Omissions of Care in Nursing Home Settings: A Narrative Review
This review aims to (1) examine existing definitions of omissions of care in the healthcare environment and associated characteristics and (2) outline adverse events that may be attributable to omissions of care among nursing home populations. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 8, 2020 Category: Health Management Authors: Aaron M. Ogletree, Rikki Mangrum, Yael Harris, David R. Gifford, Rouguia Barry, Linda Bergofsky, Deborah Perfetto Tags: Review Article Source Type: research

The Role of Cognitive Impairment, Physical Disability, and Chronic Conditions in the Association of Sleep Duration With All-Cause Mortality Among Very Old Adults
This study aimed to examine the relationship between sleep duration and all-cause mortality, and to assess the role of cognitive impairment, physical disability, and chronic conditions on this association among very old adults. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 8, 2020 Category: Health Management Authors: Zhi Cao, Christina Dintica, Ying Shang, Yangyang Cheng, Shu Li, Hongxi Yang, Li Sun, Weili Xu, Yaogang Wang Tags: Original Study Source Type: research

Comparative Effectiveness of Functional Tests in Fall Prediction After Hip Fracture
To assess the validity of 4 functional tests in predicting falls within the first year after hip fracture. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 6, 2020 Category: Health Management Authors: Patricia Wald, Patricia O. Chocano-Bedoya, Ursina Meyer, Endel J. Orav, Andreas Egli, Robert Theiler, Heike A. Bischoff-Ferrari Tags: Original Study - Brief Report Source Type: research

Measuring Self-Efficacy and Attitudes for Providing Mouth Care in Nursing Homes
Mouth care is increasingly recognized as an important component of care in nursing homes (NHs), yet is known to be deficient. To promote quality improvement and inform research efforts, it is necessary to have valid measures of staff self-efficacy and attitudes to provide mouth care. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 5, 2020 Category: Health Management Authors: Christopher J. Wretman, Sheryl Zimmerman, Kimberly Ward, Philip D. Sloane Tags: Original Study Source Type: research

Physical Activity is Associated With Fewer Subjective Cognitive Complaints in 47 Low- and Middle-Income Countries
To determine the association between physical activity (PA) and subjective cognitive complaints (SCCs), and the influential factors in this association. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 2, 2020 Category: Health Management Authors: Mireia Felez-Nobrega, Josep Maria Haro, Kirk I. Erickson, Ai Koyanagi Tags: Original Study Source Type: research

Reply to Estimated Glomerular Filtration Rate and Muscle Mass in Older Patients: Diagnostic Accuracy of Creatinine-Based Equations and Implications in Practice
We thank doctors Dharmarayan and Yoo for their comments on our article.1 In line with the literature and our results, they found a  substantial lack of consistency among the results of different formulas estimating renal function by investigating a sample including a large proportion of frail older people.2 We believe that this could partly depend on the age-composition of different samples generating such equations, which in turn may reflect differently the age-related decay of skeletal muscle mass. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 31, 2020 Category: Health Management Authors: Vincenzo Carnevale, Maria Giulia Tinti, Alfredo Scillitani, Luciano Nieddu Tags: Letter to the Editor Source Type: research

Reducing the Risk of Hospitalization for Nursing Home Residents: Effects and Facility Variation From OPTIMISTIC
The Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) project led to significant decreases in potentially avoidable hospitalizations of long-stay nursing facility residents in external evaluation. The purpose of this study was to quantify hospitalization risk from the start of the project and describe the heterogeneity of the enrolled facilities in order to better understand the context for successful implementation. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 31, 2020 Category: Health Management Authors: Justin Blackburn, Timothy E. Stump, Jennifer L. Carnahan, Susan E. Hickman, Wanzhu Tu, Nicole R. Fowler, Kathleen T. Unroe Tags: Brief Report Source Type: research

