Journal of the American Geriatrics Society
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Multicenter Study Comparative Study
Is hospice associated with improved end-of-life care in nursing homes and assisted living facilities?
To examine whether hospice enrollment for nursing home (NH) and residential care/assisted living (RC/AL) residents near the end of life is associated with symptoms and symptom management, personal care, spiritual support, and family satisfaction. ⋯ Rates of hospice use observed in this study (22%) were considerably higher than previously reported, although persons with dementia may continue to be underreferred. Hospice use is targeted to dying residents with higher levels of reported pain and dyspnea. Because difference in care largely disappears in cases when death was expected, LTC staff seem to be well positioned to provide end-of-life care for their residents and are advised to remain sensitive to instances in which death may be expected.
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Multicenter Study Comparative Study
Influenza and pneumococcal vaccination in older veterans: results from the behavioral risk factor surveillance system.
To compare influenza and pneumococcal vaccination rates of older veterans with those of nonveterans and to compare vaccination rates of veterans who receive care at U.S. Department of Veterans Affairs (VA) medical centers with those of veterans who do not. ⋯ VA care was associated with improved influenza and pneumococcal vaccine coverage, although vaccination rates for all elderly veterans fell short of Healthy People 2010 goals. Increased efforts to reach undervaccinated groups, particularly blacks and smokers, are warranted.
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Randomized Controlled Trial Multicenter Study
Effect of a dementia care management intervention on primary care provider knowledge, attitudes, and perceptions of quality of care.
To evaluate the effect of a multicomponent dementia care management program on primary care provider knowledge, attitudes, and perceptions of quality of dementia care. ⋯ A comprehensive dementia care management model resulted in few differences in provider knowledge or attitudes favorable to dementia care, suggesting that this care model's effects on quality were primarily mediated through other components of the care management program.
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Multicenter Study Comparative Study
Assessing the appropriateness of pain medication prescribing practices in nursing homes.
To test a tool for screening the quality of nursing home (NH) pain medication prescribing. ⋯ The PMAS is useful for assessing pain medication prescribing in NHs and elucidates why so many residents have poorly controlled pain.
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Multicenter Study Comparative Study
Factors associated with vaccination of medicare beneficiaries in five U.S. communities: Results from the racial and ethnic adult disparities in immunization initiative survey, 2003.
To examine vaccination in seniors in the five U.S. communities of the Racial and Ethnic Adult Disparities in Immunization Initiative. ⋯ This survey details vaccination patterns in an ethnically and geographically diverse sample of seniors and identifies some differences between blacks, Hispanics, and whites that may contribute to disparities in vaccination coverage. Survey findings highlight the importance of provider vaccination recommendations.