It is well known that frail older adults are highly vulnerable to fractures. In long-term care settings, the rate of fracture for older adults is more than double that of older adults living in community settings. Moreover, one third of older adults experience a hip fracture while living in long-term care. Not only are hip fractures one of the most critical consequences of osteoporosis, they are also one of the primary causes of hospital admissions. Residents who are returned to long-term care after hospitalization are in need of more specialized care.

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Impairments in cognitive functioning and depressive symptoms are prevalent among older adults with dementia. Older adults with dementia commonly experience a variety of cognitive and behavioral problems, which may in turn diminish physical activities and mental well-being, reduce social or occupational functions, and decrease health-related quality of life. Furthermore, research has shown that depressive symptoms are strongly related to aggravated cognitive functions in older adults with dementia. Thus, long-term care facilities who provide care to the elderly with dementia should strive to implement effective strategies to improve their cognitive functions and depressive symptoms.

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Living in assisted living facilities has become increasingly popular among older adults with dementia. However, lower staffing levels and availability of care services in assisted living facilities put residents at increased risk for negative outcomes. A recent study examined the rate of hospitalization over one year for assisted living facility residents with dementia compared with those in long-term care facilities. The study found that residents with dementia in assisted living facilities had a hospitalization rate about 4-fold higher than those in long-term care with dementia.

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Preventing the possibility of adverse events, like accidental falls, among patients who stay for a short duration of time in a nursing home may be challenging, but is necessary. These patients differ from long-term care residents in that they are in an unfamiliar environment, are not as known by the staff, and their care aims to increase independence. Research has shown that these kinds of patients are at greatest risk for falling and experiencing fractures.

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Finding the right nursing home for your loved one can be an extremely stressful task. Fortunately, Medicare.gov provides a very useful site for comparison: Nursinghomecompare. MSN News recently performed an analysis nursinghomecompare provided for 16,000 nursing facilities (that take Medicare and Medicaid) in the US: U.S. News Best Nursing Homes by Avery Comarow.

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There is something quite unique about Providence Mount St. Vincent in Seattle that sets it apart from other senior living communities. Not only is it home to approximately 400 older adult residents in need of various types of care, it is also home to the Intergenerational Learning Center—a preschool that provides children and seniors the opportunity to connect and learn from one another.

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A recent congressional report stated that in “numerous” nursing homes across the nation, older adult residents experience serious physical, sexual, and verbal abuse. A study was performed by the minority (Democratic and Independent) staff of the Special Investigations Division of the House Government Reform Committee that found that 30% of nursing homes in America—a total of 5,283 facilities—were cited for an estimated 9,000 occurrences of abuse over a recent two-year period, from January 1999 to January 2001.

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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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Urinary incontinence and behavioral problems that come with dementia are frequently cited among the most common markers necessitating nursing home placement for elderly patients. A study analyzed urinary incontinence prevalence in 321 older adult nursing home residents (average age 81.5 years) in a large city in Brazil. The overall urinary incontinence prevalence was 58.88%. A number of variables were associated with an increased rate of urinary incontinence, including white ethnicity, little to no physical activity, stroke, mobility impairment, and cognitive decline. Although urgency urinary incontinence is usually the most common form in community dwelling older adults, functional incontinence because of mobility or cognitive issues was most common in this group of people.

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