Abstract:
:A consensus among geriatricians, ethicists, and neurologists supports a palliative approach to the care of individuals with late-stage dementia. But ten years after the publication of the first large study demonstrating the lack of efficacy of percutaneous endoscopic gastrostomy (PEG) tubes in prolonging life for patients with advanced dementia, and seven years after the appearance of two articles in major medical journals arguing that tube feeding should no longer be the standard of care for individuals with advanced dementia, gastrostomy tubes remain commonplace in this population. One overlooked reason that many families and physicians continue to opt for artificial nutrition is that the case for feeding tubes is a moral one and not a scientific one. What may be at issue for families is how best to demonstrate caring, and caring is not readily amenable to empirical study. A better approach to family members who want feeding tubes for the demented is to acknowledge the symbolic value of nutrition for them and to seek an alternative means of satisfying the need to feed.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Gillick MR,Volandes AEdoi
10.1016/j.jamda.2008.03.011subject
Has Abstractpub_date
2008-06-01 00:00:00pages
364-7issue
5eissn
1525-8610issn
1538-9375pii
S1525-8610(08)00112-6journal_volume
9pub_type
杂志文章abstract:OBJECTIVES:To determine the prevalence and characteristics of advance care planning (ACP) among persons dying in long-term care (LTC) facilities, and to examine the relationship between respondent, facility, decedent, and family characteristics and ACP. DESIGN:After-death interviews of family members of decedents and ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2008.10.015
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVE:To examine whether reduced ability to self-administer medication can accurately classify living placement (independent or assisted living) in a continuing care retirement community (CCRC). DESIGN:Convenience sample of consecutive patients seen in a medical clinic. SETTING:An outpatient medical clinic at a C...
journal_title:Journal of the American Medical Directors Association
pub_type: 临床试验,杂志文章
doi:10.1016/j.jamda.2005.04.002
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND:Both anemia and blood transfusion could be precipitating factors for delirium; hence in postoperative patients with anemia at high risk for delirium, it is controversial whether transfusion is the best option. The aim of this study is to investigate the association of anemia and delirium and the role of bloo...
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.2016.04.008
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVE:Incident reports guide fall prevention efforts in long-term care (LTC) facilities, often based on descriptions of how falls occurred. The validity of these reports is poorly understood. We examined agreement on fall characteristics between fall incident reports and analysis of video footage of real-life falls...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.12.003
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Polypharmacy and multimorbidity is a threat to older people; hence, listing approaches should support physicians to optimize medication. The FORTA (Fit fOR The Aged) classification of drug appropriateness for older people provides positive or negative labels: A (A-bsolutely), B (B-eneficial), C (C...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.07.023
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVE:In cognitively normal adults, nutritional parameters are related to cognitive decline and incidence of dementia. Studies on the role of nutrition in predementia stages subjective cognitive decline and mild cognitive impairment, and mild stages of Alzheimer's disease (AD) dementia in a clinical setting are lac...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.10.020
更新日期:2020-11-15 00:00:00
abstract:OBJECTIVES:To provide an estimate and level of uncertainty for Medicaid cost savings due to Minnesota's Return to Community Initiative (RTCI). DESIGN:Medicaid cost savings are estimated using a semi-Markov model and simulation approach. SETTING AND PARTICIPANTS:RTCI is a statewide program that assists private paying ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.07.016
更新日期:2020-08-28 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:To examine individual items of the SARC-F in predicting adverse outcomes. DESIGN:Prospective cohort study. SETTING:Community-dwelling older people in Hong Kong SAR China. PARTICIPANTS:A total of 4000 men and women aged 65 years and over, stratified in 3 age groups (65-69, 70-74, 75+ years of age). MEASUR...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2017.09.006
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:Dementia is a syndrome associated with stigma and social isolation. Forty-two percent of people with dementia in the United States and almost 40% in the United Kingdom live in assisted living and residential care facilities. Up to 90% of residents with dementia experience behavioral and psychological symptom...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2015.11.015
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVES:Adverse events in nursing homes are leading causes of morbidity and mortality, prompting facilities to investigate their antecedents. This study examined the contribution of safety climate-how frontline staff typically think about safety and act on safety issues-to adverse events in Veterans Affairs (VA) nur...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.05.028
更新日期:2020-07-19 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: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::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: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: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 test different adherent strategies aimed at improving hip protector use among nursing care facility residents. DESIGN, SETTING AND PARTICIPANTS:A cluster randomized controlled trial with 234 residents older than 75 years from 9 units of 7 nursing care facilities in the Northern Sydney region, Australia. ...
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.2010.02.010
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVES:To describe the clinical characteristics, 30-day mortality, and associated factors of patients living in nursing homes (NH) with COVID-19, from March 20 to June 1, 2020. DESIGN:This is a retrospective study. A geriatric hospital-based team acted as a consultant and coordinated the care of older people livin...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.12.003
更新日期:2020-12-11 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: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: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::Long term care facilities are important sites of care for elderly adults. Despite a growing need and interest in medical direction in nursing homes, there have been limited educational opportunities in this area for geriatric medicine fellows. This article describes a novel medical director's curriculum for first-year...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2012.10.008
更新日期:2013-03-01 00:00:00
abstract:OBJECTIVES:To examine the independent associations between atrial fibrillation (AF) and objectively measured mobility in a nationally representative cohort. DESIGN:Wave 1 of The Irish Longitudinal Study on Ageing (TILDA), a population-based study assessing health, economic, and social aspects of ageing. SETTING:Commu...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.08.005
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVE:To identify nursing home standards related to items brought in from the community for residents through a nationwide survey of directors of nursing. Specifically we examined the policies with regard to food, cigarettes, alcoholic beverages, and over-the-counter medications. METHODS:A national survey was dist...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2009.03.003
更新日期:2009-07-01 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:This study assessed individual and organizational context (work environment) factors that influence use of best practices by care aides (nursing assistants) in nursing homes. Little scientific attention has been focused on understanding best practice use in nursing homes and almost none on care aides. SETTIN...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2015.03.009
更新日期:2015-06-01 00:00:00
abstract:OBJECTIVES:Distressing behavioral symptoms often associated with dementia are not uncommon in the long term care setting. Culture change with its "person-centered approach to care" provides a potential nonpharmacological intervention to reduce these symptoms. The purpose of this study was to examine the relationship be...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2012.02.006
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVES:The objective of this study was to measure the level of lighting in nursing homes in a variety of areas to determine its adequacy in meeting the visual needs of elderly residents. DESIGN:Observational study PARTICIPANTS:Eight nursing homes cooperating in an intervention study designed to prevent accidental...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2007.01.003
更新日期:2007-06-01 00:00:00
abstract::There is a paucity of data to guide evidence-based treatment decisions in managing older dermatologic patients, in part because of the frequent exclusion of older adults from clinical trials. Hence, we provide a comprehensive review of important conditions in geriatric dermatology, or "dermatogeriatrics." It is our ho...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2013.02.014
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:There is an increased demand for nursing homes (NHs) in middle-income countries such as Brazil. To monitor the quality of NHs, there is a need for reliable instruments to assess the extent to which the care provided meets the expectations and rights of residents and their families. PURPOSE:To evaluate the r...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2017.04.007
更新日期:2017-07-01 00:00:00