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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 ) |
Review
Nonpharmacologic Approaches to Insomnia in Older Adults
This review discusses options for nonpharmacologic management of insomnia in older adults. A proposed model provides insights into the multidimensional nature of insomnia as a geriatric syndrome and provides a framework for evaluation and treatment. Practical nonpharmacologic interventions (sleep hygiene, sleep restriction, stimulus control, relaxation techniques, cognitive interventions) have demonstrated effectiveness in older adults and may be considered as a component in a multifaceted approach to improve sleep quality.
Are Joint Contractures in Patients with Alzheimer’s Disease Preventable?
Joint contractures impair quality of life and lead to further complications and disability. In severe dementia, many patients are seen in a fetal position. This position causes flexion of the muscles at joints, causing the muscles to undergo shortening, resulting in degenerative tissue changes, and then leading to potential irreversible deformity. The authors discuss the development of joint contractures in Alzheimer’s disease (AD), where it is thought that the natural progression of AD terminates with patients in the fetal position.
Cerumen: Insights and Management
Cerumen is an amalgam of secretions from the cerumenous and sebaceous glands that line the lateral aspect of the external ear canal, and shed epithelial remnants and occasional extraneous material that finds its way into the external auditory canal. Although present in all age groups, cerumen may become particularly problematic in the elderly population and those residing in LTC facilities; impacted cerumen may lead to both worsening of an existing hearing deficit and unexpected cognitive and behavioral irregularities.
Palliative and End-of-Life Care in LTC: Practical Implications of Understanding Spirituality and Religion
This article is the third in a series on palliative care in the LTC setting. Part I appeared in the April issue, and Part II appeared in the May issue of the Journal.
Prevention of Overuse of Wheelchairs in Nursing Homes
The number of nursing home residents in the United States is projected to reach three million by the year 2030. Currently, over 80% of residents spend time sitting in a wheelchair every day. Many of these residents are overlooked for therapeutic treatment because they are perceived as being too physically disabled and/or without rehabilitation potential.
Improving Physical Environments for Dementia Care: Making Minimal Changes for Maximum Effect
The physical environment can play a significant role in treatment for and associated outcomes of LTC facility residents with dementia. The purpose of this article is to discuss the needs of this population and highlight research that demonstrates how relatively simple design modifications to the physical environment of existing facilities can have significant benefits for this population. Future research should explore how the physical environment impacts individuals at different stages of dementia, since many studies focus only on individuals with early-stage dementia or ignore the severity o
Palliative and End-of-Life Care in LTC: Evaluation and Treatment of Dyspnea, Death Rattle, and Myoclonus
This article is the second in a series on palliative and end-of-life care in the LTC setting. The first article appeared in the April issue of the Journal.
The goal of palliative care is to prevent and relieve suffering for patients, regardless of their stage of illness. Most LTC patients should have palliative treatments integrated into their comprehensive care plan because of their high mortality rate and prevalent burden of suffering due to their chronic illnesses. These patients can be expected to suffer from many symptoms as their illness progresses. Three troubling symptoms t
Determination of Life Expectancy: Implications for the Practice of Medicine
Healthcare providers working in long term-care facilities are often called upon to make a judgment regarding a patient’s life expectancy. These judgments can be broadly broken down into three time frames: (1) Will a patient live long enough to benefit from a specific intervention directed at treating or preventing a disease or illness? (2) Is the patient’s life expectancy less than 6 months so that the patient can be considered for enrollment in Medicare-covered hospice? (3) Is the patient going to die so soon that family members should make arrangements now to visit the patient? This arti
Care Transitions Between Nursing Homes and Emergency Departments: A Failure to Communicate
Care transitions between Emergency Departments (EDs) and nursing homes (NHs) are often poorly coordinated, putting patients at risk for adverse consequences. Studies suggest that in over 90% of all NH-to-ED patient transitions, information essential to adequate emergency care is lacking. Communication by ED staff when patients are discharged back to NHs is often substandard as well. EDs often use electronic or paper discharge templates designed for ambulatory, community-dwelling patients, which are not sufficient for NH residents. This article presents a case to illustrate some of the pitfall
Is the Use of Supplemental Vitamin C and Zinc for the Prevention & Treatment of Pressure Ulcers Evidence-Based?
Supplemental zinc and vitamin C are routinely prescribed for the prevention and treatment of pressure ulcers. The authors sought to determine whether there is sufficient evidence-based medical research to support the use of these supplements. Both zinc and vitamin C have been shown in animals to be necessary for effective wound healing. Since malnutrition in institutionalized older patients may contribute to their risk of developing pressure ulcers and may interfere with the treatment of these lesions, it has been proposed that improving nutrition through supplementation of vitamin C and zinc
ALTC Blogs
Thomas T. Yoshikawa, MD
Springfield , Massachusetts
Anytown, Alabama
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