Abstract：
:The purpose of this literature review was to assess the current state of affairs in end-of-life care for persons with dementia, to identify barriers to the provision of high-quality care, and to describe exemplary programs that have discovered ways to overcome these barriers. The literature reviewed included English-language articles published since 1990, obtained by searches of Medline, presentations at meetings and conferences, and the Internet. Barriers to quality terminal dementia care identified by this review include: (1) measurement issues regarding quality of care and quality of life, (2) inappropriate interventions stemming from lack or disregard of advance directives, cost considerations, healthcare system factors, and caregiver factors, (3) poor symptom management involving both professional and family caregivers, and (4) current health policy formulated by federal or state governments, insurance companies, and health maintenance organization. High-quality care for persons with dementia at the end of life is possible and is currently being provided in some settings. Further research into areas identified in this review is necessary if the quality of care being provided to this population is to improve.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Blasi ZV,Hurley AC,Volicer Lkeywords:
subject
Has Abstractpub_date
2002-03-01 00:00:00pages
57-65issue
2eissn
1525-8610issn
1538-9375pii
S1525-8610(04)70414-4journal_volume
3pub_type
杂志文章abstract：:Currently, the Agency for Healthcare Research and Quality (AHRQ) Common Format for nursing homes (NHs) accommodates voluntary reporting for 4 adverse events: falls with injury, pressure ulcers, medication errors, and infections. In 2015, AHRQ funded a technical brief to describe the state of the science related to saf...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：10.1016/j.jamda.2016.03.005
更新日期：2016-06-01 00:00:00
abstract：OBJECTIVE:To determine the effects of dopaminergic medication withdrawal in an elderly, demented and minimally ambulatory nursing home population with parkinsonism in New York City. METHODS:In our double-blind, randomized study, 11 patients (7 males, 4 females) were randomized into 2 groups: one group underwent levodo...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jamda.2008.07.001
更新日期：2008-11-01 00:00:00
abstract：OBJECTIVES:The aim of this study was to examine the effects of a home-based and volunteer-administered physical training and nutritional intervention program compared with social support intervention on nutritional and frailty status in prefrail and frail community-dwelling older persons. DESIGN:This was a randomized ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jamda.2016.04.018
更新日期：2016-07-01 00:00:00
abstract：OBJECTIVE:The rate of suicide is highest among the oldest old and is associated with chronic medical illness and functional impairment. These risk factors are prevalent among nursing home (NH) residents, yet little has been published on suicide in this population. METHODS:We performed a population-based, retrospective...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：
更新日期：2000-03-01 00:00:00
abstract：BACKGROUND:An estimated 1.5 million residents of nursing homes (NH) in the United States were prescribed an average of 7 to 8 medications each month. However, it is unknown which of these prescribed drugs and nutritional supplements have been tested for use among NH residents who often have distinct and complex needs c...
journal_title：Journal of the American Medical Directors Association
pub_type： 历史文章,杂志文章
doi：10.1016/j.jamda.2008.06.005
更新日期：2009-01-01 00:00:00
abstract：OBJECTIVES:The purpose of this study was to examine the beneficial effects on cognitive function by a cognitive intervention program designed for dementia care called Learning Therapy in Japan and SAIDO Learning in the United States (hereinafter "SAIDO Learning," as appropriate). SAIDO Learning is a working memory trai...
