It's no secret, most of us would like to stay in our own home as we age. Yet, sometimes our loved ones just need a little extra help to remain comfortable at home. That's where Always Best Care can help....we are dedicated to exceeding expectations....always.
They say that your golden years are the best years of your life. For most older Americans, that's how it should be - a time to relax, reflect, and live life in a familiar place. After all, senior citizens in the U.S. have worked tirelessly to build a better economy, serve their communities, and raise families.
However, as seniors grow older, completing daily tasks like showering and enjoying activities such as visiting Los Rios Street Historic District in Ladera Ranch, CA gets harder without someone by their side. Unfortunately, many older Americans aren't able to rely on their adult children for help. The reality in today's world is that family members do not have the skills or time to dedicate to caring for their parents. That's where Always Best Care Senior Services comes in.
Our in-home care services are for people who prefer to stay at home as they grow older but need ongoing care that family or friends cannot provide. More and more older adults prefer to live far away from long-term, institutionalized facilities and closer to the place where they feel most comfortable - their home. Home care in Ladera Ranch, CA is a safe, effective way to give your loved ones the care they need when they need it the most.
Home Care Services
Service AreasSince 1996, Always Best Care has provided non-medical in-home care for seniors to help them maintain a healthy lifestyle as they get older. We are proud to have helped more than 25,000 seniors maintain higher levels of dignity and respect. We focus on providing seniors with the highest level of in-home care available so that they may live happily and independently.
Unlike some senior care companies, we genuinely want to be included in our clients' lives. We believe that personalized care is always the better option over a "one size fits all" approach. To make sure our senior clients receive the best care possible, we pair them with compassionate caregivers who understand their unique needs. That way, they may provide care accordingly without compromising their wellbeing.
The Always Best Care difference lies in life's little moments - where compassionate care and trustworthy experience come together to help seniors live a fruitful, healthy life. Whether you are an aging adult that can't quite keep up with life's daily tasks or the child of a senior who needs regular in-home services, Always Best Care is here to help.
Home is where the heart is. While that saying can sound a tad cliche, it is especially true for many seniors living in America. When given a choice, older adults most often prefer to grow older at home. An AARP study found that three out of four adults over the age of 50 want to stay in their homes and communities as they age.
When you begin to think about why, it makes sense. Home offers a sense of security, comfort, and familiarity.
The truth is, as we age, we begin to rely on others for help. When a family is too busy or lives too far away to fulfill this role, in-home senior care is often the best solution. Home care services allow seniors to enjoy personal independence while also receiving trustworthy assistance from a trained caregiver.
At Always Best Care, we offer a comprehensive range of home care services to help seniors stay healthy while they get the help they need to remain independent. As your senior loved one gets older, giving them the gift of senior care is one of the best ways to show your love, even if you live far away.
To give our senior clients the best care possible, we offer a full spectrum of in-home care services:
If your senior loved one has specific care needs, our personal care services are a great choice to consider. Personal care includes the standard caregiving duties associated with companion care and includes help with tasks such as dressing and grooming. Personal care can also help individuals with chronic conditions like diabetes.
Common personal care services include assistance with:
Sometimes, seniors need helpful reminders to maintain a high quality of life at home. If you or your senior has trouble with everyday tasks like cooking, our home helper services will be very beneficial.
Common home helper care services include assistance with:
Using this kind of care is a fantastic way to make life easier for you or your senior loved one. At Always Best Care, our talented caregivers often fill the role of a companion for seniors. That way, older adults can enjoy their favorite local activities, such as visiting Hilltop Park in Ladera Ranch, CA with friends while also receiving the care they need daily or weekly.
Common companionship services include:
According to AARP, more than 53 million adults living in the U.S. provide care to someone over 50 years old. Unfortunately, these caregivers experience stress, exhaustion, and even depression. Our respite care services help family caregivers address urgent obligations, spend time with their children, and enjoy nearby activities. Perhaps more importantly, respite care gives family members time to recharge and regroup. Taking personal time to de-stress reduces the risk of caregiver burnout. So, if you've always wanted to eat at the local Mama's Comfort Food & Cocktails - Ladera Ranch or visit Founders Park, don't feel bad. Doing so is great for both you and your loved one.
