Showing papers in "Journal of the American Medical Directors Association in 2004"

TL;DR: The article shows that the combination of the medical knowledge of family physician and nursing home physician can be expected to increase the quality of medical care for the disabled elderly in institutions and in the community.

TL;DR: This article attempts to prevent potential errors in the clinical assessment of decision-making capacity, thereby supporting patients' right to make choices about their own health care.

TL;DR: In this article, the authors explore barriers to sexual expression in the nursing home setting and discuss strategies to overcome them and discuss the need for love, intimacy, and companionship for the elderly.

TL;DR: Preliminary results suggest that behavioral disturbances play a role in low body weight and weight loss in AD subjects and that those who lost weight had a significantly higher BMI at baseline than those who gained weight.

TL;DR: In this article, the authors defined the accuracy of the clinical diagnosis of dehydration during hospital admission, and to observe persons admitted from long-term care, and they found that at least a third of the diagnoses of volume depletion in older adults were incorrect based on laboratory data.

TL;DR: Nursing homes are faced with a potential fiscal incentive to tube-feed residents with advanced dementia: tube-fed residents generate a higher daily reimbursement rate from Medicaid, yet require less expensive nursing home care.

TL;DR: The level of care provided for patients by the two groups of providers was basically the same and of similar quality; however, the nurse practitioner/physician group patients were seen more often.

TL;DR: The study provides some support for the feasibility of CPG implementation in facilities that voluntarily attempted to implement the guidelines.

TL;DR: A new and potentially important link between anemia and the risk of falls in patients sustaining hip fractures from both nursing homes and the community is suggested.

TL;DR: Residents with diabetes could be one of the most "heavy care" groups in nursing facilities, as demonstrated by their levels of functional disability and prevalence of serious comorbid conditions.

TL;DR: Ways to dealing with inappropriate sexual behaviors in long-term care settings and the ethical issues involved are discussed.

TL;DR: Federal Guidelines (OBRA ‘87) indicate that the use of antipsychotics for behavior problems in dementia in the absence of true psychosis is to be discouraged, and the recently released American Academy of Neurology Guidelines suggest that atypical agents could be better tolerated compared with traditional agents.

TL;DR: The substantial number and types of services provided by these NPs, coupled with the high resident, family, and physician satisfaction with their services, suggests the need for educational, policy, and reimbursement strategies to encourage the further involvement of NPs in the care of residents in nursing homes.

TL;DR: The findings suggest that gross hearing impairment is undetected in clinical practice in over half of the residents of a large, mid-Atlantic nursing home, and highlight the need for regular hearing assessments in the nursing home population.

TL;DR: There is a major need to increase the utilization of calcium and vitamin D supplementation among institutionalized elderly to decrease the risk of osteoporotic fractures, including hip fractures.

TL;DR: Barriers to hearing aid use are complex and multifactorial, involving lack of system commitment to utilization of hearing aids, lack of knowledge by staff members, inappropriate delegation and care procedures, hearing aid design and fit issues, and difficulties for residents in handling the hearing aids.

TL;DR: The data suggest that diabetes risk is elevated among elderly patients receiving antipsychotic treatment, and as a group, the risk for atypical antipsychosis users was not significantly different than for users of conventional antipsychotics.

TL;DR: The standard definition of OH was not an independent predictor of falls in frail nursing home residents and the timing and degree of orthostatic changes in blood pressure does not significantly enhance risk prediction for falls.

TL;DR: The article defines and describes the particular value of ACP in long-term care facilities, reviews the literature on successful ACP programs in long)-term care, and concludes with practical suggestions on how to develop and implement ACP Programs.

TL;DR: This study demonstrates that interinstitutional transfers are common in older patients, and the majority of these transfers occurred within the first 3 months after hospital discharge for both payment groups.

TL;DR: It is suggested that Megace ® OS is not an effective nutritional intervention to increase oral intake under usual NH care conditions, which is often characterized by inadequate feeding assistance, but in combination with optimal mealtime feeding assistance does significantly increase Oral intake in a frail NH sample at high risk for weight loss.

TL;DR: Quality of care for UI provided to vulnerable older patients, particularly by primary care providers alone, is inadequate, despite the proven effectiveness of patient-dependent behavioral treatments, physicians rarely prescribe these interventions for UI.

TL;DR: This patient is an 85-year-old woman with a history of hypertension, depression, essential tremor, and pulmonary embolus who was admitted to a nursing home after a prolonged hospitalization for a systemic infection with oxacillin-resistant Staphylococcus aureus.

TL;DR: The frequency and context of assaults against nursing assistants from residents and to describe NAs' beliefs about their violence prevention knowledge and self-efficacy to prevent assaults from residents provide useful information that supports the need for violence prevention education and for developing violence prevention programs in nursing homes.

TL;DR: There is a need for heightened osteoporosis surveillance and preventive effort in this population in which almost half of the residents had previously undiagnosed subnormal BMD, including one sixth who had osteoporeosis.

TL;DR: Effective bidirectional communication between attending physicians and long-term care facilities is of critical importance to ensure timely, appropriate, and high-quality care that is responsive to residents' needs, values, and preferences.

TL;DR: In this article, the authors describe a cost-effective strategy for management of constipation in nursing home residents with dementia using osmotic laxatives, which avoids the costs and discomforts of rectal laxatives.

TL;DR: High climate temperature could have a negative impact on behavior in demented patients and the possible mechanisms of the negative impact of high climate temperature on behavior are proposed.

TL;DR: Frail elderly people residing in LTC facilities are more susceptible to developing a number of morbidity-inducing conditions and infections, so LTC physicians and health care professionals must focus on fluid and electrolyte balance as much as on essential nutrients such as calories and vitamins.