Articles Posted in Quality of Care

Many nursing home residents reaching the end of life are often vulnerable to burdensome symptoms and potentially improper care practices.  Managing symptoms appropriately and preventing negative care practices from occurring is paramount to high-quality care for end-of-life patients.  A recent study sought to identify common burdensome symptoms and potentially negative practices for nursing home residents reaching the end of life.  The study also aimed to come up with a procedure for care providers in nursing homes to rate impact of symptoms and practices and create recommendations for action.

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As the older population in the United States continues to grow, an increasing number of older adults are receiving long-term services and supports (LTSS) in their communities, assisted living facilities, and nursing homes. One of the greatest concerns regarding LTSS is the quality of services provided to this vulnerable population. Due to the fact that quality of life tends to decline with age, it is important that these services work to maintain or improve older adults’ quality of life as efficiently as possible. A recent study was conducted in hopes of advancing knowledge about changes in various dimensions of quality of life pertaining to health among older adults using long-term services and supports across the different care settings.
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The International Diabetes Foundation has reported that by 2035, the number of patients with diabetes will increase to 590 million. The largest rise is projected among older adults, with an expected 252.8 million cases in 2035. Diabetes is one of the primary causes of disease burden among older adults. Not only do diabetic older adults have increased risk of cardiovascular disease and cancer, they’re also at risk of cognitive dysfunction, functional limitations, and disability. Frailty is also a critical predictor of disability. However, not much research has been done to explore the possible associations between diabetes and frailty, and the mechanisms that could clarify this relationship are unclear.

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It is well known that the aging population is on a continuous rise with people living longer than ever before due to the increase in more chronic conditions, such as cancer and dementia. The progression of these conditions increase the need for more care and heighten the chance for more nursing care problems, such as malnutrition, due to degenerative physical, social, and cognitive functions. Patients who suffer from dementia, especially, may be affected in the early stages of their illness.

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Long-term services and supports (LTSS) in homes, assisted living facilities, and nursing homes are used by more than 6 million older adults in the United States.  By 2030, this number has been predicted to double. LTSS provides assistance and support with basic and imperative activities of daily living (such as bathing and cooking) and can be given in various settings (like nursing homes and assisted living facilities). Currently, LTSS are increasing in growth, but is a “system” that is also fragmented and costly with significant and ongoing concerns about quality.

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The aging population in Japan is the fastest growing in the world—by 2035, one out of every three people will be over the age of 65. With such a rapidly increasing aging population, combating age-related health issues, like physical and mental frailty or illness, is becoming critical. It is crucial that older adults maintain as much functional independence as long as possible. Thus, it is important that long-term care facilities, such as assisted living communities, be able to identify incident disability risk factors for their residents.

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Linda Boly, 59, a registered nurse who had been unjustly terminated by Legacy Good Samaritan Medical Center for complaining to management that cost-cutting measures were putting patients at risk, was awarded $3 million last Friday by a Portland jury.  Linda reported feeling vindicated by the verdict and hopied that this sends a “big message” to Legacy Health System that hastily pushing patients through process jeopardizes them.

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For frail older adults, the preservation of physical mobility, function, and ultimately independence is of highest importance. Sarcopenia, the degeneration of muscle mass, strength, and function with old age, is a significant part of physical frailty. Not only is it a critical risk factor for decreased mobility and the occurrence of falls and fractures, it is also directly associated with rates of hospitalization and long-term care admissions, heightened disability, diminished independence, quality of life, and ultimately leading to death. Research on nutrient intakes has grown due to it being a modifiable risk factor of sarcopenia. Specifically, protein, essential amino acids, leucine, and vitamin D intake are known as important factors in managing sarcopenia. Not taking enough protein and vitamin D can result in lower muscle mass, physical function and muscle strength, and a risk for falls and fractures.

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The use of hospice care has been on a continuous rise for the past 10 years, with 1.5 to 1.6 million people using hospice every year. The majority of this use is by older adults. Although most people in hospice are provided care at home (66%), a significant minority (7%) reside in care facilities such as assisted living settings. Furthermore, by 2015, 27 million people will be 65 years of age and older, and many of them will be residents of assisted living facilities.

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Aging in place has been increasingly supported by public policies in the United States by allowing frail older adults to remain at home. Policymakers often view assisted living facilities and home healthcare services as more economical and less institutional alternatives to nursing home care. Both home healthcare agencies and assisted living facilities face the challenge of caring for sicker patients with complex medical issues, providing opportunities to services in markets with nursing shortages, and finding efficient means of delivering care. The lack of appropriate nursing care may cause assisted living residents to be relocated to a nursing home when their care needs are not met and consequently increase their vulnerability. One method for assisted living facilities and home healthcare agencies to foster aging in place is to utilize telehealth services to monitor safety and health status remotely. Continue Reading

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