The U.S. Attorney's Office and other law enforcement agencies last week held the largest-ever sweep of senior fraud cases in the country, involving more than 1 million victims, reports Financial Advisor . The cases charge more than 250 people worldwide with schemes in which mostly senior victims lost more than $500 million. The cases include criminal, civil, and forfeiture actions throughout more than 50 federal districts, with 200 defendants brought up on criminal charges. Fraud schemes ranged from mass mailing, telemarketing, and investment frauds to individual cases of identity theft and theft by guardians. Some cases entailed transnational criminal organizations that defrauded hundreds of thousands, while others involved a single relative or fiduciary who exploited an individual. The sweep also encompassed 43 mass-mailing fraud operators and search warrants for 14 premises from Las Vegas to south Florida, and 20 warrants issued in Vancouver, British Columbia. "The defendants targeted ... vulnerable senior consumers both in the United States and abroad, using U.S. addresses and the U.S. mails to try to legitimize their fraudulent schemes," notes U.S. Attorney for the Eastern District of New York Richard P. Donoghue. "They sold false promises of life-changing prizes that never came true."

Polls from Willis Towers Watson found 56 percent of employers say their wellbeing programs encourage a healthier lifestyle among participants, but only 32 percent of employees agreed, reports Plan Sponsor . To address this disparity, Willis Towers Watson says employers are considering ancillary paths to change health behaviors, including financial incentives. In 2017, 46 percent of employees said they would only participate in wellbeing programs if compensated, up from 35 percent in 2011. Willis Towers Watson suggests countering this by having plan sponsors reassess the link between program design and longer-term participant behavioral changes. The survey found employees with poor health are twice as likely to be disengaged at work than those with better health, and take three times as many days off. Willis Towers Watson determined three in five employees use technology to manage health, and one in four use wearables to track fitness activity or sleep. Moreover, as technology penetrates the retirement planning area, employers may seek to incorporate online tools, such as social media, to connect with participants. Willis Towers Watson encourages integrating health-conscious workplace environments designed to prompt participants to eat clean, exercise, breathe fresh air, and resolve stress, for example by establishing on-site or near-site services. "High-performing companies are already revamping their approaches by targeting chronic conditions, evaluating the workplace environment to better support well-being, and using social networks to engage employees more effectively," notes Willis Towers Watson's Shelley Wolff.

Gentle nudges can subtly transform organizations by virtue of being structural elements embedded into the company architecture, reports Forbes . Nudges are human-centric, voluntary, and they avoid invoking an economic decision frame. Organizations should trial a nudge before scaling it and quantify the results. Outcomes will not always pan out as intended, and the organization should re-design, test, and repeat the process until something that works emerges. When nudging is adopted by many as a generalized mindset, it can help change organizational culture. The collective influence of co-oriented nudges, channeling behaviors toward a desired outcome, can re-orient the playing field so that innovation and change feel natural instead of forced. Nudging can release its potential more fully as the number of people applying this strategy to their respective work-streams grows. The nudge unit should co-generate nudges in cooperation with employees, thus enabling the transfer of useful methodological skills to them, while the nudge unit gains contextual insights from employees needed to design sensitive and practical interventions. Organizations also can spread nudging skills by integrating the strategy into learning and development activities, motivating many nudges at all levels of the organization. As long as there is an ideation platform that can capture the resulting wealth of nudge ideas, this allows the aggregation and analysis of the emerging portfolio of nudges and identifying opportunities for cross-pollination and scale-up.

A preliminary study to be presented at the American Academy of Neurology Annual Meeting found older adults who followed the Dietary Approaches to Stop Hypertension (DASH) diet were less likely to develop depression, reports Healio . The researchers learned that after an average of 6.53 years, people in the second and third tertiles of the DASH diet had lower depression rates compared to people in first tertile. Of the other diets studied, the researchers observed that the Western diet was positively linked to depression over time. "Nonpharmacologic strategies to reduce depression, such as diet, may be effective, however, few studies have investigated the relation," says Rush University Professor Laurel Cherian. The researchers believe a diet intervention trial may be required to determine the best nutritional components for prevention of late onset depression and optimization of brain health.

A research review published in the Journal of General Internal Medicine analyzed data from 41 studies with a total of 9,384 participants age 60 or older who had elective surgery, and while about one in six experienced post-surgical symptoms of delirium, frail individuals were about four times more likely to develop delirium than others, reports Reuters . About 19 percent of participants experienced delirium after surgery, with rates highest following cardiac and general surgeries and among persons older than 80. "When the body of an older adult is confronted with a major stressor, such as surgery, it may struggle to both heal from the acute stressor and to continue managing all of the other medical illnesses," says Jennifer Watt at the University of Toronto. "When the body can no longer manage all of the competing conditions, individuals may develop symptoms relating to these underlying medical illnesses such as ... delirium." Variables such as smoking, dementia, and the use of psychiatric medications also were associated with a higher risk of delirium after surgery. People who were comforted by regular visits from a spouse, friend, or caregiver were 31 percent less likely to experience delirium after surgery than those who did not receive this type of support. People experiencing post-surgical delirium also were more likely to die, have serious postoperative complications, require longer hospitalization, and be sent to institutional care communities.