Understanding Factors Associated With Psychomotor Subtypes of Delirium in Older Inpatients With Dementia
In this study, we investigate factors associated with subtypes of delirium only in patients with dementia to provide insights on the possible prevention and treatments. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 31, 2020 Category: Health Management Authors: Alessandro Morandi, Antonella Zambon, Simona G. Di Santo, Andrea Mazzone, Antonio Cherubini, Enrico Mossello, Mario Bo, Alessandra Marengoni, Giuseppe Bellelli, Italian Study Group on Delirium (ISGoD) Tags: Original Study Source Type: research

Geriatric-Specific Standards for Information Transfer Between  Nursing Homes and Acute Care Hospitals
In the 2008 Olympics, both the US women's and men's relay teams were the top qualifiers for the finals. However, both teams dropped the baton at the hand-off, and they lost the race.1 (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 31, 2020 Category: Health Management Authors: Maureen C. Dale, Margaret A. Drickamer, Philip D. Sloane Tags: Editorial Source Type: research

Erratum
The Authors wish to make a correction to their article published in JAMDA (doi: https://doi.org/10.1016/j.jamda.2018.10.031) “Predicting Future Health Transitions Among Newly Admitted Nursing Home Residents With Heart Failure”. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 31, 2020 Category: Health Management Tags: Erratum Source Type: research

Hospitalization and Post-Acute and Long-Term Care Medicine
In 2017, 15.3% of the US population 65  years of age and older were hospitalized, as were 22.1% of those 85 years of age and older.1 Given that there are 49 million persons 65 and older, and 6.5 million persons 85 and older,2 these numbers correspond to the staggering figures of 7.5 million older adults hospitalized, including 1.5 mill ion of the oldest old, every year, often multiple times. It's no wonder that the April 2020 theme issue of JAMDA is dedicated to hospital care. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 31, 2020 Category: Health Management Authors: Sheryl Zimmerman, Philip D. Sloane Tags: Editorial Source Type: research

Editorial Board
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 31, 2020 Category: Health Management Source Type: research

Table of Contents
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 31, 2020 Category: Health Management Source Type: research

General Information
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 31, 2020 Category: Health Management Source Type: research

Directions & Connections
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 31, 2020 Category: Health Management Source Type: research

Does the Formulation of Oral Solid Dosage Forms Affect Acceptance and Adherence in Older Patients? A Mixed Methods Systematic Review
Age-related changes mean that the older population can encounter barriers toward taking medication orally. Further work is needed to identify the characteristics of oral solid dosage forms that will improve patient acceptance and adherence. The aim of this systematic review was to identify if and how formulation aspects of oral solid dosage forms affect acceptance and adherence in older people. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 26, 2020 Category: Health Management Authors: Zakia B. Shariff, Dania T. Dahmash, Daniel J. Kirby, Shahrzad Missaghi, Ali Rajabi-Siahboomi, Ian D. Maidment Tags: Review Article Source Type: research

Relationships Between Social, Physical, and Psychological Factors in  Older Persons: Frailty as an Outcome in Network Analysis
Frailty is a multifactorial syndrome characterized by social, physical, and psychological stressors. Network analysis is a graphical statistical technique that can contribute to the understanding of this complex, multifactorial phenomenon. The aim of this study was to investigate the relationships between social, physical, and psychological factors and frailty in older persons. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 26, 2020 Category: Health Management Authors: Daniel Eduardo da Cunha Leme, Erika Valeska da Costa Alves, Andr é Fattori Tags: Original Study Source Type: research

Health Data Sharing in US Nursing Homes: A Mixed Methods Study
(1) To understand the extent to which nursing homes have the capability for data sharing and (2) to explore nursing home leaders' perceptions of data sharing with other health care facilities and with residents and family members. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 26, 2020 Category: Health Management Authors: Kimberly R. Powell, Chelsea B. Deroche, Gregory L. Alexander Tags: Original Study Source Type: research

