Are nursing home patients with dementia diagnosis at increased risk for inadequate pain treatment?

2005 ◽  
Vol 20 (8) ◽  
pp. 730-737 ◽  
Author(s):  
Harald A. Nygaard ◽  
Marit Jarland
Keyword(s):  
Nursing Home ◽  
Pain Treatment ◽  
Dementia Diagnosis ◽  
Nursing Home Patients ◽  
Increased Risk

scholarly journals Pneumonia in nursing home patients: is it time for a specific therapeutic strategy?

2013 ◽  
pp. 212-219
Author(s):  
Gualberto Gussoni ◽  
Ido Iori ◽  
Francesco Blasi ◽  
Alessandro Bulfoni ◽  
Sebastiano Costantino ◽  
...  
Keyword(s):  
Nursing Home ◽  
Community Acquired Pneumonia ◽  
Nursing Home Patients ◽  
Increased Risk ◽  
Risk Patients ◽  
Prospective Phase ◽  
Post Hoc ◽  
Health Care Associated Pneumonia ◽  
Hospital Acquired ◽  
The Impact

Background: Nursing home-acquired pneumonia (NHAP) was described in 1978, but only in 2005 it has been proposed as part of a new category (health care-associated pneumonia) distinct from community- or hospital-acquired infections. However, limited clinical data exist to validate this proposal. Aim of the study: To compare characteristics and outcome of patients hospitalised for pneumonia and coming from private residence or nursing home. Methods: Post-hoc analysis of the prospective phase of the FASTCAP study, performed to evaluate the impact of the Recommendations issued by the Italian Federation of Internal Medicine (FADOI) in 2002 on the management of hospitalised community-acquired pneumonia (CAP). Results: The study examined 1,219 patients coming from private residence, and 179 with NHAP. Failures of therapy were significantly more frequent in patients with NHAP (35.8% vs 24.9%; Odds Ratio 1.48; 95% confidence interval 1.05-2.09). Mortality was higher in patients coming from nursing home (24.0% vs 9.8%; OR 2.59; 95% CI 1.72-3.90). Antibiotic treatment was more frequently performed as monotherapy in case of NHAP. Conclusions: At the time of FASTCAP, NHAP was included in the category of CAP, and coherently, treatment of NHAP was not more aggressive if compared to community-acquired infections. However, our results confirm that NHAP is at increased risk for worst outcome, and probably worth considering for specific therapeutic strategies. Future studies are needed to better assess the microbiology of NHAP, and to evaluate if specific treatments, as those recommended by recent guidelines, may improve the outcome for these high-risk patients.

scholarly journals Risk of Nursing Home Use Among Older Americans: The Impact of Psychiatric History and Trajectories of Cognitive Function

2021 ◽  
Author(s):  
Maria T Brown ◽  
Miriam Mutambudzi
Keyword(s):  
Nursing Home ◽  
Cognitive Function ◽  
Latent Class ◽  
Study Data ◽  
Psychiatric Training ◽  
Psychiatric History ◽  
Term Care ◽  
Increased Risk ◽  
Course Variables ◽  
The Impact

Abstract Objectives Mental illness and cognitive functioning may be independently associated with nursing home use. We investigated the strength of the association between baseline (1998) psychiatric history, 8-year cognitive function trajectories, and prospective incidence of nursing home use over a 10-year period while accounting for relevant covariates in U.S. adults aged 65 and older. We hypothesized that self-reported baseline history of psychiatric, emotional, or nervous problems would be associated with a greater risk of nursing home use and that cognition trajectories with the greatest decline would be associated with a subsequent higher risk of nursing home use. Methods We used 8 waves (1998–2016) of Health and Retirement Study data for adults aged 65 years and older. Latent class mixture modeling identified 4 distinct cognitive function trajectory classes (1998–2006): low-declining, medium-declining, medium-stable, and high-declining. Participants from the 1998 wave (N = 5,628) were classified into these 4 classes. Competing risks regression analysis modeled the subhazard ratio of nursing home use between 2006 and 2016 as a function of baseline psychiatric history and cognitive function trajectories. Results Psychiatric history was independently associated with greater risk of nursing home use (subhazard ratio [SHR] 1.26, 95% confidence interval [CI] 1.06–1.51, p < .01), net the effects of life course variables. Furthermore, “low-declining” (SHR 2.255, 95% CI 1.70–2.99, p < .001) and “medium-declining” (2.103, 95% CI 1.69–2.61, p < .001) trajectories predicted increased risk of nursing home use. Discussion Evidence of these associations can be used to educate policymakers and providers about the need for appropriate psychiatric training for staff in community-based and residential long-term care programs.

Sign in / Sign up

Export Citation Format

Share Document