Self-Neglect in Older Adults With Cognitive Impairment

Older adults with major neurocognitive impairment and poor insight due to executive/frontal deficits often do not understand their lack of ability to safely perform instrumental activities of daily living.  An interdisciplinary approach for cases of self-neglect is useful in managing these complicated cases. Cognitive and capacity assessment regarding IADL concerns and options for self-care are required.

Caring for the Patient With End-Stage Dementia

The article reviews 4 key components to ensuring comfort care in end-of-life dementia.

Advanced Direct Care Worker: A Role to Improve Quality and Efficiency of Care for Older Adults and Strengthen Career Ladders for Home Care Workers

The Eldercare Workforce Alliance provides an overview of the skills needed to improve the role of direct care workers, with a focus on home-based long-term care settings.

Examining the Rationale and Processes Behind the Development of AMDA’s Competencies for Post-Acute and Long-Term Care

To ensure physicians treating elderly patients in skilled care settings are equipped to care for this population, AMDA convened a competency work group to develop a set of competencies geared specifically toward the nursing home attending physician.



Breaking Free From the Caregiver Prison: Can Assisted Living Social Workers Help?

This is the fourth article in a series from Allan Vann, who has shared his experience as a caregiver for his wife, Clare, who has Alzheimer's disease.

Animal-Assisted Therapy: An Exploration of Its History, Healing Benefits, and How Skilled Nursing Facilities Can Set Up Programs

Animals have long been part of the human experience, serving multiple purposes throughout history, from food to companionship. More recently, the therapeutic potential of animals in numerous clinical areas has been increasingly recognized, leading to more healthcare facilities providing animal-assisted therapy (AAT) to their patients. In this article, the author provides an overview of the history of AAT, outlines several benefits that are particularly relevant to geriatric patients, and describes how skilled nursing facilities can set up AAT programs, reviewing how to ensure proper animal selection and prevent zoonotic infections.

Improved Renal and Cognitive Function in a Hospice Patient After Polypharmacy Reduction

This case highlights the positive impact that careful medication reviews and adjustments can have in elderly patients with renal impairment, including trials of stopping potentially unnecessary and inappropriate medications.

Preventing Aspiration Pneumonia by Addressing Three Key Risk Factors: Dysphagia, Poor Oral Hygiene, and Medication Use

Although various treatment guidelines for adults with lower respiratory tract infections exist, a greater emphasis on prevention of aspiration should be considered for older adults, as the mortality associated with this disease process can be staggering in this vulnerable population.

Precious Time

This poem offers a physician's perspective on the passing of time and end-of-life care.

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.