Improving Antipsychotic Use in a Veterans Affairs Community Living Center

Quality improvement efforts resulted in an increase in percentage of as-needed antipsychotics with documented behavioral symptoms.

The Role of Nutrition in Modifiable Geriatric Syndromes

The essence of healthcare reform is to shift the paradigm of Western medicine from a treatment model to a prevention model. The inherent benefits of different healthcare interventions for the prevention of disease are debatable. To prioritize the value of different preventive services, the Agency for Healthcare Research and Quality published a technical report titled Common Syndromes in Older Adults Related to Primary and Secondary Prevention, in which they identify eight modifiable syndromes in older adults that frequently lead to institutionalization. The paper focuses on the role of declining nutritional status as a precursor to these syndromes, and outlines nutritional strategies for promoting quality of life in elderly patients. Although the etiology of many of these common geriatric syndromes may not be tied directly to inadequate diet, suboptimal nutrient intake and involuntary weight loss can exacerbate these conditions. Systems that track the effectiveness of nutritional prevention strategies in older adults will facilitate a closer relationship between best practices and the impact of these common syndromes on patient well-being.

Effective Antibiotic Stewardship Programs at Long-Term Care Facilities: A Silver Lining in the Post-Antibiotic Era

The importance and core elements of an antibiotic stewardship program are reviewed.

Pain Management in Long-Term Care Communities: A Quality Improvement Initiative

This QI project improved staff ability to document pain and use targeted pain assessments.

Relieving Drug-Induced Xerostomia With Sorbet

Offering 2 ounces of sorbet prior to meals can help ameliorate drug-induced xerostomia and improve food intake among elderly LTC residents, without changing their medication profiles.

A Caregiver’s Perspective on ALR Care for People with Dementia

This is the fifth article in a continuing series from Allan Vann, who has been the primary caregiver of his wife, Clare, who has Alzheimer's disease.

When Do Poor Outcomes Constitute Poor Care? Making the Case for Unpreventable Outcomes in Long-Term Care Residents

When poor outcomes occur, the initial reaction is to assume that the event was a result of a poor level of care. However, poor care in the nursing home should be distinguished from unpreventable outcomes. This article explores the difference between these two important distinctions.

Rapid Functional Decline After Dabigatran Toxicity in an Elderly Patient

The authors discuss the issues involving dabigatran use and present the case of an 83-year-old patient who experienced rapid functional decline preceded by a massive upper gastrointestinal hemorrhage due to dabigatran toxicity.

Conflicting Demands of Family at the End of Life and Challenges for the Palliative Care Team

Conflict arises when patients and their families seem to accept the palliative care philosophy in principal, yet demand or refuse interventions in a way that is contrary to the basic principles of comfort care.

What Geriatric Care Providers Should Know About the 2014-2015 Flu Season

ALTC discussed this year's flu season with CDC medical epidemiologist Fiona Havers, MD. Havers discusses the currently available flu vaccines, the impact of the antigenic drift on this year's vaccine efficacy, and guidelines for administering antivirals to high-risk older adults.