Hip Fracture Decisions for Nursing Home Residents with Dementia

This article should lead you to talk to your trauma surgeons and/or orthopedists to develop a routine palliative care or hospice consultation for these patients.Robert Arnold, MD is a palliative care doctor at the University of Pittsburgh and a co-founder ofVitalTalk (@VitalTalk). He loves both high and low brow comedy (The Good Place and Nanette), pop culture (the National Enquirer and Pop Culture Happy hour) and music of all kinds (not opera tho!) You can find him onTwitter at @rabob. MorePallimed posts from Bob Arnold can be found here. Morejournal article reviews can be found here. References1. Berry SD, Rothbaum RR, Kiel DP, Lee Y, Mitchell SL.Association of clinical outcomes with surgical repair of hip fracture vs nonsurgical management in nursing home residents with advanced dementia[published online May 7, 2018]. JAMA Intern Med.doi:10.1001/jamainternmed.2018.07432. Mehr DR, Tatum PE, Crist BD.Hip Fractures in Patients With Advanced Dementia What Treatment Provides the Best Palliation?JAMA Intern Med. 2018;178(6):780 –781. doi:10.1001/jamainternmed.2018.08223. Johnston CB, Holleran A, Ong T, McVeigh U, Ames E.Hip Fracture in the Setting of Limited Life Expectancy: The Importance of Considering Goals of Care and Prognosis. Journal of Palliative Medicine 2018 21:8, 1069-10734. Morrison RS, Siu AL.Survival in end-stage dementia following acute illness. JAMA. 2000;284(1):47-52
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: arnold dementia journal article nursing home pallimed writing group surgery trauma Source Type: blogs

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Conclusion Dexamethasone appears to be a promising agent in reduction of post-operative sequelae in third molar surgery. As a potent anti-inflammatory agent it has an effective role in pain, trismus and edema reduction distinguish from the routes of administration, dosage and timing, pre or post-operative prescription. PMID: 31416411 [PubMed - as supplied by publisher]
Source: Endocrine, Metabolic and Immune Disorders Drug Targets - Category: Drugs & Pharmacology Tags: Endocr Metab Immune Disord Drug Targets Source Type: research
CONCLUSION: The results suggest that intralesional PPD and topical cantharidin .7% are effective and safe treatment modalities, but benefits of intralesional PPD is being a simple, effective and safe treatment with tolerable pain and can be an alternative treatment for multiple resistant types. PMID: 31418621 [PubMed - as supplied by publisher]
Source: Journal of Dermatological Treatment - Category: Dermatology Tags: J Dermatolog Treat Source Type: research
I am happy to announce that I passed the test.  I am referring to the geriatrics examination given by the American Board of Internal Medicine (ABIM).  This means that I am recertified as a Board Certified Specialist in Geriatric Medicine. Recertification is required every 10 years, and this was the third time I succeeded.  You would think it gets easier each time, but the opposite is true.  New drugs, new side effects, new theories of aging, and new statistics had me studying two hours each morning for a good five weeks prior to the exam.  The test itself was a full day, with subject matter that co...
Source: Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers - Category: Geriatrics Authors: Tags: An Aging World Art & Medicine Featured Medical Articles Geriatric Medicine Long-Term Care geriatrics gerontology Healthcare Quality Improving Medical Care Jeff Levine MD Jeffrey M Levine MD Source Type: blogs
This discussion and research on Dying with Dementia and the unnecessary care that often accompanies the late stages of dementia is worth discussing and considering.ByAlzheimer's Reading RoomThis topic is often overlooked and avoided until it is too late.I believe these issues should be considered, and when possible,discussed in support groups. This information is worth sharing and discussing with family members.Learn More -Coping with Alzheimer'sSince individuals with advanceddementia cannot report their symptoms, these symptoms often are untreated, leaving them vulnerable to pain, difficulty breathing and various other co...
Source: Alzheimer's Reading Room, The - Category: Neurology Tags: Alzheimer's Dementia assisted living and memory care facility care homes for elderly with dementia care of dementia patients care of dementia patients at home dementia care elderly dementia care Source Type: blogs
(Hebrew SeniorLife Institute for Aging Research) Researchers from Hebrew SeniorLife's Institute for Aging Research and Brown University have conducted the first study to examine outcomes in nursing home residents with advanced dementia and hip fracture. They discovered that advanced dementia residents have a lower mortality rate after 6 months, if they undergo surgical repair. Those advanced dementia patients managed with surgery also reported less pain and fewer pressure ulcers than those whose proxies chose a palliative care approach in lieu of surgery.
Source: EurekAlert! - Social and Behavioral Science - Category: International Medicine & Public Health Source Type: news
As a geriatrician entering the twilight of my career, I look to the philosophers of my field for guidance on how to navigate my own later years. In addition to contemporary texts and journals I turned toward the ancients and discovered a gem in the writings of Cicero, one of the greatest philosophers of the Roman Empire. The work is entitled De Senectute – Latin for “On Old Age.” Cicero wrote this in 44 BC, the year before he was executed at age 63 by Marc Antony’s henchmen for his alliance with Julius Caesar’s assassins and political opposition to the rulers of Rome. On Old Age is a...
Source: Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers - Category: Geriatrics Authors: Tags: An Aging World Art & Medicine Featured Medical Articles art and aging art and medicine history medical history medicine and art Source Type: blogs
This discussion and research on Dying with Dementia and the unnecessary care that often accompanies the late stages of dementia is worth discussing and considering.ByAlzheimer's Reading RoomThis topic is often overlooked and avoided until it is too late.I believe these issues should be considered, and when possible,discussed in support groups. This information is worth sharing and discussing with family members.Learn More -Coping with Alzheimer'sSince individuals with advanceddementia cannot report their symptoms, these symptoms often are untreated, leaving them vulnerable to pain, difficulty breathing and various other co...
Source: Alzheimer's Reading Room, The - Category: Neurology Tags: Alzheimer's Dementia assisted living and memory care facility care homes for elderly with dementia care of dementia patients care of dementia patients at home dementia care elderly dementia care Source Type: blogs
Conclusion Since senior citizens are susceptible to delirium due to several of its causes, it is important to focus on the preventable ones, so it doesn’t develop. Along with preventing delirium, eliminating some causes many also prevent some forms of dementia. What are your experiences in caring for loved ones with delirium or dementia? We encourage you to share with us in the comment section below.
Source: Shield My Senior - Category: Geriatrics Authors: Tags: Senior Safety Source Type: blogs
CONCLUSIONS: Comorbidity and GS are prevalent in older adults receiving home care. Different diseases have a variable impact on occurrence of GS. Comorbidity is not always associated with an increased number of GS. PMID: 26643938 [PubMed - as supplied by publisher]
Source: European Journal of Internal Medicine - Category: Internal Medicine Authors: Tags: Eur J Intern Med Source Type: research
Abstract This is a prospective cohort study using population‐level administrative data to describe the scope of pressure ulcers in terms of its prevalence, incidence risk, associating factors and the extent to which best practices were applied across a spectrum of health care settings. The data for this study includes the information of Ontario residents who were admitted to acute care, home care, long term care or continuing care and whose health care data is contained in the resident assessment instrument‐minimum data set (RAI‐MDS) and the health outcomes for better information and care (HOBIC) database from 2010 t...
Source: International Wound Journal - Category: Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research
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