Polypharmacy is common in the nursing home population. Deprescribing programs generally result in 20-30% reductions in the targeted medications. Three categories of medications were chosen for this deprescribing initiative: anticholinergic bladder...
In July 2021, the general medicine service at a large academic Veterans Affairs (VA) medical center assumed care of residents of a 110-bed Community Living Center (CLC). We developed a curriculum to help clinicians experienced in the care of...
The complications arising from polypharmacy in older adults have been well described in literature. Increasing numbers of prescriptions have led to poor health outcomes, including increasing frailty, loss of independence and worsening nutritional...
Symptomatology of transthyretin amyloidosis varies with organ involvement, but it almost invariably presents with the common geriatric syndromes. Transthyretin cardiac amyloidosis causes restrictive cardiomyopathy which if not diagnosed and treated...
Major neurocognitive disorder due to brain metastasis in a previously independent veteran who was admitted to our post-acute care with an unrelated illness and noted with disorganized thinking, apathy, lack of hygiene and memory loss during...
Benzodiazepines (BDZ) are included in the Beer’s list as a potentially inappropriate drug class for older adults due to risk of confusion, falls, cognitive decline and dependance. Nonetheless, it is common dental practice to prescribe this class of...
The striking purple urine in the urine bag and tubing also known as “purple urine bag syndrome” (PUBS) is a rare disorder seen in older patients with chronic urinary catheters in place. The purple color is due to the buildup of indigo and indirubin...
We present a root cause analysis of a pressure injury in the setting of transition of care, that highlights need for improvement in SBAR (Situation, Background, Assessment, Recommendation) of wound status, to enhance multidisciplinary delivery of...
Platypnea-orthodeoxia syndrome is a rare disorder resulting from an interatrial shunt, such as patent foramen ovale (PFO) in this case, and functional component that promotes abnormal shunting when the patient rises to upright position.
Hindsight can be 20-20 and practicing during difficult times can inform professionals about lessons learned during crisis as well as routine efforts in long-term care. Nursing homes in the United States were the highest risk places for death caused...