Cancer Pain in Relation to Metropolitan Area Segregation and Nursing Home Racial and Ethnic Composition
To estimate pain reporting among residents with cancer in relation to metropolitan area segregation and NH racial and ethnic composition. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 25, 2020 Category: Health Management Authors: Bill M. Jesdale, Deborah S. Mack, Sarah N. Forrester, Kate L. Lapane Tags: Original Study Source Type: research

Health Care Utilization and Unmet Needs in Chinese Older Adults With Multimorbidity and Functional Impairment
This study aimed to compare health care utilization among Chinese older adults at different levels of chronic disease and functional impairment. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 24, 2020 Category: Health Management Authors: Chaofan Li, Rui Zhou, Nengliang Yao, Thomas Cornwell, Shuangshuang Wang Tags: Original Study Source Type: research

Skilled Nursing Facility Differences in Readmission Rates by the Diagnosis-Related Group Category of the Initial Hospitalization
The US Health and Human Services Office of the Inspector General report on nursing homes found that skilled nursing facilities (SNFs) exhibit wide differences in overall hospital readmission rates.1 Because there is evidence that hospital readmission rates can be lowered by discharging to specific SNFs,2 policy makers have begun using hospital readmission rates by SNFs as a measure of the quality of care patients receive at these facilities. Starting in October 2018, the Centers for Medicare& Medicaid Services (CMS) implemented the SNF Value-Based Purchasing Program (SNF VBP) with the goal of rewarding specific SNFs fo...
Source: Journal of the American Medical Directors Association - March 22, 2020 Category: Health Management Authors: John Oruongo, Katie Ronk, Oguzhan Alagoz, Jonathan Jaffery, Maureen Smith Tags: Letter to the Editor Source Type: research

Impact of an Antimicrobial Stewardship Program on Resistance to Fluoroquinolones of Urinary Enterobacteriaceae Isolated From Nursing Home Residents: A Retrospective Cohort Study
This study investigated the impact of an antimicrobial stewardship program on fluoroquinolone (FLQ) resistance in urinary Enterobacteriaceae isolated from residents of 3 French nursing homes. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 17, 2020 Category: Health Management Authors: Alessio Strazzulla, Samuel Bokobza, Edgar Ombandza, Khadjah Kherallah, St éphane Hommel, Raouf Draidi, Cédric Bonutto, Dominique Bonnet Zamponi, Rémy Gauzit, Sylvain Diamantis Tags: Original Study - Brief Report Source Type: research

Leadership, Staff Empowerment, and the Retention of Nursing Assistants: Findings From a Survey of U.S. Nursing Homes
We examined the relationship between nursing assistant (NA) retention and a measure capturing nursing home leadership and staff empowerment. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 16, 2020 Category: Health Management Authors: Clara Berridge, Julie Lima, Margot Schwartz, Christine Bishop, Susan C. Miller Tags: Original Study Source Type: research

“What Would It Take to Transform Post-Acute Care?” 2019 Conference Proceedings on Re-envisioning Post-Acute Care
Significant health care reforms resulting from the Improving Medicare Post-Acute Care Transformation Act (IMPACT Act) and Protecting Access to Medicare Act (PAMA) have important implications for patient selection, payment, and outcomes. These reforms promote new relationships between clinical care sites through joint accountability for costs and development of standard outcomes. The reforms also place a new emphasis on clinical outcomes —such as reducing hospital readmissions—as a part of new value-based payment models. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 16, 2020 Category: Health Management Authors: Christine D. Jones, Kathryn A. Nearing, Robert E. Burke, Hillary D. Lum, Rebecca S. Boxer, Jennifer E. Stevens-Lapsley, Mustafa Ozkaynak, Cari R. Levy Tags: Editorial Source Type: research

