INTRODUCTION
Diabetes mellitus (DM), primarily type 2, is a prevalent, resource-intensive condition in nursing homes (NHs), which may have significant impact on residents’ function and quality of life. Upon admission to a NH, 26.4% of residents have a diagnosis of DM, including short-stay (< 6 months) and long-stay residents (> 6 months), whose placement may be permanent.1 Almost half of residents with DM will become long-stay residents.1 Compared to those admitted without DM, residents with DM have a higher burden of comorbid disease, disability, and cognitive impairment, pain, depression

Increasingly, economists and lawmakers are taking a close look at the cost of financing Medicare, Social Security, and other entitlement programs that benefit older Americans. This is, of course, a good thing. Spending on these entitlements is rising significantly and will increase dramatically as the nation's 77 million baby boomers reach retirement age. As a nation, we need to take a critical look at these programs, know what’s coming, and know how to prepare.

While we do this, it’s important that those of us who care for and about older adults also acknowledge the value of programs

Many individuals will receive their end-of-life care in long-term care settings. Nursing home residents with life-limiting illness may or may not be formally enrolled in a hospice program, but in either case are entitled to appropriate care at the end of life.1 The broader proposition is that it is or should be a societal norm to value providing compassionate end-of life care to persons across the continuum of care settings. An important question to consider is how well or poorly the current economic and regulatory frameworks support the quality of end-of-life care that nursing home residents

Effect of an In-Home Occupational and Physical Therapy Intervention on Reducing Mortality in Functionally Vulnerable Older People: Preliminary Findings

Laura N. Gitlin, PhD, Walter W. Hauck, PhD, Laraine Winter, PhD, Marie P. Dennis, PhD, EdM, and Richard Schulz, PhD

Objectives: To evaluate the effect of a multicomponent intervention on mortality and the role of control-oriented strategy use as the change mechanism.

Design: Two-group randomized design with survivorship followed for 14 months. Participants were randomized to intervention or a no-treatment control group.

Setting