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 This Product Bulletin will discuss the dangers of hypoglycemia in diabetes patients residing in a long-term care environment. It will then discuss the possible advantages of incorporating Levemir into the treatment regimen of this patient group. 
THE BURDEN OF PARKINSON’S DISEASE AND THE NEED FOR EARLY DIAGNOSIS AND EARLY TREATMENT ASCP Official City Guide: Phoenix Senior Care Digest Interdisciplinary Report: A Steady Hand - Promoting Health in the Long-Term Care of Parkinson's Disease Closing the Mixed Dyslipidemia Treatment Understanding Opioid Dependence: Outcomes from HereTo Help ( Digital Edition ) |
AGS Position Paper
Assisted Living Facilities
BACKGROUND
The American Geriatrics Society (AGS) believes that Assisted Living Facilities (ALFs) can offer seniors an environment that could enhance their health status over other possible living arrangements. This Position Statement is to provide policymakers, administrators, health care professionals, and consumers with guidance for achieving optimum outcomes with regards to ALFs.
POSITIONS
The following principles are essential to realizing the potential benefits of ALFs:
1. ALFs have a responsibility to provide complete information to prospective residents to assure that
Who Can Stay at Home and in Command: Judging Safety and Competency in Older Individuals
**sub**Overview of Factors Which Predict an Individual’s Ability to Control Personal Finances and Select Living Situations**endsub**
After older patients receive medical care, agencies are often reluctant to allow them to return to their homes if the patients are thought to be unsafe in their environment. Sanitation, spoiled food, unkempt houses, and fear that they will wander or that they will not receive sufficient care are some of the many concerns that prevent older patients from living alone. “What we’re faced with are what factors should be measured in determining whether somebody
The NCEP III Guidelines Should Be Changed in Elderly and Younger Persons at High Risk for Cardiovascular Events
The Heart Protection Study included 20,536 persons aged 40-80 years (5806 persons aged 70-80 years at study entry and 75-85 years at follow-up) with a serum total cholesterol of 135 mg/dL or higher and prior myocardial infarction (MI) (8510 persons), other CHD (4876 persons), or no CHD (7150 persons).4 Of the 7150 persons without CHD, 1820 had cerebrovascular disease, 2701 had peripheral arterial disease, and 3982 had diabetes. Although treated hypertension was present in 8457 persons, only 237 persons were included on the basis of hypertension alone. Persons were randomized to simv
To Force Feed the Patient With Dementia or Not to Feed: Preferences, Evidence Base, and Regulation
Michael D. Cantor, MD, JD, Special Assistant to the Director, National Center for Ethics, Department of Veterans Affairs, Washington, DC, discussed when and if food and water can be withheld from a nursing home resident. There are three important considerations when making this determination: autonomy, surrogate decision-making, and the best-interest approach.
Dr. Cantor used a case discussion to illustrate a person who fits the common profile of someone who resides in a nursing home. Mr. Smith is an 89-year-old resident with advanced Alzheimer’s disease (AD) who is dependent for all of
Osteoporosis: A Neglected but Treatable Disease
Overview of the Problem
When one thinks about common causes of morbidity and mortality in elderly, osteoporosis is probably not one of the first conditions to come to mind. Even though most physicians are aware of osteoporosis, it is generally considered a less important health matter. Because elderly patients often have several medical problems, these other diseases often attract the attention of the health care provider; as a result, osteoporosis frequently is not adequately addressed. Yet, osteoporosis is a serious, debilitating ailment with morbidity, mortality, and economic costs
One Patient, Many Places: Managing Health Care Transitions, Part III: Financial Incentives and Getting Started
This article is the last in a three-part series. Part I appeared in the September issue and Part II in the October issue of the Journal.
Financial Incentives and Structural Issues
Recommendations
Health care organizations (HCOs) should:
1. Ensure that financial incentives among providers are aligned to promote (1) high quality care transitions, and (2) the transmission of essential data elements to practitioners involved in a patient’s care across different settings.
2. Structure their delivery systems to promote seamless transitions across care settings.
3. Review ben
Recognizing Difficult-to-Treat Late-Life Depression: Knowing When to Refer
**sub**The Geriatric Syndrome of Late-Life Depression **endsub**
“The task,” began Gary J. Kennedy, MD, Professor of Psychiatry and Behavioral Sciences and Director, Division of Geriatric Psychiatry and Fellowship Training Program, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, “is to recognize the difficulties in treating depression, and the assumption is that the more you know about depression, the more sensitive you become about when to refer and when to start the patient on treatment from the onset.” While Dr. Kennedy agrees that it is important for pr
Fever and Infection in the Nursing Home
In her discussion on nursing home evaluations, Suzanne Bradley, MD, Associate Professor, University of Michigan and the Ann Arbor GRECC, presented symptoms and signs of infection in long-term care, an approach to diagnosis and management, useful diagnostic tests, common pathogens, and when to initiate antibiotics.
Most strategies for evaluating fever and infection have been derived from hospitals, where the entire institution is devoted to the diagnosis of acute illness (ie, physicians are present, all diagnostic laboratories are onsite). In contrast, nursing homes focus more on comfort ca
One Patient, Many Places: Managing Health Care Transitions, Part II: Practitioner Skills and Patient and Caregiver Preparation
This series of articles addresses how health care organizations (ie, organized or integrated care systems or large provider groups that receive payment under either a capitated or fee-for-service basis) can improve the quality of transitions among care venues for patients with complex care needs. Part I provided an introduction and discussed strategies for ensuring accountability for patients in transition and facilitating the effective transfer of information. Part II focuses on enhancing practitioners’ skills and support systems, and enabling patients and caregivers to play a more active r
Legal and Criminal Investigation of Health Care Fraud in the Long-Term Care Setting
**sub**Investigation of Health Care Fraud Among Long-Term Care Practitioners **endsub**
Stuart Silver, a Supervisory Special Agent of the FBI, Atlanta, GA, who heads a squad of agents investigating health care fraud in Atlanta and monitors all health care fraud activity in the state of Georgia, began his presentation by quoting a startling figure of $100 billion as an estimate of the sum that is lost to health care fraud each year. He explained that this figure is obtained by calculating 10% of annual health expenditure in the country. While health expenditure is now at approximately $1.35 b
ALTC Blogs
Thomas T. Yoshikawa, MD
Springfield , Massachusetts
Anytown, Alabama
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