Unleash American Ingenuity and Help People with Dementia

Unleash American Ingenuity and Help People with Dementia

“In any civilized society, it is every citizen’s responsibility to obey just laws. But at the same time, it is every citizen’s responsibility to disobey unjust laws.”
– Martin Luther King, Jr.

Remove Cannabis from the CSA Today!

This is an exciting time in the world, to say the least. If we focus, it could be one where we begin to make meaningful progress in our fight to end the suffering of people living with Alzheimer’s and related dementias. It’s time to be bold. In addition to helping millions in relationship with dementia, what we’re proposing has the potential to revitalize the US economy by opening up a brand new industry and unleashing American ingenuity.

Cannabis medicine was the only medicine that ever helped ease the toughest behavioral symptoms of my mom’s (and our family’s) nearly decade-long journey through Alzheimer’s, but it was illegal for her to get it in the nursing facility she moved to because cannabis remains on the Controlled Substances Act (CSA) Schedule I of Drugs. 

The most restrictive drug schedule in the US is reserved for drugs that are known to have:

    • – no currently accepted medical treatment use in the U.S. 
    • – a lack of accepted safety for use under medical supervision 
    • – high potential for abuse 

Cannabis does not fit this definition, yet it remains on the CSA:

    • – cannabis is medically legal in 41 US states and territories. 
    • – cannabis therapeutics have never been proven to result in serious harm, nor death
    • – a “high potential for abuse” is not a scientifically proven claim about cannabis

It’s time to simply remove cannabis from the Controlled Substances Act to allow patients to maintain access to this relatively harmless plant while science catches up with what is happening in practice in more than 2/3rds of states. The President has the power to do this by Executive Order. 

The Science

In Northern California , Upstate NY and in  Florida, there are care facilities currently using cannabis medicine for their residents. But most care facilities are too afraid to use a “Schedule I substance” because they risk losing funding and licensure. Additionally, cannabis science is only taught in ten medical schools and there are no legal requirements for medical professionals to learn about this valuable tool. Not even in California. 

There are studies that show the potential benefits of medical cannabis, but due to the CSA, it is very, very difficult to research. Despite this, there are enough studies that show how beneficial cannabis is for people living with dementia for two review articles and a US Department of Health patent:

Frontiers in Integrative Neuroscience review article: “Cannabis Therapeutics and the Future of Neurology” by Dr. Ethan Russo 

[FTA] “…Initial trials of herbal cannabis for AD have begun sporadically, with a more focused effort in a California nursing home (Hergenrather, 2017). Patients were treated with a variety of preparations: THC-predominant (2.5–30 mg/dose), CBD predominant, and THCA, mainly in tinctures and confections. Marked benefit was reported on neuroleptic drug sparing, decreased agitation, increased appetite, aggression, sleep quality, objective mood, nursing care demands, self-mutilation and pain control.

Based on its pharmacology (Russo and Marcu, 2017), cannabis components may provide myriad benefits on target symptoms in this complex disorder:

    • Agitation: THC, CBD, linalool
    • Anxiety: CBD, THC (low dose), linalool
    • Psychosis: CBD
    • Insomnia/Restlessness: THC, linalool
    • Anorexia: THC
    • Aggression: THC, CBD, linalool
    • Depression: THC, limonene, CBD
    • Pain: THC, CBD
    • Memory: alpha-pinene (Russo, 2011; Russo and Marcu, 2017) + THC
    • Neuroprotection: CBD, THC
    • Reduced Aβ plaque formation: THC, CBD, THCA

Thus, an extract of a Type II chemovar of cannabis (THC/CBD) with a sufficient pinene fraction would seem to be an excellent candidate for clinical trials (Lewis et al., 2018).

Journal of Pharmacopuncture “A Review on Studies of Marijuana for Alzheimer’s Disease – Focusing on CBD, THC” by Korean research Drs. Kim, Yang, Yook

[FTA] “…These results implied that the CBD components of cannabis might be useful to treat and prevent AD because CBD components could suppress the main causal factors of AD. Moreover, it was suggested that using CBD and THC together could be more useful than using CBD or THC alone…”

US Patent 6630507B1 – Cannabinoids as antioxidants and neuroprotectants

From the US Department of Health Patent: “…The cannabinoids are found to have particular application as neuroprotectants, for example in limiting neurological damage following ischemic insults, such as stroke and trauma, or in the treatment of neurodegenerative diseases, such as Alzheimer’s disease, Parkinson’s disease and HIV dementia…”

The MORE Act + Social Justice

Passed in the House of Representatives in November 2020 and sponsored in the Senate by Vice President (elect) Harris, though not taken up by McConnell, The MORE Act would completely remove cannabis from the Federal Schedule I of Drugs. This would allow those who are currently benefiting from cannabis medicine in 35 States, to continue to do so while the relevant research studies and science can catch up with what’s happening in daily practice. By now, we all know that cannabis was not placed on the CSA Schedule I because of science, it was put there for racist, political reasons. It’s time to finally undo this generations-old wrong.

Green Future

The clean, renewable cannabis-hemp plant can replace dirty fossil fuel petroleum to make plastics, oil and gas. Hemp can replace trees for paper and biomass. Hemp can be building materials. Hemp is also an excellent source of nutrition and it’s a bioaccumulator that can clean the soil. Hemp can literally save the world, but it must be completely removed from the CSA to allow development. We must be bold in ways we never have been before.

The question is: will President Biden be bold enough to cut through the red-tape and sign an Executive Order to remove cannabis from the CSA? Or is he going to let people suffer needlessly while the congress further argues over out-dated, racist, prohibitionist policy? 

There is nothing like a new industry to inspire hope and deliver relief to millions of Americans in this exceptionally difficult time. There is nothing like cannabis medicine for people living with dementia. Let all dementia sufferers have access to this life-changing plant. De-schedule cannabis today.

Chela Fiorini-Coennen, Farmacann Education & Outreach

#BeBold #CannabisHelpsDementia #dementia #care #economy #hemp

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2020: Best Year Ever – for Cannabis Reform

2020: Best Year Ever – for Cannabis Reform

Anyone concerned about the cannabis reform movement and the legalization efforts for both Medical and Adult-Use Cannabis programs across the country might find 2020 to have been one of the most effective years for reversing the stigma created by 70-years of lies and propaganda, and allowing expanded access to this highly beneficial plant medicine, while beginning to repair some of the damage created by the failed “war on drugs.”