journal_title：Journal of the American Medical Directors Association
pub_type： 临床试验,杂志文章
doi：10.1016/j.jamda.2014.10.021
更新日期：2015-01-01 00:00:00
abstract：OBJECTIVES:To establish the mortality risk and adverse events associated with the use of atypical antipsychotic medications in people with Parkinson disease psychosis (PDP) in a clinically defined trial cohort. DESIGN:Post hoc analysis of data from a multicenter, open-label extension study of pimavanserin comparing pe...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jamda.2015.06.021
更新日期：2015-10-01 00:00:00
abstract：OBJECTIVES:There is a paucity of data for the assessment of frailty in acutely ill hospitalized older adults. We aim to (1) compare the performance of frailty measures [5-item scale of fatigue, resistance, ambulation, illnesses, and loss of weight) (FRAIL), Tilburg Frailty Indicator (TFI), and Clinical Frailty Scale (C...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2017.04.011
更新日期：2017-07-01 00:00:00
abstract：BACKGROUND:Nursing home residents' repeated transfers to hospital are costly and can lead to in-hospital complications and high mortality for frail residents. However, no research has examined the trajectory of residents' symptoms over their nursing home residency and its relationship to hospital transfer. AIM:The pur...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2016.06.019
更新日期：2016-11-01 00:00:00
abstract：:Vital signs are objective measures of physiological function that are used to monitor acute and chronic disease and thus serve as a basic communication tool about patient status. The purpose of this analysis was to review age-related changes of traditional vital signs (blood pressure, pulse, respiratory rate, and temp...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：10.1016/j.jamda.2010.04.009
更新日期：2011-06-01 00:00:00
abstract：OBJECTIVES:Patients discharged to a skilled nursing facility (SNF) for post-acute care have a high risk of hospital readmission. We aimed to develop and validate a risk-prediction model to prospectively quantify the risk of 30-day hospital readmission at the time of discharge to a SNF. DESIGN:Retrospective cohort stud...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2019.01.137
更新日期：2019-04-01 00:00:00
abstract：BACKGROUND:Inappropriate antipsychotic prescribing is a key quality indicator by which clinical outcomes might be monitored and improved in long-term care (LTC), but limited evidence exists on the most effective strategies for reducing inappropriate antipsychotic use. OBJECTIVES:The objective of the study was to evalu...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2019.07.025
更新日期：2020-03-01 00:00:00
abstract：OBJECTIVES:Because they are potentially modifiable and may coexist, we evaluated the combined occurrence of a reduced forced expiratory volume in 1 second (FEV1) and peripheral artery disease (PAD), including its association with exertional symptoms, physical inactivity, and impaired mobility, in sedentary elders with ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2014.05.008
更新日期：2014-09-01 00:00:00
abstract：OBJECTIVE:Venous thromboembolism (VTE) is common in the elderly, but its epidemiology in nursing home residents remains unclear. This study estimated rates of VTE recorded on nursing home admission and incidence during residence. DESIGN:Retrospective analysis of AnalytiCare long term care (LTC) database for the period...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2013.02.003
更新日期：2013-08-01 00:00:00
abstract：PURPOSE:The culture change (CC) movement aims to transform the traditional nursing home (NH) that is institutional in design with hierarchical management structure into a homelike environment that empowers residents and frontline staff. This study examines differences in adoption of CC practices according to a NH's sel...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2009.11.002
更新日期：2010-09-01 00:00:00
abstract：OBJECTIVES:To determine the effect of a Social Health Maintenance Organization (S/HMO) on diverting older adults admitted into a nursing facility from converting to long-stay placement. DESIGN:Members of the SCAN S/HMO and those in Medicare Fee-For-Service were compared on successful discharge to the community after b...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2009.10.009
更新日期：2010-06-01 00:00:00
abstract：OBJECTIVES:Green House and other small nursing home (NH) models are considered "nontraditional" due to their size (10-12 beds), universal caregivers, and other home-like features. They have garnered great interest regarding their potential benefit to limit Coronavirus Disease 2019 (COVID-19) infections due to fewer peo...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2021.01.069
更新日期：2021-01-26 00:00:00
abstract：OBJECTIVES:To examine costs and effects of care based on comprehensive geriatric assessment (CGA) provided by an ambulatory geriatric care unit (AGU) in addition to usual care. DESIGN:Assessor-blinded, single-center randomized controlled trial. SETTING:AGU in an acute hospital in southeastern Sweden. PARTICIPANTS:Co...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jamda.2015.01.074