The U.K.-based Wayback project seeks to trigger memories and emotions in people with dementia and help them re-engage with relatives and caregivers using virtual reality (VR), reports Reuters . Subjects use a portable VR headset to watch films, such as a re-creation of a street party held to celebrate Queen Elizabeth's coronation in 1953. A director of one British senior community says the film evoked detailed recollections in those who viewed it. "It was just amazing to see them so happy," she notes. Dementia UK's Dr. Karen Harrison-Dening thinks VR technology can help people with dementia, although the technology needs to be used cautiously. "For instance, some people with dementia experience what are called misperceptions," she says. "This can lead to confusion over which images are 'real' or not, and may prove unsettling for the person."

A recent Facebook Live conversation held by Kaiser Health News had valuable insights for employers, reports Workforce Associate Editor Andie Burjek. "Since the aging workforce is a ubiquitous workplace topic nowadays ... it's worth understanding that conditions like dementia, in most cases, happen after the age of 65," she writes. One point Burjek says she found valuable is the fact that Alzheimer's symptoms, in addition to a loss of memory, can include hallucinations, depression, anger, and verbal abuse. Also cited by Burjek is the sense of isolation caregivers often feel. "If your employee is a caregiver, he or she could be dealing with social isolation, estrangement from family members, communication barriers/confusion, and not knowing what terminology to use with the person's physician, among others," Burjek notes. She says employers should be mindful of such things if an employee has dementia or is starting to show dementia signs. "It's not just a memory disorder and there could be other symptoms," Burjek writes. "What you might perceive as poor behavior might be communication. And many of these people are still capable of performing many aspects of their jobs."

Despite a lack of reckoning about sexual harassment in the medical profession, women in the field are hoping one will soon come about, reports NBC News . "Part of it has to do with the culture of hospitals and the whole culture of healthcare in general, which is very hierarchical," notes Oregon trauma clinical nurse specialist Teresa Goodell. "Physicians and top administrators are at the peak and feel free to mistreat nurses" and others they view as subordinate. The American Medical Association describes workplace sexual harassment as unethical and notes in its Code of Medical Ethics that "Sexual relationships between medical supervisors and trainees are not acceptable, even if consensual." Many women in medicine see nothing less than a complete revamp of their entire profession as necessary, with men made aware of what is unacceptable and women looking out for and supporting each other. The problem is partly attributed to the roots of sexual harassment, which often takes the form of intimidation. "It's very hard to speak up," Goodell says. "Sometimes nurses treat other nurses badly for pursuing harassment claims, and that's just wrong. When you're doing something like this, it's so key that you have support, that you have people believe you, and if you don't, it's very, very hard to do because it's an uphill battle the whole way." In addition to the fear of retaliation for speaking up, there are other factors unique to healthcare — including the round-the-clock nature of the job and easy access to beds and call rooms in hospitals — that have allowed harassment to spread in medicine.

There are ways for staff personality assessments to benefit businesses by offering learning and morale-building opportunities, reports Forbes . Employers should initially provide workers with sufficient time to take the assessment while on the clock, and those managing the process should give participants useful instructions. It is sensible to give workers about two weeks, which provides employees enough time to plan ahead and work around other deadlines. Employees also should be urged to answer assessment questions in the context of the workplace environment. When employees receive their own results and share them with others, facilitators should take the time to explain the assessment, the personality types it reveals, and the common strengths and challenges for each category. Participants also should be reminded that the results are generalizations. Also suggested is breaking participants into smaller groups where similar personalities are encouraged to collaborate on a competitive task. Once this contest is over, participants should be asked to analyze the various ways each team fulfilled the task. Such exercises show the benefits of having a diverse set of personalities on a team. A useful group activity near the end of a session is to have each worker select a trait they would like to develop further and work out a strategy to achieve it. Personality assessments also can be helpful for coaching, with assessments conducted at the start of engagement helping employees better understand their communication style and how others might interpret it.

The results of a recent trial published in PLoS Medicine suggest agitation could be mitigated in people with dementia by social interaction among nursing community residents and staff, reports Reuters . The researchers recruited 69 U.K. nursing communities and randomly assigned about 50 percent to implement a program. Staff in those communities received training in techniques for enabling social interaction and education in the effects and risks of antipsychotic medications, while residents in the remaining communities continued to get their usual care. Of 847 subjects in the initial study group, 533 completed the study and were assessed over a nine-month period, both before and after the intervention. "A key element of this research is that we worked alongside caregivers for nine months to embed these learned elements into everyday practice," says University of Exeter Professor Clive Ballard. "This was essential because just a one-off training seminar or a training book — without this mentoring — would not have resulted in a successful intervention." Ballard notes a "person-centered" strategy incorporates individual residents' wants and needs as a way to facilitate healing, and prioritizes these wants and needs over healthcare professional goals at times. Residents who received the intervention had statistically significant decreases in agitation and neuropsychiatric symptoms and improved quality of life versus the usual-care group. No differences were observed in use of antipsychotic drugs.