By most accounts, 2020 was a year that we are all grateful has finally come to an end. An impeachment of the President Trump, the COVID-19 pandemic, mass protests, social unrest, economic collapse, a challenged presidential election and a suicide bombing; good riddance 2020.

As 2020 began, and the impeachment trial of President Trump was ending, rumors of a novel coronavirus in China were emerging, and by the Spring, the COVID-19 pandemic was in full effect. Despite some attempts to shut down the cannabis industry to help “slow the spread”, cannabis medicine emerged as an “essential business” in California and many other states. As threats of lockdowns drove huge cannabis sales numbers in every legal state, people who could afford it, were stocking up on their medicine or their “recreational” supply, preparing for the stay at home orders. 

Delivery laws were changed, dispensaries adapted to curbside pick-up where possible and social distancing and mask rules were in effect as sales continued to grow throughout the Summer. Isolated Seniors found some comfort in plant medicine. 

Then in the Fall, the election, and despite the close race at the top of the ticket and balance of power in question, one big winner emerged on election night: cannabis. Cannabis measures on ballots in five states all passed with huge margins. In fact, in most races, cannabis garnered more votes than any official on the ballot.

A majority of Arizona and New Jersey voters said yes on ballot measures to make adult-use marijuana legal. Voters in South Dakota approved marijuana for medical use, and a slim majority voted for adult-use. Mississippi voters approved an initiative to establish a medical marijuana program for certain patients with debilitating conditions, while voters in Montana voted for two initiatives to legalize, regulate and tax recreational marijuana for adults 21 and older. We saw that cannabis is not a red or blue issue. Cannabis crosses all boundaries of politics, class and culture. 

And in the final weeks of 2020, the year where everything changed, the US House of Representatives passed the MORE Act, if enacted, would effectively deschedule cannabis and expunge the records of non-violent cannabis convictions, among other reforms. The vote marked the first time in 50 years that a chamber of Congress has revisited the classification of cannabis as a federally controlled and illegal substance.

The U.S. Senate separately approved a bill that would allow for the expansion of scientific research into cannabis derivatives including CBD. The bill, known as the “Cannabidiol and Marihuana Research Expansion Act,” was advanced by unanimous consent, however, it is unlikely the House will vote on this version. The House passed a similar measure, although provisions in that bill that would allow researchers to use cannabis products from state-licensed dispensaries are not included in the Senate proposal. The Senate version does nothing to change the federal scheduling of cannabis, nor does it allow for banking in cannabis. McConnell, a long-time prohibitionist, who currently leads the Republican-controlled Senate, is from a hemp-heavy state where some may think that cannabis normalization may conflict with the future financial gains of the emerging hemp industry. Maybe the Georgia run-off election will shift the balance of power in favor of cannabis reform and we will see greater gains with a new administration.

Overall, 2020 was one of the best years for cannabis reform and the cannabis industry, both medical and adult-use, and 2021 could be even better.  Despite President-elect Joe Biden’s long history as a prohibitionist and drug warrior, VP Harris has indicated decriminalization is definitely on the table. To what extent is yet to be determined, but the Progressive Caucus is pushing for action within the first six months. There are few things that the vast majority of Americans agree on, and cannabis reform is one of them.

Moving forward, in the states, programs voted for in 2020 will be implemented, some faster than others, with New Jersey opening the floodgates for the East Coast. State legislatures are making moves in many conservative states, including Texas and Nebraska, to legalize adult-use for tax revenue to pay off massive economic losses due to the COVID-19 pandemic. Decriminalization and expungement efforts for low level cannabis crimes will be expanded throughout localities and states including Gov. J.B. Pritzker of Illinois on Thursday announcing more than 500,000 expungements and pardons for people with low-level marijuana offenses on their records.

On December 2nd, in a historic move, the United Nations descheduled cannabis in a 27-25 vote, with the United States among those voting in favor. Following a recommendation from the World Health Organization, the United Nations’ Commission for Narcotic Drugs voted to remove cannabis from Schedule IV (equal to the US Schedule I) of the 1961 Single Convention on Narcotic Drugs. This was a really big deal that barely made a blip in the news.

Look for 2021 to be another year of unprecedented expansion of access to cannabis, using the plant and its derivatives to address the opioid crisis, and the chronic conditions of aging. Researcher Christopher Kaufmann, assistant professor in the Division of Geriatrics and Gerontology in the Department of Medicine at the University of California, San Diego reports, “Pain, insomnia and anxiety were the most common reasons for cannabis use and, for the most part, patients reported that cannabis was helping to address these issues, especially with insomnia and pain.” 

And more seniors are using cannabis in 2020 and beyond for symptoms of dementia and polypharmacy, a trend we continue to see with our Farmacann family of facilities and clients.

Other interesting developments to look for in 2021 will be on using cannabis medicine for COVID symptoms, more states legalizing and expunging records and politicians using cannabis industry tax revenue for the recovery of desperate state budgets

Cannabis can save the world! As soon as the last few prohibitionists are convinced, like the vast majority of the American population on both sides of the political aisle, to support legalization.  A Gallup Poll released Nov. 9, 2020 indicated that 68% of Americans favor legalizing marijuana – double the approval rate in 2003. As we enter this new decade, the popularity and belief in the medicinal benefits of cannabis will grow exponentially, fed by the light of truth and tended by educators, activists , caregivers and the patients that use plant medicine to find relief.

Dave Coennen, Farmacann Education & Outreach

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How Cannabis Eased Our Family’s Decade-long Journey Through Mom’s Alzheimer’s Disease

How Cannabis Eased Our Family’s Decade-long Journey Through Mom’s Alzheimer’s Disease

By Chela Fiorini-Coennen

Although it’s been a devastating year for everyone, it’s fair to say that people living in senior care homes with a dementing illness have experienced the COVID-19 pandemic more intensely than the rest of us. Beyond the fact that people living with dementia are at higher risk for coronavirus for several reasons, the isolation caused by public health measures and rules designed to protect them from the virus have led to rapid decline in many, as well as “Death by COVID Isolation”. Isolation itself is a risk factor for dementia, and is known to worsen the symptoms. Our loved ones are isolated for their protection, but how do we explain that to one who can’t remember. 

