An Urgent Need for Public “Perception” Reform
Media outlets are frequently reporting about the disproportionally large number of COVID-19 cases and deaths in nursing homes. Most discussions understandably seem to focus on an urgency to “get something done” to fix this problem. In response, multiple potential policy reforms for the long-term care industry have been recently proposed. Missing from the public policy discussion is the need for “public perception reform” of nursing homes and nursing home health care professiona ls. Effective public discussion about LTC policy reform cannot occur in a society where LTC facilities are often perceived ...
Source: Caring for the Ages - February 27, 2021 Category: Health Management Authors: Adam G. Golden Source Type: news

Artifacts of Culture Change 2.0: More than a Measurement Tool
Over the past year, as long-term care communities have faced the challenges presented by the COVID-19 pandemic, numerous stories have been shared of positive outcomes achieved related to nontraditional environments and person-directed practices (J Am Med Dir Assoc 2020;21:1519 –1524). That person-directed practices, such as dedicated staffing and knowing the resident, have made a difference in so many communities is not surprising to those who have been working to support the mission and vision of Pioneer Network for over 20 years. (Source: Caring for the Ages)
Source: Caring for the Ages - February 27, 2021 Category: Health Management Authors: Joan Devine Source Type: news

Journal Highlights From the March Issue of JAMDA
Four in 10 post-acute care patients do not have timely follow-up visits with their primary care physicians after discharge from skilled nursing facilities, a longitudinal cohort study by Rochester, NY, researchers found. (Source: Caring for the Ages)
Source: Caring for the Ages - February 27, 2021 Category: Health Management Tags: Journal Highlights Source Type: news

Is There a Geriatric Mental Health Specialist in the House?
A few months ago, I received a call from a retired post-acute and long-term care practitioner who was trying to help a friend locate and schedule an appointment with a geriatric mental health specialist for his mother. The resident was 85 and lived in a small assisted living community about 90 minutes from a major metropolitan area. She had a long history of depression, anxiety, and what sounded like an undiagnosed dependent personality disorder. She had been admitted to the assisted living community one year earlier, and there was no evidence of a neurocognitive disorder. (Source: Caring for the Ages)
Source: Caring for the Ages - February 27, 2021 Category: Health Management Authors: Elizabeth Galik Tags: Caring collaborative Source Type: news

When Is It Time for a Nursing Home?
Caring ’s Editor in Chief Elizabeth Galik, PhD, CRNP, helps family members navigate tough decisions about a loved one’s need for nursing home care. (Source: Caring for the Ages)
Source: Caring for the Ages - February 27, 2021 Category: Health Management Tags: Caregiver ’s Corner Source Type: news

Amid Crises and Change, Leaders Emerge: 2021 Medical Director of the Year Nominees
The role of the post-acute and long-term care medical director has evolved over the years. However, talk to any members of AMDA – The Society for Post-Acute and Long-Term Care Medicine who fill this role, and you will hear the passion in their voices as well as their love for their residents and respect for their teams. During the pandemic, these practitioners not only have had to be great leaders and communicators, they a lso needed to quickly become COVID-19 experts — or close to it. (Source: Caring for the Ages)
Source: Caring for the Ages - February 27, 2021 Category: Health Management Authors: Joanne Kaldy Source Type: news

COVID-19 Vaccination in Nursing Homes: Trust in the Tunnel Will Help Staff See the Light at the End
The light at the end of the tunnel is in view. In recent weeks, many post-acute and long-term care residents and others have begun receiving COVID-19 vaccines. One key challenge that remains is getting staff to agree to be vaccinated. “There is so much medical misinformation on social media, where many people get their information,” said Leslie Eber, MD, CMD, president of the Colorado Society for Post-Acute and Long-Term Care Medicine. “We have to overcome this with facts, but we have to do this carefully.” (Source: Caring for the Ages)
Source: Caring for the Ages - February 27, 2021 Category: Health Management Authors: Joanne Kaldy Source Type: news

Mitigating Racial Inequities in PALTC
For the past three years, I have been the chair of the Advancing Excellence in Long-Term Care Collaborative (AELTCC). It is a membership-based, not-for-profit, national coalition that provides a forum for government, professional, consumer, trade, clinical, and other stakeholders to discuss diverse perspectives, policies, regulations, and environmental trends that affect post-acute and long-term services and supports. (Source: Caring for the Ages)
Source: Caring for the Ages - February 27, 2021 Category: Health Management Authors: Christopher E. Laxton Source Type: news

