Dorner may have had help in trying to flee to Mexico

A fugitive former Los Angeles police officer wanted in connection with a deadly shooting rampage may have had help in his efforts to flee to Mexico as a massive manhunt was gearing up to capture him, according to federal court records obtained Monday by The Times.

The records state how authorities developed "probable cause" that Christopher Jordan Dorner, 33, was possibly trying to escape to Mexico and provide new details on his actions since he allegedly killed three people, including a police officer, in a shooting rampage that police say began Feb. 3 in Irvine.

Dorner may have been helped by an associate identified only as "JY" in the criminal complaint filed in U.S. District Court in Los Angeles late last week after the former police officer was suspected of fleeing from authorities.

Federal authorities told The Times on Monday night that the court papers, filed late last week, reflected their thinking at the time, but they stressed that Dorner could be anywhere.

As the manhunt continued Monday, the Riverside County district attorney's office filed murder and attempted murder charges against Dorner, who is accused of killing one police officer and wounding two others in that county before his burning pickup was found near Big Bear.

Dorner allegedly attempted to steal a boat in San Diego and, after subduing the captain, said he was taking the vessel to Mexico, according to an affidavit filed with the federal complaint. Dorner is accused of telling the captain that he could recover his boat in Mexico.

"The attempt failed when the bow line of the boat became caught in the boat's propeller, and the suspect fled," according to the affidavit by Inspector U.S. Marshal Craig McClusky.

After authorities interviewed the boat captain early Thursday, they found Dorner's wallet and identification cards "at the San Ysidro Point of Entry" near the U.S.-Mexico border, according to the court records. That same day, a guard at the Point Loma Naval Base told authorities he had spotted a man matching Dorner's description trying to sneak onto the base, according to the filing.

The possibility that Dorner received help from the associate was raised in McClusky's affidavit. The Marine Corps and San Bernardino County Sheriff's Department investigators were conducting a surveillance operation of an Arrowbear Lake property owned by a family member of the associate Thursday and discovered a burning vehicle nearby that matched the gray Nissan pickup used by Dorner.

The charges filed Monday in Riverside County on Monday accuse Dorner of opening fire, unprovoked, on Riverside police Officer Michael Crain, 34, a married father of two who served two tours in Kuwait as a rifleman in the U.S. Marines.

Dorner faces three additional counts of attempted murder of a peace officer for allegedly shooting and critically injuring Crain's partner and firing upon two Los Angeles police officers stationed in Corona to protect an LAPD official named in an online manifesto authorities attribute to Dorner. One of the LAPD officers was grazed on the head by a bullet.

Riverside County Dist. Atty. Paul Zellerbach said the murder charge includes two special circumstance allegations that make Dorner eligible for the death penalty — killing a peace officer and discharging a firearm from a vehicle.

Filing criminal charges will ensure that if Dorner is caught, either out of the state or out of the country, the outstanding arrest warrant would clear the way for a rapid extradition.

"I want to cover all my bases. I want to make sure when he is located and arrested, he can be extradited back to California as soon as possible," Zellerbach said after holding a noon news briefing.

The district attorney believes that Dorner, if he is still alive, is not done with his quest for revenge and thirst for the public's attention.

"Even though he may have gone underground now, given the nature of his conduct and his words and his actions, he's going to reappear," Zellerbach said. "I don't think he's done.... He's trying to send a message, and it would be my belief that his message is not completed yet.''

Riverside Police Chief Sergio Diaz has called Dorner's attack on his two officers early Thursday a "cowardly ambush." Dorner allegedly opened fire as the officers sat in a patrol car, stopped at a red light.

The surviving officer, 27, who was being trained by Crain, continues to recover from surgery. He has been with the department less than a year.

"He's in a lot of pain. He's going to be facing a lot of surgeries in the coming weeks and months," Diaz said. "We don't know if he'll be able to return to active duty. We certainly hope so."

Dorner's alleged rampage began with the Feb. 3 shooting deaths of Monica Quan, a Cal State Fullerton assistant basketball coach, and her fiance, Keith Lawrence, a USC public safety officer.

Quan was the daughter of a retired LAPD captain whom Dorner apparently accused online of not representing him fairly at a hearing that led to his firing. In what police said was his posting on a Facebook page, Dorner allegedly threatened the retired captain and others he blamed for his firing.

More than 50 LAPD families remained under police guard Monday.