Lisa_Seagram_Art

There were times in her journey when my mom was in medical isolation where I couldn’t see her for a few days to a couple weeks, and even that short period was tough. After her long journey, my mom passed before the pandemic, and I can only imagine how hard it’s been for those of you who haven’t been allowed to support your loved one in assisted living the way you once did. We are all being asked to make enormous sacrifices for the greater good. And hopefully 2021 will bring better days and deeper connection.

In our first Farmacann Newsletter for 2021, we want to give you our backstory and explain why my husband and I became passionate advocates for cannabis therapeutics.

Cannabis medicine has been used by humans for centuries, and long before racist policy and corporate interests created “Reefer Madness”  spinning this healing herb into the Devil’s Lettuce throughout the 20th Century. Although they are very hard to do because of the highly restrictive drug scheduling of cannabis, there are studies which indicate that medical cannabis could be helpful in easing, isolation related depression anxiety and fear. Some researchers believe that “…THC and other cannabinoids may have an anxiolytic role in central mechanisms of fear behaviors…” and that cannabis “modulates subjective anxiety (Sethi et al., 1986; Wachtel et al., 2002; D’Souza et al., 2004).” 

Cannabis medicine really helped ease my mother’s anxiety and aggression throughout her Alzheimer’s dementia journey. I know personally that CBD and cannabis medicine have calmed my anxiety, caregiver stress, and helped ease my pain from IBD and migraines, and a 1:1 ratio of CBD:THC helps prevent my night sweats from symptoms of menopause. Of course, I’m only one person. But for my mom, and our family, cannabis became essential long before the pandemic.

Our journey began suddenly in 2010

Sure, my husband and I noticed she was forgetting stuff, but nothing too weird. “Wait ‘til you get old!” she’d say. Sure, she hadn’t been cooking much, “I’ve cooked for people all my life, I’m done!” She was getting lost driving, but that wasn’t so unusual, she always had a bad sense of direction. Finally after a fall, at the hospital the doctor said flatly, “Ms. Seagram, you have dementia.” In another room, the Social Worker told us, “You know she can’t live alone, right?” And just like that, the whole world turned upside down. 

But we’re “lucky,” they say, a diagnosis of dementia rips most families apart, and somehow it’s brought us closer together. Dementia is still a great mystery to science. They know little more today than they did 115 years ago when Dr. Alzheimer named the most common type. That’s probably why it’s the most feared diagnosis. Dementia affects more women than men, more people of color than whites. 

That night, near the hospital, we were just a couple of film crew workers sitting in a red vinyl booth at the world-famous Formosa Cafe. Colorful twinkling Christmas lights festooning the walls, surrounded by an audience of vintage, autographed black-and-white headshots: Brando, Bogart, Marilynn, Elvis all looking on as we tossed back martini’s crying in our mac and cheese about how our fun-loving, child-free, carefree lifestyle had suddenly been destroyed: Mom has Alzheimer’s Disease.

We were totally clueless, self-centered and lacked practical skills. Though I’ve worked props on medical shows, I’m not a doctor, nurse or medical professional! So we started to study: read all the books on Alzheimer’s and related dementias, did loads of internet research, went to support groups and every doctor visit with research and questions. We were still clueless, but so were the doctors. They know little more than Dr. Alzheimer knew in 1906. The leading Alzheimer’s organizations have nearly given up on a cure and are now focused on prevention and promoting brain health as the solution to these incredibly complex diseases. But it’s hard to prevent a disease the cause of which we don’t fully understand and what research there is points to a massive overhaul of our diet/nutrition, exercise regimen, sleep hygiene, and stress management. We don’t know the exact cause, and there’s no pill to fix it. 

Triage

We cared for my mom at home the first four years. Initially, it was complete triage. Constantly reacting to the major changes in all our lives. Including having to live with my narcissist mother who had been intent on breaking us up since before our first date. As the disease progressed, and our resources were drained, we had to move mom into a facility despite our absurd preference to keep her with us at home. She lived there for five years. The last two, spent crumpled and contracted, tortured and betrayed by her broken brain, trapped in her body at the mercy of a society that discards its elderly. Especially after she became non-verbal in the facility, she was frequently ignored, force fed, left wet for hours – until I was off work, and could get there to fix it. Every day. For years. It was a nightmare that only her passing could alleviate. After a nearly decade-long odyssey through dementia, my mom died February 1st, 2019.

When we began this journey in 2010 we only knew “Alzheimer’s” was a terminal disease that was bad news for your memory. Any form of dementia is no joke for all concerned. The irony is that the only way to get through it is to laugh and find the positive aspects out of the contrast, after all your dreams have been crushed – but that took us quite some time to figure out. Little did we know the answer was in our stash box all along. 

“It’s bad for her memory!”

My mom had smoked three packs of cigarettes a day from 13-50 and she also smoked small amounts of cannabis medicinally for severe pain from gallstones for nearly 40 years at bedtime. When she was diagnosed with dementia the docs were very much against her using cannabis at all. In fact, they seemed to blame it on her condition. “She can’t have Marijuana, it’s bad for her memory!” Her neurologist held us hostage for Namenda and said she couldn’t have the prescription if she used cannabis, because he said, “marijuana is a drug of abuse, it has no medical efficacy.” And they put her on five new powerful medicines, so we kept cannabis away from her for most of the first year. Primarily because we hadn’t researched the drug-drug interactions and thought her doctors must know best, this is their specialty.

For a while, it was hard to tell what was a symptom of the disease or side-effects from all the new prescription medication. My mom had been rather hard to deal with even before she got sick. They prescribed Ativan for her relentless anxiety and agitation which worked great the first day. But she had an adverse reaction the day after when she totally freaked out and called me terrible names, wildly accusing me of trying to kill her. They prescribed Zyprexa, an antipsychotic, for her severe aggression – they called it “dementia-related psychosis”. There’s a notice on the bottle that has a black box around it that reads:

WARNING: Increased Mortality in Elderly Patients With Dementia-Related Psychosis. Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death…not approved for the treatment of patients with dementia-related psychosis.” But Medicare paid for it. She was much nicer on the antipsychotic for a few days, but then, back to the name-calling freak outs. 

