Implementation of Function-Focused Care to Change Practice Behavior of Direct Care Workers in Assisted Living
Assisted living (AL) communities are home to over 830,000 adults, who are mostly 85 years and older. Older adults in AL spend the majority of their waking time sedentary and experience more decline in functional performance compared to nursing home residents. Decreased physical activity and functional impairment are strong predictors of adverse outcomes, institutionalization, and decreased quality of life. Routine care provided by direct care workers (DCWs) traditionally focuses on task completion, which limits residents ’ function and physical activity. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Jade Kim, J. Kim, B. Windemuth Tags: Quality Improvement Source Type: research

Implementation of Interdisciplinary Wound Care Rounds in a Skilled Nursing Facility
There is scant literature regarding interdisciplinary teams providing wound care in long-term care. Our long-term care facility did not have a consistent process for evaluation and treatment of wounds by nursing and physician teams. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Monica Stout, M. Stout, A. Ogunwale, N. Ramlal, K. Thompson, G. Buhr, L. Genao Tags: Quality Improvement Source Type: research

Improving Antibiotic Stewardship Program's Educational Materials in the Long-Term Care Setting
In November 2017, the Center for Medicare and Medicaid Services (CMS) mandated the implementation of Antibiotic Stewardship Programs (ASP) within Long-Term Care (LTC) facilities in the United States. A core element of this initiative is to provide multidisciplinary educational materials for practitioners, staff and residents and their families. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Andre Smyth, A. Smyth, S. Fridkin, S. Sefton, S. Saiyed, A. Bender Tags: Quality Improvement Source Type: research

Improving Deep Tissue Pressure Injury (DTPI) Outcomes: A 2.5 Year-long Quality Improvement Project
Long-term care facility (LTCF) residents with multiple co-morbidities, debility and cognitive loss are at higher risk of developing deep tissue pressure injury (DTPI). There is limited research supporting the treatment options for DTPIs, but offloading is recommended. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Autumn Henson, A. Henson Tags: Quality Improvement Source Type: research

Improving Experience of Sleep in the Community Living Center by Implementing Non-pharmacologic Interventions
Many older residents are prescribed psychoactive medications to improve sleep quality. These include antipsychotics, anxiolytics, and hypnotics. These medications are often prescribed in together and with narcotics. This practice places older adults at risk of falling, sudden death, and poor quality of life. The practice is seen in acute care and ambulatory settings. When residents are admitted to our unit, we attempt to follow CMS regulations and recommendations to provide quality care. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Ritamarie Moscola, R. Moscola, J. Scheriff, S. Whitcomb, C. Oliver Tags: Quality Improvement Source Type: research

Interprofessional Collaboration Improves Antibiotic Stewardship
The challenge to improve effective and safe use of antibiotics in PALTC settings is a national focus of great importance. Goals are to reduce the emergence of multi-drug –resistant organisms, AADE, and unnecessary cost. The Centers for Disease Control and Prevention (CDC) suggest AADE monitoring as one of several appropriate resident outcome measures for antibiotic stewardship programs, but AADE processes vary substantially among PALTC facilities. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Fatima Sheikh, B.J. Zarowitz, F. Sheikh, F.A. Naqvi, E. Heil, N. Brandt Tags: Quality Improvement Source Type: research

Music & Art in Medicine (MAM): the Effectiveness of MAM Events on the Interest and Perception of Geriatrics and Nursing Homes by Medical Students (MSs)
MAM is a MS interest group that provides community service  music and art performances. PALTC events are coordinated by the activities director. Music and Art QI projects have revealed a positive response in depression, pain, and cognition. A new QI collaboration was developed. MSs would be surveyed similar to research conducted by Janzen KM, et al., measu ring the effect of student-led educational events on geriatric patient and student participant perceptions and in research conducted by Couteur DG and Price DA reflecting MS attitudes toward older adults and careers in geriatric medicine. (Source: Journal of the Ame...
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Steven Diep, M.R. Finley, S. Diep, G. Castillo, M. Feng, J. Pious, C. Eby, A. Davila Tags: Quality Improvement Source Type: research