A scaled-down search for Dorner continued Monday in woods west of Big Bear Lake, where his burning truck was found on a forest road Thursday.

About 30 officers are searching vacation homes and cabins in "an even more remote area," and the search will resume Tuesday with the same number of law enforcement personnel, according to the San Bernardino County Sheriff's Department.

On Sunday, Los Angeles officials announced a $1-million reward for information leading to the capture and arrest of Dorner. The reward — raised from local governments, police departments, civic organizations, businesses and individuals — is thought to be the largest ever offered locally.

kate.mather@latimes.com

phil.willon@latimes.com

Times staff writer Robert J. Lopez contributed to this report.

Read More..

Young Afghan musicians in NY for date at Carnegie

SCARSDALE, N.Y. (AP) — It's the perfect trip to America. A group of youngsters from Afghanistan is going ice skating, downing New York pizza — and performing at Carnegie Hall.

The Afghan Youth Orchestra is on the New York leg of a U.S. tour. Many of its members are not far removed from eking out a living on the streets of Kabul.

The orchestra held a joint rehearsal Monday with the Scarsdale High School orchestra. That meant that young musicians from a war-torn country where music was banned for several years were playing alongside those from one of New York's toniest suburbs.

The orchestra's leader says the cooperation is symbolic of Afghanistan's future.

On Tuesday's program at Carnegie are Western classics like Vivaldi's "Four Seasons" but incorporating Afghan instruments and rhythms.

Read More..

Toy makers play up classics and creativity

NEW YORK — A digital Barbie vanity mirror that allows makeup experimentation without the mess. Customizable figurines mounted on spinning tops that battle in a portable arena. New Play Doh Plus that's fluffier and more malleable.

The hippest new toys showcased at the American International Toy Fair this week are interactive, adaptable and, often, more than a bit familiar.

"We're reinventing older brands so that kids can rediscover them as if they were new," said John Frascotti, chief marketing officer for Hasbro Inc., at the show in New York City. "A 5-year-old doesn't know or care that a toy has actually been around for decades."

More than 31,000 attendees — including 1,000 exhibitors — are congregating at the annual event, which is considered to be the start of a yearlong scramble to identify, market and occasionally copy the products expected to dominate the Christmas shopping season.

This year the hunt feels even more urgent. The U.S. toy industry had a lackluster 2012, with revenue falling slightly from the year before to $16.5 billion. Sales dropped even further compared with 2008, when they totaled $21.6 billion, according to research firm NPD Group.

Manufacturers, distributors, importers and buyers crowd the 366,000 square feet of space in the Jacob K. Javits Convention Center to display more than 150,000 products, including action figures, educational activities, bicycles, puppets, video and board games. The fair, the largest of its kind in the Western Hemisphere, began Sunday and lasts through Wednesday.

Toy analysts are already taking bets on likely trends.

One major buzzword? Construction playthings, and not just in the form of boys' building blocks.

Build-your-own robots and action figures and do-it-yourself doll backdrops helped the building sets sector grow 19.7% last year — the largest revenue gain of any toy category, according to NPD. Analysts expect another boost in 2013.

Parents want toys that their children can create themselves and customize instead of the "watch me" products that attempt to entertain kids with the push of a button, said Jim Silver, editor in chief of TimetoPlayMag.com.

"Especially with the economy the way it is, they're looking for toys that offer value through rebuilding, that kids can play with over and over again," he said.

Hasbro showed off Transformers Construct-Bots, which kids can build out from a robot frame foundation using armor, weapons and accessory parts. The company's new Iron Man Assemblers action figures can be compiled using a variety of arm, torso, leg and other body parts into hundreds of combinations.

Hot Wheels, owned by El Segundo company Mattel Inc., will soon enable children to construct their own track sets and create unique toy cars with special molds and accessory stickers.

"We live in a world of youth empowerment, where kids are used to an environment that they can control," Hasbro's Frascotti said. "They can already go to an iPad and design whatever they want, so why can't they do that in an analog world too?"

Toys that cross gender barriers are also gaining traction.

At the New York show, Hasbro debuted a silver-and-black version of its usually pink-and-purple Easy-Bake oven. The company, which was recently petitioned by tens of thousands of people for a boy-friendly Easy-Bake, said it has worked for more than a year on a more gender-neutral version of its 50-year-old cooking toy.

