To assess and honor the preferences of older adult residents is a fundamental aspect of person-centered care in long-term care facilities. Although researchers and practitioners have initiated the development of measures to assess nursing home residents’ everyday preferences, not much is known regarding how residents interpret and conceptualize their preferences and what specific clinical response must be given to balance health and safety concerns with preferences.
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Patients with dementia are often burdened by their symptoms, while adequate symptom control is crucial to maintain or enhance quality of life. Most Americans with dementia eventually become admitted to, and die in long-term care facilities. Prevalent and important symptoms at the end of life are pain, agitation, and shortness of breath. A holistic approach must be the focus of optimal symptom control due to the fact that symptoms may be interrelated (i.e. pain may be associated with agitation).
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In the United States, over 15, 500 nursing homes that are Medicaid or Medicare certified or both provide care to approximately 1.3 million people. Nursing homes must meet federally mandated minimum standards as a requirement of Medicare and Medicaid payment. Many concerns regarding the quality of nursing home care and the adequacy of oversight and enforcement have been raised over the years. To address them, nursing home provisions under the Omnibus Budget Reconciliation Act of 1987 (OBRA 87) were enacted. Unfortunately, reports of quality problems in nursing homes have not ceased.
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Emergency Department (ED) visits and subsequent hospital admissions from nursing homes (NHs) are common and can be costly to the patient and the health care system. Unfortunately, many of the over 2.2 million ED visits annually by nursing home residents are preventable. The Office of the Inspector General reported that 22% of Medicare beneficiaries experienced an adverse event leading to harm (usually hospital admission) while staying in a skilled NH, and that 60% of these were considered preventable by physician reviewers if better care processes had been used.

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Far too many nursing homes are experiencing an extreme shortage of staff that has diminished the quality and safety of care for their elderly and disabled. Frailty and dependency on nursing home staff is prevalent among residents who not only need assistance in performing basic activities of daily living, but also monitoring of their progressively complicated medical issues. Unfortunately, many nursing homes have not hired the necessary number of staff to meet their residents’ needs.

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Hip fractures (HFs) are highly prevalent among older adults and are a major cause of severe, often constant functional impairment. Those with HFs have diminished self-care abilities, causing increased disability and significant loss in independence and quality of life. Although there are those who are able to obtain complete functional restoration, most suffer from continuous decline. The caring of the average geriatric patient with HF calls for high hospital and long-term costs. Thus, it is important to identify factors that benefit or hinder regeneration to provide optimized treatment of all modifiable factors during rehabilitation. Malnutrition is very common among older hospitalized patients, with as many as 63% of geriatric patients with HF being malnourished or at risk of malnutrition.

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Research shows that nearly 80% of nursing home residents have osteoporosis and 10.8% have a hip fracture.  Dementia significantly increases residents’ risk of a hip fracture.  Although treating osteoporosis in nursing homes was proven to be feasible by the Vitamin D and Osteoporosis Study (ViDOS), only one-third of residents prone to hip fracture were treated. Moreover, a number of these residents were given calcitonin or raloxifene, which are not as effective as alendronate or zolendronic acid.

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The Servicemembers Civil Relief Act (SCRA) was passed by Congress in order to grant certain legal protection for members of the military. However, Corporate America and its front groups have found a loophole in the SCRA that allows them to violate the act without being held accountable—forced arbitration. This puts U.S. Armed Services’ brave men and women, who protect our country and should not have to worry about financial frauds and schemes back home, in jeopardy.

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It has taken far too long, but the Obama administration is finally cracking down on nursing homes to curtail inappropriate use of antipsychotic medications such as Abilify, Risperdal, Zyprexa, and clozapine on residents with Alzhiemer’s disease and dementia. Federal investigators report that many older Americans are overusing psychiatric drugs and recommend that Medicare officials stop making unnecessary prescriptions immediately

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Justice against the Palestinian Authority has finally been served. The six terrorist attacks following the Second Intifada’s end in 2004 was proven on Monday by lead trial counsel Kent Yalowitz of Arnold & Porter to have been supported by the Palestinian Authority in the form of money and personnel. Yalowitz asserted that the PA’s involvement met the legal definition of “material support,” refuting the PA lawyer Mark Rochon’s claim that the PA and the PLO were not liable for the attacks that resulted in hundreds of civilian deaths and injuries.

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