Palliative Care Services in a Nursing Home Setting-Influence on Care Preferences
We report results of palliative care (PC) progr am at our nursing facility. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Danuta Molenda, D. Molenda, K. Barnes, L. Riutta Tags: Quality Improvement Source Type: research

Proof of Concept: Nursing Home Specialist in Action. the Impact of Full-time Physician Services in Post-Acute Care
Post-Acute Care skilled nursing facilities have become a key component to improving quality of care and reducing health care costs nationwide. Several models have been considered to address the complex care and expense that post-acute care facilities must address in the current health care system to provide both quality and cost savings. Few studies have been done to evaluate the impact of full-time physician services in post-acute care facilities. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Toby Smith, T. Smith, K.L. Scott, P. Katz Tags: Quality Improvement Source Type: research

Quality Improvement Project to Enhance Knowledge of Post-Acute Care Interdisciplinary Team of Hospice Services
Hospice services provided to residents of post-acute and long-term care (PALTC) facilities are associated with higher resident and family satisfaction and lower health care costs. One barrier to timely hospice enrollment is limited understanding of hospice services and referral procedures by PALTC interdisciplinary team (IDT). We designed and implemented a Quality Improvement (QI) project to enhance the knowledge of the PALTC IDT of hospice services and referral processes. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Chidinma Aniemeke, M.R. Finley, C. Aniemeke, K.Y. Lewis, T. Pham, N.K. Patel, Y. Ye Tags: Quality Improvement Source Type: research

Readmissions? Not with Your Nurse Practitioner in Charge!
Deaconess Health System developed a post-acute embedded Nurse Practitioner (NP) program in partnered skilled nursing facilities (SNF) to improve patient transitions and coordination of care. This model has improved patient care, lowered 30-day readmission rates, lowered length of stay, and transitioned patients to the next level of care in a safe and efficient manner. This concept has completely modernized and revamped our approach to post-acute strategies and quickly met our health system ACO and population health goals. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Shelly Evans, S. Evans, K. Clodfelter, J. Redman Tags: Quality Improvement Source Type: research

Significance of STEADI Screening in Early Identification of Geriatric Patients with Undiagnosed Depression
Each year, the health care system loses billions of dollars due to falls in the geriatric population, causing significant morbidity and mortality. Clinical depression is relatively uncommon among older US adults, but depressive symptomatology has been identified as a major risk factor for falls. It was observed by the geriatric clinical practitioners that many of the patients answered “yes” to the depression question in the STEADI Fall Screening questionnaire but were not screened for depression, and those with a formal diagnosis were not treated appropriately for the severity of depression. (Source: Journal of...
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Hamza Aurakzai, H. Aurakzai, A. Garg, G. Merugu Tags: Quality Improvement Source Type: research

Teaming up to Reduce Catheter-Associated Urinary Tract Infections
Indwelling urinary catheters are a frequent cause of infection, which may result in hospitalization and increased morbidity and mortality. Catheter-associated urinary tract infection (CAUTI) and its complications are linked to increased health care costs. Adherence to proper indications and techniques for insertion and maintenance can prevent infection. The Centers for Disease Control and Prevention has published guidelines and recommendations on CAUTI prevention, quality programs and strategies to reduce CAUTI rates. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Sarah Karimi, S. Karimi, R. Kaiser, E. Cobbs, N. Lepcha, S. Whitehead Tags: Quality Improvement Source Type: research

The Care Aligned Program (CAP): Reducing Avoidable Hospitalizations Without Focusing on Hospitalizations
Reducing avoidable hospitalizations is a common concern for nursing home residents as debility, functional decline, morbidity and mortality are inevitable complications of hospitalization. Therefore, nursing homes and hospitals across the country are focusing on reducing avoidable readmissions and hospitalizations. Most programs put the emphasis on the last day or few hours before the resident was hospitalized. Instead, we developed the Care Aligned Program (CAP) as an interdisciplinary, collaborative, patient-centric, bedside and educational approach to reducing hospitalizations and re-admissions by focusing on increasing...
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: James Avery, J. Avery Tags: Quality Improvement Source Type: research