Last year, Zing Toys debuted a pink-and-purple bow-and-arrow set called the Air Huntress. At the show, Hasbro demonstrated its Nerf Rebelle Heartbreaker archery toy, a product packaged with darts covered in funky feminine patterns.

Lego used its small blocks to create life-sized models of girls in soccer uniforms and karate belts to exhibit its female-focused Lego Friends line. Spin Master adopted technology from its popular AirHogs flying toys in its new Flutterbye Fairy, a winged doll that launches off a charger modeled after a jewelry box and follows hand motions to stay aloft.

Mega Bloks stacked a pile of Barbie Build 'n Style play set suites — including blocks made up like kitchens or bedrooms — in a corner of its booth. The girl-centric construction product line launched in December and also includes pool party, fashion boutique and pet shop options along with figurines with interchangeable hair.

The market also is headed toward an "abundance" of old-school products featuring nostalgic, vintage or classic elements — "like the equivalent of bell bottoms or neon colors for toys," said Adrienne Appell, an analyst with fair organizer Toy Industry Assn.

Read More..

Grammy Awards voters spread the love all around

LOS ANGELES (AP) — Mumford & Sons wrapped up a completely unpredictable Grammy Awards with perhaps the most surprising win of the night, taking home album of the year.

It was an event that even shocked the London folk-rockers.

"We figured we weren't going to win anything because The Black Keys have been sweeping up all day, rightfully so," Marcus Mumford said.

Dan Auerbach of The Black Keys ended up the night's top winner with four trophies, including producer of the year and three rock category victories with bandmate Patrick Carney. But it was hardly a clean sweep as The Recording Academy's thousands of voters spread the love for the year's top singles.

Fun. took home major awards best new artist, in something of an upset over Frank Ocean, and song of the year for the transcendent anthem "We Are Young," featuring Janelle Monae.

"I didn't think we were going to win this one," lead singer Nate Ruess said after the best new artist win. "Frank Ocean. The Lumineers. Everybody, amazing."

Like Mumford & Sons, Gotye busted up the predictions, taking record of the year for 2012's top-selling single, the haunting "Somebody That I Used To Know," featuring Kimbra, and finished with three awards.

Prince, in hood and sunglasses and carrying a sparkly silver cane, presented him with the record of the year trophy and the Australian paid tribute to The Purple One's influence.

"A little bit lost for words, to receive an award from the man standing behind us with the cane," Gotye said. "Many years listening to this man's music growing up and a big reason I was inspired to make music. Thank you."

Jay-Z and Kanye West had three wins — sharing one award with Ocean — along with Skrillex, and a slew of nominees had two wins apiece, including former best new artist winner Esperanza Spalding.

Ocean was shut out in the major categories, but took home two trophies, including best urban contemporary album. Only Chris Brown, with whom Ocean scuffled last month, remained seated as the 25-year-old R&B winner walked to the stage during a standing ovation. Ocean beat Brown, who attended with girlfriend Rihanna, in the category.

Ocean won also won best rap/sung collaboration for "No Church in the Wild" with fellow top nominees Jay-Z and West, and The-Dream. The win came after victories for Jay-Z and West for best rap song and best rap performance for "... in Paris," another "Watch the Throne" track. Ocean also performed his song "Forrest Gump," the love song written about a man that first started the buzz that led to his announcement that his first love was a man.

"We Are Young" helped fun. earn a starring role at these Grammys with nominations in all four major categories. The band turned in a powerful early performance of "Carry On" as a downpour on stage began mid-song and guitarist Jack Antonoff got a kiss from girlfriend "Girls" creator Lena Dunham after winning.

The Black Keys took best rock performance for "Lonely Boy" during the main telecast and earlier in the day won best rock song for "Lonely Boy" and best rock album for "El Camino." He also got an assist — but no trophy — on Dr. John's best blues album "Locked Down," which he produced.

Other winners included Rihanna, Beyonce, Mumford & Sons and Taylor Swift, who opened the show as the Mad Hatter. Swift dressed in white top hat, tails, shorts and tall boots during the surreal version of her hummable hit "We Are Never Ever Getting Back Together" that included a troop of mime clowns and a guy on a tricycle with a flame-thrower attached.

The singer pretended to talk to the offending boyfriend on the phone: "I'm busy opening the Grammys and we're never getting back together."

