Abstract：
:Despite the considerable challenges to providing high-quality rehabilitation in a long-term care facility, growing demographic and fiscal pressures are likely to push the nursing home into the forefront of rehabilitation for the frail elderly. Model programs have been implemented in recent years that present alternative ways to increase access to skilled services and improve quality of care in nursing homes without a drastic increase in costs. The teaching nursing home program has supported projects to make longterm care facilities centers for education, innovative clinical care, and research, thus bringing nursing homes into the mainstream of the medical establishment. A majority of US medical schools have recognized the need for training in long-term care and have formed affiliations with nursing homes. The Department of Veterans Affairs has a large national system of nursing homes, which has made a significant contribution to the training of health professionals in many fields. Demonstration projects such as the Social Health Maintenance Organization and On Lok have sought to decrease the fragmentation of health care services for the elderly and bring nursing homes into a continuum of care. The adoption of the OBRA regulations is building a base for comprehensive assessment and improved provision of care in nursing homes nationwide. Nursing home rehabilitation has the potential to decrease institutionalization in the short-term resident, whereas maintenance therapy can improve quality of life and decrease the cost of caring for patients who must be institutionalized. But to achieve this potential, significant barriers must be overcome. Negative attitudes about aging and nursing homes percolate through all levels of health care from lack of reimbursement at the federal and state levels to the professional priorities that continue to favor "high-tech" medicine and stigmatize nursing homes and those who work in them, to low expectations of caregivers and the residents themselves. For nursing homes to provide the level of rehabilitative care that is now expected of them, current funding mechanisms and negative attitudes must be changed, and nursing homes must be recognized as a legitimate part of mainstream health care.
journal_name
Clin Geriatr Medjournal_title
Clinics in geriatric medicineauthors
Joseph CL,Wanlass Wsubject
Has Abstractpub_date
1993-11-01 00:00:00pages
859-71issue
4eissn
0749-0690issn
1879-8853journal_volume
9pub_type
杂志文章,评审abstract：:Depression is one of the most serious and prevalent neuropsychiatric disorders of old age. Despite its prevalence, depression in the aged is frequently unrecognized or is misdiagnosed. This article reviews the existing knowledge of several sleep-related areas and discusses possible future studies into sleep as a progn...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1989-05-01 00:00:00
abstract：:Cardiovascular disease (CVD) is the leading cause of death and disease burden globally. Improving reach, access, and effectiveness of postdischarge care through cardiac rehabilitation and secondary prevention strategies is an international priority. The current proliferation of mobile technology has resulted in widesp...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2019.07.004
更新日期：2019-11-01 00:00:00
abstract：:Gait disorders in elderly individuals are a major cause of falls and their attendant morbidities. Ataxia is one of the neurologic components of fall risk, as are inattention or confusion, visual impairment, vestibular impairment, subcortical white matter disease, parkinsonism, weakness, sensory loss, orthostasis or ar...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2006.06.011
更新日期：2006-11-01 00:00:00
abstract：:This article discusses the usefulness of neuropsychological testing in AD, as an adjunct to the diagnosis, as a means of the evaluation of progression, and response to treatment. Clinical neuropsychological tests that have direct relevance to AD are reviewed, with particular emphasis on recently developed tests of mem...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1994-05-01 00:00:00
abstract：:The aging kidney suffers reduction both in mass and in glomerular filtration rate. These changes may be totally or partially due to atherosclerosis and hypertension, which reduce renal blood flow. Superimposed on these processes, and perhaps responsible for primary loss of renal mass irrespective of renal vascular dis...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1985-02-01 00:00:00
abstract：:In conclusion, the majority, or at least a large proportion, of accidental injuries in the elderly are preventable with careful medical and environmental evaluation and intervention. A vigorous diagnostic, therapeutic, and preventive approach is appropriate in all older patients who fall in addition to those at a high...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1991-11-01 00:00:00
abstract：:Urinary incontinence (UI) in the older adult is a multisystem health problem that has an impact on the lives of millions of older adults. Advanced practice nurses (APNs) specializing in gerontology,family, and adult practice are equipped educationally with the expertise to prevent, assess, and manage this health probl...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2004.04.015
更新日期：2004-08-01 00:00:00
abstract：:Quality of life is becoming increasingly important in assessing the impact of therapy for hypertension in elderly persons. Although the concept of quality of life is new and is in need of further definition, good measures already exist to examine the effects of therapy in the major domains of quality of life such as s...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1989-11-01 00:00:00
abstract：:Aspirin in a dose of 160 to 325 mg should be administered on day 1 of an acute MI and continued indefinitely on a daily basis. Thrombolytic therapy should be administered within 6 to 12 hours after the onset of an acute MI with ST segment elevation or with left bundle branch block. Primary coronary angioplasty when av...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/s0749-0690(05)70113-0
更新日期：2001-02-01 00:00:00
abstract：:Venous thrombosis is a common disease. As the mean age of the population increases, so does the incidence of venous thromboembolism. Anticoagulant therapy is equally effective in young and older patients, and can reduce substantially the associated morbidity and mortality. When considering long-term oral anticoagulant...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2005.09.004
更新日期：2006-02-01 00:00:00
abstract：:As our population continues to age, the early diagnosis and optimal management of patients with gastroesophageal reflux disease becomes paramount. Maintaining a low threshold for evaluating atypical symptoms in this population is key to improving outcomes. Should patients develop complications including severe esophag...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2020.08.003
更新日期：2021-02-01 00:00:00
abstract：:Psychomotor assessment is a collaborative effort between the neurologic and the neuropsychologic evaluation. Changes associated with normal aging must be differentiated from signs and symptoms that indicate abnormal functioning. Recent developments in computer-based technology should add to the precision and accuracy ...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1989-08-01 00:00:00
