Publications

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Acceptability of an Advance Directive That Limits Food and Liquids in Advanced Dementia

JAMDA
March 1, 2016
Some individuals fear living with advanced dementia and may even commit suicide if they receive dementia diagnosis. Living with advanced dementia could be prevented if a person who cannot feed himself or herself would not be fed by others. The...

Taking off the Gowns: Enforcement of Discontinuation Protocol to Minimize the Health Care Cost

JAMDA
March 1, 2016
The purpose of contact precaution is to prevent dissemination of the pathogen. In recent years, the standard protocols of imposing contact precaution were researched and practiced in nursing homes. The previous researches were mostly focused on when...

Successful Reduction of Sliding Scale Insulin

JAMDA
March 1, 2016
Diabetes mellitus is a major health problem in the United States. Patients with diabetes have significantly higher rates of mortality, morbidity, and higher health care costs. Among the common practices in long term care which has been targeted as...

Strengthening a Palliative Approach in Long-Term Care (SPA-LTC): A New Program to Improve Quality of Living and Dying for Residents and their Family Members

JAMDA
March 1, 2016
Residents living and dying in long-term care (LTC) homes represent one of society's most frail and marginalized populations of older adults. The average length of stay within LTC has decreased significantly in recent years making LTC a major...

Roadmap to Quality: Effective Medication Reconciliation Minimizes Errors in a Long-Term Care Setting

JAMDA
March 1, 2016
Medication reconciliation commonly known as “med rec,” is identified by the Joint Commission as a process of “accurately and completely reconciling medications across the continuum of care.” The Joint Commission established National Patient Safety...

Reduction of Falls in Nursing Home by Improvement in Fall Assessment Accuracy and Early Nursing Interventions Leading to Improved Quality of Life and Substantial Cost Reduction and Improved Quality of Life

JAMDA
March 1, 2016
Fall is any event that leads to an unplanned, unexpected contact with a supporting surface. Between half and three-quarters of NH residents fall each year and about 10% to 20% of NH falls cause serious injuries; and 2% to 6% of those cause fractures...

Reducing Fear of Falling in a Long-Term Care Facility in Mexico City by Aligning the Weighing Scale with Ground Level and Preventing the Resident from Stepping Up

JAMDA
March 1, 2016
FOF is a common condition that contributes to falls and loss of independence. It affects over 50% of the institutionalized elderly. Among the main contributing factors that cause FOF are comorbidities such as hypertension, cognitive impairment and...

Reducing Emergency Room Referrals in Response to Nursing Home Calls: A Quality Improvement (QI) Update

JAMDA
March 1, 2016
Emergency Room (ER) transfers of patients from nursing homes for inappropriate reasons are expensive, worsens patient outcomes, hastens functional decline and decreases the quality of life. In reviewing call center calls for our group it was noted...

Psychotropic Medication Usage and the Presence/Absence of Geriatric Psychiatry Services in Skilled Nursing Facilities

JAMDA
March 1, 2016
There has been the recent phenomenon of specialists seeing patients onsite in our institutions. With the increase in specialized units for dementia patients with behaviors, there has been an increase in the onsite visitation of psychiatrists. At one...

Pressure Ulcer Reduction Begins with Appropriate Screening

JAMDA
March 1, 2016
Preventative interventions for pressure ulcer begin with identification of high-risk individuals. The Program of All-Inclusive Care of the Elderly (PACE) is a comprehensive care model for older adults with multiple chronic conditions. Centra, a non-...