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When Evidence Clashes With Emotion: Feeding Tubes in Advanced Dementia

This Q&A with Ramona Rhodes, MD, reviews the balance between medical evidence and emotional investment in the decision to place a feeding tube in patients with advanced dementia.

Improving Outcomes Through a Coordinated Diabetes Disease Management Model

The authors found that their QI project, which involved a specialized NP and evidence-based guidelines, led to significant improvements in patient outcomes, including reductions in hypoglycemia incidence and sliding scale insulin orders, while increasing resident-centered care and improving chronic kidney disease screenings.

Improving the Management of Urinary Tract Infections in Nursing Homes: It’s Time to Stop the Tail From Wagging the Dog

This article addresses some of the reasons why antibiotic therapy is often overprescribed and proposes recommendations for a new stepwise approach to diagnosing UTIs in residents of long-term care facilities, including determining when antibiotic therapy is the appropriate course of action.

Fall Risk Assessment Guidelines

In approximately 33% of cases, a single potential cause can be identified, whereas in approximately 66% of cases, more than one risk factor is involved. To assess the multifactorial cause of falls, the authors developed a falls risk assessment instrument that can be downloaded as a PDF and distributed.

Checklist of Nonverbal Indicators of Chronic Pain in Elderly Residents

This is a downloadable checklist that healthcare providers can use to identify nonverbal cues of chronic pain in elderly residents

More Than Just Location: Helping Patients and Families Select an Appropriate Skilled Nursing Facility

SNFs vary in their strengths and weaknesses, and some may not be equipped to care for the complex needs of individuals who are ill. In this article, the authors present evidence- and experience-based strategies that can guide hospitals to implement systems for facilitating the selection of the most appropriate SNF.

Managing Clostridium difficile Infection on the Verge of the Postantibiotic Era

Over the past few years, there has been nationwide reporting of greater frequency and severity of Clostridium difficile infection (CDI) due to the emergence of so-called hypervirulent strains. In 2013, the Centers for Disease Control and Prevention described the urgency of CDI in the context of an imminent postantibiotic era, a time in which certain infectious diseases will become unresponsive to antibiotic treatment. Annals of Long-Term Care: Clinical Care and Aging® spoke with Teena Chopra, MD, MPH, and Amar Krishna, MD, to gain insight on the complex, multifaceted treatment of CDI in the long-term care setting and how healthcare professionals are rising up to meet the challenge of antibiotic resistance.

Diabetes Foot Education: An Evidence-Based Study in Long-Term Care

In this article, the authors describe a study that evaluated the efficacy of an evidence-based program for training nurses in LTC facilities that had two objectives: (1) to increase the knowledge and skills of nurses about foot care in residents with diabetes to prevent and manage diabetic foot lesions; and (2) to encourage nurses to incorporate regular foot examinations in clinical practice. The results of the study show that implementation of the training program can heighten awareness of the barriers involved when executing quality improvement initiatives in LTC environments.

Hyperbaric Oxygen Therapy: A Brief History and Review of its Benefits and Indications for the Older Adult Patient

Hyperbaric oxygen (HBO2) therapy has long been used to treat decompression sickness, but more recently has been explored as a primary or adjunctive therapy for a number of injuries and medical conditions, many of which commonly affect the aging adult population. This article provides a brief overview of HBO2 therapy, reviewing its history, potential mechanism of action, indications in the older adult population, safety and side effects, and its potential role in nursing home care.

Sustaining Mobility Through Enhanced Bed Egress

This article focuses on the physical actions required to rise and get out of bed and discusses how these actions may present a challenge for older adults with reduced physical abilities. Solutions that facilitate the successful performance of the physical actions of bed egress are also discussed. To ensure the quality, function, and safety of long-term care living environments, it is important to consider the ergonomics of bed systems and other key furnishings.