Annals of Long Term Care

Issue

  • Issue Number: 
    4

    Like barbershop quartets and galoshes, house calls seemed a thing of the past—until fairly recently. Over the last decade, a small but growing number of physicians and other medical professionals have begun making home visits, primarily to older and disabled patients. While still modest, the number of house calls to Medicare beneficiaries has risen significantly, from roughly 1.6 million in 1996 to nearly 2.1 million in 2006, according to the American Academy of Home Care Physicians (AAHCP).

    A boost in Medicare payments for home visits in the late 1990s made house calls more economically

  • Issue Number: 
    4

    This is part I of a two-part article. Part II will address risk management strategies you can adopt now to reduce your risk of being sued as part of a medical malpractice case.

    Medical Malpractice
    Litigation claiming malpractice may be directed at LTC facilities and the practitioners who work in them.1-3 There are four criteria that must be met for malpractice litigation to have merit:

    1. Did the named individual or institution have an established duty or obligation to perform a particular service or provide care to an individual?

    2. Was there a breach o

  • Issue Number: 
    4

    Introduction
    In long-term care (LTC) residents with impaired caloric or fluid intake and a functional gastrointestinal tract, enteral nutrition through the use of a feeding tube is an important option.1-4 Year 2006 Minimum Data Set (MDS) data from New York State revealed that 8.1% of all nursing home residents were receiving tube feedings. State-to-state rates varied widely, with Nebraska having the lowest rate of 3.8% and the District of Columbia having the highest rate of 44.8%. Enteral nutrition may be provided to patients utilizing nasoenteral, gastrostomy, and jejunal feeding tube

  • Issue Number: 
    4

    1. BENEFICENCE
    • Do right (“good”) by the patient.
    • The physician’s main concern is the welfare of the patient.
    • Do what is medically helpful.

    2. NON-MALEFICENCE
    • Avoiding harm.
    • Implement effective non-hospital treatment when possible (due to complications that can arise during hospitalization of elderly patients).
    • Withhold diagnostic work-up or treatment when intervention is unlikely to result in meaningful survival or patient well-being.

    3. FUTILITY OF TREATMENT
    • Treatment should be consistent with the patient’s (clinically real

  • Issue Number: 
    4

    The purpose of this article is to review current perceptions of appropriate use of antipsychotic medications for behavioral problems in skilled nursing facility residents (SNF) with dementia. This is especially critical now given the public concern. While evidence regarding the pharmacologic treatment of behavioral problems in patients with dementia is sorely lacking, public focus is moving clinicians to stick to the evidence that is available or face some potentially significant consequences. The front page of The Wall Street Journal, a publication likely to capture the attention of re

  • Issue Number: 
    4

    Best Practices in Nursing Care for Hospitalized Older Adults with dementia
    from The John A. Hartford Institute for Geriatric Nursing and the Alzheimer's Association

    Issue Number D11.2, 2007
    Series Editor: Marie Boltz, PhD, APRN, BC, GNP
    Managing Editor: Sherry A. Greenberg, MSN, APRN, BC, GNP
    New York University College of Nursing

    WHY: Inadequate food and fluid intake can result in malnutrition, dehydration, skin breakdown, delirium, and increased morbidity and mortality.1 In the hospital, patients with dementia are more likely than other older patients to

  • Issue Number: 
    4

    Doctors Seeing Fewer Medicare Patients Due to Threat of July 1 Medicare Physician Fee Cut; AGS Launches New Advocacy Campaign to Block the Cut
    Nearly 25% of medical group practices responding to a recent national survey said they had either begun to limit the number of Medicare patients they treat or are not accepting any new Medicare patients, due to uncertainty surrounding Medicare payment rates, according to Congressional Quarterly’s “HealthBeat.”

    The American Geriatrics Society (AGS) has launched a new advocacy campaign urging Congress to block the July 1 cut. Fo

  • Issue Number: 
    4

    Translating Evidence-Based Falls Prevention into Clinical Practice in Nursing Facilities: Results and Lessons from a Quality Improvement Collaborative
    Cathleen Colón-Emeric, MD, MHSc, Anna Schenck, PhD, Joel Gorospe, RN, MSN, Jill McArdle, RN, MSPH, Lee Dobson, MPA, Cindy DePorter, MSW, and Eleanor McConnell, RN, PhD, APRN, BC

    OBJECTIVES: To describe the changes in process of care before and after an evidence-based fall reduction quality improvement collaborative in nursing facilities.

    DESIGN: Natural experiment with nonparticipating facilities serving as co

  • Issue Number: 
    4

    Q. What is dementia?
    A. Dementia is a condition of declining mental abilities, especially memory. The person will find it hard to do things he or she used to be able to do easily. Some examples are trouble balancing a checkbook, driving a car safety, or planning a meal. He or she will often have problems finding the right words and may become confused when given too many things to do at once. The personality of a dementia sufferer may also change. He or she may become aggressive, paranoid, withdrawn or depressed.

    Q. Isn’t dementia just old age or senility?
    A. Aging along d







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