Journal of the American Geriatrics Society
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To determine if dietary intake, nutritional status, and other physical markers are risk factors for the development of pressure sores in the elderly. ⋯ Risk assessment is recommended upon admission to a nursing home and weekly for the first month. Risk status can be effectively predicted by using the Braden Scale in combination with knowledge of age, blood pressure, temperature, and dietary protein intake.
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To ascertain factors influencing the level of advance directives selected by nursing home residents or surrogates and the time delay to documentation of these choices in the medical record after implementation of a facility-wide policy. ⋯ In logistic models, nursing home-employed physicians were more likely to write restricted advance directive orders than community-based physicians even after controlling for resident age, cognitive status, and physical function. In addition, implementation of a formal nursing home advance directive policy can shorten time to physician documentation of resident advance directive status.
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To determine survival, functional independence, and cognitive performance of older patients 2 years after an episode of delirium. ⋯ Delirium identifies older patients at risk for mortality or loss of independence. Delirium may also identify patients at risk for future cognitive decline.
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Comparative Study
Outcomes of skilled cardiopulmonary resuscitation in a long-term-care facility: futile therapy?
To assess whether cardiopulmonary resuscitation performed by in-house physicians is effective for long-term-care residents. ⋯ We conclude that cardiopulmonary resuscitation, even when performed by a trained and experienced physician and team, has limited benefit for elderly long-term-care populations.