Annals of Long Term Care

Residents of long-term care (LTC) facilities and their families often have questions about practices and policies in LTC settings. They may ask, for example, why medical staff recommend some, but not other, treatments for problems such as sleeplessness; why a particular exercise regimen has been recommended; or why a hospitalization should be followed by a stay at a rehabilitation center rather than immediate return to LTC. These are good questions, and they deserve thoughtful answers. The more residents and their loved ones understand the rationales behind protocols and suggestions, the more likely they are to comply with them.

When explaining such matters, it’s often helpful to refer patients and their families to information on the subject at hand. Unfortunately, not all of the health information available on the Internet or television or in magazines or newspapers is reliable. To help address this, the American Geriatrics Society’s (AGS) Foundation for Health in Aging (FHA) publishes easy-to-understand summaries of studies on health and aging in the Journal of the American Geriatrics Society (JAGS). A good number of these summaries are of studies concerning LTC. The reports, posted in the “New Research” section of the FHA’s “Aging in the Know” website, have been reviewed and approved by the studies’ authors. Each provides background information, describes the JAGS research, and includes links to related information on the FHA site. The summaries can be printed and distributed to residents and their loved ones at no cost.

Here are a few brief synopses of recent reports of JAGS studies relevant to LTC from the “Aging in the Know” site:

After Stroke, Many Older Adults Face Complicated Transitions
Older adults who have had strokes often face many transitions after they leave the hospital. After returning home or to a LTC facility, some may develop medical complications and have to return to the hospital or to an emergency room.

Healthcare providers call transitions from a setting that provides less intense care (eg, someone's home or a LTC facility) to a setting that provides more intense care (eg, hospital) "complicated transitions." To better understand which older individuals are most likely to have complicated transitions, researchers recently studied nearly 40,000 older adults who were hospitalized after having strokes. About 20% of the patients had at least one complicated transition, and 16% had more than one, the researchers found.

Older patients who: were African-American; were Medicaid beneficiaries; had longer hospital stays; had more health problems; or were sent to a LTC facility directly from the hospital were more likely to have at least one complicated transition than other patients. Because patients who were sent from hospitals to rehabilitation centers before going back home or back to a LTC facility were less likely to have complicated transitions, an intermediate stay at a rehabilitation center after hospitalization may lower the odds of a difficult transition, the researchers conclude. (For the full summary of this study, visit http://www.healthinaging.org/agingintheknow/research_content.asp?id=97 )

Exercise Can Help Nursing Home Residents with Alzheimer's Disease Manage Activities of Daily Living Longer
Alzheimer's disease (AD) makes it increasingly difficult to think, remember and manage daily activities such as eating, transferring from bed to chair, walking, bathing, dressing and going to the toilet.

To see whether regular exercise might help nursing home residents with AD manage these activities longer, researchers studied 134 older people. All lived in nursing homes and had AD.

For 12 months, half of the adults participated in a twice-weekly exercise program. The other adults did not.