At the end of the day, our goal is to become a valuable part of your senior's daily routine. That way, we may help give them the highest quality of life possible. We know that staying at home is important for your loved one, and we are here to help make sure that is possible.
If you have been on the fence about non-medical home care, there has never been a better time than now to give your senior the care, assistance, and companionship they deserve.
Always Best Care in-home services are for older adults who prefer to stay at home but need ongoing care that friends and family cannot provide. In-home care is a safe, effective way for seniors to age gracefully in a familiar place and live independent, non-institutionalized lives. The benefits of non-medical home care are numerous. Here are just a few reasons to consider senior care services from Always Best Care:
According to AARP, 9 out of 10 seniors prefer to age in place within the comfort of their own home. With in-home care, seniors have a way to stay at home, receive the care they need, and maintain a sense of independence, improving overall wellness.
If you or a member of your family have assumed the role of caregiver for your senior loved one, you know how stressful the job can be. Between caregiver burnout and constant worry, being a family caregiver is hard. In-home care relieves your burden and gives you peace of mind knowing that your older family member is in expert hands.
Unlike nursing homes, where the staff and residents rotate frequently, seniors can foster new friendships and build bonds with their caregiver. Seniors who socialize on a regular basis are often happier, which fosters positivity and leads to increased wellbeing.
No two seniors need the same kind of in-home care assistance. That is why each of our Care Plans is tailored to meet our client's individual needs. We offer plans that cover everything from light housekeeping to more involved duties like transportation to doctor's appointments. Our Care Coordinators will work closely with you to develop a personalized plan to ensure your senior's needs are exceeded.
Always Best Care offers a full array of care options for patients at all levels of health. With our trusted elderly care services, your loved one will receive the level of care necessary for them to enjoy the highest possible quality of life.
Request More Information
While it's true that some seniors have complicated medical needs that prevent them from staying at home, aging in place is often the best arrangement for seniors and their families. With a trusted caregiver, seniors have the opportunity to live with a sense of dignity and do so as they see fit - something that is unavailable to many older people today.
In-home care makes it possible for millions of seniors to age in place every year. Rather than moving to a strange nursing home, seniors have the chance to stay at home where they feel the happiest and most comfortable.
How much does a senior's home truly mean to them?
A study published by the American Society on Aging found that more than half of seniors say their home's emotional value means more than how much their home is worth in monetary value. It stands to reason, then, that a senior's home is where they want to grow old.
With the help of elderly care in Ladera Ranch, CA, seniors don't have to age in a sterilized care facility. Instead, they can age gracefully in the place they want to be most: their home. In contrast, seniors who move to a long-term care facility must adapt to new environments, new people, and new systems that the facility implements. At this stage in life, this kind of drastic change can be more harmful than helpful.
Institutional care facilities like nursing homes often put large groups of people together to live in one location. On any given day, dozens of staff members and caregivers run in and out of these facilities. Being around so many new people in a relatively small living environment can be dangerous for a seniors' health and wellbeing. When you consider that thousands of seniors passed away in nursing homes during the COVID-19 pandemic, opting for in-home care is often a safer, healthier choice for seniors.
Aging in place has been shown to improve seniors' quality of life, which helps boost physical health and also helps insulate them from viral and bacterial risks found in elderly living facilities.
For many seniors, the ability to live independently with assistance from a caregiver is a priceless option. With in-home care, seniors experience a higher level of independence and freedom - much more so than in other settings like a nursing home. When a senior has the chance to age in place, they get to live life on their own terms, inside the house that they helped make into a home. More independence means more control over their personal lives, too, which leads to increased levels of fulfillment, happiness, and personal gratification. Over time, these positive feelings can manifest into a healthier, longer life.
More independence, a healthier life, and increased comfort are only a few benefits of aging in place. You have to take into consideration the role of cost and convenience. Simply put, it's usually easier and more affordable to help seniors age in place than it is to move them into an institutional care facility. According to the US Department of Housing and Urban Development, seniors who age in the comfort of their homes can save thousands of dollars per month.
In-home care services from Always Best Care, for instance, are often less expensive than long-term solutions, which can cost upwards of six figures per year. To make matters worse, many residential care facilities are reluctant to accept long-term care insurance and other types of payment assistance.