The Impact of Quality Improvement Coaching on Skilled Nursing Facilities to Improve Transitions
Plan-Do-Study-Act (PDSA) is widely accepted as an effective Quality Improvement (QI) methodology in Skilled Nursing Facilities (SNF). Accountable care organizations (ACOs) are interested in promoting this methodology in collaborative endeavors with SNFs to enhance care transitions. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Mamata Yanamadala, M. Yanamadala, H. Jacobson, A. Mims Tags: Quality Improvement Source Type: research

Utilizing Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) to Improve Ineffective Communication in Long-Term Care Settings
Ineffective communication remains a major factor contributing to medical errors and sentinel events in health care that lead to fatalities and billions in malpractice cost. Nurses have a leading role in communicating valuable patient information to maintain patient safety. In the long-term care setting, ineffective communication and poor teamwork have been found to be contributing factors to 89% of adverse events, such as medication errors, delayed or inappropriate interventions and missed nursing care. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Airelle Rucker, A. Rucker, B. Windemuth Tags: Quality Improvement Source Type: research

Effects of Physiatric Consultation in Post-acute Care
This study represents a regression analysis of certain factors we theorized might be affected by the presence of a physiatrist practicing in a SNF environment. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Steve Gnatz, S.M. Gnatz Tags: Research Source Type: research

Evaluation of the Skilled Nursing Facility (SNF) Transitional Care Management Program (TCMP) Using Decision Support on Post-Acute Discharge SNF Length of Stay and Subsequent Hospital Readmissions
Accounting for both significant total medical expense and variation, managing Skilled Nursing Facility (SNF) post-acute care (PAC) utilization has become a major focus area for accountable care organizations (ACOs). In 2017 our healthcare system implemented the SNF TCMP across 5 hospitals for our Medicare ACO population beginning with Hospital D as a pilot in 2015. Our SNF TCMP includes 2 major elements: 1) use of dedicated care managers who oversee the care of our medicare ACO patients requiring PAC SNF level of care through that patient ’s entire PAC SNF episode guided by 2) use of the LiveSafe tool, a proprietary ...
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Charles T. Pu, C.T. Pu, Y. Gao, S. Garrels, M. Vestal, M. Turner, C. Vogeli Tags: Research Source Type: research

Fall Risk Associated with Mechanical Lifts in Nursing Homes
Use of mechanical lifts for patient transfer has decreased incidence of work-related injuries, increased efficiency of transfers, improved patient comfort and safety, is cost effective, reduced pressure ulcers and has been proposed to decrease patient falls. However, little data is available on fall risk reduction and mortality benefit. This case control retrospective study examines fall rate linked to mechanical lifts like the Hoyer lift in Nursing Homes. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Sandita Seecharan, S. Seecharan, J. Genese, C. Arana, A. Liggett, N. Kulsum, R. Ahmad Tags: Research Source Type: research

Impact of a Multifaceted Strategy to Reduce Inappropriate Antibiotic Prescribing for Uncomplicated Cystitis in Nursing Home Residents as Assessed Using the Medication Appropriateness Index
While antibiotics may be necessary for uncomplicated cystitis, they are often prescribed inappropriately. To determine the impact of a multifaceted strategy on the appropriateness of antibiotic prescribing for uncomplicated cystitis in older non-catheterized nursing home residents. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: David Nace, D. Nace, S. Perera, S. Schweon, P. Drinka, C. Crnich, G. Anderson, S. Saracco, M. Mulligan, J. Hanlon Tags: Research Source Type: research