Palliative Wound Care for PALTC
It is well-known that many residents in the post-acute and long-term care setting have contracted, suffered from, and succumbed to COVID-19. Lesser known is that many PALTC wound experts expect the rates of pressure injuries to increase due to the virus ’s impact on oxygen perfusion and the vascular system. These experts are encouraging PALTC clinicians to have candid conversations with patients and their responsible parties about the concept of maintenance and/or palliative wound care (Wound Manag Prev 2020;66:5–7). (Source: Caring for the Ages)
Source: Caring for the Ages - February 27, 2021 Category: Health Management Authors: Victoria Nalls Source Type: news

We Are PALTC
Twenty-Two Things I Wish I Had Known When I First Started Doing Nursing Home Work (Source: Caring for the Ages)
Source: Caring for the Ages - February 27, 2021 Category: Health Management Authors: J. Doug Nelson Source Type: news

The Nursing Home in The Community
Dear Dr. Jeff: The nursing home where I work has given excellent, person-centered care to a large and diverse group of residents for many years. Our CMS ratings are always four or five stars. During the pandemic, our staff has literally risked their lives and endangered their families to care for frail residents, including many whose COVID status was unknown because we could not get access to tests or were forced to accept them before test results were known. Yet our reputation in the community remains poor. (Source: Caring for the Ages)
Source: Caring for the Ages - February 27, 2021 Category: Health Management Authors: Jeffrey Nichols Tags: Dear Dr. Jeff Source Type: news

In Memoriam: William D. Smucker, MD
The family of AMDA – The Society for Post-Acute and Long-Term Care Medicine has lost a dear friend and esteemed colleague, Dr. William “Bill” Smucker, who passed away on January 11 with his family at his side. Dr. Smucker was a long-time friend and supporter of the Society who served on many committees and was f requently a guest lecturer at our Society’s Annual Conference. Dr. Smucker also served as president of OMDA – The Ohio Medical Directors Association and was very influential and an educational leader for the Ohio Chapter. (Source: Caring for the Ages)
Source: Caring for the Ages - February 27, 2021 Category: Health Management Source Type: news

Expressions of Distress: Solutions from the Interdisciplinary Team
Mrs. S is an 89-year-old white woman who has been living in a long-term care facility for two years; she transitioned from an independent living setting (an apartment) after she began to have difficulty managing her personal care and medications safely. She has a past medical history of dementia, believed to be a multi-infarct dementia (current Montreal Cognitive Assessment score is 14/30), a history of hypertension, type 2 diabetes, depression, and degenerative joint disease. (Source: Caring for the Ages)
Source: Caring for the Ages - February 27, 2021 Category: Health Management Authors: Barbara Resnick, Paige Hector Tags: Interdisciplinary Teams Case Studies Source Type: news

Don ’t Miss These Events
Website: https://paltc.org/annual-conference (Source: Caring for the Ages)
Source: Caring for the Ages - February 27, 2021 Category: Health Management Source Type: news

In This Issue
The newest addition to the Society ’s podcast family, Caring On-The-Go brings readers issue highlights and exclusive commentary in a new format. 2 (Source: Caring for the Ages)
Source: Caring for the Ages - February 27, 2021 Category: Health Management Source Type: news

Spotlight on Policy: CMS Releases Updated Conversion Factor for CY 2021
At the very end of 2020, the Consolidated Appropriations Act of 2021 modified the Calendar Year (CY) 2021 Medicare Physician Fee Schedule (MPFS). Here are some of the highlights: (Source: Caring for the Ages)
Source: Caring for the Ages - February 27, 2021 Category: Health Management Source Type: news

Listen, Learn, and Use: 2021 Webinar Program Offers Exclusive Practical Information, Top Experts
During 2020, members of AMDA – The Society for Post-Acute and Long-Term Care Medicine and other practitioners counted on virtual programming for education and information, and one popular source was the Society’s webinars. That will continue this year with a lineup of 30-minute and 60-minute webinars featuring leading exper ts on a wide range of practical and cutting-edge topics. Among the programs scheduled to date: (Source: Caring for the Ages)
Source: Caring for the Ages - February 27, 2021 Category: Health Management Tags: News from the Society Source Type: news