Atrial Fibrillation in Older Patients with Syncope and Dementia: Insights from the Syncope and Dementia Registry
To evaluate the clinical characteristics and the long-term outcome of atrial fibrillation (AF) patients with dementia and history of syncope or falls. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 12, 2020 Category: Health Management Authors: Alice Ceccofiglio, Stefano Fumagalli, Chiara Mussi, Enrico Mossello, Mario Bo, Anna Maria Martone, Giuseppe Bellelli, Franco Nicosia, Daniela Riccio, Assunta Langellotto, Gianni Tava, Virginia Boccardi, Elisabetta Tonon, Pasquale Abete, Andrea Ungar Tags: Original Study Source Type: research

Reducing the Burden of Complex Medication Regimens: SImplification of Medications Prescribed to Long-tErm care Residents (SIMPLER) Cluster Randomized Controlled Trial
To assess the application of a structured process to consolidate the number of medication administration times for residents of aged care facilities. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 12, 2020 Category: Health Management Authors: Janet K. Sluggett, Esa Y.H. Chen, Jenni Ilom äki, Megan Corlis, Jan Van Emden, Michelle Hogan, Tessa Caporale, Claire Keen, Ria Hopkins, Choon Ean Ooi, Sarah N. Hilmer, Georgina A. Hughes, Andrew Luu, Kim-Huong Nguyen, Tracy Comans, Susan Edwards, Lyntar Tags: Original Study Source Type: research

Long-Term Care Facilities and the Coronavirus Epidemic: Practical Guidelines for a Population at Highest Risk
COVID-19, the abbreviated name for the coronavirus disease 2019, has quickly drawn the attention of worldwide media, public health officials, health care providers, and a worried public. Since its identification in Wuhan, China on December 31, 2019, the virus has spread to over 100 countries, including the United States. This spread has occurred despite aggressive public health measures to contain it.1 As of March 8, 2020, there have been over 105,000 known cases of COVID-19 infection with over 3500 deaths. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 12, 2020 Category: Health Management Authors: David Dosa, Robin L.P. Jump, Kerry LaPlante, Stefan Gravenstein Tags: Editorial Source Type: research

Comparing Advance Care Planning in Young-Onset Dementia in the USA vs Belgium: Challenges Partly Related to Societal Context
This study aimed to explore the engagement in and the conceptualization of advance care planning from the perspective of family caregivers of persons with young-onset dementia and to identify potential similarities and differences in this area between American and Belgian persons with young-onset dementia and their family caregivers. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 11, 2020 Category: Health Management Authors: Romy Van Rickstal, Aline De Vleminck, Sean R. Morrison, Raymond T. Koopmans, Jenny T. van der Steen, Sebastiaan Engelborghs, Judith Neugroschl, Melissa D. Aldridge, Mary Sano, Lieve Van den Block Tags: Original Study Source Type: research

Predictors of Successful Oxygen Weaning in Older Patients Undergoing Pulmonary Rehabilitation
To identify clinical and/or functional variables predictive of successful oxygen-weaning among older patients affected by respiratory insufficiency undergoing pulmonary rehabilitation. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 11, 2020 Category: Health Management Authors: Tiziano Nestola, Laura Orlandini, Antonella Ferrari, Valter Monzani, Giorgio Gallimbeni, Luigi C. Bergamaschini, Matteo Cesari Tags: Original Study - Brief Report Source Type: research

Impact of Behavioral Disturbance on Caregiver Burden and Nursing Home Placement
We thank Dufournet et  al for a thorough review of factors involving nursing home placement for patients with cognitive difficulty.1 However, their conclusion gives the impression that the extent of cognitive impairment, neuropsychiatric symptoms, and behavioral disorders, has little to no impact on caregiver burden sca le that merits further discussion. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 10, 2020 Category: Health Management Authors: Abid Iraqi, Terry Lynn Hughes Tags: Letter to the Editor Source Type: research

Frailty Index Status of Canadian Home Care Clients Improves With Exercise Therapy and Declines in the Presence of Polypharmacy
This study aimed to investigate if exercise therapy and polypharmacy was associated with frailty state transitions for home care service recipients. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 9, 2020 Category: Health Management Authors: Rasmus Tolstrup Larsen, Luke A. Turcotte, Rudi Westendorp, Henning Langberg, John P. Hirdes Tags: Original Study Source Type: research