Justin Timberlake debuted new tracks "Suit & Tie" with Jay-Z and "Pusher Love" in a performance that was broadcast in retro black and white. Rihanna and the extended Marley family paid tribute to Bob Marley. Sting and Bruno Mars helped each other out on their hits "Locked Out of Heaven" and "Walking on the Moon." Elton John and Ed Sheeran teamed on "The A Team" and Miguel and Wiz Khalifa joined forces teamed up on "Adorn." Alicia Keys played drums during Maroon 5's "Daylight," before Adam Levine's band backed her on "Girl on Fire."

Jack White brought both his male and female bands on stage, tearing through "Love Interruption" and "Freedom at 21" before a standing ovation from the crowd. And Elton John, Mavis Staples, Brown, Mumford & Sons and Brittany Howard of Alabama Shakes paid tribute to the late Levon Helm with a spirited rendition of "The Weight."

Adele won the first award of the night on the main telecast, taking home best pop solo performance for "Set Fire to the Rain (Live)," in one of the night's least-surprising moments — though the singer was somewhat taken aback.

"I just wanted to be part of the night, because I loved it last year, obviously," she said of winning a record-tying six awards in 2012.

Carrie Underwood won best country solo performance for "Blown Away," Zac Brown Band won best country album for "Uncaged" and Kelly Clarkson turned in the night's most exuberant acceptance speech after winning best pop vocal album for "Stronger." After hugging much of the front row and momentarily getting stuck to Miranda Lambert's dress, Clarkson charged the stage with a giant smile.

"Miguel, I don't know who the hell you are, but we need to sing together," she said. "I mean, good God. That was the sexiest dancing I've ever seen."

Skrillex won best dance recording for "Bangarang," featuring Sirah, best dance/electronica album for "Bangarang" and best remixed recording a year after winning those same awards in his first appearance at the Grammys.

"You know what, I thought I'd get used to it, but I tripped over every word when I was up there," Skrillex said of his acceptance speeches. "I felt like I just wanted a pool of ice water and just couldn't even breathe or think. It was crazy. I think it was even crazier than last year."

Celebrities rolled down the red carpet in the early afternoon under heavy police guard during a continued manhunt for an alleged cop killer. Many stars showed a fair amount of skin — check out the Twitter pic of Ellen DeGeneres ogling Katy Perry's revealing dress — despite CBS's mandate that stars dress appropriately with butts, breasts and other sensitive areas covered adequately.

Nevertheless, Jennifer Lopez showed up on stage in a dress slit all the way to her hip.

"As you can see, I read the memo," Lopez joked.

___

AP writers Mesfin Fekadu, Sandy Cohen and Anthony McCartney in Los Angeles contributed to this report.

___

Online:

http://grammy.com

___

Follow AP Music Writer Chris Talbott: http://twitter.com/Chris_Talbott.

Read More..

Well: Getting the Right Addiction Treatment

“Treatment is not a prerequisite to surviving addiction.” This bold statement opens the treatment chapter in a helpful new book, “Now What? An Insider’s Guide to Addiction and Recovery,” by William Cope Moyers, a man who nonetheless needed “four intense treatment experiences over five years” before he broke free of alcohol and drugs.

As the son of Judith and Bill Moyers, successful parents who watched helplessly during a 15-year pursuit of oblivion through alcohol and drugs, William Moyers said his near-fatal battle with addiction demonstrates that this “illness of the mind, body and spirit” has no respect for status or opportunity.

“My parents raised me to become anything I wanted, but when it came to this chronic incurable illness, I couldn’t get on top of it by myself,” he said in an interview.

He finally emerged from his drug-induced nadir when he gave up “trying to do it my way” and instead listened to professional therapists and assumed responsibility for his behavior. For the last “18 years and four months, one day at a time,” he said, he has lived drug-free.

“Treatment is not the end, it’s the beginning,” he said. “My problem was not drinking or drugs. My problem was learning how to live life without drinking or drugs.”

Mr. Moyers acknowledges that treatment is not a magic bullet. Even after a monthlong stay at a highly reputable treatment center like Hazelden in Center City, Minn., where Mr. Moyers is a vice president of public affairs and community relations, the probability of remaining sober and clean a year later is only about 55 percent.

“Be wary of any program that claims a 100 percent success rate,” Mr. Moyers warned. “There is no such thing.”

“Treatment works to make recovery possible. But recovery is also possible without treatment,” Mr. Moyers said. “There’s no one-size-fits-all approach. What I needed and what worked for me isn’t necessarily what you or your loved one require.”