Impact of Obesity on Hospital Readmission and Skilled Nursing Facility Length of Stay
Prevalence of obesity in older adults is increasing and skilled nursing facilities (SNF) are facing challenges while caring for these complex older adults. Although obesity paradox confers some immunity in Class I obesity, Class II and III obese older adults may have higher risk for a complicated SNF stay due to their multiple co-morbidities, baseline functional impairments and increased post-surgical rehabilitation needs. These factors may impact SNF length of stay (LOS) and 30- and 90-day hospital readmission rates. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Ana Montoya, S. Dewar, A. Montoya, R. Vittal Tags: Research Source Type: research

Inter-Professional Learning and Home Visit Experiences of Trainees During Geriatrics Rotation at Riverside University Health System
A Geriatrics rotation at Riverside University Health Systems (RUHS) is a 1-month rotation for current trainees. Because of the inter-professional environment of the rotation, pre-clinic and pre-home visit team huddles were introduced to provide a collaborative treatment plan for Geriatric patients. Due to a paucity of information available regarding the efficacy of huddles and home visit experiences in a Geriatrics setting, this current study is being proposed to evaluate the inter-professional learning and home visit experiences of trainees during their 1-month Geriatrics rotation at RUHS. (Source: Journal of the American...
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Mohammed Yousuf Zaveri, M.Y. Zaveri, W. Hamade Tags: Research Source Type: research

Measuring Pain in Aphasia: The Reliability and Validity of the PACSLAC-D Observational Scale
Self-report pain scales are the most common way to assess pain in stroke patients with aphasia. The use of self-report pain scales in patients with aphasia is challenging due to communication or cognitive problems. A feasible, reliable and valid instrument to assess pain in patients with aphasia is yet not available. The aim of this study is to examine the reliability and validity of the Pain Assessment Checklist for Seniors with Severe Dementia-Dutch version (PACSLAC-D) in stroke patients with and without aphasia. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Hanneke Smaling, N. de Vries, H. Smaling, J. van der Steen, W. Achterberg Tags: Research Source Type: research

Medical Education in the Long-Term Care Setting: Exploring Residents ’ Experience of Learning in This Environment
Long-Term Care (LTC) education has been shown to increase geriatric knowledge and skills of trainees. Literature on factors influencing learning in the LTC learning environment is sparse. With an aging population and increasing complex multimorbidity, training physicians to deal with this challenge is a priority. The aim of this study is to explore learners ’ experience of learning within a competency-based curriculum with direct clinical supervision in the LTC environment. It also explores the impact of training on self perception of competence to manage older adults across other care settings. (Source: Journal of t...
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Itode Ewa, I. Ewa, R. DeFina, O.E. Maeve, A. Dennis Tags: Research Source Type: research

Medication Reconciliation Errors Among Skilled Nursing Facilities Discharged Patients
This study investigated the prevalence of medication reconciliation errors among patients discharged to Skilled Nursing Facilities (SNFs) and whether these medication reconciliation errors impacted 30-day readmission. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Heeyoon Kim, H. Kim, M. Monachese, L. Kim Tags: Research Source Type: research

Nursing Home Employee Self-Reflection on Life Stressors and Compassion Fatigue
Working in a nursing home can be stressful, and can result in compassion fatigue as staff encounter multiple demands, expectations, and requests by residents, patients, families and management. Risk factors of compassion fatigue include irritability with self or others, chronic lateness, exhaustion, low self-esteem, and even hopelessness. People suffering from compassion fatigue may feel overburdened by emotions and a desire to escape from work, while at the same time feeling isolated and finding it difficult to remain flexible on the job. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Paige Hector, P. Hector, R. Bonifas Tags: Research Source Type: research

Perceived Impact of the Namaste Care Family Program on People with Advanced Dementia, Nursing Staff, and Family Caregivers: A Qualitative Study
Many people with advanced dementia die in nursing homes. Family caregivers regularly judge quality of life as poor and may find it difficult to establish meaningful contact with their relative. The daily US Namaste Care program integrates personalized and palliative care with meaningful activities for people with advanced dementia. We adapted Namaste Care to involve family caregivers more and examined the perceived impact of Namaste Care Family on nursing home residents with advanced dementia, nursing staff, and family caregivers in the Netherlands. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Hanneke Smaling, H. Smaling, K. Joling, S. Doncker, W. Achterberg, J. van der Steen Tags: Research Source Type: research