They prescribed Seroquel, a different antipsychotic with the same warning, to replace the Zyprexa. They prescribed Lexapro for depression, because she was terribly depressed that she was losing her mind, her freedom, herself. They prescribed Depakote, a powerful anti-seizure medication that also has a black box warning, to relieve mom’s restlessness, and the cyclical, constant questions. She never stopped asking the same questions over and over, and she developed a tremor, an ironic side effect of the anti-seizure medication. They prescribed Trazadone to help mom’s insomnia. And of course, they prescribed Aricept and Namenda to try to slow down the disease process. All these drugs have serious side effect warnings  that include kidney and liver damage, organ failure, stroke and sudden death. Which wouldn’t be so bad, if they actually worked and provided a decent quality of life.

Mom fell frequently on the meds, taken as prescribed, on their lowest doses  –  some of the lesser side-effects of these drugs include nervousness, restlessness and inability to sit still, particularly troublesome when there’s also weakness, loss of balance, and dizziness.  She experienced all those side effects and worse, the meds didn’t do anything for the symptoms we were trying to treat. The falls forced me to take time off work, which is when we finally wised up. Mom refused to get out of bed for three weeks. Somehow she remembered she had fallen several times and was terrified to fall again. Her new doctor was calling it “failure to thrive.” We thought for sure, this was it. 

In her room, her TV on, I was researching side-effects and drug-drug interactions. Mom turns to me and says, “I want a joint.” I call her new doctor and she says, “Look, she won’t get out of bed, give her anything she wants.” So I rolled us a joint and we smoked it together. Before we finish Mom says, “Let’s go to the living room and watch TV!” This began the discovery. 

Our Research Begins

I learned the U.S. Department of Health has held patent #6630507B1 on cannabis since 1998 as “…neuroprotectants, for example in limiting neurological damage following ischemic insults, such as stroke and trauma, or in the treatment of neurodegenerative diseases, such as Alzheimer’s disease…”  And that led us to discovering the mountain of evidence that cannabis actually helps ease the symptoms and slow the disease process of dementia.

A simple Pub-Med search reveals study after study after study that cannabis eases the terrible symptoms of dementia better than anything else available on the market. A documentary called “The Scientist” shows that every nursing home in Israel uses cannabis medicine for their elderly. Mainstream media sources show that there are a few facilities in Northern California and New York state  that are also currently using full-spectrum cannabis oil with people living with dementia. 33 State Departments of Health list Alzheimer’s Disease or other neurodegenerative diseases on their qualifying conditions for medical cannabis. How is it that a film worker turned family caregiver can uncover this life-changing information, but doctors seem willfully ignorant? 

We stopped going to the doctors who had advised so strongly against cannabis and prescribed all the deadly, ineffective, off-label black-box drugs. They were obviously not aware of the most current science, nor did they seem interested. This was tricky because we didn’t have many assets to speak of and mom was on Medicare and Medicaid. But her new, fresh out of medical school, vegan doctor was really open-minded. I guess she believed in the power of plants, because she certainly didn’t learn about cannabis in her formal training. 

How Cannabis Helped Mom

We weaned off five harsh prescription black-box drugs that were covered by insurance to find we only needed one plant-based medicine that we had to pay for out-of-pocket. It was obvious that Mom had greater focus and interaction when she was medicated with cannabis: she laughed, smiled and communicated with us, she was no longer agitated or aggressive. Cannabis helped mom have a carefree attitude about losing her mind. 

Cannabis oil helped my mom so much that I made sure that she had it every time I saw her. Quietly, however, since the Nursing facility told us they would throw us out for using cannabis, a “Schedule One” drug.  The first facility mom was in actually DID throw her out. After drug testing her for cannabis, and telling me to “knock it off” or they would ask us to leave. They kicked mom out after she drew the foul when another woman pushed her from behind and mom spun around and slapped her in the face in retaliation – my mom was the leader of the girls gang growing up in Brooklyn. The facility was not medicating her agitation and aggression at all and wouldn’t allow me to medicate her either…what did they expect?

Cannabis helped ease my mom’s symptoms from the moment we started using it, until her last breath – a couple drops of full spectrum CBD oil every hour eased her intense death rattle, and made it smooth like the sound of the oceans ebb and flow. 

Schedule I of Drugs

Perhaps the reason there is no widely known effective treatment for dementia, nor it’s terrible symptoms, is because of the Controlled Substances Act Schedule I of Drugs? Maybe, at least part of the answer to complex brain issues is in complex plant medicine. Maybe all plants should be allowed to be studied before the cost of caring for people living with dementia surpasses the GDP. 

In January 2019, The World Health Organization called for cannabis to be rescheduled internationally & admitted that it was erroneously put on the CSA in 1971 – that they have been wrong for decades. At the end of 2020 the WHO finally rescheduled cannabis and officially classified it as a less dangerous drug, hopefully paving the way for more research and greater access. Cannabis has been proven to help all of the difficult symptoms of dementia. 

Western Medicine is failing millions of people living with dementia and has not come up with anything promising in more than 100 years.  We don’t have to be restricted by draconian ideas on plant-medicine any longer. However, because cannabis remains on the Controlled Substances Act Schedule I of Drugs, doctors are uneducated and afraid of losing their licensing, and researchers have a very hard time funding studies and getting the plant material from the one and only government approved grower in Mississippi (NIDA). Public pressure can change this. We could ease the suffering for millions of people living with dementia today, with education and policy change.

If the government studies under prohibition taught us anything, it’s that this plant has  low risk of harm – it certainly does not have a black-box warning. With no end in sight for Alzheimer’s Disease and related dementias, we must expand where we search for solutions to one of the greatest threats to human health and our national and global economy. More studies with real-world cannabis products need to be done. 

After all the devastating losses from the COVID-19 pandemic this year, we must drop old racist policies that have held back cannabis research and prevented people from realizing the benefits from this plant that acts on so many different pathways simultaneously. Cannabis could even potentially help fight COVID-19 complications. We need to be able to freely study the potential of this vital plant. Call and write to all your elected officials and tell them to open up cannabis research, implement education and normalize the cannabis industry across all 50 states.

We must be bold. If not now, when?

