Journal of the American Medical Directors Association
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Physical restraints are often used to prevent falls and to secure medical devices in older people in hospitals. Restraint reduction has been advocated on the grounds that physical restraints have negative psychological effects and are not effective in preventing falls. The potential effect of restraint reduction on length of hospital stay (LOS) has not been investigated. This study was undertaken to compare the average length of stay of older patients in a convalescent medical ward setting before and after a restraint reduction program. ⋯ Physical restraint reduction was associated with significant reduction in average length of stay in convalescent medical wards, especially in the cognitively impaired patients.
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To study the effects of functional decline on admission to long-term institutionalized care within 12 months from acute hospital admission. ⋯ Loss of function in ADL tasks following hospitalization increased the risk for institutionalization, irrespective of preadmission ADL impairment. Potentially, counteracting loss of function in ADLs after acute hospital admission by more intensive rehabilitation may partly reduce the need for institutionalization.
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The association of apathy with Alzheimer disease and other dementias and caregiver burden has been examined in a number of studies; however, less is known about its relationship with delirium and mortality. We aimed to investigate the prevalence, relationship with delirium and dementia, and prognostic value of apathy in an elderly and frail inpatient population. ⋯ Apathy is a common and serious neuropsychiatric symptom associated with cognitive decline, delirium, and disability, and it also independently predicts mortality.
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Randomized Controlled Trial
Can botulinum toxin decrease carer burden in long term care residents with upper limb spasticity? A randomized controlled study.
To evaluate whether botulinum toxin can decrease the burden for caregivers of long term care patients with severe upper limb spasticity. ⋯ Long term care patients who were treated for upper limb spasticity with intramuscular injections of botulinum toxin A had a significant decrease in the caregiver burden. The treatment was also associated with improved scores on patient-centered outcome measures.