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JAMDA
March 1, 2020

The burden of polypharmacy has become an increasing challenge in long-term care (LTC). Multiple medications prescribed may increase the risk of adverse drug events, such as falls and hospital transfers, especially for frail older adults with cognitive impairment. Deprescribing interventions, such as medication reviews, education for healthcare providers and patients, and electronic deprescribing tools can reduce polypharmacy by initiating dosage reduction and discontinuation of potentially inappropriate medications (PIM).

JAMDA
March 1, 2020

Interdisciplinary (ID) care plan meetings are a key component of nursing home care in 2019. Initially established as a didactic technique for teaching graduate nurses in the 1930s, the care plan has gone through many iterations to make it what it is today. Today, as part of CMS regulations, each long-term care (LTC) facility must “develop and implement a baseline care plan for each resident” and “…each resident has the right to participate in choosing treatment options and must be given the opportunity to participate in the development, review and revision of his/her care plan.” Based upon...

JAMDA
March 1, 2020

Transitions across healthcare settings lead to unintentional errors, rehospitalizations, and mortality, and a key reason is poor communication between care settings. We developed a weekly telehealth videoconference to facilitate a virtual care conference meeting between hospital-based and skilled nursing facility (SNF) provider teams to optimize error-prone transitions.

JAMDA
March 1, 2020

Symptoms of delirium are common in the post-acute care setting, particularly in patients who have dementia or are approaching the end of life. When behavioral measures fail to adequately manage symptoms, there are few alternative options. Antipsychotic medications have long been the mainstay of pharmacologic treatment for delirium, despite a paucity of evidence for efficacy and newer data suggestive of possible harms. Moreover, the use of a new antipsychotic medication in veterans admitted to a short-term rehabilitation center is seen as potentially inappropriate and negatively affects the...

JAMDA
March 1, 2020

There has been a growing emphasis towards emotional well-being in the care of older adults. This is especially important with regards to residents in a nursing home, where they can often feel marginalized or depressed. The aim of this study is to evaluate the effectiveness of pet-therapy in improving the mood and well-being in this subset of the population.

JAMDA
March 1, 2020

Many patients are discharged to post-acute care facilities (PACFs) following surgery. These patients have either had major surgery and require close monitoring and intensive rehabilitation, or have significant medical co-morbidities. Currently they are transported, sometimes at considerable cost, to the surgeon’s office for post-surgery visits (PSVs). These trips can be painful and uncomfortable. A staff member from the PACF may need to accompany the patient. During PSVs surgeons observe the patient's incision(s), and assess potential complications following surgery, pain, and functional...

JAMDA
March 1, 2020

VA CLCs are surveyed per Centers for Medicare and Medicaid Services (CMS) regulations by the Long-Term Care Institute (LTCI). With the accreditation focus being primarily on The Joint Commission survey process, we found that many at our facility were unfamiliar with the LTCI survey process. In addition, at the start of fiscal year (FY) 18, LTCI took over responsibility for surveying of Life Safety Code regulations for the CLCs in conjunction with the clinical survey.

JAMDA
March 1, 2020

It is critically important to ensure quality care and social support for older adults within long-term care (LTC) and assisted living (AL) facilities. Studies have demonstrated that a higher frequency of visits by family improves the psychosocial status and well-being of residents. Of the limited studies on familial relationships with LTC and AL residents, even fewer studies address the role of modern communication methods.

JAMDA
March 1, 2020

Nursing home (NH) residents are at increased risk for malnutrition compared to community-dwelling older adults. Poor nutrition is associated with depression, functional decline, and higher 1-year mortality. Communal dining environments create a social dining atmosphere that increases the amount of food being consumed.

JAMDA
March 1, 2020

Clostridioides difficile (C. difficile) definition: “a germ (bacteria) that causes life-threatening diarrhea. It is usually a side-effect of taking antibiotics.” According to the Centers for Disease Control and Prevention (CDC) 2015 report, over 100,000 C. difficile infections (CDI) occur in the U.S. nursing home population yearly. Approximately 29,000 patients died 30 days post-diagnosis of CDI with about 15,000 deaths being directly attributable to CDI; over 80% of mortalities related to CDI happen in residents aged 65 and above.