With Always Best Care's home care services, seniors and their families have a greater level of control over their care plans. In-home care gives seniors the chance to form a bond with a trusted caregiver and also receive unmatched care that is catered to their needs. In long-term care facilities, seniors and their loved ones have much less control over their care plan and have less of a say in who provides their care.
In-home care is a valuable resource that empowers seniors to age in place on their own terms. However, a big concern for many families and their loved ones is how much in-home care costs. If you're worried that in-home care is too expensive, you may be pleasantly surprised to learn that it is one of the most affordable senior care arrangements available.
Typically, hiring an Always Best Care in-home caregiver for a few hours a week is more affordable than sending your loved one to a long-term care facility. This is true even for seniors with more complex care needs.
At Always Best Care, we will work closely with you and your family to develop a Care Plan that not only meets your care needs, but your budget requirements, too. Once we discover the level of care that you or your senior need, we develop an in-home care plan that you can afford.
In addition to our flexible care options, families should also consider the following resources to help offset potential home care costs:
When you or your senior loved one needs assistance managing daily tasks at home, finding a qualified caregiver can be challenging. It takes a special kind of person to provide reliable care for your senior loved one. However, a caregiver's role involves more than meal preparation and medication reminders. Many seniors rely on their caregivers for companionship, too.
Our companion care services give seniors the chance to socialize in a safe environment and engage in activities at home. These important efforts boost morale and provide much-needed relief from repetitive daily routines. A one-on-one, engaging conversation can sharpen seniors' minds and give them something in which to be excited.
At Always Best Care, we only hire care providers that we would trust to care for our own loved ones. Our senior caregivers in Ladera Ranch, CA understand how important it is to listen and communicate with their seniors. A seemingly small interaction, like a short hug goodbye, can make a major difference in a senior's day. Instead of battling against feelings of isolation, seniors begin to look forward to seeing their caregiver each week.
Understanding the nuances of senior care is just one of the reasons why our care providers are so great at their job.
Unlike some senior care companies, our caregivers must undergo extensive training before they work for Always Best Care. In addition, our caregivers receive ongoing training throughout the year. This training ensures that their standard of care matches up to the high standards we've come to expect. During this training, they will brush up on their communication skills, safety awareness, and symptom spotting. That way, your loved one receives the highest level of non-medical home care from day one.
While it's true that many seniors prefer to age at home, sometimes in-home care isn't the best fit. For those seniors and their families, choosing an assisted living facility makes more sense. Unfortunately, finding the optimal care facility is easier said than done in today's day and age. That's when Always Best Care's assisted living referral services begin to make a lot of sense.
Assisted living is a form of housing intended for seniors who require varying degrees of medical and personal attention. Accommodations may include single rooms, apartments, or shared living arrangements. Assisted living communities are typically designed to resemble a home-like environment and are physically constructed to encourage the independence of residents.
At assisted living communities, seniors receive help with daily activities such as bathing, dressing, and eating. They may also benefit from coordination of services with outside healthcare providers, and monitoring of resident activities to ensure their health, safety, and well-being. Caregivers who work at assisted living communities can also provide medication administration and personal care services for older adults.
Other services offered within assisted living communities can include some or all of the following:
At Always Best Care, our representatives can match your senior's emotional, physical, and financial needs with viable assisted living communities nearby. Results are based on comparative data, so you can select the best choice for you or your loved one.
Always Best Care works closely with local senior living communities to gain valuable knowledge that we then use to help seniors and their loved ones make informed decisions. This information can include basic care and rent, resident availability, and services provided. Because Always Best Care is compensated by these communities, we provide senior living referral services at no extra cost to you.
Some of the most popular assisted living communities to consider in our area include the following:
For many seniors, moving into a senior living community revolves around how and when they want to make a transition to more involved care. Some seniors are more proactive about transitioning to independent living. Others choose to remain home until their care needs or other requirements are satisfied. Remember - our staff is here to help. Contact our office today to learn more about assisted living communities and how we can find a facility that exceeds your expectations.
The first step in getting quality in-home care starts with a personal consultation with an experienced Always Best Care Care Coordinator. This initial consultation is crucial for our team to learn more about you or your elderly loved one to discover the level of care required. Topics of this consultation typically include:
A discussion of your needs and how our trained caregivers can offer assistance in the most effective way
A draft of your care plan, which includes highly detailed notes and a framework for the care that you or your senior will receive
Discuss payment options and help coordinate billing with your insurance provider
Our caregivers are trained to spot changes that clients exhibit, like mental and physical decline. As your trusted senior care company, we will constantly assess and update your Care Plan to meet any new emotional, intellectual, physical, and emotional needs.
