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Understanding the Variability in Care of Nursing Home Residents with Advanced Dementia

GeriPal

If you develop dementia, odds are you will spend the last months to years of your life in a nursing home or assisted living facility. This study explored nursing home organizational factors and staff perceptions that are associated with the variation in care for residents with advanced dementia. Rehabbed to Death.

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Dysphagia Revisited: A Podcast with Raele Donetha Robison and Nicole Rogus-Pulia

GeriPal

Summary Transcript Summary Almost a decade ago, our hospice and palliative care team decided to do a “Thickened Liquid Challenge.” Nicole: Yeah, I think definitely delirium, but there are also a lot of medical conditions that can be specific to hospitalizations. Raele: Yep, they definitely can be.

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End-of-Life Dreams and Visions (ELDVs)

Hospice and Nursing Homes Blog

Research reported in the American Journal of Hospice Palliative Care concludes that p ositive general attitudes toward end-of-life dreams, visions, ( ELDV) and positive perceptions are correlated with better bereavement outcomes. I asked Rose after feeding her. “Me? Oh, I’ll definitely be going back. One is a hundred five.

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GeriPal 300th Episode: Ask Me Anything Hot Ones Style

GeriPal

Eric: Definitely MAID- Alex: Eric knows, MAID in Canada Eric: Medical Aid In Dying in Canada. He wants to know what do you guys think about the effect of private equity on hospice and long-term care? Eric: One out of six hospices, so there is financial concern, not just again with hospices, nursing homes, and now physician groups.

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Diabetes in Late Life: Nadine Carter, Tamryn Gray, Alex Lee

GeriPal

When I’m on nursing home call, the most common page I receive is for a blood sugar value. When I’m on palliative care consults and attending in our hospice unit we have to counsel patients about deprescribing and de-intensifying diabetes medications. Summary Transcript Summary Diabetes is common. How high is too high?

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POLST Evidence and Update: Kelly Vranas, Abby Dotson, Karl Steinberg, and Scott Halpern

GeriPal

For a trial to have value, it should not exclude patients over age 80, or those with dementia, or patients residing in nursing homes. Additional links mentioned in the podcast: Recent JGIM article on POLST in California nursing homes, hospitalization, and nursing home care Karl’s GeriPal post on appropriate use of POLST Enjoy!

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Substance Use Disorder in Aging and Serious Illness: A Podcast with Katie Fitzgerald Jones, Jessica Merlin, Devon Check

GeriPal

Devon, I see that you have an R21 to study concurrent prescribing of opioids and benzodiazepines, which are like the second most common thing I prescribe in combination after opioids and laxatives for people in hospice. And so, for-profit hospices, for-profit methadone clinics pop up everywhere, and their care is pretty variable.