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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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Surrogate Decision Making: Bernie Lo and Laurie Dornbrand

GeriPal

In 1988, Cruzan’s parents requested that her feeding tube be removed, arguing that she would not want to continue in this state. On the one hand, this was unfortunate, as it meant Nancy Cruzan could not be disconnected from the feeding tube immediately. In 1990 the Supreme Court ruled…for the state of Missouri. Alex: Bernie.

Document 195
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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!

Document 266
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Deprescribing Super Special Part II: Podcast with Elizabeth Bayliss, Ariel Green, and Kevin McConeghy

GeriPal

Kevin’s study looks at a period of time in the COVID pandemic when a large multistate nursing home provider created a “nonessential medication on hold” (NEMOH) policy in order to conserve critical nursing resources and PPE, and to limit exposure risk for residents by reducing unnecessary contact. ” Ariel: Exactly.

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S3 Ep.1 : How Training Has Changed Over the Last 20 Years, With New Hosts Linda Leekley and Amanda Sternklar

Home Care Pulse

Before that healthcare was cooking along really growing and then this balanced budget act was passed in 1997 and it drastically slashed Medicare reimbursement amounts for services across the continuum. There’s still just a handful that, that have no CE requirements for nurses. That happened. And so that’s what happened.

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Aging and the ICU: Podcast with Lauren Ferrante and Julien Cobert

GeriPal

In a separate study in Chest , Lauren found pre-ICU frailty was associated with post-ICU disability and new nursing home admission. He, his Twitter feed though is brilliant. So, maybe the person with advanced dementia is coming in from the nursing home and nobody can find the living will from however many years ago.