Journal of the American Medical Directors Association
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To evaluate the impact of using different diagnostic criteria on prevalence rates of delirium and subsyndromal delirium (SSD) among demented long-term care (LTC) residents. ⋯ Prevalence rates for delirium are much affected by the diagnostic formulations used. The use of DSM-IV-TR among this population could result in fewer cases being identified as delirious and thus compromise proper care for those individuals. Considering that SSD was prevalent among this population, a systematic implementation of protocols targeting risk factors of delirium might be beneficial among demented LTC residents.
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Hospital readmission from the nursing home is often a concerning development for nursing home residents who have recently been dismissed from the hospital. Clinicians and family often consider the potential prognosis when residents return to the hospital. The objective was to determine the relationship between two-year mortality and 30-day hospital readmission status from the nursing home. ⋯ Older adults who are admitted to the nursing home are at significant risk of 2-year mortality with 2.5 times the odds of mortality in 2 years compared to those residents who are not readmitted. Those patients who are readmitted are older which could explain some of this difference or they could have significant comorbid illness which explains the higher mortality. When faced with residents who have multiple hospital admissions, the provider should consider potential discussion of end of life issues and advanced directives given the prognosis.