If you have never considered in-home care before, we understand that you and your family may have concerns about your Care Plan and its Care Coordinator. To help give you peace of mind, know that every team member and caregiver must undergo comprehensive training before being assigned to a Care Plan.
At the end of the day, we only hire the best of the best at Always Best Care. Whether you need home care in Ladera Ranch, CA 24-hours a day or only need a respite for a couple of hours, we are here to serve you.
When you're ready, we encourage you to contact your local Always Best Care representative to set up a Care Consultation. Our Care Coordinators would be happy to meet with you in person to get to know you better, discuss your needs, and help put together a personalized Care Plan specific to your needs.
Researchers at Cal State Fullerton have begun running tests on soil samples in Ladera Ranch.LADERA RANCH, CA — A chemistry lab at Cal State Fullerton is running tests on soil samples from one South Orange County town where a string of children have been diagnosed with a rare form of cancer, The Orange County Register reported.According to the newspaper, the samples were collected from several locations in Ladera Ranch — where the cases were reported — including Boreal Plunge Park, Wagsdale Dog Park and Town ...
LADERA RANCH, CA — A chemistry lab at Cal State Fullerton is running tests on soil samples from one South Orange County town where a string of children have been diagnosed with a rare form of cancer, The Orange County Register reported.
According to the newspaper, the samples were collected from several locations in Ladera Ranch — where the cases were reported — including Boreal Plunge Park, Wagsdale Dog Park and Town Green.
Three professors are leading what is called the initial phase of a voluntary research project at Cal State Fullerton, the newspaper said.
The effort will test for the presence of heavy metals in the samples, such as lead and arsenic, which were at one point common ingredients in since-outlawed pesticides, the report said.
The project comes after a string of Ladera Ranch children were diagnosed with Ewing sarcoma, a rare form of cancer, earlier this year.
In July, First Assistant U.S. Attorney for the Central District of California Bill Essayli called attention to the matter by asking the EPA to investigate the possible connection between the cancer cases and pesticide use in Ladera Ranch.
"There has been an unusual cluster of pediatric cancers in the Ladera Ranch community," Essayli wrote on X. "I am requesting that @EPA conduct an appropriate investigation into whether there are any environmental causes, and whether any federal environmental laws are implicated."
Daniel Curtis is one of three Cal State Fullerton professors currently analyzing soil samples.
"It's very difficult to prove causation, and we don't even know that this is environmental," Prof. Daniel Curtis told NBC Los Angeles. "It could be something else that's potentially causing childhood cancers, but what we want to do is figure out if there is something in the environment. We can figure out if it's here."
According to NBC, researchers at USC also agreed to conduct their own study on the Ewing sarcoma cases.
Ewing sarcoma is extremely rare — only about 200 to 250 cases are diagnosed each year nationwide, according to the National Organization For Rare Disorders.
Earlier this year, Ladera Ranch's community HOA placed a temporary ban on certain chemicals used in landscape maintenance.
Last week, HOA board members agreed to stop using the chemicals in high-traffic areas like parks, according to NBC los Angeles.
According to the outlet, while some research does suggest a link between pesticide use and Ewing sarcoma, there is so far no direct connection between pesticides and these types of cancer.
While no direct connection has been recorded, parents have been voicing concerns about the number of children suffering from the rare cancer.
"I think people need to listen and wake up and realize something is happening to our children," Jessica Keetch told NBCLA. "This is not random."
Keetch told the outlet that her 18-year-old daughter, Haven, had her right foot amputated after getting diagnosed with a rare cancer called synovial sarcoma, which health experts say affects about 1,000 people a year in the United States.
"I'll always remember that day," she said. "I'll cry thinking about it because it's the worst day for a parent you can ever have."
And Keetch's family isn't alone.
Megan Matteson, who also lives in Ladera Ranch, lost her son Brody in March after battling Ewing sarcoma and treatment-related leukemia, the New York Post reported.
"To have three families that just contacted me right away after Brody was diagnosed was helpful but scary at the same time," Matteson told the New York Post.
