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JAMDA
March 1, 2020

Behavioral Psychological Symptoms of Dementia (BPSD) are described as symptoms of apathy, agitation, inappropriate vocalization, aggression, wandering, and resistiveness to care. Not managing BPSD appropriately can cause an increase in frustration, stress, and burnout amongst staff members, and negatively impacts the health and quality of life for residents with dementia. Psychotropic medications are often administered to residents with BPSD in long-term care facilities and can lead to adverse effects such as an increase in falls, mortality, cardiovascular events, and hospitalizations.

JAMDA
March 1, 2020

Individuals with dementia who exhibit adverse behaviors are often treated with psychotropic medications despite harmful side effects and recommendations to use non-pharmacological interventions. Cognitive Stimulation Therapy (CST) has consistently been shown to improve cognitive functioning and quality of life (QOL) in individuals with mild to moderate dementia, and reduce the number of adverse behaviors.

JAMDA
March 1, 2020

The geriatric population is at high risk of severe low blood glucose (LBG) events due to diminished homeostatic mechanisms, especially on hypoglycemic medications. Moderate to severe LBG events in these patients can contribute to behavior changes such as agitation, change in level of consciousness, disruption of sleep, instability and increased risk of myocardial infarction, stroke and falls. Rapid recognition and appropriate treatment and prevention of LBG and recurrences can reduce risk for hospitalization in the geriatric population.

JAMDA
March 1, 2020

Hospitalizations from senior living facilities result in complications, morbidity, and Medicare expenditures of over 1 billion dollars annually. Lack of after-hours, on-site physician availability in these facilities may contribute to avoidable emergency department (ED) visits and hospitalizations. Often, when unable to evaluate a patient visually, the on-call provider may opt to send the patient to the ED for further evaluation. This, in turn, puts patients in an unfamiliar, noisy environment, increasing rates of delirium and causing a significant stress burden on the patient, not to...

JAMDA
March 1, 2020

Parkinson’s disease (PD) is a multifaceted condition that impacts a wide range of functions, including speech. The effect of loss of communication ability creates a cascade of effects which includes decreased participation in social events, social isolation, and potentially depression. If improvements in voice occur, the cascade can be diverted. A physiological basis, as well as research evidence, supports use of singing to improve voice of those with PD. The implementation of a choir for those with PD has the potential to provide a socially engaging intervention, which is cost effective...

JAMDA
March 1, 2020

Patients who transition from hospital to skilled nursing facilities (SNF) frequently require home healthcare (HHC) services upon discharge to home. The certifying physician must document that he or she, or an allowed non-physician practitioner (NPP), has had a face-to-face encounter (FTF) with the patient to document patient’s homebound status and need for skilled services, and sign the plan of care. Given that a university-affiliated home health care agency (U-HHC) and the university-affiliated providers caring for patients in SNF share the same electronic health record, incorporating the...

JAMDA
March 1, 2020

Hand washing has been established as the single most effective way to significantly reduce the transmission of infections within healthcare facilities. Rising higher complexity of patients, multi-drug resistant infections, and increasing need for broad spectrum antimicrobial therapies have been well documented at post-acute and long-term care settings. Proper hand washing education and organized hand hygiene audit tools could have a great impact on reducing the spread of infections, decreasing the utilization of antimicrobials, and achieving overall good patient outcomes.

JAMDA
March 1, 2020

A significant proportion of skilled nursing facility residents hold at least 1 psychiatric diagnosis. Newer, revised Centers for Medicaid and Medicare Services (CMS) definitions, regulations, and limits regarding psychotropic use in skilled nursing facilities necessitate novel solutions for non-pharmacologic management of behavioral symptoms arising from conditions commonly seen in this setting.

JAMDA
March 1, 2020

With health systems growing in size and complexity, older adults who seek medical care are forced to navigate the difficult terrain of the emergency room (ED), possible hospitalization and/or re-hospitalization, and skilled nursing facility (SNF) rehabilitation before returning home. With each transition, patients experience different providers, settings, medications, and medical needs. Additionally, patients and providers experience a lack of communication, inadvertent medication errors, and lost information.

JAMDA
March 1, 2020

Chronic Obstructive Pulmonary Disease (COPD) will become the 3rd leading cause of death worldwide in 2020 and is currently the 3rd leading cause of hospital readmissions in the US. In October 2014, the Centers for Medicare and Medicaid Services (CMS) introduced penalties followed by bundle payments for care improvement initiates in patients hospitalized with an acute exacerbation of COPD (AECOPD). Fragmented care across settings cause readmissions for COPD. A patient-tailored case management initiative mitigated 30-day hospital readmissions at Sub-Acute Rehabilitation (SAR) centers.