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 facility liaisons where decedents received care. SETTING:Stratified sample of 164 residential care/assisted living facilities and nursing homes in Florida, Maryland, New Jersey, and North Carolina. SUBJECTS:Family members and facility liaisons who gave 446 and 1014 reports, respectively, on 1015 decedent residents. MEASUREMENTS:Reports of death/dying discussions, known treatment preferences, and reports and records of signed living wills (LW), health care powers of attorney (HCPOA), do-not-resuscitate orders, and do-not-hospitalize orders. RESULTS:Family respondents reported a higher prevalence, compared with facility reports, of HCPOAs (92% versus 49%) and LWs (84% versus 43%). In family reports, non-white race and no private insurance were significantly associated with lower prevalence of LWs and HCPOAs; additionally, residing in nursing homes (versus assisted living facilities) and in North Carolina were associated with lower prevalence of reported LWs. In facility reports, non-white race, unexpected death, and residing in North Carolina or Maryland were significantly associated with lower prevalence of LWs, whereas high Medicaid case mix, intact cognitive status, and high family involvement were associated with lower prevalence of HCPOAs. Concordance of family and facility reporting of HCPOAs was significantly greater in facilities with fewer than 120 beds. CONCLUSIONS:The prevalence of ACP in LTC is much higher than previously described, and there is marked variation in characteristics associated with ACP, despite moderately high concordance, when reported by the facility or family caregivers.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Daaleman TP,Williams CS,Preisser JS,Sloane PD,Biola H,Zimmerman Sdoi
10.1016/j.jamda.2008.10.015subject
Has Abstractpub_date
2009-05-01 00:00:00pages
243-51issue
4eissn
1525-8610issn
1538-9375pii
S1525-8610(08)00417-9journal_volume
10pub_type
杂志文章abstract:BACKGROUND:Despite recommendations for annual vaccinations against influenza, many older African-Americans do not receive this vaccine. For 1 month in our private medical offices, we conducted a survey to estimate the vaccination rate for our practice, the reasons why older African-Americans declined to be vaccinated, ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:Individuals with heart failure (HF) who are hospitalized and admitted to skilled nursing facilities (SNFs) are at high risk for rehospitalization and death. The care preferences of this high-risk population have not been studied. OBJECTIVES:To describe care preferences of patients with HF admitted to SNFs f...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2017.05.021
更新日期:2017-10-01 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:OBJECTIVES:The purpose of this study was to examine whether a 12-week combined physical exercise training and nutritional intervention improves physical performance and enhances health-related quality of life (HRQOL) among prefrail elderly women living in the community. DESIGN:This was a randomized controlled trial in...
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.2014.12.005
更新日期:2015-03-01 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: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: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::Sexuality is a basic human need that begins at birth and continues throughout life. The sexual needs of the elderly are similar to those of the young, but with variations in frequency, intensity, and mode of expression. Regardless of age, every individual has a need for love, intimacy, and companionship. Unfortunately...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1097/10.1097/01.JAM.0000061465.00838.57
更新日期:2004-03-01 00:00:00
abstract:OBJECTIVES:The primary objective of this study was to identify proton pump inhibitor (PPI) prescribing patterns in a population of older adults admitted to 22 Midwestern skilled long term care facilities (LTCF) with medical coverage provided by the US Medicare Part A program. The relationship between PPI prescribing pa...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2013.01.021
更新日期:2013-06-01 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:OBJECTIVES:Assisted living (AL) is an expanding site of end-of-life (EOL) care in the United States. Understanding determinants of quality of life (QoL) for AL residents near EOL is vital to optimize care for this growing population, most of whom have some degree of cognitive impairment (CI). This analysis aimed to ide...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.10.012
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVE:To assess whether medical orders within Physician Orders for Life-Sustaining Treatment (POLST) forms reflect patients' preferences for care at the end of life. DESIGN:This cross-sectional study assessed the agreement between medical orders in POLST forms and the free-form text documentation of an advance car...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.10.016
更新日期:2020-11-13 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::Managing Alzheimer's disease (AD) continues to challenge long-term care physicians and administrators. Although pharmacologic treatment can substantially benefit AD patients in the nursing home setting, common misconceptions and skepticism about its value are barriers to treatment use. Aggressive treatment for AD maxi...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2005.09.010
更新日期:2006-02-01 00:00:00
abstract:OBJECTIVE:To identify the differences of incidence of disability between frail older persons with and without slow walking speed. DESIGN:Prospective cohort study. SETTING:Japanese community. PARTICIPANTS:A total of l4,081 older adults aged ≥65 years living in the community, participated in a baseline assessment and ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2015.03.019
更新日期:2015-08-01 00:00:00
abstract::Singapore faces a rapidly aging population. By 2030, 19% of her population will be aged 65 years and above. Other Asian countries face similar problems, with South Korea having the fastest aging population worldwide, followed by China and Thailand. With Singapore possessing an advanced aging population, its policy pro...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2013.12.082
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVES:Prevention and public reporting of falls have suffered due to inadequate attention given to the association of falls and cognitive impairment (CI) among nursing home (NH) residents. This study examines the relationship between CI, residence on dementia special care units (SCUs) and other resident characteris...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2012.07.018
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:Exercise has been proposed as a possible treatment for postprandial hypotension (PPH), yet, its use has not been extensively investigated. This study aimed to determine the effects of intermittent walking on blood pressure (BP) and heart rate (HR) following ingestion of a glucose drink in older people with P...
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.2014.08.013
更新日期:2015-02-01 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: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
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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.2014.04.011
更新日期:2014-12-01 00:00:00
abstract:INTRODUCTION:Antibiotic stewardship programs (ASPs) are coordinated interventions promoting the appropriate use of antibiotics to improve patient outcomes and reduce microbial resistance. These programs are now mandated in nursing homes (NHs) but it is unclear if these programs improve resident outcomes. This systemati...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2017.06.019
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the effects of the modified Hospital Elder Life Program (mHELP) comprising 3 nurse-administered protocols in older patients undergoing gastrointestinal (GI) surgery. DESIGN:Cluster randomized trial. SETTING:Two 36-bed GI wards at a university-affiliated medical center in Taiwan. PARTICIPANTS:Ol...
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.2018.09.016
更新日期:2019-05-01 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: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:OBJECTIVES:To assess whether using coronavirus disease 2019 (COVID-19) community activity level can accurately inform strategies for routine testing of facility staff for active severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. DESIGN:Cross-sectional study. SETTING AND PARTICIPANTS:In total, 59,...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.10.038
更新日期:2021-01-01 00:00:00
abstract::Antibiotics are among the most widely prescribed drugs in long-term care facilities, which highlights the importance of antibiotic stewardship (ABS) in this setting. In this article, we describe the experiences with ABS in nursing homes (NHs) from the perspective of 4 European countries: the Netherlands, Norway, Polan...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.10.005
更新日期:2020-01-01 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:Approximately 14% of Medicare beneficiaries are readmitted to a hospital within 30 days of home health care admission. Individuals with dementia account for 30% of all home health care admissions and are at high risk for readmission. Our primary objective was to determine the association between dementia sev...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.09.012
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to create a screening tool to predict first-time injurious falls in community-living older men and women. DESIGN:Longitudinal cohort study between 2001 and 2009. SETTING:The Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), Sweden. PARTICIPANTS:Community-living ol...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.02.023
更新日期:2019-09-01 00:00:00