Abstract：
OBJECTIVE:To characterize Medicare skilled nursing facility (SNF) residents who become acutely ill with heart failure (HF) and assess the association between the outcomes of rehospitalization and mortality, and severity of the acute exacerbation, comorbidity, and processes of care. DESIGN:SNF medical record review of Medicare patients who developed an acute exacerbation of heart failure (HF) during the 90 days following nursing home admission. SETTING:A total of 58 SNFs in 5 states during 1994 and 1997. PARTICIPANTS:Patients with 156 episodes of acute HF among 4693 random Medicare nursing home admissions. MEASUREMENTS:Demographic variables, symptoms, signs, comorbidity, nursing home characteristics, nurse staffing ratios, and processes of care were compared between acute HF subjects transferred to hospital and those not transferred; and between subjects who died within 30 days of an acute exacerbation and those who survived. RESULTS:After adjusting for age, disease severity, and comorbidity, residents whose change in condition was evaluated during the night shift were more likely to be hospitalized (OR 4.20, 95%CI 1.01-17.50). Residents who were prescribed an angiotensin-converting enzyme inhibitor or who received an order for skilled nursing observation more often than once a shift were 1/3 as likely to die as those who did not (OR 0.303, 95%CI 0.11-0.82), after adjusting for hypotension, delirium, do not resuscitate orders, and prior hospital length of stay. CONCLUSION:For residents who develop an acute exacerbation of HF during a SNF stay, there is an association between attributes of nursing home care and the outcomes of rehospitalization and mortality.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Hutt E,Frederickson E,Ecord M,Kramer AMdoi
10.1097/01.JAM.0000073964.19754.C0keywords:
subject
Has Abstractpub_date
2003-07-01 00:00:00pages
195-9issue
4eissn
1525-8610issn
1538-9375pii
S1525-8610(04)70345-Xjournal_volume
4pub_type
杂志文章abstract：BACKGROUND:Under the federally mandated Long-Term Care Ombudsman Program (LTCOP), certified volunteer ombudsmen (CVO) advocate for the welfare and rights of residents in nursing facilities. In Texas, the Department on Aging contracts with 28 agencies to deliver the LTCOP in respective regions. Regional ombudsman staff ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1097/01.JAM.0000094062.31602.D9
更新日期：2003-11-01 00:00:00
abstract：OBJECTIVE:Older adults receiving Medicare home health services who experience undernutrition may be at increased risk of experiencing adverse outcomes. We sought to identify the association between baseline nutritional status and subsequent health service utilization and mortality over a 1-year period in older adults r...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2010.08.017
更新日期：2011-05-01 00:00:00
abstract：OBJECTIVES:To explore next-of-kin's (NOK's) perceptions of end-of-life (EOL) care in the nursing home setting and to compare these perceptions for residents receiving hospice care plus usual care versus usual care only. DESIGN:Mailed survey. SETTING:Three nursing homes in central Massachusetts. PARTICIPANTS:Nursing ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2010.07.017
更新日期：2011-02-01 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：:Diabetes mellitus (DM) is a major health problem for the aging population. Glycemic control is fundamental to the management of diabetes, as glycemic levels are closely linked to development of diabetes-related complications. Measurement of the hemoglobin A1c (A1c) to assess chronic glycemic control is an integral com...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：10.1016/j.jamda.2005.03.012
更新日期：2005-05-01 00:00:00
abstract：OBJECTIVE:To assess all-cause mortality patients with dementia treated with typical and atypical antipsychotic drugs (APDs). DESIGN:Registry-based cohort study. SETTING AND PARTICIPANTS:A total of 58,412 patients diagnosed with dementia and registered in the Swedish Dementia Registry were included in the study. Of th...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2018.12.019
更新日期：2019-03-01 00:00:00
abstract：PURPOSE:The purpose of this study was to explore approaches used by administrators to respond to grief and bereavement among staff after the death of a resident. METHODS:Continuing care retirement community (CCRC) facilities (n = 10) were randomly selected from a larger study of 31 facilities. Open-ended interviews we...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2015.06.013
更新日期：2015-10-01 00:00:00
abstract：OBJECTIVES:In the United States, home health agencies (HHAs) provide essential services for patients recovering from post-acute care and older adults who are aging in place. During the COVID-19 pandemic, HHAs may face additional challenges caring for these vulnerable patients. Our objective was to explore COVID-19 prep...
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.2020.06.002
更新日期：2020-07-01 00:00:00
abstract：OBJECTIVES:To describe the relation between physician visits and physicians' recognition of a resident's terminal phase in long-term care facilities (LTCFs) in Belgium, England, Finland, Italy, the Netherlands, and Poland. DESIGN:In each country, a cross-sectional study was conducted across representative samples of L...