#CannabisHelpsDementia

Chela Fiorini-Coennen

Chela and her husband Dave, working with Farmacann doing Education and Outreach, are Family Caregivers Turned Advocates who were so inspired by her mother’s journey they wrote a movie, launched the “Cannabis Helps Dementia” podcast , and started AlzNotes.com Crash Course for Caregivers under the umbrella of  Coennen Creative: Wellness Marketing Solutions. It’s their mission to improve the lives of those in relationship with dementia through care gap training and plant-based education. They specialize in private Zoom/phone coaching as well as provide a Community Intensive featuring the Virtual Dementia Tour all over Southern California, until COVID-19 put in person learning on hold. You can find them on all the socials @AlzNotes 

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Study: Seniors with Chronic Conditions See Improved Quality of Life with Medical Cannabis

Study: Seniors with Chronic Conditions See Improved Quality of Life with Medical Cannabis

Researchers affiliated with Concordia University, Center for Gerontology in Illinois conducted a qualitative inquiry of state-registered medical cannabis patients 64 and older who reported that cannabis therapy improves their quality of life and reduces their use of pharmaceutical medications.

However, many of the subjects were frustrated with the lack of guidance on medical cannabis provided by their primary care physician. Whether due to lack of formal training on the subject or the fear of the Schedule 1 status of the plant, doctors and other healthcare providers are often hesitant to speak to their patients about cannabis therapy. 

According to the data published in the journal Clinical Gerontologist the majority of the study’s participants “reported satisfaction with being able to use medical cannabis to manage symptoms, get relief from pain, and have an improved quality of life all while lessening their dependence on pharmaceutical drugs.”

From the report: 

“Most of our participants were retired, unemployed, or receiving disability benefits due to a chronic condition, yet they did note improvements in their ability to manage symptoms and productivity. Pain control was consistently described as one of the most important outcomes of medical cannabis use, and this must be considered in relation to public policy, medical symptom management, and long-term care regulations.”

According to the clinical implications of the research findings:

      • Older adults need better information and assistance from clinicians about the use of medical cannabis (including products, packaging, use of dispensary).
      • Physicians must be prepared to understand how medical cannabis use impacts current treatment protocols and document use accordingly in the medical record.
      • Physicians should counsel on variability of quality and concentration of medical cannabis and related dosing and potential drug interactions (e.g., delayed time to effect after ingestion of oral cannabis).

Farmacann is providing solutions for clinicians to recommend cannabis in California

relief cbdSince 2011, Farmacann has been working with doctors and other healthcare providers trained and experienced with cannabis medicine in California’s North Bay area, developing products with the most effective ratios and dosages to give seniors the relief they are looking for, including, according to this study: “to manage symptoms, get relief from pain, and have an improved quality of life all while lessening their dependence on pharmaceutical drugs.” 

Farmacann clients, caregivers and their nursing staff consistently report on the efficacy of our products in managing chronic conditions, achieving pain relief and creating a general sense of well being; all with a significant reduction in polypharmacy, which is now a requirement in all facilities in California.

Farmacann is dedicated to the education of patients, health care providers and care facilities on the benefits as well as the precautions associated with cannabis therapy and will be launching the first of a series of free webinars on cannabis medicine.

Our first instalment premieres the week of January 11, 2021 – Cannabis Therapeutics in Residential Care Facilities & Introduction to Farmacann Concierge Service. 

Sign-Up here and learn how you or a loved senior in your life can benefit from cannabis medicine at home or in a care facility RIGHT NOW in California’s North Bay area, and soon in all of California.

Farmacann, Education & Outreach

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GW Pharma Hopes to Bring Its Second Cannabis-Based Drug to Market in the U.S.

As big pharmaceutical companies vie to enter the medical cannabis space and establish a foothold with overpriced and inaccessible cannabis based drugs…

GW Pharma Hopes to Bring Its Second Cannabis-Based Drug to Market in the U.S.

“In June 2018, the FDA approved a cannabidiol (CBD) prescription medication for the first time. Called Epidiolex, it is approved specifically to treat seizures in two rare, severe forms of child-onset epilepsy in patients who are 2 and older.

This approval precipitated the removal of Epidiloex specifically from the Controlled Substances Act, allowing its sale and transport, with a doctor’s prescription, in every state in the US.

Now GW Pharma is trying to bring a second cannabis formulation to the United States, with Phase 3 trials now beginning for Sativex for for the treatment of MS spasticity. The cannabis based drug is also being studied by Kings College London for use by people living with dementia, specifically Alzheimer’s Disease.

Sativex known Nabiximols in the US, is a 1:1 formulation of CBD and THC:

“Nabiximols is a complex botanical medicine formulated from extracts of the cannabis plant that contains the principal cannabinoids THC and CBD and also contains minor constituents, including other cannabinoid and non-cannabinoid plant components, such as terpenes, sterols and triglycerides, according to company data. The product is administered as an oral spray.”

Since 2011, Farmacann has established itself as the leader in research and development of cannabis therapeutics based on evidence of efficacy in real world environments in Northern California Residential Care Facilities and in the homes of patients throughout the area.

And as California’s legal and regulatory environment has changed, so has Farmacann, by developing products and packaging that always meet or exceed the manufacturing, testing and regulatory requirements of the State of California, Medical Professionals and Licensed Care Facilities.

While the rest of the country waits for Big Pharma to enter the medical cannabis space, Farmacann is delivering relief to 7 counties in the Bay Area with the same ratio and established efficacy:

THRIVE Caps 1:1 CBD:THCTHRIVE – Monthly

Ratio CBD:THC: 1:1
Dosage: 5mg CBD and 5mg THC (each capsule)
Packaging: Pill Cards of 30 capsules, each that contain a total of 300mg of combined cannabinoids.

Ideal for: Patients seeking a balance between physical comfort and mental relaxation.

And with a monthly subscription at $81, inclusive of state and local taxes and delivery, this is cannabis medicine that is accessible now in Northern California, and soon the entire state and beyond.

Farmacann – Providing seniors & medical professionals with a technology platform that simplifies access to effective & affordable alternative cannabis choices

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THE EVIDENCE: CANNABIS THERAPY FOR ALZHEIMER’S AND DEMENTIA SYMPTOMS

THE EVIDENCE FOR CANNABIS THERAPY FOR SYMPTOMS OF ALZHEIMER’S AND DEMENTIA

BY Chela Coennen. www.alznotes.com

Did you know the U.S. Department of Health has held a patent on cannabis since 1998 as “…neuroprotectants, for example in limiting neurological damage following ischemic insults, such as stroke and trauma, or in the treatment of neurodegenerative diseases, such as Alzheimer’s disease…” patent #6630507B1.

