Annals of Long Term Care

Adverse drug events (ADEs) are defined by the Institute of Medicine (IOM) as, “injuries resulting from a medical intervention related to a drug.”¹ Institutionalized elderly experience ADEs at a rate as high as 10.8 events per 100-patient months, often as a result of polypharmacy, multiple comorbid illnesses, and difficulty with monitoring prescribed medications.^2-4 This translates into approximately 135 ADEs each year in an average-size nursing home (NH; bed size of 105), or approximately 2 million events a year among all U.S. NH residents. ADEs represent the most cli

Background

Polypharmacy is a common problem encountered by clinicians caring for elderly.1 It is encountered in all care settings ranging from outpatient to long-term care (LTC), where it is particularly linked with falls and other associated problems.2 Polypharmacy refers to the use of multiple medications by a patient. The term is used when too many forms of medication are used by a patient, more drugs are prescribed than clinically warranted,3 or even when all prescribed medications are clinically indicated, but there are too many to take (“pill burden”). This has a potentia

INTRODUCTION
Nevada continues to lead nationwide with the fastest growing age 65-and-over population. The number of seniors residing in Nevada increased by 72% between 1990 and 2000, and this population is estimated to grow another 20% between 2000 and 2004.¹ Between the aging population and migration of older seniors, the rates of disability are increasing significantly. Disability, though not caused directly by age alone, increases in frequency with age. In 2003, 39% of the age 65-and-over population in Nevada reported a chronic condition that limited function. 8% of these senio

Palliative care, as defined by the World Health Organization, is “an approach to care that improves the quality of life of patients and their families facing the problems associated with life-threatening illness through the prevention and relief of suffering by means of early identification and impeccable assessment of pain and other problems, physical, psychosocial and spiritual.” Nursing homes (NHs) are the site of death for 40% of Americans, and many NH residents have life-threatening illnesses associated with physical, psychosocial, and spiritual pain. Clearly, palliative care can play