As with many smokers who must make multiple attempts to quit before finally overcoming an addiction to nicotine, people hooked on alcohol or drugs often must try and try again.

Nor does treatment have as good a chance at succeeding if it is forced upon a person who is not ready to recover. “Treatment does work, but only if the person wants it to,” Mr. Moyers said.

Routes to Success

For those who need a structured program, Mr. Moyers described what to consider to maximize the chances of overcoming addiction to alcohol or drugs.

Most important is to get a thorough assessment before deciding where to go for help. Do you or your loved one meet the criteria for substance dependence? Are there “co-occurring mental illnesses, traumatic or physical disabilities, socioeconomic influences, cultural issues, or family dynamics” that may be complicating the addiction and that can sabotage treatment success?

While most reputable treatment centers do a full assessment before admitting someone, it is important to know if the center or clinic provides the services of professionals who can address any underlying issues revealed by the assessment. For example, if needed, is a psychiatrist or other medical doctor available who could provide therapy and prescribe medication?

Is there a social worker on staff to address challenging family, occupational or other living problems? If a recovering addict goes home to the same problems that precipitated the dependence on alcohol or drugs, the chances of remaining sober or drug-free are greatly reduced.

Is there a program for family members who can participate with the addict in learning the essentials of recovery and how to prepare for the return home once treatment ends?

Finally, does the program offer aftercare and follow-up services? Addiction is now recognized to be a chronic illness that lurks indefinitely within an addict in recovery. As with other chronic ailments, like diabetes or hypertension, lasting control requires hard work and diligence. One slip need not result in a return to abuse, and a good program will help addicts who have completed treatment cope effectively with future challenges to their recovery.

How Families Can Help

“Addiction is a family illness,” Mr. Moyers wrote. Families suffer when someone they love descends into the purgatory of addiction. But contrary to the belief that families should cut off contact with addicts and allow them to reach “rock-bottom” before they can begin recovery, Mr. Moyers said that the bottom is sometimes death.

“It is a dangerous, though popular, misconception that a sick addict can only quit using and start to get well when he ‘hits bottom,’ that is, reaches a point at which he is desperate enough to willingly accept help,” Mr. Moyers wrote.

Rather, he urged families to remain engaged, to keep open the lines of communication and regularly remind the addict of their love and willingness to help if and when help is wanted. But, he added, families must also set firm boundaries — no money, no car, nothing that can be quickly converted into the substance of abuse.

Whether or not the addict ever gets well, Mr. Moyers said, “families have to take care of themselves. They can’t let the addict walk over their lives.”

Sometimes families or friends of an addict decide to do an intervention, confronting the addict with what they see happening and urging the person to seek help, often providing possible therapeutic contacts.

“An intervention can be the key that interrupts the process and enables the addict to recognize the extent of their illness and the need to take responsibility for their behavior,”Mr. Moyers said.

But for an intervention to work, Mr. Moyers said, “the sick person should not be belittled or demeaned.” He also cautioned families to “avoid threats.” He noted that the mind of “the desperate, fearful addict” is subsumed by drugs and alcohol that strip it of logic, empathy and understanding. It “can’t process your threat any better than it can a tearful, emotional plea.”

Resource Network

Mr. Moyer’s book lists nearly two dozen sources of help for addicts and their families. Among them:

Alcoholics Anonymous World Services www.aa.org;

Narcotics Anonymous World Services www.na.org;

Substance Abuse and Mental Health Services Administration treatment finder www.samhsa.gov/treatment/;

Al-Anon Family Groups www.Al-anon.alateen.org;

Nar-Anon Family Groups www.nar-anon.org;

Co-Dependents Anonymous World Fellowship www.coda.org.

---

This is the second of two articles on addiction treatment. The first can be found here.

Read More..

Dozens of airline fees rose or changed in 2012, study finds

Airline travel fees — including charges to check a bag and to board early — have become so prevalent that travelers almost need an advanced degree in mathematics to calculate overall trip costs.

Last year at least 36 airline fees increased, and 16 others were redefined, bundled or unbundled with other services, according to a recent study by the consumer travel website Travelnerd.

One bright spot in the Travelnerd study of 14 U.S. airlines is that most fee increases were only $5 to $10 each.

In one case an airline had a big fee reduction. The study found that United Airlines reduced its fee for checking an overweight bag to $100 from $200 for bags 50 to 70 pounds and to $200 from $400 for bags 71 to 100 pounds.

