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JAMDA
March 1, 2016

Behavioral and psychological symptoms of dementia (BPSD) are common in patients with dementia who are admitted to assisted living facilities. These symptoms place a large burden on the staff and care providers of such patients to ameliorate such elusive affects, especially since there are no FDA approved drugs to treat BPSD. Recently, personalized music therapy (PMT) has been touted as a safe, inexpensive, and non-pharmaceutical intervention for dementia.

JAMDA
March 1, 2016

The most common infection in the nursing facility (NF) setting is suspected urinary tract infection. Up to 50% of NF residents have asymptomatic bacteriuria (ASB). Treatment of ASB is unnecessary and increases the risk of adverse drug events, C. Difficile infection and antimicrobial resistance. Inappropriate ordering of urine cultures is a prime factor leading to overtreatment.

JAMDA
March 1, 2016

Readmission following discharge is a concern for hospitals, payers, and veterans. Programs targeting single diseases for readmission reduction may miss opportunities to address the complex relationships between multiple domains of care.

JAMDA
March 1, 2016

In 2013, 10% of Medicare total program outlays went to spending on post-acute care, a large portion of which can be attributed to Skilled Nursing Facilities (SNFs). These expenditures are partially due to high length-of-stays (LoS), an issue many are afraid to combat due to the threat of re-hospitalization. Recurrent hospitalizations represent a substantial and often preventable human and financial burden in the United States and have become a major focus point for the Centers for Medicare and Medicaid Services.

JAMDA
March 1, 2016

A care transition represents a vulnerable time for older adults, especially those experiencing cognitive or functional impairment, low health care literacy, multiple chronic conditions, or lack of caregiver support. Integrated and home-based geriatric care management has been shown to improve quality of care and reduce acute care utilization among high-risk members.

JAMDA
March 1, 2016

PPI use has increased over the years. Once begun, PPIs tend to be used for long periods without clear therapeutic intent. PPIs are generally safe but long term use is linked to nutritional deficiencies, infections, fractures and more. It is hence relevant to avoid excessive and inappropriate use of PPIs in long-term care (LTC) settings.

JAMDA
March 1, 2016

Hospitals and skilled nursing facilities (SNF) face growing financial pressure to decrease readmission rates. Transitional care has proven effective for patients with chronic conditions across healthcare settings, typically from the hospital to home or from the hospital to SNF. However, it is rarely implemented when transitioning a patient from SNF to home. Many of these patients are placed in SNF after hospital discharge because of significant co-morbid conditions that place them at high risk for readmission, and many of the factors causing the risk are still present at discharge from SNF...

JAMDA
March 1, 2016

In 2012, ∼25% of skilled nursing center residents nationwide were prescribed antipsychotics, despite a 2005 Federal Drug Administration “black box” alert warning that these medications may increase residents' risk of heart failure, sudden death, and pneumonia. Although experts agree that non-pharmacologic measures (such as environmental modifications) are preferable to medications, there is little guidance about what staff should do in lieu of prescribing medications. As a result, Maine nursing center leaders developed the Curtailing Antipsychotic Medications in LTC Medicine (CALM)...

JAMDA
March 1, 2016

Patients receive medical care in a variety of settings including long-term care (LTC) nursing facilities, assisted living facilities, transitional care facilities, and private homes. The number of patients who require skilled nursing care either at home or in a LTC facility will increase in the coming years as the number of older adults and the complexity of their medical conditions increases. Clinicians who care for these patients outside of the clinic often lack standard medical equipment and supplies, which can lead to significant interruptions in patient care or incomplete care...

JAMDA
March 1, 2016

National antipsychotic use in the long-stay residents has declined to 19% now. Efforts are underway to reduce this rate even further. In specialized dementia units, however, where patients with BPSD are concentrated, medication use rates are expected to be much higher. Additionally, other psychotropic medications are often utilized in the management of BPSD. There is scarcity of data regarding the use of all psychotropic medications and regarding prevalence of medication use and outcomes in specialized dementia units setting.