Earlier this week, Bond Legal announced it had launched an investigation into the cases, saying it is seeking information from familiar whose children lived in or regularly visited the Ladera Ranch community.
"The concentration of cases in a single community is deeply troubling, especially to those who live there," Bond Legal Managing Partner Candice Bond told the New York Post.
Assemblymembers Diane Dixon (R-Newport Beach) and Kate Sanchez (R-Mission Viejo) also joined in the call to investigate the cases this past summer.
"My position on the use of pesticides has been and will continue to be unequivocal and non-negotiable," Dixon said in a statement. "Those who use pesticides must uphold the highest safety standards and adhere to existing laws throughout Orange County."
Following NBC Los Angeles' reporting this month, First Assistant U.S. Attorney for the Central District of California Bill Essayli announced Thursday that he is requesting the Environmental Protection Agency to investigate the rare cancer cases affecting children in Ladera Ranch.NBCLA first reported that six children were diagnosed with Ewing sarcoma — a rare bone and soft-tissue cancer — but later learned of about a dozen rare cancer cases in children in Ladera Ranch and other Orange County cities. About 200 to 240 childr...
Following NBC Los Angeles' reporting this month, First Assistant U.S. Attorney for the Central District of California Bill Essayli announced Thursday that he is requesting the Environmental Protection Agency to investigate the rare cancer cases affecting children in Ladera Ranch.
NBCLA first reported that six children were diagnosed with Ewing sarcoma — a rare bone and soft-tissue cancer — but later learned of about a dozen rare cancer cases in children in Ladera Ranch and other Orange County cities. About 200 to 240 children and teens are diagnosed with Ewing sarcoma every year in the nation, according to the American Cancer Society.
Essayli said he wants the federal agency to look into possible environmental causes and whether federal environmental laws are implicated.
His letter to EPA Administrator Lee Zeldin cites NBCLA's July 8 reporting on families and residents voicing concerns about the number of cases in the Ladera Ranch community.
In the master-planned community of Ladera Ranch, parents like Jessica Keetch believe something is causing children to get cancer.
"I think people need to listen and wake up and realize something is happening to our children," Keetch said. "This is not random."
She said her 18-year-old daughter, Haven, had her right foot amputated after getting diagnosed with a rare cancer called synovial sarcoma, which health experts say affects about 1,000 people a year in the country.
"I'll always remember the day," Keetch said. "I'll cry thinking about it because it's the worst day for a parent you can ever have."
Megan Matteson, who also lives in Ladera Ranch, lost her son, Brody, in March to a rare cancer called Ewing sarcoma.
"To have three families that just contacted me right away after Brody was diagnosed was helpful but scary at the same time," Matteson said.
While there is no official cause-and-effect data linking pesticides and these types of cancers, families in Ladera Ranch are fighting for their community to use non-toxic pesticides.
Dr. Bruce Blumberg, a professor of developmental and cell biology at the University of California, Irvine, believes there is a link between these cancers and pesticides. He said there is data that shows a correlation between cancers and pesticide use.
"Unless there's a compelling reason to continue to use toxic chemicals, it makes a lot of sense to not use them," Blumberg said.
In 2016, he joined activists in fighting for Irvine to ban non-toxic pesticides and won. Irvine has since made exceptions to the rule for open spaces and trails.
"It's not as if we are talking about malaria. We are talking about weeds, for the most part, and I don't know why we should be so willing to use toxic chemicals to eliminate weeds when they can be pulled up or gotten rid of in a non-toxic way," Blumberg said.
Keetch and others in Ladera Ranch are urging their homeowners' association to find a safer alternative to toxic chemicals.
"These are our children. These are our babies," Keetch said. "I raised my children in Ladera, thinking it's safe. Maybe there's no safe community, but if we can do better, we need to do better."
In response to the announcement from Essayli, the Ladera Ranch Maintenance Corporation released a statement, saying it's temporarily halting the routine use of certain landscape maintenance products forweed management and plant growth regulation for 60 days.
"This temporary pause applies only to routine landscape maintenance applications within LARMAC-maintained common areas and does not affect activities necessary to protect public health and safety, such as rodent control or responses to invasive pests," the homeowners' association said.
The association said it's taking steps to increase transparency, including details involving the community's landscape management.
