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JAMDA
March 1, 2016

Presbyphagia is common in nursing home residents due to age and common comorbid conditions. In an attempt to avoid aspiration during acute illness, initial inpatient hospital orders may designate NPO (Nil Per Os, or nothing by mouth) status until the swallowing ability can be evaluated by a speech therapist. This places patients at risk for medication withdrawal syndromes.

JAMDA
March 1, 2016

Hospice care plays an important role in the management of terminally ill patients in long-term care. The ability to predict six-month mortality in patients with progressive neurological illnesses is problematic. This case illustrates this difficulty, emphasizes the importance of shared goals of care, and highlights the need for open communication between the primary physician and the hospice team.

JAMDA
March 1, 2016

Falls in the elderly are associated with significant morbidity and mortality, reduced function and loss of independence. In nursing homes, over half of residents who can ambulate fall at least once a year and the biggest risk factor for falls is previous falls. We present a case of falls, mutifactorial in etiology, that responded to simple non-pharmacological interventions.

JAMDA
March 1, 2016

Multiple risk factors and atypical clinical presentations make accurate diagnosis a challenge in nursing home residents.

JAMDA
March 1, 2016

Osteoporosis is a silent disease, until fractures occur. Based on BMD criteria alone, osteoporosis is widely prevalent, estimated to be 10.2 million among non–institutionalized individuals in the United States in 2010. This prevalence is much higher than what is estimated. Being a disease of aging, osteoporosis is widely rampant in the nursing home, seen in 70-85% of nursing home residents. Unfortunately, only 9.1-11.5% of post-fracture patients are on anti-osteoporosis medications. We present a common clinical scenario of an elderly woman with untreated osteoporosis who undergoes short...

JAMDA
March 1, 2016

Skin tears are very common in the institutionalized elderly. Appropriate wound care and monitoring for skin tears is important. Non-healing skin tears should be biopsied to rule out malignancy.

JAMDA
March 1, 2016

Adverse bleeding events are higher in patients treated with anti-platelet therapy (APT) combined with anti-coagulation therapy (ACT) than with either alone. Currently, there is no clear evidence that the combination of APT and ACT decreases the risk of stroke, systemic embolism, or myocardial infarction compared with anticoagulation alone. The following case exemplifies a not-uncommon scenario of combination anti-thrombotic therapy contributing to a hospitalization for a frail nursing home resident.

JAMDA
March 1, 2016

Two cases of VTE were observed within a six month period in geriatric orthopedic patients in the post-acute care setting who received appropriate prophylaxis. We then reviewed the literature and current guidelines to determine if such events could be prevented.

JAMDA
March 1, 2016

Young-onset dementia (YOD) is defined as dementia that develops before the age of 65. Neuropsychiatric symptoms (NPS) have important clinical consequences for patients and their family members. To date, knowledge about the prevalence and correlates of NPS in YOD is limited, but essential to establish specific tailored care for patients with YOD. The aim of this study was to explore the prevalence and correlates of NPS in nursing home residents with YOD.

JAMDA
February 28, 2016

To assess the long-term mortality risk associated with antipsychotic drug (AP) use in nursing homes.