Journal of the American Medical Directors Association
-
To determine modifiable factors related to abusive behaviors in nursing home residents with dementia. ⋯ Abusive behaviors may develop from lack of understanding leading to resistiveness to care. Behavioral interventions preventing escalation of resistiveness to care into combative behavior and the treatment of depression can be expected to decrease or prevent abusive behavior of most nursing home residents with dementia.
-
Randomized Controlled Trial
Using video images to improve the accuracy of surrogate decision-making: a randomized controlled trial.
When patients are unable to make important end-of-life decisions, doctors ask surrogate decision makers to provide insight into patients' preferences. Unfortunately, multiple studies have shown that surrogates' knowledge of patient preferences is poor. We hypothesized that a video decision tool would improve concordance between patients and their surrogates for end-of-life preferences. ⋯ Patients and surrogates viewing a video decision support tool for advanced dementia are more likely to concur about the patient's end-of-life preferences than when solely listening to a verbal description of the disease.
-
To examine the psychometric properties and clinical utility of the CPAT, an instrument to assess pain in nursing home residents with dementia. ⋯ This study provides evidence that the CPAT is a reliable and valid pain assessment instrument when used in nursing home residents with dementia. It has also been shown to be a tool with suitable clinical utility and feasibility. Further study is warranted to ascertain if its use will lead to improved resident function and quality of life and whether the results of this study are reproducible in other dementia populations. The CPAT's ability to quantify pain and measure treatment response has not been determined.
-
This study tests the research hypothesis that certified medical directors are able to use their training, education, and knowledge to positively influence quality of care in US nursing homes. ⋯ The presence of certified medical directors is an independent predictor of quality in US nursing homes.