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Article
Geriatrics & Gerontology
Monica R. Perracini et al.
Summary: An international consensus process has generated a minimum list of long-term care interventions to be included in a service package for universal health coverage (UHC). This package will contribute to a more robust framework for integrated services for older people in need of long-term care.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Editorial Material
Geriatrics & Gerontology
Timothy J. Holahan et al.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Article
Geriatrics & Gerontology
Sheryl Zimmerman et al.
Summary: Assisted living (AL) is a care model that has evolved to meet the supportive care needs of older adults. However, the involvement of real estate, hospitality, and healthcare sectors has raised concerns about the variability, quality, and standards of AL. Despite the intention to provide person-centered care and quality of life, tensions related to AL models, regulation, financing, resident acuity, and the workforce have caused a deviation from the original constructs. This article presents the background of these tensions and potential solutions for a better future of AL.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Editorial Material
Geriatrics & Gerontology
Paul R. Katz et al.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Editorial Material
Geriatrics & Gerontology
Katherine S. McGilton et al.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Letter
Geriatrics & Gerontology
Rebecca L. Utz
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Article
Geriatrics & Gerontology
Kezia Scales
Summary: The direct care workers who assist individuals in need of long-term services and supports play a critical role in ensuring their safety, health, and well-being. However, these workers have been inadequately compensated, supported, and respected, leading to high turnover and job vacancy rates. This article emphasizes the importance of transforming direct care jobs and stabilizing the workforce, and highlights key requirements such as competitive wages, updated training standards, investment in frontline supervisors and peer mentors, and an elevated position for direct care workers within the care team.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Letter
Geriatrics & Gerontology
Natalie R. Baker et al.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Article
Geriatrics & Gerontology
Talitha Vrijmoeth et al.
Summary: To achieve successful generalist-specialist collaboration, it is important to clarify roles and expectations, build trust and familiarity, ensure regular communication, and have support from government, payers, and organizations.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Article
Geriatrics & Gerontology
Joseph E. Gaugler et al.
Summary: This article examines the state of family involvement in residential long-term care (RLTC) and the impact of the COVID-19 pandemic on family involvement.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Letter
Geriatrics & Gerontology
Roy A. Thompson et al.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Article
Geriatrics & Gerontology
Mary Ersek et al.
Summary: Many individuals in nursing homes have unmet palliative and end-of-life care needs. This article reviews three approaches to meeting these needs, including hospice services, palliative care consultation, and facility-based palliative care services. However, access to specialized care is limited, services are not clearly defined, and more empirical evidence is needed.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Editorial Material
Geriatrics & Gerontology
Philip D. Sloane
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Article
Geriatrics & Gerontology
Xuemei Zhu et al.
Summary: This study examines the associations between NH design and COVID-19 cases, deaths, and transmissibility, and provides relevant design recommendations. The results show that increased percentage of private rooms, larger living area per bed, and presence of a ventilator-dependent unit are significantly associated with reductions in COVID-19 cases, deaths, and transmissibility among residents. Increased number of certified beds in the NH is also associated with reduced resident cases and deaths.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Article
Geriatrics & Gerontology
Swati Gaur et al.
Summary: Decades of concerns about nursing home care quality have led to layers of regulations and penalties. However, the current regulatory strategy focusing on deficiencies and sanctions hinders the establishment of a safety culture, requiring a collaborative effort between nursing homes and regulatory agencies.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Article
Geriatrics & Gerontology
Edmond Ramly et al.
Summary: This study developed and evaluated a proposed model for large-scale data-driven quality improvement in assisted living. The model has been voluntarily implemented by 810 Wisconsin-licensed assisted living communities, and the evaluation showed positive outcomes in terms of appropriateness, acceptability, adoption, feasibility, fidelity, penetration, and sustainability. The study findings suggest a promising path and future directions for wider implementation.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Article
Geriatrics & Gerontology
Brian M. Wong et al.
Summary: The collaborative care program LTC+ was developed and implemented during the COVID-19 pandemic to enhance care in nursing homes and reduce unnecessary acute care transfers. It provided virtual consultations, nursing support, rapid access to lab services, and educational resources. Results showed that a significant number of consultations successfully addressed care concerns and avoided transfers to acute care. This integrated care model has the potential to improve access and equity in long-term care.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Article
Geriatrics & Gerontology
Natalie A. Manley et al.
Summary: The COVID-19 pandemic has posed challenges to communication in PALTC settings. Telemedicine is an alternative, but the burden of equipment management on staff may be overwhelming. The use of a mobile HIPPA-compliant telepresence robot offers a solution to overcome this barrier and reimagine PALTC options in the future.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Article
Geriatrics & Gerontology
Christian Bakker et al.
