Current Issue: Volume 21 - Issue 5 - May 2013
Department » Editor's Page
Although long-term care settings house a variety of patients with chronic illnesses or disabilities that interfere with their ability to care for themselves for extended periods of time, not all of these patients are frail. For a person to be classified as frail, he or she will exhibit three or more of the following characteristics: low physical activity, muscle weakness, slowed performance, fatigue or poor endurance, and unintentional weight loss.1 Patients who meet these criteria are among the most complex patients to care for, particularly because they are especially vulnerable to illnesses and injuries, yet have a low threshold for tolerating these stresses, which also places them at higher risk of poor outcomes. In this issue of Annals of Long-Term Care: Clinical Care and Aging” , we include several articles that shed light on how the care of frail older adults can be improved, including at the end of life.
Feature » Case Series
Care Demands by Families and Family Healthcare Proxies: A Dilemma for Palliative Care and Hospice Care Staff
Healthcare providers might think that families whose loved ones are admitted to palliative or hospice care units for end-of-life care have a reasonable idea of what type of care will be provided; however, this is often not the case. Sometimes families or family healthcare proxies have false expectations or are misinformed, which can be particularly challenging to manage when this is superimposed on strong cultural, religious, and other confounding belief systems. These situations can also tax the healthcare staff, who need to balance meeting the needs of the dying patient with the needs and expectations of the family as much as possible, all while maintaining professional, ethical, and legal standards within the context of good and appropriate palliative and hospice care. The author presents two cases that exemplify the types of conflicts that may arise in palliative and hospice care settings when family healthcare proxies have unrealistic expectations and make inappropriate care demands of the healthcare staff.
Feature » Series: Nutrition Issues in Long-Term Care
Evidence-based clinical interventions to prevent and treat unintentional weight loss in elderly persons are outlined in the literature, but evidence-based strategies on the organizational level are less readily available and are therefore underutilized. Yet evidence-based organizational strategies have the potential to improve resident care to a far greater extent than clinical interventions implemented by a single healthcare professional treating individual residents. In this article, the authors discuss evidence-based organizational strategies to prevent weight loss in frail elders residing in long-term care settings. The organizational strategies reviewed focus on staffing, planning, leadership/supervisory, educational, environmental, and interdisciplinary interventions. Based on their findings, the authors conclude that nurse leaders need to be more aggressive in implementing management and leadership decisions that are evidence-based and lead to organizational improvements.
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Dual Visual and Hearing Impairment Associated With Significant Increase in All-Cause Mortality
[PLoS One] 2013;8(3):e55054.
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