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 in charge of a group of CVOs administers each local program. The volunteer ombudsman role is threefold: advocate, mediator, and friendly visitor. METHODS:This descriptive study used a 75-item mail survey designed to gain a better understanding of CVOs' perspectives of their role and effectiveness. A total of 361 active, certified volunteers participated, representing all of the 28 regional Texas ombudsman programs. A series of focus groups was used to amplify survey data. RESULTS:Findings indicate overall role satisfaction, although perception of satisfaction varied with volunteers' age, length of service, level of education, and work experience. Volunteers felt most effective in promoting residents' rights and welfare, and least effective in dealing with financial exploitation, nutrition, and hydration issues. Although not always able to achieve desired changes, most volunteers believed that the ombudsman presence was a positive force. A need for improved understanding and support of the ombudsman role among facility staff and regulatory agents was exposed. DISCUSSION:CVOs' potentially favorable impact on the institutional setting in general, and facility personnel in particular, is dependent on the support from state personnel and regional ombudsman staff as well as the willingness of nursing facility staff to cooperate. Volunteers' sense of performance effectiveness is essential to the success of the LTCOP. Specific recommendations based on study findings are intended to assist in assuring continuous program quality improvement purposed to ensure residents' quality of life.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Ostwald SK,Runge A,Lees EJ,Patterson GDdoi
10.1097/01.JAM.0000094062.31602.D9keywords:
subject
Has Abstractpub_date
2003-11-01 00:00:00pages
323-8issue
6eissn
1525-8610issn
1538-9375pii
S1525-8610(04)70392-8journal_volume
4pub_type
杂志文章abstract:OBJECTIVE:To investigate whether polypharmacy is associated with a higher incidence of frailty in a large cohort of North Americans during 8 years of follow-up. DESIGN:Longitudinal study, follow-up of 8 years. PARTICIPANTS:A total of 4402 individuals at high risk or having knee osteoarthritis free from frailty at bas...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2017.02.009
更新日期:2017-07-01 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:Pressure ulcers, like other chronic wounds, fail to proceed through an orderly and timely process to produce anatomical or functional integrity. Treatment of pressure ulcers is directed to improving host factors and providing an optimum wound environment. In addition to providing a moist wound environment, i...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jamda.2004.12.007
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVES:Older people who are admitted to inpatient rehabilitation settings often experience sleep disturbance or disorders. Both intrinsic and environmental factors may contribute to reduced sleep quality. Poor sleep quality has been reported to be associated with poorer rehabilitation outcomes. The aim of this revi...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2020.03.002
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVES:This study examined the extent to which program site-based and Veteran characteristics were associated with potentially avoidable hospitalizations or other hospitalization of Veterans enrolled in the Veterans Affairs (VA) Home Based Primary Care (HBPC). DESIGN:Retrospective claims-based study. SETTING AND ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.12.033
更新日期:2021-01-29 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:This document offers guidance to clinicians and facilities on the use of telemedicine to deliver medically necessary evaluation and management of change of condition for nursing home residents. SETTINGS AND PARTICIPANTS:Members of the telemedicine workgroup of AMDA-The Society for Post-Acute Long-Term Medic...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2018.11.022
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVES:Validated process measures that correlate with patient outcomes are needed for research and quality improvement. DESIGN:Cross-sectional analysis within a cluster-randomized fall prevention study. SETTING:Nursing homes in North Carolina (n = 16). PARTICIPANTS:Nursing home staff (n = 541) and residents with...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2017.10.018
更新日期:2018-05-01 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:For persons with dementia, the appropriate duration of cholinesterase inhibitor (ChEI) use remains unclear. We examined patterns of ChEI use during nursing home (NH) transition and the factors associated with discontinuation following admission. DESIGN:Population-based retrospective cohort study using linke...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2018.07.020
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVE:To compare the effects of care based on comprehensive geriatric assessment (CGA) as a complement to usual care in an outpatient setting with those of usual care alone. The assessment was performed 36 months after study inclusion. DESIGN:Randomized, controlled, assessor-blinded, single-center trial. SETTING:...
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.2015.12.008
更新日期:2016-03-01 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:BACKGROUND:Exercise tolerance is an important clinical aspect of chronic obstructive pulmonary disease that can be easily and reliably measured with the 6-minute walking test (6MWT). To improve the utility of the 6MWT for patient and health care system management, the interpretation of the functional status measure in ...