A simple Pub-Med search reveals study after study after study that cannabis eases the terrible symptoms of dementia better than anything else available on the market. A documentary called “The Scientist” shows that every nursing home in Israel uses cannabis medicine for their elderly. Mainstream media sources show that there are a few facilities in Northern California and New York state  that are also currently using full-spectrum cannabis oil with people living with dementia. 33 State Departments of Health list Alzheimer’s Disease or other neurodegenerative diseases on their qualifying conditions for medical cannabis, with more states coming on board every year.

By far, the most effective treatment for Mom’s Alzheimer’s was a 1:1 ratio of balanced, full spectrum Cannabis oil – and we tried everything available on the market since 2010: Zyprexa, Ativan, Seroquel, Depakote, Trazadone, aricept and namenda! There’s NO known risk of sudden death or risk of organ failure, like the other meds used (mostly off label) to treat Alzheimer’s (and/or related dementias) symptoms!

Full-spectrum Hemp oil naturally void of the psychoactive ingredient some are looking to avoid, is known to be helpful for some people, in some cases. But for people living with dementia, researchers and clinicians in the field seem to agree that people living with brain change need some THC in their medicine. As explained by Dr. Ethan Russo in an interview we did with him in 2018:

Read the entire article in Frontiers in Integrative Neuroscience 

“CANNABIS THERAPEUTICS AND THE FUTURE OF NEUROLOGY”

October 18, 2018

[FTA]”…Initial trials of herbal cannabis for AD have begun sporadically, with a more focused effort in a California nursing home (Hergenrather, 2017). Patients were treated with a variety of preparations: THC-predominant (2.5–30 mg/dose), CBD predominant, and THCA, mainly in tinctures and confections. Marked benefit was reported on neuroleptic drug sparing, decreased agitation, increased appetite, aggression, sleep quality, objective mood, nursing care demands, self-mutilation and pain control.

Based on its pharmacology (Russo and Marcu, 2017), cannabis components may provide myriad benefits on target symptoms in this complex disorder:

    • Agitation: THC, CBD, linalool
    • Anxiety: CBD, THC (low dose), linalool
    • Psychosis: CBD
    • Insomnia/Restlessness: THC, linalool
    • Anorexia: THC
    • Aggression: THC, CBD, linalool
    • Depression: THC, limonene, CBD
    • Pain: THC, CBD
    • Memory: alpha-pinene (Russo, 2011Russo and Marcu, 2017) + THC
    • Neuroprotection: CBD, THC
    • Reduced Aβ plaque formation: THC, CBD, THCA

“Thus, an extract of a Type II chemovar of cannabis (THC/CBD) with a sufficient pinene fraction would seem to be an excellent candidate for clinical trials” (Lewis et al., 2018)…”

Dr. Russo was also recently interviewed for  Forbes

“Cannabis For Parkinson’s And Alzheimer’s Diseases – An Interview With Dr. Ethan Russo”

February 26, 2019

[FTA] “…The best results in PD were reported in a Czech study in 2004, in which patients ate raw leaves of cannabis for as much as three months and reported significant improvement in overall function, tremor, bradykinesia and rigidity, with few side effects…

The story in AD is even more intriguing. Both THC and CBD have been shown to interfere with the production of abnormal toxic matter in the brain of such patients. This is quite exciting, inasmuch as synthetic drugs designed for similar purposes have yet to advance in the clinic. Both THC and particularly CBD are known neuroprotective agents that hold the potential to slow or perhaps even halt the degenerative process. On the symptom side, THC as a single agent has proven beneficial in AD patients in reducing nocturnal agitation, improving sleep and appetite. Observations of nursing home patients in California with dementia have produced similar benefits as well as reducing the need for nursing intervention and amounts of other drugs…”

Dr. Jeffrey Hergenrather is successfully using cannabis medicine in three RCFEs in the Santa Rosa, CA area and was recently interviewed for Next Avenue:

Can Medical Marijuana Help with Dementia?

SOME STUDIES, AND FAMILIES, SAY YES; SOME EXPERTS EMPHASIZE CAUTION
[FTA] ‘KIND OF A LIFESAVER’

“Dr. Jeffrey Hergenrather, a general practice physician based in Sebastopol, Calif., and recent past president of the Society of Cannabis Practitioners, has been consulting on cannabis medicine since 1997. During that time, he says he has helped hundreds of patients with dementia improve their quality of life with cannabis.

“Typically, I’ll get a call from a family after the nursing home staff has gotten to a point where a patient’s inappropriate behaviors are too difficult to handle, and they are in agreement about administering a cannabis medicine. I’ll do the evaluation and, as needed, give this as an order to the staff to dispense,” Hergenrather says.

The scientific literature lists 29 agitated behaviors – such as yelling, repeated questions and violent behaviors – all of which, unlike other conventional medicines, are very well-managed with cannabis, Hergenrather says.

“It really is quite impressive to utilize cannabis and then see the patients actually push away from their other medicines. They know what the other medicines do for them and they’ll say that they don’t want to take them. But they will take the cannabis because they feel relaxed and happy and calm, and maybe even a little euphoric,” he says.

“It’s been kind of a lifesaver,” Hergenrather continues. “The patients are happier, the families are happier and it greatly helps the staff because the behaviors are so much easier to manage.”

Cannabis gave Mom clarity, calm, joy & a laissez faire attitude about losing her mind!

Cannabis made her “now” more satisfying and helped her communicate with us more easily. It helped us focus on the skills that mom still had remaining, and to make the best of what was happening.

Cannabis oil for behavioral issues. You can put it in food, a cookie, etc.

Israel has been researching cannabis for 50 years. They use cannabis in all of their nursing homes.

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Global task force protocols for medical cannabis

“Global task force establishes protocols for medical cannabis use to treat pain”

It’s fairly well-known that medical cannabis is being used by patients to ease chronic pain, and many other hard to treat issues.

[FTA] “…There are limited randomized controlled trial data to guide clinicians on how to dose and administer medical cannabis,” Arun Bhaskar, MD, a pain medicine consultant with the Pain Management Centre at Imperial College Healthcare NHS Trust in London, said during a virtual PAINWeek presentation. “This evidence gap, coupled with the clinical reality that patients are receiving medical cannabis for chronic pain, highlights the demand for expert consensus guidance from experienced clinicians on how to safely and effectively dose and administer medical cannabis.”

The panel produced an often recommended “start low and go slow” approach  that you can find in the full “Helio” journal article. 

Have you asked your doctor about cannabis medicine for pain?

