A large variety of chronic diseases is related to changes in body composition. The loss of skeletal muscle mass is particularly critical with regard to an older adult’s quality of life due to the fact that it could lead to decreases in exercise ability and activities of daily living. Cachexia is defined as a condition in which one loses more than 5% of body weight in the duration of 12 months and is associated with the presence of a chronic disease, such as cancer, chronic obstructive pulmonary disease, and heart failure. Much research has been done in the past several years in regards to finding new treatments to prevent muscle deterioration and cachexia is patients suffering from chronic diseases, but also the muscle deterioration related to “healthy aging.”

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It is an unfortunate fact that nursing homes frequently use forced arbitration clauses that, once coerced to be signed by a resident, strips him of his legal rights and is rendered powerless in the event of a future dispute.  Former US Representative Henry Waxman recently published an op-ed in the Sacramento Bee (CA), outlining the reprehensible attributes of forced arbitration clauses and how nursing homes pressure patients and their loved ones into signing them before being admitted.  Unless the Center for Medicare and Medicaid Services calls for an end to forced arbitration, they will continue to be abused. As an original author of the Federal Nursing Home Reform Act that enabled the center to have regulatory authority over nursing homes, Waxman vehemently advocates for the ban of forced arbitration due to its primary use as a tool to avoid accountability.

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Older adults living in assisted living facilities often require assistance with medication management. A recent study analyzed the roles in assisted living medication management and satisfaction with unlicensed assisted personnel (UAP) as medication aides, a commonly used approach to decrease staffing expenses. The results of the study detail medication management roles, empirical confirmation of existing assisted living nursing profession standards, and satisfaction with the role of UAP as medication aide from all perspectives. A few clinical implications from the study were creating a supportive environment for medication aides (i.e., UAPs), the significance of the role of the Registered Nurse as a facilitator of assisted living medication management, and the necessity for collaboration and interprofessional team development across various settings.

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Adverse events in hospitals remain highly prevalent to this day.  From 2008 to 2012, the Department of Health and Human Services conducted a series of studies pertaining to hospital adverse events, which are injurious outcomes from medical care. A Congressionally mandated study was part of this work that sought to identify a national incidence rate for adverse events in hospitals. Researchers developed methods to determine adverse events, as well as the extent to which events are preventable, and measure the cost of events in accordance with the Medicare program. A recent study that is part of that work evaluated post-acute care provided in skilled nursing facilities (SNFs). SNF post-acute care aims to help its patients enhance their health and functioning after a hospitalization and is second only to hospital care among inpatient expenses to Medicare. Not much is known about resident safety in SNFs.

This study approximates the national incidence rate, preventability, and expense of adverse events that occur in SNFs by using a two-stage medical record review to pinpoint events for a sample of 653 Medicare beneficiaries discharged from hospitals to SNFs for post-acute care.

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A decreased ability to distinguish between colors is characteristic of people who suffer from Parkinson’s disease, but is less severe among those who have Gaucher’s disease with “Parkinsonian” symptoms. Although most of the world’s population is not as prone to developing Gaucher’s disease compared to Parkinson’s, Ashkenzi Jewish families are most commonly affected by it.  According to recent research conducted by Jerusalem’s Shaare Zedek Medical Center (SZMC), Gaucher’s disease is characterized by symptoms much like Parkinson’s disease but not as severe.  The study was led by Professor Shlomi Siman-Tov of the SZMC’s Gaucher Center’s opthalmology department and Professor Nir Giladi of Tel Aviv Sourasky Medical Center.  The study was published in The Journal of Parkinson’s Disease.

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The number of nursing home residents battling with urinary incontinence is much greater than older adults living in the community. Urinary incontinence in the nursing home is as high as 78% in women and 72% in men, with these rates increasing with age.

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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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Stroke is the primary reason for long-term disability. Physical rehabilitation strategies that are intensive, repetitive, and task-oriented can significantly improve motor function in patients with stroke through encouraging motor learning and neuroplasticity. Repetitive task training that requires the performance of functionally relevant tasks at high intensity levels can enhance transfer ability, balance, lower limb function, and walking speed in patients who have survived a stroke.

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As dementia becomes more prevalent within the older adult population, care that aims to provide comfort or quality of life, as in palliative care, may be a more appropriate option than curative care. A primary characteristic of quality of palliative care is advanced care planning (ACP). It is also a key component for nursing home patients with dementia. ACP is an anticipatory decision-making strategy for patients, family, and professional caregivers that helps to prioritize care goals and future care that is perceived appropriate when considering the patient’s preferences. It differs from traditional care planning in that plans are made in anticipation of future debilitation in a person’s condition.

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The older population is steadily growing worldwide. The aging process often involves a continuous decline in cognitive function, normally leading to minor changes to cognitive processes such as memory retrieval and the speed at which information is encoded. For normal progression of aging, this functional decrease is not critical enough to have any debilitating effect on average daily activities. In cases where the decline is more significant, dementia, delirium, and depression can develop. Antidepressants are often used for the treatment of depression and dementia, but there is limited evidence showing that this type of pharmacotherapy is effective. Moreover, the prescription of these drugs often results in about half the patients experiencing recurrence of the original symptoms. Notwithstanding these uncertain results, attending physicians still rely on antidepressants as a standard option and prescribe them to 43.2% of patients with dementia and depression.

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