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.2011.06.009
更新日期:2012-03-01 00:00:00
abstract::Medication errors remain an important cause of patient morbidity and mortality. Although all medications have the potential to induce unwanted adverse effects, data on the actual incidence and overall severity of preventable adverse drug reactions remains unknown. An Institute of Medicine report (Institute of Medicine...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2007.07.004
更新日期:2007-10-01 00:00:00
abstract:OBJECTIVES:Advance care planning in young-onset dementia largely remains a blind spot within current literature. This study aimed to explore the engagement in and the conceptualization of advance care planning from the perspective of family caregivers of persons with young-onset dementia and to identify potential simil...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.01.007
更新日期:2020-06-01 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:OBJECTIVES:Immigrants often face many unique cultural and logistical challenges in their health care that differ from nonimmigrants. We sought to describe and compare characteristics and the time to placement between recent immigrants and long-standing residents waiting for long-term care (LTC). DESIGN:Population-base...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.07.018
更新日期:2020-08-25 00:00:00
abstract:OBJECTIVES:Pulmonary infections are common in children with quadriplegic cerebral palsy. High frequency chest wall oscillation with the vest therapy (VT) is used to promote pulmonary clearance and to prevent pneumonias in cystic fibrosis patients. The purpose of this study was to ascertain the effectiveness of VT in pa...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1097/01.JAM.0000028225.84012.3B
更新日期:2002-09-01 00:00:00
abstract::Nursing homes can be ideal clinical teaching and learning environments for acquiring geriatric specialty and interdisciplinary team skills, particularly those regarding assessment, care planning, management, monitoring, and collaborating in an interdisciplinary milieu. Little is known as to how geriatric specialty tra...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2008.11.002
更新日期:2009-03-01 00:00:00
abstract:OBJECTIVES:To test whether coordination of discharge from hospital reduces hospitalizations in patients with chronic obstructive pulmonary disease (COPD). DESIGN:Randomized controlled clinical trial. SETTING:Specialized pulmonary hospital. PARTICIPANTS:Patients hospitalized for an acute exacerbation of COPD. INTERV...
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.2013.03.003
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVE:Sex-specific impact of frailty on all-cause mortality in older age population remains controversial. This meta-analysis aimed to evaluate the association between frailty and all-cause mortality in older age women vs men from the general population. DESIGN:Meta-analysis. SETTING AND PARTICIPANTS:PubMed and E...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.05.059
更新日期:2020-07-15 00:00:00
abstract:OBJECTIVE:To determine what variables separate community-dwelling elders from assisted living-dwelling elders. DESIGN:Cross-sectional. SETTING:Community and assisted living facilities in Connecticut. PARTICIPANTS:114 individuals (77 community dwelling, 37 assisted living). ASSESSMENTS:Nutritional survey, 6-minute w...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2009.07.006
更新日期:2010-02-01 00:00:00
abstract:PURPOSE:Long-term care facilities have lagged heavily behind other health providers in adopting health information technology (IT). This article examines the facility characteristics that are associated with health IT adoption. DESIGN AND METHODS:This study is a secondary data analysis of information gathered between ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2016.02.028
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Informal caregivers of patients with a cognitive impairment may face exhaustion while taking care of their relatives, and are themselves at higher risk of disease. The objective was to assess the relationship between patients' comorbidities evaluated with the Charlson index, and the caregiver burd...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2015.10.011
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVES:This study aimed to examine the incidence of, and factors associated with, hospital presentation for self-harm among older Canadians in long-term care (LTC). DESIGN:Retrospective cohort study. SETTING AND PARTICIPANTS:The LTC data were collected using Resident Assessment Instrument-Minimum Data Set (RAI-MD...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.12.022
更新日期:2021-01-15 00:00:00
abstract:OBJECTIVE:To investigate whether depression and/or antidepressants can be a potential risk factor for the development of dementia and mild cognitive impairment (MCI). DESIGN:Systematic review and meta-analysis of longitudinal studies. SETTING AND PARTICIPANTS:Community or clinical settings. Participants included pati...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,meta分析
doi:10.1016/j.jamda.2018.12.004
更新日期:2019-03-01 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:BACKGROUND:Unexplained absence of nursing home (NH) residents is one of the most challenging issues related to the care of older people. The aim of this review was to examine the death and injury outcomes of unexplained absence of NH residents. METHOD:We searched MEDLINE, CINAHL, EMBASE, PsycINFO, AgeLine, and Cochran...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2017.01.007
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVES:The number of older people dying in long-term care facilities (LTCFs) is increasing globally, but care quality may be variable. A framework was developed drawing on empirical research findings from the Palliative Care for Older People (PACE) study and a scoping review of literature on the implementation of p...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.01.009
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVES:Elderly persons with low muscle mass (LMM) or sarcopenia are prone to frailty and functional decline. This study aimed to investigate the relationship between serum selenium level and skeletal muscle mass in community-dwelling elderly. DESIGN:Cross-sectional observational study. SETTING AND PARTICIPANTS:A ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.06.014
更新日期:2014-01-01 00:00:00