abstract：:This article discusses the specific effects of smoking on the heart and coronary arteries and demonstrates how these effects increase the risk for cardiovascular morbidity and mortality. The conflicting results of various studies concerning the association of smoking and coronary heart disease in older persons are rev...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1996-02-01 00:00:00
abstract：:What are the dermatologic needs of aging and skin disease in the elderly in the new millennium? This question may be impossible to answer, but predictions may be derived from current sources of data. Data from the US Census Bureau and the National Ambulatory Medical Care Survey are used to characterize current use of ...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章
doi：10.1016/s0749-0690(05)70090-2
更新日期：2001-11-01 00:00:00
abstract：:Syncope is a common clinical problem accounting for 3% of all emergency room visits and 1% to 6% of all hospital admissions. Both a sign and a symptom, syncope can be caused by a wide variety of conditions. Syncope in the geriatric patient can be a particularly challenging problem because of the coexistence of multipl...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2012.07.002
更新日期：2012-11-01 00:00:00
abstract：:This article provides a comprehensive review of the outcomes of polypharmacy in nursing homes. Our review had some limitations. First, we only included studies beginning in 1990, and significant earlier studies are not included. Only English language articles were included. We only researched studies from MEDLINE, and...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2012.01.005
更新日期：2012-05-01 00:00:00
abstract：:Many health care professionals lack knowledge about artificial nutrition and hydration at the end of life or may hold different attitudes about artificial nutrition and hydration compared with other treatments. Consequently, they may convey inaccurate or misleading information to patients or their surrogate decision m...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/s0749-0690(05)70058-6
更新日期：2000-05-01 00:00:00
abstract：:Schizophrenia in late life includes both chronic early-onset schizophrenia and late-onset schizophrenia. Treatment with neuroleptics in relatively low doses is often useful in controlling psychotic symptoms in these patients. The value of neuroleptics is limited, however, by the risks of side effects such as tardive d...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1992-05-01 00:00:00
abstract：:Half of all lung cancers occur in persons aged 65 years and older. The symptoms of lung cancer in the elderly may be nonspecific and misleading. Age trends in incidence, histologic subtype, and stage suggest that selective screening of older persons for lung cancer should be studied. Recent data reveal that the mortal...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1987-11-01 00:00:00
abstract：:Efforts toward early detection of Alzheimer disease (AD) have focused on refinement and identification of diagnostic markers, with the goal of preventing or delaying disease progression. Mild cognitive impairment (MCI) has emerged as a potential precursor to dementia. Though not without controversy, MCI has been assoc...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2013.07.008
更新日期：2013-11-01 00:00:00
abstract：:The use of radioactive isotopes in thyroid evaluation and therapy gives important information in the endocrine assessment of the aged. Thyroid uptake imaging can be used to establish a hypothyroid or hyperthyroid state and can determine the functional status of a palpable nodule. Investigational agents, such as T1 201...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1995-05-01 00:00:00
abstract：:American health-care practitioners are faced with a rapidly growing, geriatric, Hispanic-American population. This group shares certain cultural links but is largely heterogeneous and comprised of many subgroups, the largest of which are Mexican Americans, Puerto Ricans, and Cuban Americans. Health-care practitioners ...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1995-02-01 00:00:00
abstract：:This article reviews the literature on transitional care to and from the LTC environment, highlighting strategies to improve the quality of care transitions. Several factors are vital in the improvement of systems of care dealing with transitions. Key factors include communication with and among health care providers,...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章
doi：10.1016/j.cger.2011.02.004
更新日期：2011-05-01 00:00:00
abstract：:Although exercise capacity declines with age, the decline appears to be slight when measured in healthy, physically active subjects. There is growing evidence that exercise has a positive influence on increasing healthy function and decreasing the impact of diseases common in the elderly. While the dose-response relat...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1988-02-01 00:00:00
abstract：:The routine prescription of hormone replacement therapy for elderly women to prevent heart disease is not indicated. Until better data are available, the use of estrogens primarily to prevent heart disease probably should be reserved for women at high risk by virtue of their LDL/HDL ratio or the presence of manifest c...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1993-02-01 00:00:00
abstract：:Both primary and secondary cancer prevention may improve cancer control among older persons. Although chemoprevention of cancer is feasible, the agents currently used for chemoprevention have several complications. As a result, the use of these substances should be individualized based on risk-benefit ratio. It is rea...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/s0749-0690(02)00028-9
更新日期：2002-08-01 00:00:00
abstract：:More than half of all lymphomas occur in patients aged 60 years or older. This article reviews the management of low-grade and aggressive histology lymphomas in patients older than age 65. Cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy is well tolerated in patients who have a good perfo...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1997-05-01 00:00:00
abstract：:Although many individuals who have had strokes or other physical problems assume that they can no longer drive, they are often unaware of retraining programs. In addition to formal courses supported by sponsoring agencies, such as the AAA, there are also programs run by occupational therapists. This article addresses ...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：
更新日期：1993-05-01 00:00:00
abstract：:Older adults undergoing elective surgical procedures suffer higher rates of morbidity and mortality than younger patients. A geriatric-focused preoperative evaluation can identify risk factors for complications and opportunities for health optimization and care coordination. Key components of a geriatric preoperative ...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2017.08.004
更新日期：2018-02-01 00:00:00
abstract：:Although dementias are defined by their cognitive and functional deficits, psychiatric problems are common, contribute to patient distress and caregiver burden, and precipitate institutionalization. Successful treatment involves understanding that physiologic, psychological, and environmental factors can contribute to...
journal_title：Clinics in geriatric medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cger.2014.04.002
更新日期：2014-08-01 00:00:00