"Travelers really have to be extra cautious when booking a flight," said Alicia Jao, vice president of travel media at Travelnerd, who predicts travelers will see even more fees in 2013. "U.S. carriers are becoming creative at charging consumers extra fees."

But some airlines seem to charge fees arbitrarily, said Perach Mazol, a Los Angeles resident who recently flew to Florida with friends from Romania to take a cruise.

On her flight from L.A. to Fort Lauderdale, Fla., on Spirit Airlines, she said the Florida airline did not charge for the carry-on bags she and her friends were carrying, but the carrier asked for $50 each to carry the same bags on the flight back. (Spirit is one of only two airlines in the U.S. that charge passengers for carry-on luggage.)

"I don't understand why they charged us on one flight and they don't on the other," Mazol said. "It's confusing."

A spokeswoman for Spirit said the airline tries to enforce its policies consistently.

"Maybe she got lucky one way and didn't have to pay," Spirit spokeswoman Misty Pinson said.

United offering satellite-based Wi-Fi

United Airlines was one of the last major airlines to offer onboard wireless Internet. But the Chicago carrier is trying to make up for its tardiness.

United offers Wi-Fi in about 3% of its fleet of about 700 planes, one of the lowest rates of any major carrier in the nation, according to a recent study.

But United recently became the first U.S.-based international carrier to offer satellite-based Wi-Fi Internet for passengers traveling on long-haul overseas flights.

The carrier has installed satellite-based Wi-Fi on nearly a dozen planes, with plans to expand the service to more than 300 planes, or about 43% of the fleet, by the end of the year.

"With this new service, we continue to build the airline that customers want to fly," said Jim Compton, vice chairman and chief revenue officer at United.

Satellite-based Wi-Fi is typically as fast as ground-based Wi-Fi, experts say, but the advantage is that it can give passengers Internet access when flying over areas where cellular towers don't exist — such as the Pacific or Atlantic oceans.

But, of course, there is a price to pay for the service.

United is charging $3.99 to $14.99 for standard speed, depending on the duration of the flight, and $5.99 to $19.99 for faster speeds.

United is not the only airline to offer satellite-based Wi-Fi. Southwest Airlines, the nation's largest domestic carrier, offers it through Westlake Village-based Row 44.

Delta to raise fee to access lounges

Airline fees are rising not only for onboard services but for amenities at the airport too.

Delta Air Lines, which has invested more than $20 million in its airport lounges over the last two years, announced that it would raise the cost for annual membership to access its lounges across the country by $50, starting March 1.

The increase means that an annual membership will range from $350 to $450, depending on membership level. (The more miles passengers fly on Delta the less they pay for membership.)

Among the investments Delta has made is the addition of a new luxury bar that opened recently at Delta's lounge at Los Angeles International Airport. Instead of helping themselves at a self-serve bar, members can now belly up to a fully stocked bar and order a drink from a bartender.

hugo.martin@latimes.com

Read More..

A delicate new balancing act in senior healthcare

When Claire Gordon arrived at Cedars-Sinai Medical Center, nurses knew she needed extra attention.

She was 96, had heart disease and a history of falls. Now she had pneumonia and the flu. A team of Cedars specialists converged on her case to ensure that a bad situation did not turn worse and that she didn't end up with a lengthy, costly hospital stay.

Frail seniors like Gordon account for a disproportionate share of healthcare expenditures because they are frequently hospitalized and often land in intensive care units or are readmitted soon after being released. Now the federal health reform law is driving sweeping changes in how hospitals treat a rapidly growing number of elderly patients.

The U.S. population is aging quickly: People older than 65 are expected to make up nearly 20% of it by 2030. Linda P. Fried, dean of the Columbia University Mailman School of Public Health, said now is the time to train professionals and test efforts to improve care and lower healthcare costs for elderly patients.

"It's incredibly important that we prepare for being in a society where there are a lot of older people," she said. "We have to do this type of experiment right now."

At Cedars-Sinai, where more than half the patients in the medical and surgical wards are 65 or older, one such effort is dubbed the "frailty project." Within 24 hours, nurses assess elderly patients for their risk of complications such as falls, bed sores and delirium. Then a nurse, social worker, pharmacist and physician assess the most vulnerable patients and make an action plan to help them.

The Cedars project stands out nationally because medical professionals are working together to identify high-risk patients at the front end of their hospitalizations to prevent problems at the back end, said Herb Schultz, regional director of the U.S. Department of Health and Human Services.

