Annals of Long Term Care

**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

**sub**JCAHO Standards on Pain Management: Toward Improved Management of Pain in Older Adults **endsub**
“You will encounter health care professionals who are resistant to the fact that there are now standards for pain management that accredited health care facilities have to meet,” began June L. Dahl, PhD, Professor, Department of Pharmacology, University of Wisconsin Medical School, Madison. “We have to help them understand why it’s so important to have standards.”

Not only is pain common in older adults, but pain in older persons is often undertreated, Dr. Dahl explained. In

I was brought up never to say, “I told you so.” My parents and teachers drummed it into both my id and ego that being right offered its own satisfactions. As such, there was no need to show off. I do think I have internalized this injunction reasonably well and held off on trumpeting my wisdom to the whole world—at least until now.

And it may well not have been my acquired modesty that has always kept me so quiet. Perhaps I did not have too many opportunities to be any smarter than the next guy. (Speaking of modesty, it can apparently be taken too far. As Churchill famously quipped a

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

**sub**The Evolving View of the Older Patient With CAD: Identifying and Managing Risk Earlier **endsub**
“The nonmodifiable risk factors for CAD (coronary artery disease) are those that are predisposing to the process of atherosclerosis and coronary disease, and the contributing factors include inactivity and obesity,” explained Alan B. Miller, MD, Professor of Medicine, University of Florida College of Medicine, Jacksonville. “Modifiable causative risk factors include hypertension, dyslipidemia, diabetes, and smoking. High systolic blood pressure is the predominant problem in hyperten