Physician Perspectives and Practice Management of Blood Pressure Control in Older Patients with Hypertension
The American College of Cardiology (ACC), the American Heart Association (AHA), the American College of Physicians (ACP) and the American Academy of Family Physicians (AAFP) all differ in their recommendations for hypertension management in older adults. The current study aims to examine physician practices for controlling hypertension in geriatric patients. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Usman Khan, U. Khan, C. Nouryan, K. Finuf, S. Fishbane, G.W. Klein Tags: Research Source Type: research

Point Prevalence and Characteristics of In-House Antimicrobial Use in Nursing Homes, New Haven and Hartford Counties, Connecticut, 2017
National trends indicate an increase in the amount and complexity of healthcare delivery in nursing homes (NH). As this care is provided in relatively limited resource settings, there is concern about the role NH play in the rise of antimicrobial resistant organisms. The lack of existing data prompted the CDC ’s Emerging Infections Program (EIP) to conduct a point prevalence survey to gather data on antimicrobial use (AU) and healthcare-associated infections (HAI) in NH in 10 EIP sites including Connecticut (CT). (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Paula Clogher, P. Clogher, K. Srinivasan, M. Maloney, J. Meek Tags: Research Source Type: research

Post-Acute Care Utilization and Quality Among High Risk Medicare Enrollees
This study helps address this gap by 1) assessing the impact of geriatric risk factors on post-acute utilization and outcomes among hospitalized Medicare patients, and 2) examining whether differences in post-acute utilization between Medicare Advantage and fee-for-service Medicare patients persist after controlling for geriatric conditions. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Shannon Wu, S. Wu Tags: Research Source Type: research

Recurrent Falls in Advanced Dementia: Could It Signal Unmet Palliative Needs?
Falls in long-term care (LTC) facilities are a major safety and quality concern, and are considered a preventable cause of injury. The majority of falls occur among residents with moderate to severe dementia. A cascade of repeated falls, with or without injury, invariably occurs with the progression of dementia, often in residents with some preserved mobility. Single or recurrent falls eventually lead to functional decline, change in mobility status, and death. This trajectory is further complicated when residents are treated with multiple anti-hypertensives, with concern for orthostatic hypotension possibly due to cerebra...
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Julia Hermanowski, J. Hermanowski, J. Morphew, M. Calles, S. Dewar, R. Vittal Tags: Research Source Type: research

Silent Constipation: A Potentially Lethal, Although, Under-Recognized, Under-Diagnosed and Under-Treated Entity
Constipation is a commonly prevalent condition and often a distressing digestive complaint. Left untreated, it may be associated with severe morbidity and occasionally in mortality. To determine 1) the correlation between patient ’s complain of constipation, with radiological evidence for excessive colonic fecal retention, and 2) appropriateness of therapy for constipation, by clinicians. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Naznin Esphani, N. Esphani Tags: Research Source Type: research

The Burden of Health Conditions for Aging Adults in the United States: Disability-Adjusted Life Years
This study sought to determine the burden of common health conditions in a nationally-representative sample of aging adults in the United States. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Ryan McGrath, R. McGrath, S.A. Snih, K. Markides, O. Hall, M. Peterson Tags: Research Source Type: research

The Dynamic Synergy of Family and Team Member Caregiving for Veterans in Home Based Primary Care
The U.S. Department of Veterans Affairs ’ (VA) Home-Based Primary Care (HBPC) Program provides in-home interdisciplinary, comprehensive, longitudinal primary care for frail, chronically ill, or disabled veterans with complex medical, social, and behavioral conditions. This research describes the role relationships between HBPC team memb ers and HBPC Veterans’ caregivers play in delivering care, from the perspective of HBPC team members. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Suzanne M. Gillespie, C. Manheim, L.M. Haverhals, C. Gillman, J. Karuza, T. Olsan, S.T. Edwards, C.L. Levy, S.M. Gillespie Tags: Research Source Type: research

