INTRODUCTION
Hip fractures often have very serious consequences for older adults with dementia, including higher risk for developing delirium and a higher mortality rate, than they have for more cognitively intact individuals.1,2 Shen et al3 and Takayama et al4 found poor quality of life and recovery rate results following hip fracture surgery for those with dementia.

Although Toussant and Kohia’s5 literature review found several studies demonstrating the benefit of physical rehabilitation in persons with dementia, many of these patients with hip fracture are deemed poor candidates for

President Bush’s 2008 budget proposal, which aims to eliminate the deficit by 2012, calls for unprecedented cuts in Medicare and Medicaid funding that would create enormous obstacles for long-term care facilities.

All told, proposed cuts in funding for the programs would total more than $101 billion over five years. More than a third of these cuts would come from limits on annual inflation adjustments for reimbursements to nursing homes, hospitals, and healthcare providers caring for beneficiaries. While the President has proposed similar cuts in the past, he’s now calling for permane

Q: Would scales that weigh total weight and percentage of body fat help us to pick up congestive heart failure (CHF) or other medical symptoms any easier, or be helpful in nursing homes?

Allen B. Jackson, MD

Larry E. Johnson, MD, PhD, Medical Director, Community Living Center/Nursing Home Care Unit, Central Arkansas Veterans Healthcare System, and Associate Professor of Geriatrics, and Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, responds:

A: The short answer is “probably not.”

The long answer is:
My skepticism regarding body

INTRODUCTION
Ethical issues are frequently encountered in caring for elderly patients in both acute and long-term care settings. The authors describe a case concerning an elderly male with a newly diagnosed advanced dementia and progressive neurologic disorder, who did not wish to be evaluated or treated based on his Christian Science religion. The authors explore the ethical dilemmas, describe the various ethical principles involved, and illustrate the complexity of medical decision-making. Ongoing discussions with family and appropriate multidisciplinary consultations are key to the clinic

Best Practices in Nursing Care to Older Adults
from The Hartford Institute for Geriatric Nursing, New York University, College of Nursing

Issue Number 1, Revised 2007
Series Editor: Marie Boltz, MSN, APRN, BC, GNP
Managing Editor: Sherry A. Greenberg, MSN, APRN, BC, GNP
New York University College of Nursing

WHY: Normal aging brings about inevitable and irreversible changes. These normal aging changes are partially responsible for the increased risk of developing health-related problems within the elderly population. Prevalent problems experienced by older adults include: slee