Plan for 2021 and Beyond: Caring, Healing, and Building a Better Future for Post-Acute and Long-Term Care
As a newly hired nursing home medical director in the 1990s, I felt unprepared for the challenges of the position. I looked for education and training specific to this care setting and was delighted to find, and join, the American Medical Directors Association, which subsequently became AMDA – The Society for Post-Acute and Long-Term Care Medicine. Over the ensuing 25 years, I have had the privilege of being an active member of our Society. Like many of our leaders, I’ve spent countless hours serving on the Board of Directors, working on multiple committees and workgroups, helping d raft clinical practice guide...
Source: Caring for the Ages - February 27, 2021 Category: Health Management Authors: Karl Steinberg Source Type: news

The Secret Diary of Hendrik Groen, 83 ¼ Years Old
The year 2013 was chronicled in a diary kept by Hendrik Groen (the author ’s pseudonym), the self-proclaimed “inmate” of an assisted living senior community in the Netherlands. In the resulting book, The Secret Diary of Hendrik Groen, 83¼ Years Old (Grand Central/Hachette, 2017), each day has some description of the prior day’s goings-on. “If I sound like an ol d grump, isn’t that what this diary is for?” he wrote. “It lets me gripe and moan from time to time, and it doesn’t bother anyone.” He came to rely on these daily reflections at first because they he...
Source: Caring for the Ages - February 27, 2021 Category: Health Management Authors: Charlie Vargas Tags: Creative Corner Source Type: news

One of My Best Friends is 93
When I started my career as an intensive care unit nurse, I thought I had a pretty good idea of what it takes to be a nurse practitioner (NP). But my experience in post-acute and long-term care over the past five years has certainly changed that. It has been a privilege to be a part of older adults ’ care teams. The relationships I have developed over the last five years as an adult geriatric NP have afforded me a lifetime of smiles, tears, laughter, and personal growth in addition to my professional experience, and this is just the beginning of my journey in PALTC. (Source: Caring for the Ages)
Source: Caring for the Ages - February 27, 2021 Category: Health Management Authors: Jamyl N. Walker Tags: Foundation Futures Source Type: news

Commentary on Nalls
(Source: Caring for the Ages)
Source: Caring for the Ages - February 27, 2021 Category: Health Management Source Type: news

Commentary on Golden
(Source: Caring for the Ages)
Source: Caring for the Ages - February 27, 2021 Category: Health Management Source Type: news

Caring On-The-Go
This year another member of the podcast family of AMDA – The Society for Post-Acute and Long-Term Care Medicine saw the light of day. Caring On-The-Go’s first episode premiered on January 27, 2021, featuring three stories selected by Caring for the Ages’ Editor in Chief Elizabeth Galik, PhD, CRNP. (Source: Caring for the Ages)
Source: Caring for the Ages - February 27, 2021 Category: Health Management Source Type: news

The Impact of the COVID-19 Pandemic on Individuals With Dementia
The COVID-19 pandemic has put a prolonged physical and emotional strain on residents, families, and staff in post-acute and long-term care settings. Life has been particularly challenging for nursing home and assisted living residents with dementia, who account for 50% or more of all residents in PALTC. In the early days of the pandemic, when personal protective equipment (PPE) and testing were limited, PALTC staff relied heavily on social distancing as well as visitor and room restrictions to help control the spread of COVID-19. (Source: Caring for the Ages)
Source: Caring for the Ages - December 29, 2020 Category: Health Management Authors: Elizabeth Galik Tags: Caring Collaborative Source Type: news

Building Recognition into Workplace Culture
The experience of gratitude is an important part of psychosocial well-being for everyone. With all the daily challenges and unknowns in our lives (especially during the pandemic), expressions of gratitude can provide much needed affirmation to help us get through a tough day and lift our spirits, and even to remind us of why we chose this work. (Source: Caring for the Ages)
Source: Caring for the Ages - December 29, 2020 Category: Health Management Authors: Paige Hector Tags: Communication and Culture Source Type: news

