Journal of the American Medical Directors Association
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Randomized Controlled Trial Clinical Trial
Effectiveness of a group exercise program in a long-term care facility: a randomized pilot trial.
The purpose of this pilot was to determine whether a strength and flexibility program in frail long-term care facility (LTC) residents would result in improved function. ⋯ Frail elderly in a LTC facility were able to participate and benefit from a strength training program. The program was delivered with low-cost equipment by an exercise physiologist and LTC staff. The advantage of such a program is that it provides recreational and therapeutic benefits.
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To determine the costs of treating pneumonia in the nursing home setting and explore what factors are most responsible for that cost with a view to reducing cost. ⋯ There is wide variation in treatment for residents with similar clinical presentations. For residents at low risk of mortality, using less expensive antibiotics and reducing ED evaluation could result in cost reductions, although the effect on outcomes is unknown.
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Comparative Study
Tube-feeding versus hand-feeding nursing home residents with advanced dementia: a cost comparison.
To compare the costs associated with caring for severely demented residents nursing homes with and without feeding tubes. ⋯ Nursing homes are faced with a potential fiscal incentive to tube-feed residents with advanced dementia: tube-fed residents generate a higher daily reimbursement rate from Medicaid, yet require less expensive nursing home care. From a Medicare perspective, tube-fed patients are expensive due to the high costs associated with feeding tube placement and acute management of complications. Further work is needed to determine whether these potential financial incentives influence tube-feeding decisions in practice.
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Clinical Trial
Pain Assessment for the Dementing Elderly (PADE): reliability and validity of a new measure.
To establish the reliability and validity of a measure to assess pain in individuals with advanced dementia. ⋯ The PADE is a reliable and valid tool to assess pain in dementing elderly residents of long-term care facilities.
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To develop a clinically relevant and easy to use pain assessment tool for individuals with advanced dementia that has adequate psychometric properties. ⋯ The PAINAD is a simple, valid, and reliable instrument for measurement of pain in noncommunicative patients. Since the patient population used for its development and testing was limited to a relatively small number of males, further research is needed before it can be universally recommended.