The Effect of Musical Intervention Vs Standard Treatment on Reducing Agitation Over a Twelve-Day Period
Approximately 7.7% of patients with dementia in Long-Term Care (LTC) who are agitated are prescribed psychotropics medications, which can lead to well-known adverse effects. Music intervention can be used to help improve health and alleviate agitated behavior in older patients with dementia, and there is a vast amount of literature demonstrating a beneficial effect. However, many limitations exist in the methods and outcomes. Most investigators recommend that more research is necessary, and no clinical guidelines exist. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Jessie Moodie-Shepherd, J. Moodie-Shepherd, R. Goldberg Tags: Research Source Type: research

The Perception of Older and Other Stakeholders on Long-Term Care Services with Higher Individual Autonomy: A Qualitative Study in Hong Kong and Analysis of Official Data During 2004-2016
The modern long-term care system is facing a growing demand for better tailored and more responsive care; choice and flexibility of care users has become one of major goals of the system. There is a trend that public-funded long-term care systems in the OECD countries opted for providing entitlements to service users in form of cash or other forms of personal budgets for them to choose and purchase the care services that suit their needs. The Hong Kong government is also providing vouchers for older adults to choose community and residential care services. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Kailu Wang, K. Wang, A.Y.K. Wong, E. Lai-yi Wong, A.W.L. Cheung, E. Yeoh Tags: Research Source Type: research

Four Potentially Practice-Changing Articles From 2018
Four key articles published in 2018 have been selected to represent clinical situations where recent evidence may prompt changes in practice relevant to the nursing home population. There is no evidence of benefit for levothyroxine replacement in mild subclinical hypothyroidism. Duloxetine may be considered as an option for the treatment of pain and stiffness in osteoarthritis of the knees. Supplemental oxygen in the absence of hypoxemia is unnecessary and potentially harmful. Methylphenidate has modest benefit in treating apathy in dementia. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Christopher James Patterson Tags: Special Article Source Type: research

Unpacking Communication About End-of-Life Care: Resulting Recommendations
Communication is a good thing —critiques of Twitter and other forms of social media notwithstanding. In health care, high-quality physician-patient communication benefits patients' emotional health, symptoms, function, physiology, and pain.1 In nursing homes, staff who communicate more effectively with residents with dementia witness less resistance to care2 and reduced need for antipsychotic medications.3 Other examples of the benefits of communication in nursing homes include decreased falls4 and improved patient safety when using structured communication protocols such as SBAR (situation, background, assessment, r...
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Sheryl Zimmerman, Laura C. Hanson Tags: End-of-Life Care Source Type: research

2019 Annual Conference Oral Presentations
A Fellowship Curriculum to Teach Dementia Behavior Problem-Solving Skills (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Tags: Oral Presentations Source Type: research

Editorial Board
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 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 - February 27, 2019 Category: Health Management Source Type: research

General Information
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Source Type: research

Directions & Connections
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Source Type: research

Conditional Permission to Not Resuscitate: A Middle Ground for Resuscitation
Every decision to perform or withhold cardiopulmonary resuscitation (CPR) has ethical implications that are not always well understood. Value-based decisions with far-reaching consequences are made rapidly, based on incomplete or possibly inaccurate information. For some patients, skilled, timely CPR can restore spontaneous circulation, but for others, success may either be unobtainable or bring serious iatrogenic consequences. Because CPR is an aggressive process yielding mixed results, patients must be informed about the likelihood of its positive and adverse outcomes. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Richard B. Stuart, Stephen Thielke Tags: Special Article Source Type: research

