Hip fractures are a common experience within the aging population and can become a primary cause of severe, often incessant functional debilitation in older adults.  Moreover, hip fractures can significantly affect an older adult’s self-care abilities, causing increased dependency and significant loss of autonomy and wellbeing. Although some patients are able to regain almost full functional restoration, most continue to suffer from decline. It is well known that nutritional status is an important aspect of health status. Poor nutritional status in older adult patients usually is related to higher occurrences of complications, rehospitalizations, and mortality compared to those who are well-nourished. However, it is not clear how nutritional status prior to hip fracture affects an older adult patient’s functional recovery process postoperation from hip fracture.  Thus, a recent study examined prefracture nutritional status in a sample of older adult patients with hip fracture to explore how this influenced functional recovery and the clinical course.

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It is well known that the older population is increasing worldwide and that Alzheimer’s disease is one of the leading forms of dementia experienced by older adults. It has also been well established that physical exercise enhances health and well-being in older adults by improving mobility, physical and cognitive function, mood, and preventing falls. 30% of older adults with dementia reside in nursing homes due to the debilitating effects and loss of independence related to the cognitive disease. The types of physical exercise that are most appropriate for this vulnerable population are important to know to ensure that the physical therapy they are receiving is evidence-based and engages the individuals with dementia both physically and cognitively.

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Too many of our nations extremely vulnerable and fragile older adults are being taken complete advantage of by nursing homes. Nursing homes are increasingly being operated by huge corporations (e.g., Wall Street) that aim for profit more than a genuine commitment to providing quality care for residents. Currently, 60% of nursing homes are controlled by for-profit entities, with a growing number run by private equity groups. According to one report, 60% of the homes that have been bought are run by managers who have curtailed nursing staff levels to the point where only one clinical registered nurse must oversee 20 residents. These corporations have pushed nursing home residents to sign forced arbitration clauses that prohibit them from suing, no matter what injustices they have experienced while under nursing home care. These clauses strip residents of their basic constitutional rights, making it extremely difficult for victims to hold a facility accountable for neglect and abuse, while allowing nursing homes to get away with providing minimal care.

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Frailty and dementia are extremely prevalent in the aging population, both of which are related to the high risks of disability. Frailty increases vulnerability in older adults and diminishes their ability to deal with stressors. Most studies have shown that cognitive disability is strongly associated with physical frailty. A recent study explored how physical frailty influenced cognition in individual’s without dementia in order to better understand the pure effect of frailty on cognitive functioning and the susceptibility of cognitive states in different frail conditions.

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Today, more than 5 million people in the United States are living with Alzheimer’s disease. Not only will this number continue to rise to almost 14 million by 2050, almost 30 million Baby Boomers will develop Alzheimer’s disease in the next 35 years. It is crucial that cognitive decline is identified early and accurately. Impaired cognition due to causes such as depression, side effects of medication, excessive alcohol consumption, thyroid problems, vitamin deficiencies, and sleep deprivation are reversible. Moreover, early detection of even progressive, fatal diseases such as Alzheimer’s allows for future planning of issues pertaining to legal and financial affairs and end-of-life care.

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Immobility occurs as a result of a process of degeneration that influences nearly all organ systems due to altered gravitation forces and decrease of motor function. Immobility or disuse appears most pronounced on the musculoskeletal system. These changes occur during the early stages after immobilization and are directly associated with diminished movement and weight-bearing stress. Due to the fact that the primary role of the musculoskeletal system is to support the body against gravity and move the body in space, loss of function of the musculoskeletal system will have a critical effect on a person’s functional mobility.

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From a medical and rehabilitative standpoint, immobility is used to characterize a syndrome of physiologic decline that is a consequence of a decrease in activity and loss of conditioning. Many older adults experience physiological decline due to acute changes in mobility that occur as a result of acute medical illness and hospitalization. It is important that care providers in long-term care facilities be knowledgeable about the process of degeneration as they care for older adult patients. The most common causes of immobility in the older adult population are directly associated with the outcomes of disease and age-related physiologic changes. Long periods of acute immobilization often result in rapid loss of functioning and incomplete recovery of function after remobilization. The effect of immobility on older adults has a profound influence on morbidity, personal independence, health care expenses, quality of life, and mortality.

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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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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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