NBC Los Angeles has learned of about a dozen rare cancer cases in children in Ladera Ranch and other Orange County cities.In the master-planned community of Ladera Ranch, parents like Jessica Keetch believe something is causing children to get cancer."I think people need to listen and wake up and realize something is happening to our children," Keetch said. "This is not random."She says her 18-year-old daughter, Haven, had her right foot amputated after getting diagnosed with a rare cancer called syno...
NBC Los Angeles has learned of about a dozen rare cancer cases in children in Ladera Ranch and other Orange County cities.
In the master-planned community of Ladera Ranch, parents like Jessica Keetch believe something is causing children to get cancer.
"I think people need to listen and wake up and realize something is happening to our children," Keetch said. "This is not random."
She says her 18-year-old daughter, Haven, had her right foot amputated after getting diagnosed with a rare cancer called synovial sarcoma, which health experts say affects about 1,000 people a year in the country.
"I'll always remember the day," Keetch said. "I'll cry thinking about it because it's the worst day for a parent you can ever have."
Megan Matteson, who also lives in Ladera Ranch, lost her son, Brody, in March to a rare cancer called Ewing sarcoma.
"To have three families that just contacted me right away after Brody was diagnosed was helpful but scary at the same time," Matteson said.
While there is no official cause-and-effect data linking pesticides and these types of cancers, families in Ladera Ranch are fighting for their community to use non-toxic pesticides.
Dr. Bruce Blumberg, a professor of developmental and cell biology at the University of California, Irvine, believes there is a link between these cancers and pesticides. He says there is data that shows a correlation between cancers and pesticide use.
"Unless there's a compelling reason to continue to use toxic chemicals, it makes a lot of sense to not use them," Blumberg said.
In 2016, he joined activists in fighting for Irvine to ban non-toxic pesticides and won. Irvine has since made exceptions to the rule for open spaces and trails.
"It's not as if we are talking about malaria. We are talking about weeds, for the most part, and I don't know why we should be so willing to use toxic chemicals to eliminate weeds when they can be pulled up or gotten rid of in a non-toxic way," Blumberg said.
Keetch and others in Ladera Ranch are urging their homeowners' association to find a safer alternative to toxic chemicals.
"These are our children. These are our babies," Keetch said. "I raised my children in Ladera, thinking it's safe. Maybe there's no safe community, but if we can do better, we need to do better."
The Ladera Ranch Maintenance Corporation met last week and says it is now forming a committee to review its landscaping practices.
New statistics on child cancer cases in Orange County from California officials have sparked more questions from Ladera Ranch residents."Everyone wants to know if there's really something behind it or if it's just a random statistical anomaly," Ladera Ranch resident Robert Messer said.Residents are anxious for answers from the California Department of Public Health after families said several children have been diagnosed with the rare Ewing sarcoma cancer."It seems like it's an unreal number of kids sick,&...
New statistics on child cancer cases in Orange County from California officials have sparked more questions from Ladera Ranch residents.
"Everyone wants to know if there's really something behind it or if it's just a random statistical anomaly," Ladera Ranch resident Robert Messer said.
Residents are anxious for answers from the California Department of Public Health after families said several children have been diagnosed with the rare Ewing sarcoma cancer.
"It seems like it's an unreal number of kids sick," resident Karen Smith said. "We want to know what is the true cause. There's a lot of information out there that might not be true."
The California Cancer Registry confirmed that there are fewer than 11 cases in Ladera Ranch but didn't specify when the children were diagnosed or how the numbers compare to Ewing sarcoma cases in similar communities. The latest numbers county officials have date back to 2021 and cover a ten-year period.
"There are 35 cases in Orange County as of 2021," Orange County Supervisor Katrina Foley said. "I have asked multiple times, can we get a map that shows that pinpoints where these 35 cases are in Orange County? So far, no one has been able to get me that information. So, we don't even know how many cases truly are in Ladera."
The numbers from 2012 to 2021 were similar statewide and in Orange, Los Angeles and San Diego counties, with fewer than one case per 100,000 kids.
"Has that number grown?" Foley asked. "If it has grown, has it grown to a significant incident that it would be a cause for alarm. We need answers so that we can plan. So that we can protect the public health."
