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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According to a recent article from The New York Times, federal investigators have  reported that Medicare payments received by nursing homes far exceed the amount it costs them to provide care, manipulating the billing system in some instances by providing patients more therapy services than is necessary.

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Older adults with dementia often experience apathy, but this symptom is commonly overlooked. Studies have shown that environment-based interventions have a positive influence on apathy. However, not much research has been done to explore influential environmental qualities. Researchers have pointed out that environmental factors have a significant influence on apathy.  Environmental factors such as institutionalization, which can lead to diminished incentive, reward, or control, can influence the development of apathy. Environmental factors are especially significant given that they are often easier to change than many internal factors related with aging and dementia.

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A recent study found that approximately 25% of older adults experience depressive symptoms. Candidate genes that are known to influence depression and that have been commonly studied include those that effect serotonin, dopamine, or nueroplasticity. However, the majority of candidate gene studies have not considered the relationship of genetics, demographic, clinical, and behavioral markers and how they combine to trigger depressive symptoms among older adults. The aim of the study was to gain a deeper understanding of depressive symptoms among elderly people.

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Many older adults who suffer from cognitive disability also display challenging or problem behaviors.  These types of behaviors threaten the physical safety of the individuals or others or cause community facilities to become inaccessible. There has been much concern for many years regarding the use of psychotropic drugs—specifically, antipsychotics—that are used inappropriately in patients with cognitive disability and that are often prescribed solely for challenging behavior rather than for diagnosed cognitive illness, despite lack of substantial evidence.

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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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The prescription of potentially inappropriate medications to older adults is known to be highly prevalent in the United States, estimating from 12% for community-living seniors to 40% for those dwelling in nursing homes (NHs). When prescribed drugs are clearly indicated, founded on scientific evidence, and are well tolerated, medication use is considered beneficial. Medications that are inappropriately prescribed often lead to negative health consequences. Furthermore, age-related physiological changes may influence the change of pharmacokinetic and pharmacodynamics responses to medications, further decreasing the tolerability of many medications in older adults.

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Yelp has long been a popular site used to find businesses. Now, Yelp can help people make informed decisions even more about hospitals, long-term care facilities, and dialysis centers. Yelp has recently partnered with ProPublica, an award-winning nonprofit new organization,  to integrate health care statistics and consumer opinion survey data displayed on the Yelp business pages of over 25,000 medical care facilities. Yelp users can now see hospital wait times, nursing home fines or post-dialysis readmission rates conveniently on the business’ Yelp pages.
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Older adults are increasingly turning to assisted living facilities for their care needs. Not only is assisted living more affordable than long-term care (i.e. nursing home care), it also provides a more homelike and autonomous setting, as well as secure housing, personal support, and limited health care. However, unlike traditional nursing homes, assisted living facilities have lower staffing levels and provide less professional services, which put vulnerable older adults at higher risk. Delayed identification of developing health problems and decreased ability to provide more intensive care could result in hazardous consequences for assisted living residents and, ultimately, greater need for acute care. US physicians who were asked to compare assisted living with long-term care reported diminished confidence in the abilities of assisted living staff, described less treatment options in this setting, and stated that they were more likely to move an assisted living resident with a medical issue to an emergency department.

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