Journal of the American Medical Directors Association
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The purpose of this study was to describe emergency commitment of residents from nursing homes and to discuss relevant policy issues. ⋯ There are facility, client, and regulatory factors that can be addressed to reduce the inappropriate usage of emergency commitments in nursing homes.
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The anticholinergic risk scale (ARS) score is associated with the number of anticholinergic side effects in older outpatients. We tested the hypothesis that high ARS scores are negatively associated with "global" parameters of physical function (Barthel Index, primary outcome) and predict length of stay and in-hospital mortality (secondary outcomes) in older hospitalized patients. ⋯ High ARS scores are negatively associated with various components of the Barthel Index and predict in-hospital mortality in the presence of hyponatremia among older patients. The ARS score may be useful in the acute setting to improve risk stratification.
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To examine trends of influenza vaccination in nursing homes before and after public reporting (objective-1), and to assess the effect of influenza vaccinations on hospitalization events (objective-2). ⋯ There is no clear evidence that public reporting improves vaccination rates in nursing homes. The effects of vaccination on hospitalization events in nursing homes are mixed.
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Hip fractures are one of the most costly consequences of falls in the elderly. Despite their increased risk of falls and fractures, nursing home residents are often neglected in service utilization and costing studies. The purpose of this study was to determine service use, initial and long-term direct costs of incident femoral fractures in nursing home residents 65 years or older in Germany. ⋯ Residents with femoral fractures used a wide range of health services. Our study underestimates the true costs to society in Germany. Efforts should be directed to economic evaluations of fall-prevention programs aiming at reducing fall-related fractures including femoral fractures.
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To examine nutrition status and to explore risk factors for malnutrition in an urban veterans' long-term care (LTC) facility in Western Canada to determine whether nutrition should be a higher priority for managers, physicians, and staff. ⋯ Most residents were found to be at risk or actually malnourished. Analyses of the results indicate that managers, physicians, and staff need to focus on residents with depression and dementia, and those whose health is unstable. Ethical considerations are important in choosing appropriate interventions because many LTC residents are at an end-of-life stage. Effective nutrition interventions (eg, adding resources to support residents during meals, changing environmental factors) exist but what has not been well investigated are the methods for translating such knowledge into practice.