Journal of the American Geriatrics Society
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Association between treatment or usual care region and hospitalization for fall-related traumatic brain injury in the Connecticut Collaboration for Fall Prevention.
To evaluate the association between the treatment region (TR) or usual care region (UCR) of the Connecticut Collaboration for Fall Prevention (CCFP), a clinical intervention for prevention of falls, and the rate of hospitalization for fall-related traumatic brain injury (FR-TBI) in persons aged 70 and older and to describe the Medicare charges for FR-TBI hospitalizations. ⋯ The significantly lower rate of hospitalization for FR-TBI in CCFP's TR suggests that the engagement of practicing clinicians in the implementation of evidence-based fall-prevention practices may reduce hospitalizations for FR-TBI.
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Randomized Controlled Trial Multicenter Study Comparative Study
Outcomes of feeding problems in advanced dementia in a nursing home population.
To describe quality of care for feeding problems in advanced dementia and probability and predictors of weight loss and mortality. ⋯ Weight loss is a predictor of death in advanced dementia. Treatments can often stabilize weight, but weight loss should be used to trigger discussion of goals of care and treatment options.
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Multicenter Study Comparative Study
Hospice use and public expenditures at the end of life in assisted living residents in a Florida Medicaid waiver program.
To examine the association between hospice use and public expenditures in a sample of dually eligible assisted living (AL) residents at the end of life. ⋯ Hospice use at the end of life may not be associated with lower public expenditures in older dually eligible AL residents. Future research should examine the association between hospice enrollment and the quality of end-of-life care.
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Multicenter Study Comparative Study
Cumulative incidence of functional decline after minor injuries in previously independent older Canadian individuals in the emergency department.
To estimate the cumulative incidence of functional decline in independent older adults 3 and 6 months after a minor injury treated in the emergency department (ED) and to identify predictors of this functional decline. ⋯ Minor injuries in independent older adults treated in EDs are associated with a 15% cumulative incidence of functional decline 3 months after the injury that persisted 6 months later. Simple-to-measure factors such as occasional use of a walking aid, daily medication, need for help with IADLs, and physician assessment of decline may help identify independent older adults at risk of functional decline during their consultation. These results confirm the need to improve risk assessment and management of this population in EDs.
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Multicenter Study Comparative Study
Continuous deep sedation until death in nursing home residents with dementia: a case series.
To describe the characteristics of continuous deep sedation until death and the prior decision-making process of nursing home residents dying with dementia and to evaluate this practice according to features reflecting sedation guideline recommendations. ⋯ Continuous deep sedation until death for nursing home residents does not always guarantee a dying process free of symptoms and might be amenable to improvement.