A Single Question as a Screening Tool to Assess Fear of Falling in Young-Old Community-Dwelling Persons
This study aimed to investigate the relationship between 2 FOF measures: the Falls Efficacy Scale-International (FES-I) and the single question on FOF and activity restriction (SQ-FAR). Factors associated with disagreement between the 2 measures were further examined. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 8, 2020 Category: Health Management Authors: Giulia Belloni, Christophe B üla, Brigitte Santos-Eggimann, Yves Henchoz, Laurence Seematter-Bagnoud Tags: Original Study Source Type: research

Assisted Living Communities During Hurricane Irma: The Decision to Evacuate or Shelter in Place and Resident Acuity
To investigate the factors associated with whether assisted living communities (ALCs) in Florida evacuated or sheltered in place for Hurricane Irma in 2017, focusing on license type as a proxy for acuity of care. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 6, 2020 Category: Health Management Authors: Lindsay J. Peterson, Joseph June, Nazmus Sakib, Debra Dobbs, David M. Dosa, Kali S. Thomas, Dylan J. Jester, Kathryn Hyer Tags: Original Study - Brief Report Source Type: research

Temporal Relationship Between Depressive Symptoms and Cognition in Mid and Late Life: A Longitudinal Cohort Study
To examine the bidirectional temporal relationship between depressive symptoms and cognition in relation to risk, reaction, and prodrome. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 5, 2020 Category: Health Management Authors: Roopal Desai, Georgina M. Charlesworth, Helen J. Brooker, Henry W.W. Potts, Anne Corbett, Dag Aarsland, Clive G. Ballard Tags: Original Study Source Type: research

TEMPORARY REMOVAL: The Impact of Music and Memory on Resident Level Outcomes in California Nursing Homes
The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated.The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 3, 2020 Category: Health Management Authors: Debra Bakerjian, Kristen Bettega, Ana Marin Cachu, Leslie Azzis, Sandra Taylor Source Type: research

Reducing Transfers among Long-Stay Nursing Facility Residents to Acute Care Settings: Effect of the 2013 ‒2016 Centers for Medicare and Medicaid Services Initiative
From 2013 to 2016, the Centers for Medicare and Medicaid Services Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents ( “the Initiative”) tested a series of clinical interventions and care models, through organizations called Enhanced Care and Coordination Providers (ECCPs), with the goal of reducing avoidable inpatient hospital admissions among long-stay nursing home residents. We identify the effect of the Init iative on the probability and count of acute care transfers [capturing any transfer to the hospital, including hospitalizations (inpatient stays), emergency department visi...
Source: Journal of the American Medical Directors Association - March 3, 2020 Category: Health Management Authors: Alison J. Vadnais, Emily Vreeland, Nicole M. Coomer, Zhanlian Feng, Melvin J. Ingber Tags: Original Study - Brief Report Source Type: research

The Impact of Music and Memory on Resident Level Outcomes in California Nursing Homes
To study the effects of a nonpharmacologic intervention, Music and Memory (M&M), on residents with dementia and/or behavioral problems living in nursing homes (NHs). (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 3, 2020 Category: Health Management Authors: Debra Bakerjian, Kristen Bettega, Ana Marin Cachu, Leslie Azzis, Sandra Taylor Tags: Original Study Source Type: research

Effects of Statins for Secondary Prevention on Functioning and Other Outcomes Among Nursing Home Residents
Studies examining the effects of statins after acute myocardial infarction (AMI) excluded frail older adults, especially nursing home (NH) residents, and few examined functional outcomes. Older NH residents may benefit less from statins and be particularly susceptible to adverse drug events like myopathy-related functional decline. We evaluated the effects of statins on 1-year functional decline, rehospitalization, and death in NH residents. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - March 2, 2020 Category: Health Management Authors: Andrew R. Zullo, Richard Ofori-Asenso, Marci Wood, Allison Zuern, Yoojin Lee, Wen-Chih Wu, James L. Rudolph, Danny Liew, Michael A. Steinman Tags: Original Study Source Type: research

