Journal of the American Medical Directors Association
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To determine the demographic and clinical predictors of in-hospital mortality among hospitalized nursing home (NH) residents. ⋯ Among hospitalized NH residents, age 85 years or older and several acute conditions, but not chronic morbidities, predicted in-hospital mortality. Elderly NH residents at risk of developing these acute conditions may benefit from palliative care.
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To examine the association of family members' perception about the adequacy of home health services at the last place of care before death. ⋯ The perception that home health services before death did not meet the decedent's needs may contribute to greater nursing home use.
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Two aspiration syndromes have been identified: Aspiration pneumonia is infectious caused by micro-aspiration of oral bacteria secondary to neurogenic dysphagia or sedation. Infectious bacteria may also be aspirated from the stomach. ⋯ Large bolus gastric aspiration events may have an acute/dramatic onset. This article discusses (1) prevention of recurrent aspiration events caused by 2 common motility disorders: neurogenic dysphagia and gastro esophageal reflux; (2) mechanical source control (debridement/drainage) of sites that may harbor large collections of bacteria protected from antibiotics in biofilm including dental plaque, coated tongue, and chronic sinusitis.