries’ support for paid long-term care services for residents age 65 and older. This includes all residents who need long-term care, including those with Alzheimer’s disease, other forms of dementia and other disabling chronic illnesses. Not included are services provided by unpaid family caregivers.

Look at where the United States ranks compared with Australia, Japan, France and the 30 other developed countries that belong to the Organization for Economic Cooperation and Development. Paid support for long-term care is much less in our country than in theirs.

The second chart, on Page 64, gives a sense of how much paid support for long-term care is provided in people’s homes. Again, the data is not specific to Alzheimer’s disease or dementia, although these are primary reasons older adults need long-term care.

And again, the United States falls short in terms of the amount of paid care it provides in home settings, even though older people tend to prefer these settings over institutions.

The third chart, on Page 75, brings results in the other two down to the level of families. When paid long-term care support is scarce or unavailable, you would expect a heavier load to fall on unpaid caregivers, and this is what the chart shows. Look at the number of caregivers in the United States who put in 10 to 19 hours a week (34.2 percent) or 20 hours or more a week (30.5 percent), and compare those with similar figures for France, Australia and Britain, all of which provide more paid long-term care than we do. Where are informal caregivers working the hardest? Right here at home in the United States.

For me, the take-away is clear. Other countries with which the United States is closely aligned have embraced long-term care as an essential social responsibility while we have not. Unless and until we do so, caregivers here will be among the most harried, stressed and burdened among wealthy, developed countries in the world.

Read More..