更新日期：2015-06-01 00:00:00
abstract：INTRODUCTION:The Electronic Health Record (EHR) is being advocated as a tool to improve patient care. Nationwide initiatives are under way to determine how to implement EHR. To date, community nursing homes have not been involved in that effort. Many reasons, including multiple providers in a home, physical structure o...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2006.09.013
更新日期：2007-01-01 00:00:00
abstract：:The prevalence of malnutrition ranges up to 50% among patients in hospitals worldwide, and disease-related malnutrition is all too common in long-term and other health care settings as well. Regrettably, the numbers have not improved over the past decade. The consequences of malnutrition are serious, including increas...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2014.05.011
更新日期：2014-08-01 00:00:00
abstract：OBJECTIVES:The primary objective was to evaluate the risk of fractures associated with use of zopiclone, a new Z-hypnotic, in a population-based cohort of older people in New Zealand (NZ) in a real-world setting. The secondary objective was to examine a nonlinear relationship with age and risk for fractures in zopiclon...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2016.12.085
更新日期：2017-04-01 00:00:00
abstract：OBJECTIVE:To determine if a facility-wide oral care educational program will improve the quality of routine oral care provided to nursing home residents. DESIGN:Single-blind, pre-post observational study of direct caregivers providing routine oral care to residents in 2 nursing homes. INTERVENTION:A 30-minute oral ca...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2009.09.001
更新日期：2009-11-01 00:00:00
abstract：OBJECTIVE:To investigate the ability of nurses to recognize delirium and its symptoms and to investigate the factors associated with undetected delirium. DESIGN:A prospective, observational study with repeated measurements over a 6-month period. SETTING:Seven long term care settings in Montreal and Quebec City, Canad...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2010.11.002
更新日期：2012-03-01 00:00:00
abstract：OBJECTIVES:To investigate the effects of light therapy on cognition, depression, sleep, and circadian rhythms in a general, nonselected population of seniors living in a long term care facility. DESIGN:A double-blind, placebo-controlled trial. SETTING:The experiment took place at a long term care facility in Pennsylv...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jamda.2011.05.006
更新日期：2012-02-01 00:00:00
abstract：OBJECTIVES:Safe and easily implemented treatment regimens are needed for the management of patients with type 2 diabetes mellitus (T2DM) in long-term care (LTC) and skilled nursing facilities. DESIGN:This 6-month open-label randomized controlled trial compared the efficacy and safety of a DPP4 inhibitor (linagliptin) ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jamda.2017.11.002
更新日期：2018-05-01 00:00:00
abstract：:A case is reported of an initially 78-year-old man whose presentation and course, closely followed over 10 years by an academic neurologist, were consistent with classic idiopathic Parkinson's disease (PD), including unilateral onset, obvious cogwheeling, and a very good prolonged response to levodopa/carbidopa (LD/CD...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1097/01.JAM.0000141949.31853.25
更新日期：2004-11-01 00:00:00
abstract：INTRODUCTION:Hospital admissions due to traumatic brain injuries (TBIs) in older persons are increasing. Falls are the leading mechanism of injury in this age group. TBIs are associated with unfavorable outcomes such as mortality and institutionalization. OBJECTIVES:To estimate rates of TBIs in older persons with seve...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2016.02.032
更新日期：2016-07-01 00:00:00
abstract：OBJECTIVES:To define the prevalence of dysphagia and its associated factors and to investigate the influence of dysphagia and nutritional therapies performed in dysphagic subjects on clinical outcomes, including nutritional status, pressure ulcers, hospitalization, and mortality. DESIGN:A prospective observational stu...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2018.07.023
更新日期：2019-02-01 00:00:00
abstract：OBJECTIVES:To evaluate the impact of a multicenter intervention to reduce potentially inappropriate antipsychotic use in Canadian nursing homes at the individual and facility levels. DESIGN:Longitudinal, population-based cohort study to evaluate the Canadian Foundation for Healthcare Improvement's Spreading Healthcare...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.04.004
更新日期：2020-06-01 00:00:00
abstract：BACKGROUND:Health care-related adverse events (HCRAEs), which should not be confused with (blameworthy) medical errors, are common; they can lead to hospital admissions and can have grave consequences. Although they are sometimes potentially preventable, information is lacking on HCRAEs leading to admission to differen...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2015.06.019
更新日期：2015-12-01 00:00:00