Created in California, FarmaCann is designed with patients in mind. With good manufacturing practices, efficacy, compliance, and ease of use for the facility or home caregiver, recommending medical professionals can feel confident that their patient will get what is intended. FarmaCann is medicine.

Does your doctor know about FarmaCann?

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#medicalcannabis #pain #seniors #cannabiseducation #cannabisismedicine

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“Study Finds Older Adults Using Cannabis to Treat Common Health Conditions”

“Study Finds Older Adults Using Cannabis to Treat Common Health Conditions” – Times of San Diego

If medical cannabis is legal in most states, then why aren’t doctors required to learn about it in school or continuing education?

[FTA] “…The findings demonstrate the need for the clinical workforce to become aware of cannabis use by seniors and to gain awareness of both the benefits and risks of cannabis use in their patient population,” said Dr. Alison Moore, senior author and chief of the division of geriatrics at UCSD’s School of Medicine. “Given the prevalence of use, it may be important to incorporate evidence-backed information about cannabis use into medical school and use screening questions about cannabis as a regular part of clinic visits.”

Ask your doctor if they’ve had any training in how medical cannabis works with the endocannabinoid system to ease many of the hard to treat issues that seniors often face including aches and pains of arthritis, insomnia, anxiety, depression, polypharmacy, agitation, aggression in dementia, PTSD, and more.

If your doctor is looking to learn more about this medicine, perhaps show them this story or the report from UC San Diego Medical School published in the Journal of American Geriatrics Society.

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doctor-recommendation

#cannabisismedicine #seniors #cannabiseducation #relief

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“Medical Cannabis Doesn’t Cause Cognitive Decline in Seniors, Study Finds”

“Medical Cannabis Doesn’t Cause Cognitive Decline in Seniors, Study Finds” – Jerusalem Post

Study participants showed no real difference in brain function than the control group, and they had great pain relief with a low side-effect profile.

[FTA] “…Chronic pain affects 19%-37% of the adult population worldwide and medical cannabis has, in recent years, been raised by patients and researchers alike as a “highly effective” possible treatment….Our research findings may reduce concerns among physicians who deal with chronic pain and among patients suffering from it regarding the possible effects of cannabis on brain function,” the researchers added.

Of course more studies are always needed and welcome but CBD is legal all over the country and the majority of states have some kind of medical cannabis program.

Ask your doctor if they’ve read this story or the journal article that it was based on.

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Seniors seated on a panel high-fiving each other

#CannabisIsMedicine #CannabisEducation #seniors #care #painrelief #FarmaCann

 

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Nursing Homes Oust Unwanted Patients With Claims of Psychosis

Nursing Homes Oust Unwanted Patients With Claims of Psychosis

By Jessica Silver-Greenberg and Rachel Abrams

New York Times Sept. 20, 2020

They are finding what families say are pretexts to send patients to hospitals for psychiatric care — and then refusing to let them return.

In a New York nursing home, a resident hurled a bingo chip. At a home in Georgia, a 46-year-old woman, paralyzed from the waist down, repeatedly complained that no one had changed her diaper. In a California facility, a patient threw tableware.

In all three cases, the nursing homes cited the incidents as a reason to send the residents to hospitals for psychiatric evaluations — and then to bar them from returning.

Across the United States, nursing homes are looking to get rid of unprofitable patients — primarily those who are poor and require extra care — and pouncing on minor outbursts to justify evicting them to emergency rooms or psychiatric hospitals. After the hospitals discharge the patients, often in a matter of hours, the nursing homes refuse them re-entry, according to court filings, government-funded watchdogs in 16 states, and more than 60 lawyers, nursing home employees and doctors.

The practice at times violates federal laws that restrict nursing homes from abruptly evicting patients.

“Even before the pandemic, there was tremendous pressure to get rid of Medicaid patients, especially those that need high levels of staffing,” said Mike Wasserman, a former chief executive of Rockport Healthcare Services, which manages California’s largest chain of for-profit nursing homes. “The pandemic has basically supercharged that.” He said homes often take advantage of fits of anger to oust patients, claiming they need psychiatric care.

About 70 percent of American nursing homes are for profit. The most lucrative patients are those on short-term rehabilitation stints paid for by private insurers or Medicare, the federal program that insures seniors and people with disabilities. Poor people on longer-term stays are covered by Medicaid, which reimburses nursing homes at a much lower rate than Medicare.

The financial incentive to have more Medicare or privately insured patients, and fewer on Medicaid, becomes more pronounced when the Medicaid patients have illnesses, like dementia, that require extra care from staff.

Nursing homes have faced acute staff shortages as the coronavirus has left employees sick or afraid to go in to work. Workers said they faced increased pressure from their employers during the pandemic to get rid of the most expensive, least lucrative patients

Invoking psychiatric problems is a popular tool. Nursing homes routinely admit patients with dementia, Alzheimer’s or similar illnesses, and angry outbursts are common.

In March, the Rehabilitation Center of Santa Monica, Calif., sent Joan Rivers, who suffered from dementia and was on Medicaid, to the emergency room at USC Verdugo Hills Hospital. The nursing home’s staff said Ms. Rivers, 87, had tossed aside her chair, scaring other residents, according to her daughter, Evon Smith, and a government-funded watchdog.

Ms. Smith said that she had repeatedly asked the Rehabilitation Center to take her mother back, but that it had refused. A social worker at Verdugo Hills said she, too, had tried unsuccessfully to get the nursing home to readmit Ms. Rivers.

Linda Taetz, the chief compliance officer at Mariner Health Care, which operates the Rehabilitation Center and 19 other nursing homes in California, said the center hadn’t known that Ms. Rivers wanted to return.

Ms. Rivers eventually was admitted to the Colonial Care Center nursing home in Long Beach, Calif. There, she contracted Covid-19. She died on July 20.

Federal law requires nursing homes to follow strict guidelines when they intend to evict someone: They must give 30 days’ notice and come up with a plan to transfer the resident to a facility that can meet his or her needs. If a resident goes to a hospital, the facility must hold the bed for a week.

But nursing homes frequently flout these rules, according to employees and state-funded ombudsmen who help oversee the industry. The New York Times reported in July that nursing homes were evicting an increasing number of low-income — and therefore low-profitability — residents into homeless shelters and run-down motels, apparently in violation of federal law.

There is no national data on nursing home evictions. The Times contacted ombudsmen in all 50 states. Some said they had not seen nursing homes dumping patients in hospitals during the pandemic. But in 16 states, including California, Texas and New York, ombudsmen said the problem was continuing. Some said they believed it was getting worse.

