The risk factors and impact on survival of feeding tube placement in nursing home residents with severe cognitive impairment

1997 ◽  
Vol 157 (3) ◽  
pp. 327-332 ◽  
Author(s):  
S. L. Mitchell
Keyword(s):  
Risk Factors ◽  
Nursing Home ◽  
Cognitive Impairment ◽  
Nursing Home Residents ◽  
Feeding Tube ◽  
Tube Placement ◽  
Severe Cognitive Impairment ◽  
Impact On Survival ◽  
Feeding Tube Placement

scholarly journals Advanced cognitive impairment among older nursing home residents

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tadeja Gracner ◽  
Patricia W. Stone ◽  
Mansi Agarwal ◽  
Mark Sorbero ◽  
Susan L Mitchell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Nursing Home ◽  
Cognitive Impairment ◽  
Mortality Risk ◽  
Advanced Disease ◽  
Nursing Home Residents ◽  
Functional Score ◽  
Data Set

Abstract Background Though work has been done studying nursing home (NH) residents with either advanced Alzheimer’s disease (AD) or Alzheimer’s disease related dementia (ADRD), none have distinguished between them; even though their clinical features affecting survival are different. In this study, we compared mortality risk factors and survival between NH residents with advanced AD and those with advanced ADRD. Methods This is a retrospective observational study, in which we examined a sample of 34,493 U.S. NH residents aged 65 and over in the Minimum Data Set (2011–2013). Incident assessment of advanced disease was defined as the first MDS assessment with severe cognitive impairment (Cognitive Functional Score equals to 4) and diagnoses of AD or ADRD. Demographics, functional limitations, and comorbidities were evaluated as mortality risk factors using Cox models. Survival was characterized with Kaplan-Maier functions. Results Of those with advanced cognitive impairment, 35 % had AD and 65 % ADRD. At the incident assessment of advanced disease, those with AD had better health compared to those with ADRD. Mortality risk factors were similar between groups (shortness of breath, difficulties eating, substantial weight-loss, diabetes mellitus, heart failure, chronic obstructive pulmonary disease, and pneumonia; all p < 0.01). However, stroke and difficulty with transfer (for women) were significant mortality risk factors only for those with advanced AD. Urinary tract infection, and hypertension (for women) only were mortality risk factors for those with advanced ADRD. Median survival was significantly shorter for the advanced ADRD group (194 days) compared to the advanced AD group (300 days). Conclusions There were distinct mortality and survival patterns of NH residents with advanced AD and ADRD. This may help with care planning decisions regarding therapeutic and palliative care.

Mo1053 Feeding Tube Placement: Do We Need to Take It Down a PEG? Identifying Risk Factors for Adverse Outcomes After PEG Tube Placement

2016 ◽  
Vol 83 (5) ◽  
pp. AB443-AB444
Author(s):  
Varun Kapur ◽  
Mohammed I. Ali ◽  
Daniel Hassumani ◽  
Elango Edhayan ◽  
Karen Hagglund ◽  
...  
Keyword(s):  
Risk Factors ◽  
Feeding Tube ◽  
Adverse Outcomes ◽  
Tube Placement ◽  
Peg Tube ◽  
Feeding Tube Placement

scholarly journals Prevalence of and Risk Factors for Multidrug-ResistantAcinetobacter baumanniiColonization Among High-Risk Nursing Home Residents

2015 ◽  
Vol 36 (10) ◽  
pp. 1155-1162 ◽  
Author(s):  
Lona Mody ◽  
Kristen E. Gibson ◽  
Amanda Horcher ◽  
Katherine Prenovost ◽  
Sara E. McNamara ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nursing Home ◽  
High Risk ◽  
Functional Disability ◽  
Insertion Site ◽  
Nursing Home Residents ◽  
Feeding Tube ◽  
Multidrug Resistant ◽  
Antibiotic Resistant ◽  
Nested Case Control

OBJECTIVETo characterize the epidemiology of multidrug-resistant (MDR)Acinetobacter baumanniicolonization in high-risk nursing home (NH) residents.DESIGNNested case-control study within a multicenter prospective intervention trial.SETTINGFour NHs in Southeast Michigan.PARTICIPANTSCase patients and control subjects were NH residents with an indwelling device (urinary catheter and/or feeding tube) selected from the control arm of the Targeted Infection Prevention study. Cases were residents colonized with MDR (resistant to ≥3 classes of antibiotics)A. baumannii; controls were never colonized with MDRA. baumannii.METHODSFor active surveillance cultures, specimens from the nares, oropharynx, groin, perianal area, wounds, and device insertion site(s) were collected upon study enrollment, day 14, and monthly thereafter.A. baumanniistrains and their susceptibilities were identified using standard microbiologic methods.RESULTSOf 168 NH residents, 25 (15%) were colonized with MDRA. baumannii. Compared with the 143 controls, cases were more functionally disabled (Physical Self-Maintenance Score >24; odds ratio, 5.1 [95% CI, 1.8–14.9];P<.004), colonized withProteus mirabilis(5.8 [1.9–17.9];P<.003), and diabetic (3.4 [1.2–9.9];P<.03). Most cases (22 [88%]) were colonized with multiple antibiotic-resistant organisms and 16 (64%) exhibited co-colonization with at least one other resistant gram-negative bacteria.CONCLUSIONFunctional disability,P. mirabiliscolonization, and diabetes mellitus are important risk factors for colonization with MDRA. baumanniiin high-risk NH residents.A. baumanniiexhibits widespread antibiotic resistance and a preference to colonize with other antibiotic-resistant organisms, meriting enhanced attention and improved infection control practices in these residents.Infect Control Hosp Epidemiol 2015;36(10):1155–1162

Agitation and Touch in the Nursing Home

1989 ◽  
Vol 64 (3_suppl) ◽  
pp. 1019-1026 ◽  
Author(s):  
Marcia S. Marx ◽  
Perla Werner ◽  
Jiska Cohen-Mansfield
Keyword(s):  
Nursing Home ◽  
Cognitive Impairment ◽  
Positive Relationship ◽  
Nursing Home Residents ◽  
Personal Space ◽  
Interpersonal Distance ◽  
Aggressive Behaviors ◽  
Severe Cognitive Impairment ◽  
The Relationship

The relationship between manifestations of agitated behaviors and interpersonal distance was examined in 24 nursing home residents with high agitation and severe cognitive impairment. Analysis indicated that agitated residents displayed divergent responses to touch: touch was related to an increase in aggressive behaviors and to a decrease in physically nonaggressive behaviors (e.g., strange movements). The positive relationship between aggressiveness and touching suggests that residents may interpret touching as a violation of their personal space. The finding that residents exhibited fewer strange movements when touched suggests that touching can act as a quieting and comforting form of communication. The implications of these findings for caregivers are discussed.

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