The Truth About Masks, for Your Loved One and You
Jawwad Hussain, MD, a Chicago-based physician, separates the facts from the myths and shares the truths about why masks matter. (Source: Caring for the Ages)
Source: Caring for the Ages - December 29, 2020 Category: Health Management Tags: Caregiver ’s Corner Source Type: news

Getting to Normal Will Require Better Testing, Vaccination, and Communication
“Normalcy” has become a nostalgic word in recent months, especially as the COVID-19 pandemic rages on with no end in sight. Everyone yearns to return to more predictable times, yet no one knows what the “new normal” will look like or when it will arrive. During a program at the 71st American Health Care Association/National Center for Assisted Living (AHCA/NCAL) Annual Convention& Expo in October, Matthew Beacom, MD, of the University of Nebraska Medical Center, said, “Normalcy will come when we have accurate, reproducible point-of-care testing and treatment. (Source: Caring for the Ages)
Source: Caring for the Ages - December 29, 2020 Category: Health Management Authors: Joanne Kaldy Source Type: news

Foundation Leaps Over Barriers to Boost Practitioners Moving Forward
This year has been fraught with challenges, chaos, and stunning surprises. We ’ve all desperately needed some source of optimism, energy, and empowerment, and the Foundation for Post-Acute and Long-Term Care Medicine is working with AMDA – The Society for Post-Acute and Long-Term Care Medicine to serve as a beacon of good during these difficult times. (Source: Caring for the Ages)
Source: Caring for the Ages - December 29, 2020 Category: Health Management Authors: Joanne Kaldy Tags: Our Foundation Source Type: news

Not a Pizza Party: How to Help Frontline Staff During the COVID-19 Pandemic
“You are heroes. You are doing tremendous work in nursing homes around the country, and that work is being recognized,” said David Grabowski, PhD, professor of health care policy at Harvard Medical School, in the opening session of the National Association of Health Care Assistants’ (NAHCA) re cent CNA Staffing Summit. He discussed the true value of certified nursing assistants (CNAs) and other frontline caregivers and ways to step up efforts to recognize and support them. (Source: Caring for the Ages)
Source: Caring for the Ages - December 29, 2020 Category: Health Management Authors: Joanne Kaldy Source Type: news

Leadership, Advocacy, and Communication in Crisis: COVID-19 and Beyond
Fear and uncertainty. Dallas Nelson, MD, CMD, assistant professor of medicine at the University of Rochester, spoke honestly about her early reactions to COVID-19. During the recent “Leadership, Ethics& PALTC Virtual Symposium ” of AMDA – The Society for Post-Acute and Long-Term Care Medicine, she said, “In March, I felt a sense of impending doom. I knew it would be bad, but I didn’t know exactly what to expect.” There was “a lot of fear,” she recalled. Like many health care professionals, she was afraid of getting sick herself, but even more she worried about getting her...
Source: Caring for the Ages - December 29, 2020 Category: Health Management Authors: Joanne Kaldy Source Type: news

Symposium Speakers Discuss Looming PALTC Issues and Solutions for Brighter Future
After spending two days listening to expert guidance, inspirational stories, research updates, and best practices, the participants in AMDA – The Society for Post-Acute and Long-Term Care Medicine’s “Leadership, Ethics& PALTC Virtual Symposium ” looked to the future and started to plan for brighter days. “This last session for all of us is about dreaming big, embracing innovation, and being nimble. We want to send you away with new ideas to think about as we move forward,” said Alice Bonner, PhD, RN, GNP, adjunct faculty at Johns Ho pkins University School of Nursing and senior advis...
Source: Caring for the Ages - December 29, 2020 Category: Health Management Authors: Joanne Kaldy Source Type: news

Nothing Short of a Miracle: Society President David Nace Discusses AMDA ’s Accomplishments and Challenges
Before becoming the president of AMDA – The Society for Post-Acute and Long-Term Care Medicine, David Nace, MD, MPH, CMD, spoke with some of his predecessors about the role. “They told me about what was involved, and they said I would be perfectly fine. They lied,” he joked. Turning serious, he said, “We have been preparing for a possible pandemic, but never in our wildest dreams did we see one that would turn the world upside down and pose this level of challenge for all of us. And I certainly didn’t foresee it happening on the eve of my inauguration.” (Source: Caring for the Ages)
Source: Caring for the Ages - December 29, 2020 Category: Health Management Authors: Joanne Kaldy Source Type: news