“We have been seeing these kinds of illegal discharges all the time, because nursing homes seem to have figured out that they will rarely, if ever, be penalized,” said Alison Hirschel, senior legal counsel to the Michigan ombudsman program. “It’s devastating for residents and their families all the time, but especially horrible and dangerous during a pandemic.”

Medicaid patients who require lots of staff attention “have a target on their back,” she said.

The problem predates the pandemic.

Gloria Single was a resident of the Pioneer House nursing home in Sacramento. She had dementia and pulmonary disease and was on California’s version of Medicaid. Pioneer House was receiving about $400 a day for her care.

In 2017, Ms. Single got upset and threw utensils, according to a lawsuit against Pioneer House filed in state court by Ms. Single’s lawyer. The nursing home called 911, and Ms. Single was taken to a hospital for an involuntary psychiatric hold, in which patients are held until they are determined not to be a danger to themselves or others. The hospital determined later that day that there was nothing wrong with Ms. Single aside from her pre-existing dementia.

But Pioneer House would not let her return. The California Department of Health Care Services concluded that Pioneer House had violated the law and ordered it to let her go back. The home still refused. After about five months at the hospital, Ms. Single was moved to another nursing home. She died last year.

“You can get $1,000 extra a day by getting rid of the Gloria Singles of the world and replacing them with someone on Medicare,” said Matthew Borden, Ms. Single’s lawyer.

John Supple, a lawyer for the Retirement Housing Foundation, which operates Pioneer House, said that its medical director had deemed the home unsuitable for Ms. Single’s medical needs and that Pioneer House had never received the medical records it needed to readmit her. (Ms. Single’s lawyer disputes that. The lawsuit is ongoing.) Mr. Supple said Pioneer House had held Ms. Single’s bed for months and had not replaced her with a Medicare patient.

During the pandemic, nursing homes in Illinois and Michigan have repeatedly sent elderly and disabled Medicaid patients to NeuroBehavioral Hospital in Crown Point, Ind., said Kimberly Jackson, a discharge planner at the psychiatric hospital. In one case, a resident who yelled at a staff member was branded as being violent and having a psychoticbreak.

“The homes seem to be purposely taking symptoms of dementia as evidence of psychosis,” Ms. Jackson said. (Christy Gilbert, the chief operating officer of the hospital’s parent company, said instances when nursing homes dumped patients in her company’s hospitals were “very few and far between.”)

In June, Life Care Center of Plainwell, Mich., sent Nicki Safapour, a Medicaid patient who needs a wheelchair, to NeuroBehavioral Hospital. Because of a developmental disability, Mr. Safapour, 55, has the mental capacity of a 5-year-old, according to his brother John, who is his legal guardian. He said Life Care had told him that Mr. Safapour assaulted an employee and another resident.

A state health inspector later determined that the discharge was illegal, according to a copy of the inspector’s report reviewed by The Times.

“It seemed like they were just trying to get rid of Nicki,” John Safapour said. “He took up a lot of staff time.”

A spokesman for Life Care, Davis Lundy, said that privacy rules prohibited him from discussing Mr. Safapour’s case, but that Life Care had a significant number of residents on Medicaid and that “we never discharge patients based on their payer source.”

The families of some evicted patients have had to take them into their homes, although they lack the training or equipment to care for them.

In June, Connie Rodina got a phone call from the Richmond Healthcare and Rehabilitation Center in Richmond, Kan. Her 63-year-old brother, Jon Fowler, who suffers from mental illness and dementia, had hit another resident. Ms. Rodina, her brother’s guardian, was told that she needed to pick him up immediately.

By the time Ms. Rodina arrived, Mr. Fowler was already being transported to an emergency room. The hospital was ready to discharge him a couple of days later, after treating him for a urinary tract infection. Ms. Rodina said Richmond Healthcare wouldn’t take him back.

“You can’t just put somebody out like that,” said Camille Russell, a regional ombudsman who filed a complaint against the facility with the Kansas Department for Aging and Disability Services. The complaint is pending, she said.

Ms. Rodina couldn’t find another nursing home that would admit Mr. Fowler, who needs near-constant care. After her brother had been in the hospital for weeks, she reluctantly moved him into her home.

“It’s basically taken my life away from me,” Ms. Rodina said. “It’s impossible for me to care for him.”

Representatives of Richmond Healthcare didn’t respond to requests for comment.

In some cases, nursing homes have ignored orders from regulators to take back patients they sent to emergency rooms or psychiatric hospitals.

Charles Borden, a stroke victim with dementia, had been staying at the skilled nursing facility at Tahoe Forest Hospital in Truckee, Calif. Medicaid was covering his long-term stay. But in April, after Mr. Borden elbowed a nursing assistant and cursed at her, the nursing home sent him to the hospital’s emergency room for a psychiatric evaluation.

Within hours, the emergency room cleared Mr. Borden to return to the nursing home. But it wouldn’t take him back, according to court records. (While the nursing home and the main Tahoe Forest hospital share a campus and are owned by the same organization, the nursing home is financially independent from the hospital.)

Later that day, the nursing home dropped off all of Mr. Borden’s possessions at the E.R. and moved another resident into the room that Mr. Borden had shared with his wife, Beverly.

Two days later, on April 22, Mr. Borden’s son appealed the decision to California’s health care agency. It determined that the nursing home was legally required to take Mr. Borden back. The nursing home refused.

The state agency said it had no authority to force the nursing home to let Mr. Borden return, aside from fining it $50 for every day it refused.

Matt Mushet, a lawyer for the nursing home, said it “is committed to the optimal safety of all patients and team members.” He said that he couldn’t comment on Mr. Borden’s case but that “it’s important for the public to understand there is more than one side to this story.”

Mr. Borden has spent the past five months marooned in the hospital. His dementia makes it hard for him to understand what is going on, his son said, but Mr. Borden asks every day to see his wife.

Jessica Silver-Greenberg is an investigative reporter on the business desk. She was previously a finance reporter at the Wall Street Journal. @jbsgreenberg • Facebook

Rachel Abrams joined The Times as a business reporter in 2013. She was part of the award-winning teams that covered sexual harassment and misconduct and General Motors’ crisis involving fatal ignition switches. She previously worked for Variety. @rachelabramsny

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