"For seniors, it is better care, it is high-quality care and it is peace of mind," he said.

The effort and others like it also have the potential to reduce healthcare costs by cutting preventable medical errors and readmissions, Schultz said. The federal law penalizes hospitals for both.

Gordon, an articulate woman with brightly painted fingernails and a sense of humor, arrived at Cedars-Sinai by ambulance on a Monday.

Soon, nurse Jacquelyn Maxton was at her bedside asking a series of questions to check for problems with sleep, diet and confusion. The answers led to Gordon's designation as a frail patient. The next day, the project team huddled down the hall and addressed her risks one by one. Medical staff would treat the flu and pneumonia while at the same time addressing underlying health issues that could extend Gordon's stay and slow her recovery, both in the hospital and after going home.

To reduce the chance of falls, nurses placed a yellow band on her wrist that read "fall risk" and ensured that she didn't get up on her own. To prevent bed sores, they got her up and moving as often as possible. To cut down on confusion, they reminded Gordon frequently where she was and made sure she got uninterrupted sleep. Medical staff also stopped a few unnecessary medications that Gordon had been prescribed before her admission, including a heavy narcotic and a sleeping pill.

"It is really a holistic approach to the patient, not just to the disease that they are in here for," said Glenn D. Braunstein, the hospital's vice president for clinical innovation.

Previously, nurse Ivy Dimalanta said, she and her colleagues provided similar care but on a much more random basis. Under the project, the care has become standardized.

The healthcare system has not been well designed to address the needs of seniors who may have had a lifetime of health problems, said Mary Naylor, gerontology professor at the University of Pennsylvania School of Nursing. As a result, patients sometimes fall through the cracks and return to hospitals again and again.

"That is not good for them and that is not good for society to be using resources in that way," Naylor said.

Using data from related projects, Cedars began a pilot program in 2011 and expanded it last summer. The research is continuing but early results suggest that the interventions are leading to fewer seniors being admitted to the intensive care unit and to shorter hospital stays, said Jeff Borenstein, researcher and lead clinician on the frailty project. "It definitely seems to be going in the right direction," he said.

The hospital is now working with Naylor and the University of Pennsylvania to design a program to help the patients once they go home.

"People who are frail are very vulnerable when they leave the hospital," said Harriet Udin Aronow, a researcher at Cedars. "We want to promote them being safe at home and continuing to recover."

In Gordon's case, she lives alone with the help of her children and a caregiver. The hospital didn't want her experiencing complications that would lengthen the stay, but they also didn't want to discharge her before she was ready. Under the health reform law, hospitals face penalties if patients come back too soon after being released.

Patients and their families often are unaware of the additional attention. Sitting in a chair in front of a vase of pink flowers, Gordon said she knew she would have to do her part to get out of the hospital quickly. "You have to move," she said. "I know you get bed sores if you stay in bed."

Gordon said she was comfortable at the hospital but she wanted to go back to her house as quickly as she could. "There's no place like home," she said.

Two days later, that's where she was.

anna.gorman@latimes.com

Read More..

Chris Brown crashes car while evading paparazzi

BEVERLY HILLS, Calif. (AP) — Police in Beverly Hills say Chris Brown escaped injury after crashing his Porsche into a wall while being chased by paparazzi.

Lt. Lincoln Hoshino said the collision occurred around noon Saturday. Brown told police that he lost control of his black Porsche during the chase.

Hoshino said police will investigate the incident. He said he didn't know whether the paparazzi in the pursuing vehicles have been identified.

A call to Brown's lawyer was not immediately returned.

The crash came a day before the Grammy Awards, where Brown is up for best urban contemporary album.

Read More..

For Families Struggling with Mental Illness, Carolyn Wolf Is a Guide in the Darkness

When a life starts to unravel, where do you turn for help?

Melissa Klump began to slip in the eighth grade. She couldn’t focus in class, and in a moment of despair she swallowed 60 ibuprofen tablets. She was smart, pretty and ill: depression, attention deficit disorder, obsessive-compulsive disorder, either bipolar disorder or borderline personality disorder.

In her 20s, after a more serious suicide attempt, her parents sent her to a residential psychiatric treatment center, and from there to another. It was the treatment of last resort. When she was discharged from the second center last August after slapping another resident, her mother, Elisa Klump, was beside herself.