Truth-Telling in Times of Crisis
In “Truth-Telling, Equity,& Professionalism: Lessons in Leadership from the COVID Frontlines, ” James Wright, MD, PhD, MATS, CMD, shared his very personal journey through the COVID-19 pandemic and related how truth-telling was his companion throughout. This partnership was important, he said, because “truth-telling is not only part of our professional code. It is the currency by which we purchase the trust of the community.” (Source: Caring for the Ages)
Source: Caring for the Ages - December 29, 2020 Category: Health Management Authors: Joanne Kaldy Source Type: news

Doctors Without Borders Lends a Gloved Hand to U.S. Nursing Homes
Doctors Without Borders/M édecins Sans Frontières (MSF), the medical humanitarian care organization that has worked for 50 years in conflict zones and on infectious disease outbreaks throughout the world, for the first time in its history has stepped into more than 750 long-term care facilities during the COVID-19 pandemic — including dozens of nursing homes in Michigan and Texas. (Source: Caring for the Ages)
Source: Caring for the Ages - December 29, 2020 Category: Health Management Authors: Christine Kilgore Source Type: news

Clarifying and Improving the Role of the Psychiatric Consultant
The chief cause of problems is solutions. — Eric Sevareid (Source: Caring for the Ages)
Source: Caring for the Ages - December 29, 2020 Category: Health Management Authors: Steven Levenson Tags: OBRA Regs Revisited Source Type: news

To Prescribe or Deprescribe Statins, That Is the Question
The treatment of elevated cholesterol, particularly with β-hydroxy β-methylglutaryl-CoA (HMG-CoA) reductase inhibitors, commonly known as statins, is measured by the Centers for Medicare& Medicaid Services in various different ways. Statin Use in Persons With Diabetes (SUPD), a new Medicare Part D star measure in 2019, was listed as measure D14 in 2020; it calculates the percentage of patients between 40 and 75 years old who received at least two diabetes medication fills and also received a statin medication during the measurement period. (Source: Caring for the Ages)
Source: Caring for the Ages - December 29, 2020 Category: Health Management Authors: Jeanne Manzi Source Type: news

Providers Get Creative to Fight COVID Isolation
Every day across the United States and the world, health care providers demonstrate quiet humanity as they deliver patient care during a pandemic. Here are just a few stories that exemplify that from Legacy Care, an independent medical group of physicians and advanced practice providers who deliver on-site care for post-acute and long-term care, inpatient rehabilitation, and assisted living communities around the nation. (Source: Caring for the Ages)
Source: Caring for the Ages - December 29, 2020 Category: Health Management Authors: Marcia Meredith Source Type: news

A Better World in the Future: Part 2
In this month ’s column, Dr. Jeff continues to answer the question from the November/December 2020 issue, focusing on deprescribing. (Source: Caring for the Ages)
Source: Caring for the Ages - December 29, 2020 Category: Health Management Authors: Jeffrey Nichols Tags: Dear Dr. Jeff Source Type: news

Don ’t Miss These Events
Birmingham, AL (or virtually) (Source: Caring for the Ages)
Source: Caring for the Ages - December 29, 2020 Category: Health Management Source Type: news

In This Issue
Benefits of oral anticoagulants for atrial fibrillation outweigh their risks for older adults. 7 (Source: Caring for the Ages)
Source: Caring for the Ages - December 29, 2020 Category: Health Management Source Type: news

Journal Highlights From the January Issue of JAMDA
Individuals who have advanced dementia or other conditions that put them at a high risk of death within six months may benefit from a reduction of blood pressure medications, yet deprescribing occurs in less than half of these individuals, according to results of a national retrospective cohort study. (Source: Caring for the Ages)
Source: Caring for the Ages - December 29, 2020 Category: Health Management Tags: Journal Highlights Source Type: news

Plan Now for AMDA ’s Virtual Reunion
Registration is now open for PALTC21, the Virtual Annual Conference of AMDA – The Society for Post-Acute and Long-Term Care Medicine on March 11–14. This family reunion for PALTC practitioners everywhere offers leading experts discussing the topics on everyone’s minds as well as cutting-edge research, with many opportunities to connect and interact. (Source: Caring for the Ages)
Source: Caring for the Ages - December 29, 2020 Category: Health Management Tags: News From the Society Source Type: news

