scholarly journals Diagnostic Failure of Cognitive Impairment in Nursing Home Residents May Lead to Impaired Medical Care

2019 ◽  
Vol 47 (4-6) ◽  
pp. 209-218 ◽  
Author(s):  
Björn Westerlind ◽  
Carl Johan Östgren ◽  
Patrik Midlöv ◽  
Jan Marcusson
Keyword(s):  
Nursing Home ◽  
Cognitive Impairment ◽  
Medical Care ◽  
Nursing Home Residents ◽  
Control Group ◽  
Cognitively Impaired ◽  
Dementia Diagnosis ◽  
Laboratory Findings ◽  
Group A ◽  
The Impact

Background/Objectives: Dementia and cognitive impairment are common in nursing homes. Few studies have studied the impact of unnoted cognitive impairment on medical care. This study aimed to estimate the prevalence of diagnostic failure of cognitive impairment in a sample of Swedish nursing home residents and to analyze whether diagnostic failure was associated with impaired medical care. Method: A total of 428 nursing home residents were investigated during 2008–2011. Subjects without dementia diagnosis were grouped by result of the Mini Mental State Examination (MMSE), where subjects with <24 points formed a possible dementia group and the remaining subjects a control group. A third group consisted of subjects with diagnosed dementia. These three groups were compared according to baseline data, laboratory findings, drug use, and mortality. Results: Dementia was previously diagnosed in 181 subjects (42%). Among subjects without a dementia diagnosis, 72% were cognitively impaired with possible dementia (MMSE <24). These subjects were significantly older, did not get anti-dementia treatment, and had higher levels of brain natriuretic peptide compared to the diagnosed dementia group, but the risks of malnutrition and pressure ulcers were similar to the dementia group. Conclusions: Unnoted cognitive impairment is common in nursing home residents and may conceal other potentially treatable conditions such as heart failure. The results highlight a need to pay increased attention to cognitive impairment among nursing home residents.

scholarly journals RACIAL DIFFERENCES IN PHYSICAL ACTIVITY IN NURSING HOME RESIDENTS WITH COGNITIVE IMPAIRMENT

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S168-S168
Author(s):  
Nicole A Viviano ◽  
Elizabeth Galik ◽  
Barbara Resnick
Keyword(s):  
Physical Activity ◽  
Nursing Home ◽  
Cognitive Impairment ◽  
Light Intensity ◽  
Racial Differences ◽  
Nursing Home Residents ◽  
Moderate Level ◽  
Future Research ◽  
Cognitively Impaired ◽  
Significant Difference

Abstract INTRODUCTION: Nursing home residents with moderate to severe cognitive impairment are mostly sedentary. It is more likely that African-American (AA) older adults tend to be more sedentary than their white counterparts. The purpose of this study was to examine racial differences in overall time spent in physical activity (PA), time in sedentary, light intensity, and moderate levels of PA, and participation in activities of daily living (ADLs) among cognitively impaired nursing home residents. METHODS: This was a secondary data analysis from the Function and Behavior Focused Care Intervention study. The sample included 336 cognitively impaired residents from 12 nursing homes. RESULTS: The mean age of the residents was 86.2 (SD=10.1) with an average MMSE score of 7.8 (SD=5.0) where 41% were AA and 59% white. White and AA participants engaged in only 51.2 and 46.1 minutes of light and 1.5 and 1.1 minutes of moderate level PA, respectively. There was a significant difference in time spent in light-intensity PA with whites spending more time in this level of activity [F(4, 242) = 3.360, p = .01]. Conversely, AAs had better functional ability than white residents [F(4, 242) = 4.754, p &lt; .001]. There were no significant racial differences in time in sedentary, or moderate level PA. DISCUSSION: These findings are consistent with prior research showing that AAs had lower PA levels compared to their white counterparts. Future research should focus on increasing PA among nursing home residents and consider specific interventions to increase activity among AA residents.

scholarly journals A Hope Intervention Compared to Friendly Visitors as a Technique to Reduce Depression among Older Nursing Home Residents

2010 ◽  
Vol 2010 ◽  
pp. 1-6 ◽  
Author(s):  
Donna M. Wilson ◽  
Alexandra Marin ◽  
Param Bhardwaj ◽  
Bonnie Lichlyter ◽  
Amy Thurston ◽  
...  
Keyword(s):  
Experimental Study ◽  
Nursing Home ◽  
Pilot Study ◽  
Older Persons ◽  
Intervention Group ◽  
Nursing Home Residents ◽  
Control Group ◽  
Control Subjects ◽  
Hope Intervention ◽  
The Impact

Depression is common among older persons. An experimental study was undertaken to test the impact of a four-week hope program on depressed nursing home residents. Residents aged 65 or older, who met the criteria for this pilot study and agreed to participate, were randomly assigned to (a) an intervention group, and provided with weekday hope interventions mainly involving positive messages and pictures or (b) a modified control group, and provided with a friendly weekday greeting. The structured hope intervention was not proven effective for reducing depression or raising hope. Instead, a significant reduction in depression among the control subjects was found, as well as a nonsignificant increase in their level of hope. Although these findings suggest friendly visitors may be a more efficacious nonpharmacological approach for reducing depression, further investigations are needed to confirm this and to explore the impact of other hope interventions.

scholarly journals Dog visits in nursing homes – increase complexity or keep it simple? A randomised controlled study

