Publications

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Teaching the Bulls About the China Shop

Caring for the Ages
October 1, 2016
The bulls of the U.S. health care market (hospitals and payers, heavyweights in influencing national health care policy) have entered the fragile ecosystem of the post-acute care china shop to reform the care of vulnerable older adults. These...

Frailty, Sarcopenia Increased Risk for Hospitalization, Functional Decline in Diabetics

Caring for the Ages
October 1, 2016
Researchers at Saint Louis University School of Medicine have determined that, among older patients with diabetes, frailty and sarcopenia are predictors for hospitalization and new disabilities.

Job Task Analysis Surveys Underway to Establish PALTC Medicine as Specialty

Caring for the Ages
October 1, 2016
This month, practitioners in post-acute and long-term care medicine have an unusual and important opportunity to help shape the body of knowledge for this unique field by responding to a pair of job task surveys, one for medical directors and the...

The Virtuous Cycle Is Broken

Caring for the Ages
October 1, 2016
The “Virtuous Cycle,” as it applies to the modern mega-academic health science center, represents the circular synergism of medical education, research, and patient care. The mission of the Association of Academic Health Centers — an advocacy...

Do No Harm … Whatever That Means

Caring for the Ages
October 1, 2016
The phrase “first do no harm” (in Latin, primum non nocere) is fundamental to the ethics of medical treatment in the Western world and has endured for approximately 2,500 years. It is attributed to Hippocrates, who wrote that “The physician must...

Non-TCA/SSRI Antidepressants Increase Fall Risk in Elderly Frail Women

Caring for the Ages
October 1, 2016
Antidepressants from classes other than tricyclics (TCAs) and selective serotonin reuptake inhibitors (SSRIs) did not appear to reduce the risk for falls, according to results of the Zoledronic acid in frail Elders to STrengthen bone (ZEST) study.

Most Sepsis Cases Begin Outside of the Hospital

Caring for the Ages
October 1, 2016
Sepsis is a medical emergency that begins outside of the hospital in 79% of cases. In addition, 72% of patients with sepsis had recently used health care services or had chronic diseases that required frequent medical care.

There’s No ‘I’ in ‘Team’: Working Together in Long-Term Care

Caring for the Ages
October 1, 2016
Dear Dr. Jeff:

Great Expectations: The Most Important Conversation of All

Caring for the Ages
October 1, 2016
Although I am biased, I think there’s a lot to be learned from 12-step programs, and a lot that can be applied to the post-acute and long-term care setting. One of the slogans from my favorite 12-step program is as follows: “An expectation is...

Sarcopenia Gets a Code of Its Own

Caring for the Ages
October 1, 2016
On Oct. 1, sarcopenia received its own International Classification of Disease, Tenth Revision, Clinical Modification (ICD-10-CM) code. The assigned code, M62.84, can now be used by post-acute and long-term care practitioners to indicate sarcopenia...