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.2018.08.015
更新日期：2019-06-01 00:00:00
abstract：OBJECTIVES:From 2013 to 2016, the Centers for Medicare and Medicaid Services Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents ("the Initiative") tested a series of clinical interventions and care models, through organizations called Enhanced Care and Coordination Providers (ECCPs), with ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.01.002
更新日期：2020-09-01 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：:Osteoporosis is expected to increase as our population pyramid shifts toward old age. It is associated with increased risk of fractures, leading to complications of limitation of ambulation, loss of independence, and chronic pain. Depression is also a common occurrence in the elderly population. Currently, up to 35% o...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：10.1016/j.jamda.2011.09.003
更新日期：2012-06-01 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：OBJECTIVES:Existing studies have indicated that caring for a person with disabilities in a family could result in strong adverse impacts on the health of his or her spouse. However, little is known about the potential joint burden and interactive patterns in a family when both spouses are in poor health. The objective ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2016.01.006
更新日期：2016-04-01 00:00:00
abstract：:Nutritional problems are frequent in nursing homes including undernutrition, obesity, and diabetes mellitus, mainly related to disability and behavior troubles. Adequate nutritional care relies both on the quality of menus for regular and modified diet (texture-modified and enriched food) and on the staff knowledge of...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：10.1016/j.jamda.2009.04.003
更新日期：2010-01-01 00:00:00
abstract：BACKGROUND:During aging, a shift of protein metabolism from muscle to splanchnic tissue contributes to increased muscle protein loss after a period of metabolic stress (eg, fasting). OBJECTIVE:To study the adaptation of protein metabolism in the whole body and tissue (ie, skeletal muscle and splanchnic area) to metabo...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2013.06.005
更新日期：2013-09-01 00:00:00
abstract：OBJECTIVES:The current treatment program for fragility hip fractures (HFx) emphasizes a combination of early surgery, rehabilitation, and tertiary prevention strategy for osteoporosis; however, the effect is unclear and little information is available on the risk factors predicting the occurrence of a second hip fractu...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2014.05.010
更新日期：2014-10-01 00:00:00
abstract：:Recent research has shown that while Lewy body dementia. (LBD) may be the second most common form of dementia, it is difficult to confirm the disease before autopsy. Patients with LBD share many clinical signs and symptoms with patients diagnosed with Alzheimer's disease (AD), making it difficult to differentiate betw...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：
更新日期：2001-07-01 00:00:00
abstract：BACKGROUND:The subject of estrogen in regard to short-term memory is controversial. There is support in the medical literature for estrogen improving short-term memory in women, but there are few data on this subject pertaining to genetic men. OBJECTIVE:To examine the effects of supplemental estrogen on short-term mem...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：
更新日期：2000-01-01 00:00:00
abstract：OBJECTIVE:To describe nurse hand hygiene practices in the home health care (HHC) setting, nurse adherence to hand hygiene guidelines, and factors associated with hand hygiene opportunities during home care visits. DESIGN:Observational study of nurse hand hygiene practices. SETTING:and Participants: Licensed practical...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.07.031
更新日期：2020-09-15 00:00:00
abstract：OBJECTIVES:The Beers (2012) criteria and the screening tool of older persons' potentially inappropriate prescriptions (STOPP) criteria are often used to identify potentially inappropriate medication (PIM) use in elderly patients. The aim of this study is to determine the prevalence of PIM use in nursing home residents ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2014.08.008
更新日期：2014-01-01 00:00:00
abstract：OBJECTIVES:Pneumonia is a frequent condition in older people. Our aim was to examine the total healthcare cost related to pneumonia in nursing home (NH) residents over a 1-year follow-up period. DESIGN:This was a prospective, longitudinal, observational, and multicenter study that was a part of the Incidence of Pneumo...
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.2017.01.021
更新日期：2017-05-01 00:00:00
abstract：:Throughout the millennia, the cannabis plant has been utilized as a recognized therapy for pain relief and symptom management. Following the Prohibition-era stigmatization and criminalization of all forms of cannabis of the early 20th century, there has been a recent nationwide and worldwide resurgence in interest and...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2018.11.013
更新日期：2019-01-01 00:00:00
abstract：:Vitamin D deficiency is a common finding in institutionalized older persons. Vitamin D-deficient elderly persons are at higher risk of falls and fractures. Long-term care residents should be considered at high risk of vitamin D deficiency and therefore vitamin D supplementation is highly recommended in this population...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：10.1016/j.jamda.2010.09.013
更新日期：2011-03-01 00:00:00
abstract：OBJECTIVES:The objective of this study is to explore factors that elucidate reasons for psychotropic drug (PD) prescription for neuropsychiatric symptoms (NPS) in nursing home (NH) residents with dementia. DESIGN:A qualitative study using a grounded theory approach. SETTING:Twelve NHs in The Netherlands. PARTICIPANT...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2014.08.016
更新日期：2014-01-01 00:00:00
abstract：:Suboptimal vitamin D status is common in sick, elderly patients and is associated with secondary hyperparathyroidism, increased bone turnover, and accelerated bone loss. Nutritional supplementation of elderly patients with vitamin D and calcium has been associated with a reduction in fractures and falls. Recently, the...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2005.12.010
更新日期：2006-03-01 00:00:00
abstract：OBJECTIVE:To determine the short- (4 weeks) and long-term (6 month) effectiveness of Tibetan medicated bathing therapy in patients with post-stroke limb spasticity. DESIGN:Prospective, blinded, randomized controlled trial. SUBJECTS:Post-stroke patients with limb spasticity were recruited between December 2013 and Feb...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2019.10.018
更新日期：2020-03-01 00:00:00
abstract：:Sexuality is an important component of emotional and physical intimacy that men and women experience throughout their lives. Research suggesting that a high proportion of men and women remain sexually active well into later life refutes the prevailing myth that aging and sexual dysfunction are inexorably linked. Age-r...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：10.1016/j.jamda.2013.01.022
更新日期：2013-08-01 00:00:00
abstract：:Because long-term care residents often have chronic illnesses and complex care regimens, nutritional issues are common in these populations. Furthermore, management is complicated because some residents are terminally ill and under palliative care treatment plans that allow for dehydration and low oral intake. As a re...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：10.1016/j.jamda.2008.03.005
更新日期：2008-09-01 00:00:00
abstract：OBJECTIVES:While various short variants of the Montreal Cognitive Assessment (MoCA) have been developed, they have not been compared among each other to determine the most optimal variant for routine use. This study evaluated the comparative performance of the short variants in identifying mild cognitive impairment or ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2019.02.004
更新日期：2019-08-01 00:00:00
