Abstract:
:As the complexity, prevalence and visibility of ethical dilemmas in medical care of the elderly have grown, hospitals and nursing homes have attempted to develop mechanisms for responding to these difficult ethical issues. While it is known that many hospitals rely on education and advice provided by an ethics committee, little data exist on the responses of nursing homes, despite the unique nature of ethical issues in a long-term care setting. The present paper reports findings from a national survey of administrators of 4504 nursing homes in which mechanisms for handling ethical dimensions in patient care were investigated. Results from 29% of respondents reveal that few nursing homes have established ethics committees (2% of the sample) and that committee formation appears positively associated with facility size and religious affiliation. Committees that have been formed engage in policy review (81%), advisory case review (67%) and education (45%). Few committees include patients or their representatives as members, and few have the authority to make binding decisions (26%). While the most effective response to ethical issues in medical decision-making is being debated, standing committees provide one means to contribute to the quality of decision-making by patients, their family members and their physicians. However, broader inclusion of patient perspectives and education of members regarding ethical analysis are necessary precursors to effective functioning of ethics committees in long-term care.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Glasser G,Zweibel NR,Cassel CKdoi
10.1111/j.1532-5415.1988.tb01786.xsubject
Has Abstractpub_date
1988-02-01 00:00:00pages
150-6issue
2eissn
0002-8614issn
1532-5415journal_volume
36pub_type
杂志文章abstract:OBJECTIVE:To determine if there is a relationship between body mass index and the ability to perform the usual activities of living in a sample of community-dwelling elderly. DESIGN:Secondary data analysis of The National Health and Nutrition Examination Survey-I Epidemiologic Follow-up Study (1982-1984). Follow-up ho...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1994.tb07483.x
更新日期:1994-04-01 00:00:00
abstract:OBJECTIVES:To explore whether models of health behavior change can help to inform interventions for advance care planning (ACP). DESIGN:Qualitative cross-sectional study. SETTING:Community. PARTICIPANTS:Sixty-three community-dwelling persons aged 65 and older and 30 caregivers with experience as surrogate decision-m...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2009.02396.x
更新日期:2009-09-01 00:00:00
abstract:OBJECTIVES:To determine whether patient age is associated with differences in flexible bronchoscopy technique and tolerance. DESIGN:Prospective cohort study. SETTING:University hospital system. PARTICIPANTS:One thousand three hundred fifty-eight adults, including 219 (16.1%) aged 70 and older, undergoing bronchoscop...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1365-2389.2003.51303.x
更新日期:2003-07-01 00:00:00
abstract:OBJECTIVE:Acute myocardial infarction (AMI) is an important cause of mortality and morbidity in older patients. The aim of this study was to determine the proportion of unselected admissions with AMI that is older than 75 years and to examine management and outcomes in this group. DESIGN:An historical cohort study of ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1999.tb02991.x
更新日期:1999-03-01 00:00:00
abstract:OBJECTIVES:Evidence suggests inflammation is associated with cognitive impairment, but previous epidemiological studies have reported conflicting results. DESIGN:Prospective population-based cohort. SETTING:Epidemiology of Hearing Loss Study participants. PARTICIPANTS:Individuals without cognitive impairment in 1998...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12994
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVES:To compare the effectiveness of acute geriatric unit care, based on all or part of the Acute Care for Elders (ACE) model and introduced in the acute phase of illness or injury, with that of usual care. DESIGN:Systematic review and meta-analysis of 13 randomized controlled and quasi-experimental trials with ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,meta分析,评审
doi:10.1111/jgs.12028
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVES:Older black patients are at risk for underutilization of preventive services. Our objectives were to assess the delivery of five preventive services in Title 330-funded health centers in low income neighborhoods in Cleveland, Ohio, and to determine the association of health system factors and health status w...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2000.tb03902.x
更新日期:2000-02-01 00:00:00
abstract:OBJECTIVES:To examine transitions that individuals with dementia experience longitudinally and to identify points of care when transitions are highest and the factors that contribute to those transitions. DESIGN:Population-based 10-year retrospective cohort study from 2000 to 2011. SETTING:General community. PARTICI...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14033
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVES:To develop and test the Function-Focused Care in Assisted Living (FFC-AL) intervention so as to alter the decline that older adults in AL experience. DESIGN:Cluster-randomized controlled trial using repeated measures to test the effect of FFC-AL. SETTING:Four AL facilities with at least 100 beds. PARTICIP...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1532-5415.2011.03699.x
更新日期:2011-12-01 00:00:00
abstract:OBJECTIVES:To investigate the association between blood pressure and mortality in very old people. DESIGN:Population-based cohort study. SETTING:County of Västerbotten, Sweden. PARTICIPANTS:Half of all subjects aged 85 and all of those aged 90 and 95 and older (N=348) in one urban and five rural municipalities in th...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2008.01948.x
更新日期:2008-10-01 00:00:00
abstract::Although there has been increasing attention to the ethical and legal issues involved in the patient's right to have treatment or hospitalization withheld, there have been few empirical evaluations of programs designed to accomplish that end. Over a 7-year period, a medical group cared for 110 patients in a skilled nu...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1988.tb03433.x
更新日期:1988-01-01 00:00:00
abstract::This study was undertaken to identify the demographic characteristics of patients aged 55 or older in a drug-overdose group admitted to the Emergency Department of Arizona Health Sciences Center during the 3-year period, August 1975-July 1978. Of the 646 overdose patients observed, 60 (9.5 percent) were aged 55 or old...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1980.tb00004.x
更新日期:1980-12-01 00:00:00