Toward Common Data Elements for International Research in Long-term Care Homes: Advancing Person-Centered Care
To support person-centered, residential long-term care internationally, a consortium of researchers in medicine, nursing, behavioral, and social sciences from 21 geographically and economically diverse countries have launched the WE-THRIVE consortium to develop a common data infrastructure. WE-THRIVE aims to identify measurement domains that are internationally relevant, including in low-, middle-, and high-income countries, prioritize concepts to operationalize domains, and specify a set of data elements to measure concepts that can be used across studies for data sharing and comparisons. (Source: Journal of the American ...
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Kirsten N. Corazzini, Ruth A. Anderson, Barbara J. Bowers, Charlene H. Chu, David Edvardsson, Anette Fagertun, Adam L. Gordon, Angela Y.M. Leung, Katherine S. McGilton, Julienne E. Meyer, Elena O. Siegel, Roy Thompson, Jing Wang, Sijia Wei, Bei Wu, Michae Tags: Special Article Source Type: research

Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Oldest Adults: Predictors of In-Hospital Mortality and Need for Post-acute Care
Older age is associated with higher risk of death during acute exacerbations of chronic obstructive pulmonary disease (AE-COPD). Older patients hospitalized for AE-COPD often require post-acute care after acute phase. The aim of this study was to evaluate components of a comprehensive geriatric assessment and clinical/laboratory parameters, in order to find predictors of in-hospital mortality and need for post-acute care in patients aged 80 and older hospitalized for AE-COPD. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 27, 2019 Category: Health Management Authors: Francesco Spannella, Federico Giulietti, Guido Cocci, Laura Landi, Francesca Elena Lombardi, Elisabetta Borioni, Alessandra Cenci, Piero Giordano, Riccardo Sarzani Tags: Original Study Source Type: research

Quality of Hospital Communication and Patient Preparation for Home Health Care: Results From a Statewide Survey of Home Health Care Nurses and Staff
To evaluate the quality of communication between hospitals and home health care (HHC) clinicians and patient preparedness to receive HHC in a statewide sample of HHC nurses and staff. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 21, 2019 Category: Health Management Authors: Christine D. Jones, Jacqueline Jones, Kathryn H. Bowles, Linda Flynn, Frederick A. Masoudi, Eric A. Coleman, Cari Levy, Rebecca S. Boxer Tags: Original Study-Brief Report Source Type: research

Effect of Housing Type and Neighborhood Socioeconomic Indicators on Survival After Low Falls in Older Adults
Falls result in significant morbidity and mortality among older adults and are a concern in ageing populations. There has been evidence that socioeconomic status (SES) predicts postfall outcome; worse postfall survival has been associated with lower education,1 lower income,2 and neighborhood deprivation.2 As a small urbanized country, we were interested to evaluate if SES, at both individual and neighborhood levels, was similarly associated with postfall survival in the older adults of our population. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 20, 2019 Category: Health Management Authors: Wycliffe E. Wei, Chek Hooi Wong, David B. Matchar, Arul Earnest, Win Wah, Marcus Eng Hock Ong, Ting Hway Wong Tags: Research Letter Source Type: research

Cosas de la Edad, a Therapeutic Intergenerational Experience
“The embrace of a 4-year-old child can work wonders on the health of the older adult.” This was one of the most consistent findings of Cosas de la Edad (“A Matter of Age”), a televised social health intervention and one of few attempts to quantify the impact of intergenerational interaction. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 20, 2019 Category: Health Management Authors: Patricia L ópez Pardo, Mariano Sánchez, José Luis Linaza Tags: Letter to the Editor Source Type: research

Effects of Acupressure on Sleep Quality and Psychological Distress in Nursing Home Residents: A Randomized Controlled Trial
To compare the efficacy of acupressure with sham acupressure in older-adult nursing home residents presenting with poor sleep quality and psychological distress. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - February 20, 2019 Category: Health Management Authors: I-Hui Chen, Tzu-Pei Yeh, Yueh-Chen Yeh, Mei-Ju Chi, Mei-Wen Chen, Kuei-Ru Chou, Yin-Yi Lien, Chih-Fen Yuan Tags: Original Study Source Type: research