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Caring for the Ages
June 1, 2019

July is almost here, the month that begins the medical year. July 1 is the day the new interns start their rotations at the hospital, perhaps not the best time to be in the hospital if you can avoid it. It’s also the day my mother died in a local (Carlsbad, CA) nursing facility 10 years ago, after a remarkable, agonizing, exquisite 17 days with no food or fluids where my three adult siblings, other loved ones and I shared the bedside vigil and many fond reminiscences for much longer than we’d anticipated.

Caring for the Ages
June 1, 2019

The Patient Driven Payment Model (PDPM) will take effect on October 1, 2019. This not only represents a major change in how skilled nursing facilities are reimbursed; it also will significantly impact the dynamic between clinicians and the facilities they serve.

Caring for the Ages
June 1, 2019

Increasing numbers of patients are referred to skilled nursing facilities, or SNFs, following discharge from the hospital. A new model, however, can help predict as early as the day of admission which patients are likely to require discharge to a SNF, according to a retrospective cohort study.

Caring for the Ages
June 1, 2019
Caring for the Ages
June 1, 2019

Mrs. G is an 80-year-old white female who has lived in assisted living for several years. She scores 24 on the Saint Louis University Mental Survey (SLUMS), indicating that she has some mild cognitive impairment, and she is independent with bathing and dressing, although she needs encouragement to shower and to change clothes regularly. She is often anxious, as exhibited by her repeated requests for help in the evenings, and she has made multiple complaints of vague pain, shortness of breath, and difficulty sleeping.

Caring for the Ages
June 1, 2019

Dear Dr. Jeff:

Caring for the Ages
June 1, 2019

“Back in the hospital again?! Impossible! I sent her home with information, handwritten instructions, and spoke to her for some time regarding how to take her medications and follow up. She smiled when I asked if she understood everything and said, ‘Yes!’ After all that, she did not take her meds as directed or return to the office as scheduled. I just don’t know how to overcome noncompliant patients!”

Caring for the Ages
June 1, 2019

We recently celebrated two days that are near and dear to my heart, but not to as many others as I would hope: the National Day of Recognition for Long-Term Care Physicians and Doctors’ Day. The initial intent of this piece was to seek your continuing support for the Foundation for PALTC Medicine. However, in the spirit of these two “holidays,” I feel the need not to ask you for anything, but to give to you today.

Caring for the Ages
June 1, 2019

Sleep-disordered breathing is a common but underrecognized problem in the post-acute and long-term care (PALTC) setting, with an estimated prevalence of 25% to 50%. It’s also common in patients with congestive heart failure (CHF) — with either reduced or preserved ejection fraction — and it worsens with both CHF exacerbation and the progression of CHF severity.

Caring for the Ages
June 1, 2019

Non-motor symptoms — and fluctuations in these symptoms — are a surprisingly common and often disabling part of life for residents with Parkinson’s disease (PD), said Julie Gammack, MD, CMD, at the annual conference of AMDA — The Society for Post-Acute and Long-Term Care Medicine in Atlanta, GA.