Spotlight on Policy: Will the Election Change PALTC Practices?
With 2020 now over — thank goodness — the thinking now shifts to what the rest of the COVID-19 pandemic and the post-pandemic world will look like. In the midst of unpredictable change due to the pandemic, there also will be a changeover in the White House and the federal agencies. That means there will be a new s ecretary for the Department of Health& Human Services (HHS) as well as a new administrator for the Centers for Medicare& Medicaid Services (CMS). (Source: Caring for the Ages)
Source: Caring for the Ages - December 29, 2020 Category: Health Management Tags: News From the Society Source Type: news

AMDA and Partners Offer Guidance on Crisis Standards of Care
“When you have a time of crisis, what happens depends on what ideas are floating around, and what ideas have been developed, and thought through, and are made effective.”—Milton Friedman (Source: Caring for the Ages)
Source: Caring for the Ages - December 29, 2020 Category: Health Management Authors: Erin O. Vigne Source Type: news

Oral Anticoagulants for Atrial Fibrillation: Benefits Outweigh Risks for Older Adults
Atrial fibrillation (AF) causes one in seven strokes overall, and one in four strokes in people over the age of 80, according to the National Institutes of Health — which makes stroke prevention a pillar of AF management. Yet oral anticoagulation (OAC), which reduces the risk of stroke by one-half to two-thirds in people with AF, is underutilized in the assisted living and long-term care population. (Source: Caring for the Ages)
Source: Caring for the Ages - December 29, 2020 Category: Health Management Authors: Christine Kilgore Source Type: news

Expert Urges Providers to Implement New Hypertension Guidelines
Many guidelines take four to six years to be understood and implemented, but at the Annual Conference of AMDA – The Society for Post-Acute and Long-Term Care Medicine, Thiruvinvamalai S. Dharmarajan, MD, cautioned against any further delay in implementing the 2017 Hypertension Clinical Practice Guidelines, which recommend lower blood pressure targets and more intensive treatment for most patients with hyp ertension. (Source: Caring for the Ages)
Source: Caring for the Ages - October 31, 2020 Category: Health Management Authors: Christine Kilgore Source Type: news

AMDA Rises to Policy Challenges During the COVID-19 Pandemic
When it became clear that society would face the greatest challenge of this generation, post-acute and long-term care clinicians found themselves on the front lines of battling the deadly COVID-19 pandemic. Since March when the news broke of the first outbreak in a nursing facility in Washington State, AMDA – The Society for Post-Acute and Long-Term Care Medicine has been developing guidance, providing education, and serving as a vital resource on how to deal with COVID-19 in PALTC. (Source: Caring for the Ages)
Source: Caring for the Ages - October 31, 2020 Category: Health Management Authors: Alex Bardakh Tags: Public Policy Source Type: news

Advance Care Planning Video Intervention
Ms. B is an 86-year-old woman with advanced dementia and multiple comorbidities who is a long-term care resident of a nursing home affiliated with a large hospital system. Her family is very involved; her daughter lives locally, and her son, who has her health care power of attorney, lives across the country. Mrs. B has returned from a recent hospitalization for sepsis due to a recurrent urinary tract infection, and the interdisciplinary team is reestablishing her care. This was her fourth hospitalization in the last six months. (Source: Caring for the Ages)
Source: Caring for the Ages - October 31, 2020 Category: Health Management Authors: Elizabeth Brown, Milta Oyola Little, Neema Sharda Tags: Pragmatic Research Source Type: news

Don ’t Miss These Events
Website: https://apex.paltc.org/local/catalog/view/product.php?productid=317 (Source: Caring for the Ages)
Source: Caring for the Ages - October 31, 2020 Category: Health Management Source Type: news

Deprescribing: A Tool to Optimize Medications Across the Continuum of Care
Older adults often take numerous medications each day, contributing to polypharmacy and the continuous prescribing cascade. This may lead to adverse effects, poor outcomes, and decreased quality of life. Deprescribing may be one solution to this common scenario. (Source: Caring for the Ages)
Source: Caring for the Ages - October 31, 2020 Category: Health Management Authors: Heather Cook Tags: LTC Pharmacy Source Type: news