Hospital length of stay is dramatically shorter today than in the past. As a result, many older adults require post-acute care in order to regain lost functioning brought on by acute illnesses. Over two-thirds of older adults admitted to post-acute care facilities have at least one delirium symptom. This article describes the problem of delirium in post-acute care and a program of cognitive rehabilitation developed by the authors that has been successfully implemented in a skilled nursing setting. The program requires interdisciplinary collaboration among the medical director, nursing staff, and recreational therapist to be successful. The program has the potential to improve quality of life and reduce costs of care for older adults who are at risk of poor health outcomes following hospitalization. (Annals of Long-Term Care: Clinical Care and Aging 2008;16[2]:40-46)

Nutritional supplementation is common in the long-term care (LTC) setting. Vitamin A deficiency is rarely seen in LTC, and there is some evidence that supplementation may be harmful to these residents. Studies support benefits of vitamin B₁₂ and folate in individuals who have a deficiency, and the relative risk of supplementation is small. Methylmalonic acid measurements and 1-mg doses of cyanocobalamin and folic acid may be prudent for deficient LTC residents. Finally, vitamin D may help to prevent a variety of conditions from infection to falls. Vitamin D may be one of the most useful single vitamin supplements that can be provided to LTC residents. How to best supplement vitamin D is not entirely clear. Daily dosing of vitamin D or intermittent dosing with megadoses (50,000 IU capsules) are both options to consider. This article reviews supplementation with vitamins A, B, and D based on recent data on risk and benefits, especially in a frail older population. Annals o

Many health and social service providers lack awareness of and knowledge about the long-term care (LTC) needs of the lesbian and gay population, about how to provide culturally- sensitive and affirming services and programs, and about ways to increase accessibility and acceptability of LTC options for lesbian and gay older adults. This article reviews the history of oppression experienced by lesbians and gay men, what is known about them, and issues for consideration by staff in LTC facilities. A life course perspective provides the conceptual framework for understanding the challenges and opportunities faced by older lesbians and gay men in LTC. Recommendations are provided to combat heterosexist assumptions and enhance culturally competent care. (Annals of Long-Term Care: Clinical Care and Aging 2008;16[2]:33-38)