Recently we read with concern about an apparent cluster of Ewing sarcoma cases, and possibly other rare pediatric cancers, in Ladera Ranch. We are writing as two epidemiologists who seek to understand the causes of childhood cancers to offer our advice and expertise to the community and the authorities conducting the investigations now under way.First, it is important to understand that the number of cases alone does not indicate an increased rate. To determine the rate of Ewing sarcoma in Ladera Ranch children requires establishing t...
Recently we read with concern about an apparent cluster of Ewing sarcoma cases, and possibly other rare pediatric cancers, in Ladera Ranch. We are writing as two epidemiologists who seek to understand the causes of childhood cancers to offer our advice and expertise to the community and the authorities conducting the investigations now under way.
First, it is important to understand that the number of cases alone does not indicate an increased rate. To determine the rate of Ewing sarcoma in Ladera Ranch children requires establishing the population denominator, i.e. the number of children at risk of the disease.
Media reports suggest the first Ewing sarcoma case in Ladera Ranch was diagnosed in 2007, thus the denominator will include far more people than just the present pediatric population of the town. Investigators will calculate the rate of Ewing sarcoma in Ladera Ranch and compare it to the rate in all of Orange County or California. It is not guaranteed that properly calculated population rates will support the community’s perception of a cluster.
Should the rate of Ewing sarcoma be found to be elevated in Ladera Ranch we do support an investigation of potential causes in order to allay community concerns, but it is important to manage expectations about what cluster investigations can and cannot reveal.
In 2012, scientists reviewing the prior 20 years of state and federal investigations put it succinctly: “It is fair to state that extensive efforts to find causes of community cancer clusters have not been successful.”
Subsequently they made recommendations on how to improve investigations, for instance by incorporating modern innovations like tumor sequencing, which we endorse.
No amount of scientific sophistication, however, can overcome the fundamental problem facing any cluster investigation, namely the small absolute numbers of cases. At the turn of the century there were up to 16 cases of childhood leukemia diagnosed in Fallon, Nevada versus 1 or 2 expected. Despite spending millions of dollars investigating this highly improbable event the authorities found no clear cause.
The community of Ladera Ranch is particularly concerned about pesticide use as a potential cause of Ewing sarcoma.
We have published studies examining pesticide exposure and some childhood cancers and agree that they may contribute to causation of a number of cancer types, but Ewing sarcoma is not one of them. The evidence base connecting environmental chemicals of any kind to Ewing sarcoma is very thin. It is important to understand that even if pesticide exposure doubled or tripled the incidence of Ewing sarcoma that is not likely to result in a “cluster.”
At its peak in adolescence the rate of Ewing sarcoma is about 7 cases per million children and three times that rate is still exceedingly rare. Pesticides are used in many other areas of Orange County and California (the US state with highest pesticide usage, particularly in the Central Valley) without having led to other apparent clusters, which also argues against them being a strong cause of Ewing sarcoma.
None of this is to say that pesticides are harmless or that they should continue to be used in Ladera Ranch, but we think it very unlikely any investigation is going to provide definitive proof that pesticides caused these cases of Ewing sarcoma among the town’s children.
The most valuable and informative part of the investigation will instead be the comparison of the Ladera Ranch cases to the larger Ewing sarcoma population. Do they look the same or different in terms of demographics, age at diagnosis, location of tumor, etc? Particularly if it is possible to sequence their tumor and normal DNA then investigators will be able to say if anything is out of the ordinary among patients in the town.
It is natural for people to feel that there must be a cause behind uncommon occurrences but this instinct is frequently wrong. It is human nature to draw a circle around an apparent cluster of events that appears nonrandom, which can lead to what is commonly called the “Texas sharpshooter” fallacy.
As two scientists who study probability we can tell you that coincidence can, in fact, be the reason for an apparent cluster. This is because in a country the size of the United States it is likely that cases will randomly occur closely in time and space somewhere over the course of a few decades, even if it is very improbable to have happened in Ladera Ranch specifically.
We look forward to a thorough scientific investigation of Ewing sarcoma and other pediatric cancers in Ladera Ranch and hope the community understands the limits of what science can tell them about the reasons this awful disease befell their children.
Dr. Logan G. Spector is professor of pediatrics at the University of Minnesota Medical School. Dr. Joseph Wiemels is professor of population and public health sciences at the Keck School of Medicine of USC. They are the chair and a member, respectively, of the Childhood Cancer and Leukemia International Consortium.
949.705.6501