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251571
Author(s):  
Karen Thodberg ◽  
Poul B. Videbech ◽  
Tia G. B. Hansen ◽  
Anne Bak Pedersen ◽  
Janne W. Christensen
Keyword(s):  
Nursing Home ◽  
Cognitive Impairment ◽  
Linear Models ◽  
Controlled Trial ◽  
Nursing Home Residents ◽  
Controlled Study ◽  
Period 2 ◽  
Parametric Statistics ◽  
Randomised Controlled ◽  
The Impact

Objective To compare the immediate response of nursing home residents to dog visits with or without an activity, and the impact of cognitive ability. Methods In a randomly controlled trial, 174 nursing home residents were allocated to 12 bi-weekly 10-minute visits: either ordinary dog visits (D, n = 57, 49 analysed), dog visits with an activity (DA, n = 56, 48 analysed), or visits with activity but no dog (A, n = 61, 54 analysed). We recorded frequency and duration of residents’ verbal and physical interactions with the dog and persons. Data were analysed in three periods of four visits (period 1–3) as binomial variables (generalised linear models) or durations (non-parametric statistics). Results Both visit type and impairment level affected the likelihood of interacting with the dog (D and DA). In some periods increased cognitive impairment lowered odds of touching the dog in DA visits (period 1: F1,85 = 5.17, P < 0.05) and talking to it directly (period 1: F1,90 = 4.60, P < 0.05; period 3: F1,87 = 5.34, P < 0.05). Throughout, residents talked less to persons during DA visits compared to D and A (P = 0.01–0.05), and level of cognitive impairment correlated negatively with talk duration (P < 0.001). Generally, high cognitive impairment level lowered odds of interacting with (period 1: F1,89 = 7.89, P < 0.01; period 2: F1,97 = 6.76, P = 0.01; period 3: F1,92 = 13.57, P < 0.001) and talking about the activities (period 1: F1,89 = 13.78, P <0.001; period 2: F1,88 = 3.27, P = 0.07; period 3: F1,86 = 3.88, P = 0.05). Conclusion Visits without specific activities stimulated residents to interact with the dog, whereas increasing the complexity of dog visits by adding activities resulted in less interaction with the dog for severely impaired residents. The optimal dog visit for the less cognitively impaired residents could include activities and thereby a possibility to interact with the dog in different ways, whereas for severely impaired residents, just being with the dog seems more appropriate.

The effect of brain vitalization activity on dementia incidence in elderly at Budi Luhur Nursing Home of Yogyakarta, Kasongan, Bantul

2020 ◽  
Vol 1 (3) ◽  
pp. 43-50
Author(s):  
Firstyono Miftahul Aziz ◽  
Suratini Suratini
Keyword(s):  
Nursing Home ◽  
The Elderly ◽  
Control Group ◽  
P Value ◽  
Sampling System ◽  
Randomized Sampling ◽  
Care For The Elderly ◽  
Dementia Incidence ◽  
The Family ◽  
The Impact

For some people, dementia is considered as a disease that is common in elderly, regardless the impact of dementia. Taking care for the elderly with dementia brings stress for the family. It can cause and increase the family burden. Brain vitalization gymnastics is one of the methods to improve memory. The study aims to investigate the effect of brain vitalization activity on dementia incidence in elderly at Budi Luhur Nursing Home of Yogyakarta. The study used Quasi Experimental with Pretest-Posttest control group and randomized sampling system. The samples were taken randomly as many as 26 respondents and were divided into two groups namely 13 respondents of experimental group and 13 respondents of control group. The statistical test used Wilcoxon Match Pairs Test. The result showed that Wilcoxon Match pairs test obtained p value 0,003, which is smaller than 0,005. There is an effect of brain vitalization activity on dementia incidence in elderly at Budi Luhur Nursing Home of Yogyakarta

The effect of the implementation of a good medical practice booklet on nursing home residents’ drug prescriptions: a difference-in-differences analysis based on data from electronic pill dispensers (Preprint)

2019 ◽  
Author(s):  
Stéphane Sanchez ◽  
Cécile Payet ◽  
Marie Herr ◽  
Anne Dazinieras ◽  
Caroline Blochet ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Medical Practice ◽  
Intervention Group ◽  
Medication Use ◽  
Nursing Home Residents ◽  
Control Group ◽  
Multilevel Regression ◽  
Difference In Differences ◽  
Good Medical Practice ◽  
The Impact

BACKGROUND The elderly are particularly exposed to adverse events from medication. Among the various strategies to reduce polypharmacy, educational approaches have shown promising results. OBJECTIVE We aimed to evaluate the impact of the implementation of a good medical practice booklet on polypharmacy in nursing homes. METHODS We identified nursing homes belonging to a geriatric care provider that had launched a policy of proper medication use using a good medical practice booklet delivered to prescribers and pharmacists. Data were derived from electronic pill dispensers. The effect of the intervention on polypharmacy was assessed with multilevel regression models, with a control group to account for natural trends over time. The main outcomes were the average daily number of times when medication was administered and the number of drugs with different presentation identifier codes per resident per month. RESULTS 96,216 residents from 519 nursing homes were included between 1 January 2011 and 31 December 2014. The intervention group and the control group both decreased their average daily use of medication (-0.05 and -0.06). The good medical practice booklet did not have a statistically significant effect (exponentiated difference-in-differences coefficient 1.00, 95% confidence interval 0.99-1.02, P=.45). CONCLUSIONS Although the good medical practice booklet itself did not seem effective in decreasing medication use, our data show the effectiveness of a higher-level policy to decrease polypharmacy.

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