Journal of the American Medical Directors Association
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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.
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A clinical study was conducted to measure the effectiveness and operational characteristics of a new device intended to reduce the incidence of falls in elderly patients at high risk of falling. The NOC.watch device consists of a credit-card size device contained within an adhesive "patch"worn on the thigh continuously for many days. The patch is small, wireless, disposable, waterproof, shockproof, and unobtrusive. When a patient's leg becomes weight-bearing (such as when a patient gets out of bed or stands up unassisted), the receiver emits an audible signal which both alerts the patient to sit down and also summons a caregiver. ⋯ The prototype NOC.watch device appears to have a large impact on reducing fall risk in nursing home patients, with minimal adverse effects. However, due to the lack of an equivalent control group, these results should be confirmed with a larger, randomized, controlled study to better estimate the true magnitude of the effect of the NOC.watch device on fall rates.
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To determine the prevalence of hypertension and the appropriate treatment of hypertension in older persons in an academic nursing home. ⋯ Of older persons with hypertension in an academic nursing home, 16% had poor control of their hypertension. There was overuse of calcium channel blockers and alpha blockers and underuse of diuretics, beta blockers, and ACE inhibitors in treating hypertension. Physician education needs to be intensified to provide better medical care of older persons with hypertension through the use of optimal doses of drugs found to be effective and safe by evidence-based studies.
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Because of difficulty experienced in assessing pain in frail older patients and the lack of pain assessment tools with standardization in the elderly, the Functional Pain Scale (FPS), an instrument incorporating both subjective and objective components to assess pain, was developed and evaluated. ⋯ The Functional Pain Scale was determined to be reliable, valid, and responsive. The responsiveness of the Functional Pain Scale was superior to the other instruments tested. The Functional Pain Scale is an acceptable instrument for assessing pain in older adults and may reflect changes in pain better than other instruments tested. Further testing in other populations is warranted.