“I was banging my head against the wall,” the mother said. “What do I do next?” She frantically called support groups, therapy programs, suicide prevention lines, anybody, running down a list of names in a directory of mental health resources. “Finally,” she said, “somebody told me, ‘The person you need to talk to is Carolyn Wolf.’ ”

That call, she said, changed her life and her daughter’s. “Carolyn has given me hope,” she said. “I didn’t know there were people like her out there.”

Carolyn Reinach Wolf is not a psychiatrist or a mental health professional, but a lawyer who has carved out what she says is a unique niche, working with families like the Klumps.

One in 17 American adults suffers from a severe mental illness, and the systems into which they are plunged — hospitals, insurance companies, courts, social services — can be fragmented and overwhelming for families to manage. The recent shootings in Newtown, Conn., and Aurora, Colo., have brought attention to the need for intervention to prevent such extreme acts of violence, which are rare. But for the great majority of families watching their loved ones suffer, and often suffering themselves, the struggle can be boundless, with little guidance along the way.

“If you Google ‘mental health lawyer,’ ” said Ms. Wolf, a partner with Abrams & Fensterman, “I’m kinda the only game in town.”

On a recent afternoon, she described in her Midtown office the range of her practice.

“We have been known to pull people out of crack dens,” she said. “I have chased people around hotels all over the city with the N.Y.P.D. and my team to get them to a hospital. I had a case years ago where the person was on his way back from Europe, and the family was very concerned that he was symptomatic. I had security people meet him at J.F.K.”

Many lawyers work with mentally ill people or their families, but Ron Honberg, the national director of policy and legal affairs for the National Alliance on Mental Illness, said he did not know of another lawyer who did what Ms. Wolf does: providing families with a team of psychiatrists, social workers, case managers, life coaches, security guards and others, and then coordinating their services. It can be a lifeline — for people who can afford it, Mr. Honberg said. “Otherwise, families have to do this on their own,” he said. “It’s a 24-hour, 7-day-a-week job, and for some families it never ends.”

Many of Ms. Wolf’s clients declined to be interviewed for this article, but the few who spoke offered an unusual window on the arcane twists and turns of the mental health care system, even for families with money. Their stories illustrate how fraught and sometimes blind such a journey can be.

One rainy morning last month, Lance Sheena, 29, sat with his mother in the spacious family room of her Long Island home. Mr. Sheena was puffy-eyed and sporadically inattentive; the previous night, at the group home where he has been living since late last summer, another resident had been screaming incoherently and was taken away by the police. His mother, Susan Sheena, eased delicately into the family story.

“I don’t talk to a lot of people because they don’t get it,” Ms. Sheena said. “They mean well, but they don’t get it unless they’ve been through a similar experience. And anytime something comes up, like the shooting in Newtown, right away it goes to the mentally ill. And you think, maybe we shouldn’t be so public about this, because people are going to be afraid of us and Lance. It’s a big concern.”

Her son cut her off. “Are you comparing me to the guy that shot those people?”

“No, I’m saying that anytime there’s a shooting, like in Aurora, that’s when these things come out in the news.”

“Did you really just compare me to that guy?”

“No, I didn’t compare you.”

“Then what did you say?”

Read More..

Boeing 787 Dreamliner takes test flight to assess batteries

SEATTLE — Aerospace giant Boeing Co. sent a 787 Dreamliner passenger jet on a test flight Saturday, the first since the new airliner was grounded three weeks ago because of a battery fire.

The aircraft took off from Boeing Field in Seattle and spent more than two hours flying back and forth over the inland Columbia Plateau. It landed at Boeing Field shortly before 3 p.m. Pacific Time. According to flight-tracking website FlightAware, the aircraft flew 1,131 miles, slightly more than the 919 planned.

The Federal Aviation Administration granted permission for test flights Thursday.

The 787 is the first commercial airliner to rely heavily on lithium-ion batteries, the same kind used in cellphones. Each plane has two of the 63-pound blue power bricks, one near the front to provide power to the cockpit if the engines stop and one near the back to start up the auxiliary power unit, which is essentially a backup generator.

On Jan. 7, a battery on a plane that had recently landed in Boston short-circuited and caught fire. Nine days later, a battery on an All Nippon Airways plane started smoking, leading to an emergency landing in Japan.

Boeing said Saturday's flight was to assess the in-flight performance of the batteries. Data would be used to support continuing investigations of the recent incidents.

Read More..