Estimated Glomerular Filtration Rate and Muscle Mass in Older Patients: Diagnostic Accuracy of Creatinine-Based Equations and Implications in Practice
The study by Carnevale et  al compared the different methods used to measure estimated glomerular filtration rate (eGFR) with the estimated total skeletal muscle mass (eTSMM) and highlighted the high degree of variability.1 The decline in muscle mass or sarcopenia that occurs with aging renders the value of serum creatinine as a poor estimate of eGFR, especially in the frail old, a fact demonstrated decades ago.2 In particular, the modification of diet in renal disease (MDRD) study included only a limited number of older adults, as acknowledged by the authors, in a comparison of the MDRD formula with the Cockcroft-Gau...
Source: Journal of the American Medical Directors Association - March 1, 2020 Category: Health Management Authors: Thiruvinvamalai S. Dharmarajan, Jinil Yoo Tags: Letter to the Editor Source Type: research

The Effect of Using PARO for People Living With Dementia and Chronic Pain: A Pilot Randomized Controlled Trial
To evaluate the effect of interaction with a robotic seal (PARO) on pain and behavioral and psychological symptoms of people with dementia and chronic pain. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 28, 2020 Category: Health Management Authors: Lihui Pu, Wendy Moyle, Cindy Jones, Michael Todorovic Tags: Original Study Source Type: research

Adapting Gerontechnological Development to Hospitalized Frail Older People: Implementation of the ALLEGRO Hospital-Based Geriatric Living Lab
Gerontechnology aims at improving the functioning of older people and their carers in their daily lives as well as improving gerontological practices. To promote gerontechnology innovation in the hospital and bridge the gap between gerontechnology developers and hospitalized frail older patients, our objective was to create and implement a hospital-based geriatric living lab. We designed a hospital-based living lab, providing reflexive workshops bringing around the table gerontechnology users and developers, supplemented with an experimental hospital room receiving both the users and the devices to be tested. (Source: Jour...
Source: Journal of the American Medical Directors Association - February 27, 2020 Category: Health Management Authors: Fr édéric Noublanche, Cécile Jaglin-Grimonprez, Laurence Laignel, Guillaume Sacco, Philippe Allain, Cédric Annweiler, SAM Group Tags: Pragmatic Innovations in Post-Acute and Long-Term Care Medicine Source Type: research

A Case of Trunnionosis After Total Hip Arthroplasty
Trunnionosis is a complication after placement of prosthetic devices that composes 2% of revisions of total hip arthroplasty. Metal-on-metal hip replacements include the ball, the stem, and the prosthesis that rests on top of the ball. The trunnion is where the femoral neck attaches to the femoral head. This area can wear, creating trunnionosis; the mechanism is unclear, but theory suggests shearing forces and micromotion within the prosthetic joint cause corrosion products that destroy surrounding tissues. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2020 Category: Health Management Authors: Michael Silverman, Hila Miskin, Ricardo Blondet, Deepak Mandi, Sandra DiScala, Michael Silverman Tags: Case Report/Case Series Source Type: research

A Recipe for Disaster: Gabapentin and Opioid Use in an Older Adult
Chronic pain is common among older adults, as is the use of medications to treat these symptoms. Aging physiology, in combination with a higher likelihood of medication use and declining renal function, makes older adults more susceptible to adverse drug effects. As such, monitoring for side effects and changes in renal function is important to avoid drug toxicity, especially during acute illness when medication errors and acute changes in renal function are more likely to occur among older adults. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2020 Category: Health Management Authors: Patricia Guzman Rojas, Patricia Guzman Rojas, Karin Johnson, Belinda Setters Source Type: research