abstract:OBJECTIVE:To determine whether serum thyrotropin (TSH) levels are altered in euthyroid older persons compared with middle-aged adults. DESIGN:Serum TSH and thyroid hormone levels were measured in a large group of older persons (> 70 years old, n = 216) and their middle-aged offspring (40-60 years old, n = 211) after e...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1993.tb06177.x
更新日期:1993-08-01 00:00:00
abstract::Patients aged 70 years and older who were admitted to a coronary care unit in 1976 with documented acute myocardial infarction were followed to April 30, 1982. At that time, of the 46 patients who had survived initial hospitalization, 28 had died, 16 were still living, and two were lost to follow up. The actuarial sur...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1983.tb03714.x
更新日期:1983-07-01 00:00:00
abstract:OBJECTIVES:To determine whether heat waves (HWs) affect exposure to drugs with anticholinergic effects (DACEs) on admission and the effect of such on length of stay (LOS) and in-hospital mortality in older adults. DESIGN:Retrospective. SETTING:Metropolitan teaching hospital. PARTICIPANTS:Individuals aged 65 and olde...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14100
更新日期:2016-05-01 00:00:00
abstract:OBJECTIVES:To determine the effectiveness of vitamin D supplementation in preventing decline in physical function in older men. DESIGN:Randomized, double-blind, placebo-controlled clinical trial. SETTING:Single-center study conducted at a Veterans Affairs Healthcare System. PARTICIPANTS:Sedentary men aged 65 to 90 (...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/jgs.14510
更新日期:2017-02-01 00:00:00
abstract::Nursing homes have become "ground zero" for the coronavirus disease 2019 (COVID-19) epidemic in North America, with homes experiencing widespread outbreaks, resulting in severe morbidity and mortality among their residents. This article describes a 371-bed acute-care hospital's emergency response to a 126-bed nursing ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16625
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Depression screening and treatment for older adults are recommended in Age-Friendly Health Systems. Few studies have evaluated the association between depressive symptoms and postoperative functioning. We aimed to determine the association between varying levels of depressive symptoms in the preop...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16781
更新日期:2020-12-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1994.tb06210.x
更新日期:1994-10-01 00:00:00
abstract:OBJECTIVES:To test whether a decision aid improves quality of decision-making about feeding options in advanced dementia. DESIGN:Cluster randomized controlled trial. SETTING:Twenty-four nursing homes in North Carolina. PARTICIPANTS:Residents with advanced dementia and feeding problems and their surrogates. INTERVEN...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1532-5415.2011.03629.x
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVES:To assess the effect of exposure to evidence-based medication after hospital discharge for Medicare beneficiaries with acute myocardial infarction (AMI). DESIGN:A discrete-time hazard model was used to estimate time to outcome associated with exposure to four drug classes (angiotensin-converting enzyme inhi...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2012.04165.x
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVES:To assess whether catheter replacement is associated with better clinical outcomes in individuals with long-term urinary catheters. DESIGN:Prospective, noninterventional study. PARTICIPANTS:Individuals (mean age 79.2±11.5) who had had an indwelling urinary catheter for longer than 7 days and a symptomatic ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15517
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVES:To study the prevalence of dementia in Singapore among Chinese, Malays, and Indians. DESIGN:A two-phase, cross-sectional study of randomly selected population from central Singapore with disproportionate race stratification. SETTING:Community-based study. Subjects screened to have cognitive impairment at p...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2008.01992.x
更新日期:2008-11-01 00:00:00
abstract:OBJECTIVES:To assess the association between ownership of Chinese elder care facilities and their performance quality and to compare the case-mix profile of residents and facility characteristics in government-owned and private-sector homes. DESIGN:Cross-sectional study. SETTING:Census of elder care homes surveyed in...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12647
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVES:To assess changes in medication use after a diagnosis of dementia in individuals with type 2 diabetes mellitus. DESIGN:Difference-in-differences analysis of changes in the number of dispensed chronic medications between individuals with and without newly diagnosed dementia. SETTING:Integrated healthcare de...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14429
更新日期:2017-01-01 00:00:00
abstract::The United States Senator from Maryland, as speaker at the Awards luncheon of the American Geriatrics Society (Washington meeting), presented his views on priorities in various health programs for the elderly, and asked for the Society's cooperation in making some of the difficult decisions that lie ahead. An importan...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1979.tb01672.x
更新日期:1979-09-01 00:00:00
abstract:OBJECTIVES:To evaluate the effect of medical Primary Integrated Interdisciplinary Elder Care at Home (PIECH) on acute hospital use and mortality in a frail elderly population. DESIGN:Comparison of acute hospital care use for the year before entering the practice (pre-entry) with the most-recent 12-month period (May 1,...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2012.03965.x
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVE:To evaluate the use of influenza vaccine, rapid influenza testing, and influenza antiviral medication in nursing homes in the US to prevent and control outbreaks. METHODS:Survey questionnaires were sent to 1017 randomly selected nursing homes in nine states. Information was collected on influenza prevention,...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2000.tb02606.x
更新日期:2000-10-01 00:00:00
abstract::It has been reported that postural hypotension in the elderly is common. However, these studies included institutionalized and more or less disabled persons. Furthermore, postural hypotension may be related to baseline blood pressure. In this study, the influence of age and blood pressure on the hemodynamic and plasma...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1989.tb05684.x
更新日期:1989-06-01 00:00:00
abstract::The ratio of pepsinogen I to pepsinogen II in the circulation decreases progressively with increasing severity of atrophic gastritis of the fundic gland mucosa. Fasting blood was obtained from 359 free-living and institutionalized elderly people (age range, 60 to 99 years). A pepsinogen I/pepsinogen II ratio less than...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1986.tb03985.x
更新日期:1986-11-01 00:00:00