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Caring for the Ages
October 1, 2019

Annual Conference

Caring for the Ages
October 1, 2019

The Dover Park Hospice in Singapore asked me to visit their hospice to observe how they had adapted Namaste Care, a program I had developed for people with advanced dementia. Originally it was a small group program for nursing homes, but now it has expanded and can be found in care homes and hospice organizations all over the world. On the first day of my visit, I was asked to observe a Namaste Care session. Five social workers were giving five patients hand massages. The room was perfect — very lovely and homelike — and calming music was playing.

Caring for the Ages
October 1, 2019

Mrs. B is a 100-year-old white female with a history of dementia, squamous cell carcinoma to the bilateral lower extremities, and venous insufficiency. She is no longer able to verbally express her opinions or desires, although she recognizes familiar faces and engages with others. She requires minimal assistance with transfers and ambulates with a front-wheeled walker. She is resistant and combative with care (usually hitting staff), especially during dressing, bathing, and transferring.

Caring for the Ages
October 1, 2019

It is a cardinal fact that if one wishes to perpetuate any given behavior, then that behavior needs to be rewarded. A simple “thank you” or “you made a difference in the care of me or my loved one” from a family or resident is always welcome for those of us in the post-acute and long-term care (PALTC) continuum. Even better, a mention by a meaningful person in the facility (a colleague, the director of nurses, the administrator, or others) that you made a great diagnosis, started a meaningful program, or touched the life of a resident in a positive way makes the week better and brings a...

Caring for the Ages
October 1, 2019

A new study covering almost all nursing home residents in Ontario, Canada, has shown highly variable urine culturing rates across facilities and a strong association of culturing with antibiotic use and Clostridioides difficile infection — a diagnostic “cascade effect,” the authors reported.

Caring for the Ages
October 1, 2019

Phase 3 of the revised Medicare and Medicaid Requirements of Participation for long-term care, which will go into effect next month, require skilled nursing homes to provide “trauma-informed care (TIC),” an approach to care that factors in the pervasive nature of trauma and establishes safe and nurturing environments where residents won’t be retraumatized. However, the Centers for Medicare & Medicaid Services haven’t yet provided guidance on this directive, so trying to comply may feel like completing a jigsaw puzzle without all the pieces.

Caring for the Ages
October 1, 2019

Enrollment in nursing schools is up as more people — men and women alike — see this as an exciting field where they can have a rewarding career and job security. However, while nursing schools are attracting more students, too few of their graduates are choosing to practice in post-acute and long-term care (PALTC). As a result, a perfect storm is brewing: a rapidly growing over-65 population, a large number of nurses nearing retirement age, and not enough students choosing this specialty. PALTC communities and their team leaders are scrambling to find creative ways to attract more nurses...

Caring for the Ages
October 1, 2019

Practitioners are already beyond busy addressing all the clinical and regulatory demands on them. So why should they take the time to hone their leadership and management skills? Michael Wasserman, MD, CMD, president of the California Association of Long Term Care Medicine (CALTCM), suggested during a recent On-The-Go podcast for AMDA — The Society for Post-Acute and Long-Term Care Medicine that practitioners increasingly are expected to take leadership roles, so these skills are essential. “We are delivering clinical care to the most complex population in history, and more care is being...

Caring for the Ages
October 1, 2019

“Caring Collaborative” is more than the catchy title of our regular editors’ column for Caring for the Ages — it is meant to be a guide for our work. Today’s post-acute and long-term care (PALTC) environment requires a caring collaborative among a range of disciplines to be successful. This is so very different than the past PALTC environment with its fee-for-service, acute care, siloed focus, which was typically run by community physicians who worked independent of other disciplines.

Caring for the Ages
October 1, 2019

There is a well-known association between transitions of care and medication-related problems, notably in the form of adverse drug events. Although we have limited evidence-based information on this topic in assisted living facilities (ALFs), some of what we’ve learned from transitions of older adults to nursing homes provides useful insight into what we can expect.