An Unusual Case of Fever and Altered Mental Status
Parkinsonism hyperpyrexia syndrome (PHS) is a dysautonomic disorder that was described in 1981 for the first time. It can present after reduction or discontinuation of antiparkinson medications, co-prescription of neuroleptic medications, dehydration, hot weather, discontinuation of deep brain stimulator, and wearing off phenomenon. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2020 Category: Health Management Authors: Patricia Guzman Rojas, Patricia Guzman Rojas, Laura Morton Source Type: research

Atypical Progressive Meningioma: Not Always Benign
While relatively rare in the general population, meningiomas are the most common tumors in the CNS. Most meningiomas are benign (80%) and can be managed only with continued observation without need for surgery or radiation therapy. There is also a significant number of cases that progress to malignancy (1%-4%). However, there is also a subset of atypical meningioma that portends a worse prognosis and can present many challenges during treatment. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2020 Category: Health Management Authors: Sean Huang, Sean Huang, Edward Gometz Source Type: research

Avoiding Sodium Polystyrene Sulfate (SPS) in Hyperkalemia
Hyperkalemia, defined as a concentration of potassium greater than 5.5 mEq/L in adults, is commonly found on labwork in the subacute nursing facility, often seen in the setting of kidney disease as a result of impaired excretion of potassium in the urine. Treatment is focused upon inducing potassium loss, often through use of loop diuretics such as furosemide. Sodium polystyrene sulfate (SPS) is often used; however, it carries with it significant associated risks and potential complications. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2020 Category: Health Management Authors: Sean Huang, Sean Huang, Edward Gometz Source Type: research

Catatonia as an Usual Cause of Change of Mental Status in a Veteran in a Long-Term Care Facility
Catatonia – a diagnosis that involves motor, cognitive, behavioral, and autonomic irregularities -- may be seen in a variety of medical, psychiatric, and neurologic conditions or medication exposures. Here, we describe a case of catatonia seen in a VA Long term Care (LTC) facility. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2020 Category: Health Management Authors: Mariana Gonzalez, Mariana Gonzalez, Mary Hofmann, Johanne Louis Source Type: research

Discontinuation of Antipsychotic Medication in Two Nursing Home Patients with Diagnosis of Schizophrenia
Antipsychotic medications are a vital part of controlling psychosis in schizophrenic patients. However, when those patients live in nursing facilities, we are obligated by CMS to undertake gradual dose reductions of antipsychotic medication if possible. Sometimes, these efforts are successful and sometimes they fail. Antipsychotic medications have many side effects, including sedation, diabetes, hyperlipidemia, weight gain, motor rigidity, impaired gait, and falls. Monitoring of blood glucose, lipids, and extrapyramidal symptoms is mandatory. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2020 Category: Health Management Authors: Cynthia Kuttner, Cynthia Kuttner Source Type: research

Early Identification of Acute Pulmonary Emboli Through the Use of Contact-Free Continuous Patient Monitoring
Skilled nursing facilities (SNFs) are faced with providing care for residents with increasing clinical complexity. Residents are being discharged from hospitals to post-acute care earlier and with multiple active co-morbidities. Clinicians working in the SNF are charged with delivering high-quality medical care in the facility and reducing avoidable re-hospitalizations. Initially developed for use in the acute care setting, contact-free continuous patient monitoring (CFCPM) is a system designed to continually collect vital signs and other clinical parameters. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2020 Category: Health Management Authors: Zachary J. Palace, Zachary J. Palace, Resmi Sulekha Source Type: research

Fever, Myalgia, and Headache Progressing to Confusion: A Case of Neuroinvasive West Nile Virus in the Older Adult
West Nile Virus (WNV) infection is the most common mosquito-borne illness in the United States. Most cases are asymptomatic or with mild symptoms. Older adults are more likely to have central nervous system (CNS) involvement, and a higher risk for mortality. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2020 Category: Health Management Authors: Hyungseok Oh, Hyungseok Oh, Jamie Bass Source Type: research