Annals of Long Term Care

I do love being a doctor, but have over the years managed to maintain my hobbies. Apparently, this is good for healthy aging—both physical and mental, not to speak of one’s marriage after retirement. Speaking of avocations, although I have strummed a guitar and sung for many years now, it has been a long time since I played a gig in front of a gaggle of summer camp counselors—all of them age 17 to 25 years. Of course, I used to do this quite frequently, but that was when I was 17 to 25 years old. Over the ensuing years, I have occasionally performed, usually with the reluctant but melodious help of my wife. In those cases, however, it was always in front of a less chronologically challenged audience.

“I’m tired. I don’t know what’s the matter with me.”

As usual, Grandma expected to be well. It was a weakness not to; she expected it even at 94, and when it eluded her, there was a taint of disgust in her voice.

I leaned over to speak into her ear. “I’ve come to see you, Grandma. It’s Kitty.”

“Kitty, why how wonderful. I haven’t seen you for such a long time.” Her voice was weak. She didn’t move, other than her shoulders laboring to aid her breathing. She continued to face the wall in her room in the nursing home, her knees pulled up to her frail body.

Healthcare coverage has historically focused on providing acute life-sustaining services, but there has been growing attention paid to improving end-of-life care. This attention has been increasing as of late in healthcare reform, with other recommended changes being proposed. Of course, end-of-life care is critical from a cost perspective—both emotional and financial.

This issue is especially keen at this time given the concern by many over healthcare costs, specifically concerns with ineffective treatment at the end of life. Studies have shown that approximately one-third of Med

As a gerontologist with 18 years of experience providing services to older adults and their families, mostly in nursing homes (NHs), I am curious about progressive models and innovative methods of caring for older adults. Increasingly, I have started to wonder about the experiences of other countries as they grapple with the issue of long-term care (LTC). What are their structures? How do their programs, services, and facilities compare to ours? Could our future be found somewhere else? Therefore, it was with great anticipation and excitement that I became a participant in The American Society

Comprehensive Interdiscipilinary Geriatric Assessment has been shown to be associated with mixed outcomes in various clnical settings.1 However, studies evaluating Comprehensive Interdisciplinary Geriatric Assessment in the long-term care (LTC) setting are nonexistent. A very similar process in the nursing home (NH) setting involves the Interdisciplinary Care Plan process, which must be performed on admission, quarterly, and with acute change of condition of the patient. Federal regulations indicate that a facility must develop a comprehensive care plan for each resident. It must include measu