Summary: Although dementia has a profound impact in general, young-onset dementia requires specific care and support. The establishment of an appropriate infrastructure, care centers, and training programs, as well as the development of care standards and quality hallmarks, have improved postdiagnostic care and support for young-onset dementia in the Netherlands.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Article
Geriatrics & Gerontology
Tetyana Pylypiv Shippee et al.
Summary: Long-term services and supports (LTSS) show racial segregation, with Black, Indigenous, and persons of color (BIPOC) users having less access to quality care and reporting poorer quality of life compared to White counterparts. Systemic racism, manifested through segregated care, low Medicaid reimbursement, and insufficient staff wages, contributes to these disparities. Recommendations include increasing reimbursement rates, reconsidering pay-for-performance programs, incorporating cultural measures in quality reporting, implementing culture change, expanding access to HCBS services, adopting culturally appropriate practices, and promoting integrated HCBS programs for BIPOC individuals.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Editorial Material
Geriatrics & Gerontology
Raymond T. C. M. Koopmans et al.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Article
Geriatrics & Gerontology
Rachel M. Werner et al.
Summary: The COVID-19 pandemic highlighted problems with long-term care financing and payment in the US, including underfunding and fragmentation. A proposed solution is to establish a new federal benefit for long-term care as part of the Medicare program to improve resource allocation and equity.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Article
Geriatrics & Gerontology
Heather H. Keller et al.
Summary: Poor food and fluid intake are common problems in long-term care, and institutional factors are partially responsible. Evidence-based guidelines can provide best practices, but feasibility and environmental factors must be considered in implementation. Relationships among residents, family members, and staff offer opportunities for improving nutrition.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Article
Geriatrics & Gerontology
Jesus Mateos-Nozal et al.
Summary: During the SARS-CoV-2 pandemic, hospital-based liaison geriatric units (LGUs) were established in Spanish hospitals to improve coordination between nursing homes and hospitals. This model has been shown to be feasible, improve healthcare for nursing home residents, and prevent hospital referrals.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Article
Geriatrics & Gerontology
Mauricio Matus-Lopez et al.
Summary: The aging of the world's population is a reality, and it is uncertain whether the extra years will be lived in better health. The World Health Organization has called for the creation of suitable and equitable long-term care systems to meet the needs of older people, particularly in Latin America. This article discusses the characteristics of Costa Rica's national long-term care system and its potential impact on neighboring countries with similar economic conditions.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2022)
Article
Geriatrics & Gerontology
Benoit Robert et al.
Summary: The study examined the effectiveness of the SAFE Unit in reducing hospital length of stay and post-discharge acute care use. It found that patients in the SAFE Unit had shorter hospital stays and were more likely to be discharged home than control patients, with similar 30-day acute care outcomes post-discharge.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2021)
Article
Geriatrics & Gerontology
Elizabeth M. White et al.
Summary: During the COVID-19 pandemic, nursing home staff faced ongoing constraints on testing and continued reliance on crisis standards for extended use of personal protective equipment. They expressed fears of infection, empathy for residents, burnout due to increased workloads, staffing shortages, and emotional burden, as well as the demoralizing impact of negative media coverage and lack of organizational communication and teamwork. These challenges are likely to contribute to increased burnout, turnover, and staff shortages in the long term for this already strained and vulnerable workforce.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2021)
Article
Geriatrics & Gerontology
Rebecca L. Utz
Journal of the American Medical Directors Association
(2021)
Article
Geriatrics & Gerontology
Edward Chong et al.
Summary: The EDIFY program aims to provide early geriatric specialist interventions in the emergency department to reduce acute admissions. The study results showed that the program successfully reduced potentially avoidable acute admissions without increasing the risk of rehospitalization, ED re-attendance, or mortality.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2021)
Article
Geriatrics & Gerontology
Jiyoun Song et al.
Summary: This study examines the timing of start-of-care visits for home health care patients and identifies factors associated with delays beyond 2 days postdischarge. Findings suggest that factors such as race, insurance type, and day of discharge influence the timing of start-of-care visits. Clinical characteristics like surgical wounds and intravenous therapies are associated with earlier start-of-care visits.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2021)
Article
Geriatrics & Gerontology
Derek R. Manis et al.
Summary: Older adults residing in assisted living facilities with a dementia care program had a significantly lower rate of transition to nursing homes compared to those without such a program, supporting the expansion of dementia care programs in assisted living facilities.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2021)
Article
Geriatrics & Gerontology
Heidi J. Welberry et al.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2020)
Article
Geriatrics & Gerontology
Rebekah L. Gardner et al.
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
(2020)