Psychotropic Drug Utilization in Long-Term-Care Facilities for the Elderly in Ontario, Canada

1999 ◽  
Vol 11 (3) ◽  
pp. 223-233 ◽  
Author(s):  
David K. Conn ◽  
Ian Ferguson ◽  
Krystyna Mandelman ◽  
Carol Ward
Keyword(s):  
Nursing Homes ◽  
Long Term Care ◽  
The Elderly ◽  
The United States ◽  
International Studies ◽  
Prescription Data ◽  
Homes For The Aged ◽  
Term Care ◽  
Care Facilities

Objective: Despite considerable data from a number of countries regarding psychotropic utilization in long-term-care facilities for the elderly, there has been a lack of similar data from Canada. The purpose of this study was to gather prescription data from a series of institutions in Ontario and to compare the results to those of other international studies. Method: Single-day surveys were carried out in six homes for the aged, four nursing homes, two retirement homes, and a veterans' center. The results were compared to those of recent studies from other countries. Results: The data revealed considerable differences in rates of prescription between different classes of institutions and between similarly classified institutions. The prescription rate of neuroleptics ranged from 11.8% (of patients) in retirement homes to 29.8% in nursing homes. Antidepressant use ranged from 12.2% in nursing homes to 24.6% in homes for the aged, and benzodiazepine use ranged from 22.5% in nursing homes to 36.4% in retirement homes. Conclusions: The overall rate of prescription for psychotropic medications was somewhat lower than in most international studies. The rate of prescription of neuroleptics in nursing homes fell in the midrange of studies, somewhat higher than in recent studies from the United States and an earlier Italian study, but lower than in recent reports from Sweden, Austria, and Australia. The rate of neuroleptic use in homes for the aged was comparable to the rate in the U.S. studies. The overall rate of prescription of antidepressants and benzodiazepines appears to be comparable to that in recent studies from other countries.

Predictors of Mortality in Board and Care Homes

1997 ◽  
Vol 36 (1) ◽  
pp. 77-87 ◽  
Author(s):  
Nicholas G. Castle
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Social Services ◽  
Long Term Care ◽  
Significant Proportion ◽  
The Elderly ◽  
Term Care ◽  
Care Facilities ◽  
Board And Care

Long-term care institutions have emerged as dominant sites of death for the elderly. However, studies of this trend have primarily examined nursing homes. The purpose of this research is to determine demographic, functional, disease, and facility predictors and/or correlates of death for the elderly residing in board and care facilities. Twelve factors are found to be significant: proportion of residents older than sixty-five years of age, proportion of residents who are chair- or bed-fast, proportion of residents with HIV, bed size, ownership, chain membership, affiliation with a nursing home, number of health services provided other than by the facility, the number of social services provided other than by the facility, the number of social services provided by the facility, and visits by Ombudsmen. These are discussed and comparisons with similar studies in nursing homes are made.

Improving the Fate of Nursing Homes During the COVID-19 Pandemic: The Need for Policy

2021 ◽  
pp. e1-e3
Author(s):  
R. Tamara Konetzka
Keyword(s):  
Public Health ◽  
United States ◽  
New York ◽  
Nursing Homes ◽  
Long Term Care ◽  
New York Times ◽  
The United States ◽  
Term Care ◽  
Care Facilities

Approximately 40% of all COVID-19 deaths in the United States have been linked to long-term care facilities.1 Early in the pandemic, as the scope of the problem became apparent, the nursing home sector generated significant media attention and public alarm. A New York Times article in mid-April referred to nursing homes as “death pits”2 because of the seemingly uncontrollable spread of the virus through these facilities. This devastation continued during subsequent surges,3 but there is a role for policy to change this trajectory. (Am J Public Health. Published online ahead of print January 28, 2021: e1–e3. https://doi.org/10.2105/AJPH.2020.306107 )

No more nursing homes? Changes in consumer preferences for long-term care facilities following COVID-19

2020 ◽  
Vol 26 (11) ◽  
pp. 276-280
Author(s):  
Amber F Schultz ◽  
Jia Yu
Keyword(s):  
Nursing Homes ◽  
Long Term Care ◽  
Consumer Preferences ◽  
Care Facility ◽  
The Elderly ◽  
Term Care ◽  
Long Term Care Facility ◽  
Medical Disorders ◽  
Care Facilities

Since the first COVID-19 case was discovered in December 2019, over 12.1 million cases have been reported in more than 188 countries and territories. In the USA, the Centers for Disease Control and Prevention has confirmed almost 3.05 million COVID-19 cases, with more than 132 000 deaths. The COVID-19 pandemic has had a particularly dramatic impact on the elderly and those with chronic underlying medical disorders. Before the second outbreak in July, long-term care facilities were the most severely affected in terms of case numbers, especially nursing homes. This article provides information and insight into the potential changes in consumer preferences toward long-term care facility selection and the possible structural change of the long-term care industry in three aspects; structure, conduct and performance.

Psychogeriatric Care: Problems and Challenges

1988 ◽  
Vol 1 (3) ◽  
pp. 31-36
Author(s):  
Douglas H. Rapelje
Keyword(s):  
Physical Environment ◽  
Long Term Care ◽  
Initial Step ◽  
The Elderly ◽  
Homes For The Aged ◽  
Term Care ◽  
Care Facilities ◽  
Trained Staff ◽  
Care Problems

From the aspect of homes for the aged, understanding the needs of the elderly mentally frail is the initial step to providing more suitable conditions. Many of the traditional features of these long-term care facilities need to be questioned and challenged. Care does not stop at the physical environment, indeed it goes even beyond establishing excellent relationships with the families involved and a caring, well-trained staff. Stress is needed on emphasizing the resident's remaining capacities and skills, not on behavioural problems.

Diarrhea Among Residents of Long-Term Care Facilities

1993 ◽  
Vol 14 (7) ◽  
pp. 397-404
Author(s):  
Richard G. Bennett
Keyword(s):  
Long Term Care ◽  
The Elderly ◽  
The United States ◽  
Term Care ◽  
Older Americans ◽  
Infectious Gastroenteritis ◽  
Care Facilities ◽  
Control And Prevention ◽  
Sporadic Cases

Both sporadic cases of diarrhea and outbreaks of infectious gastroenteritis occur commonly in long-term care facilities. There are no national statistics on the prevalence or incidence of diarrhea among residents of nursing homes, but recent studies from the Centers for Disease Control and Prevention have described the increased morbidity and mortality associated with gastrointestinal illnesses among the elderly. Although deaths related to diarrheal illnesses have long been considered a problem of infants and young children in the developed world, 51% of the 28,538 diarrhea-related deaths in the United States from 1979 through 1987 occurred in adults older than 74 years, and 27% occurred in adults between 55 and 74 years old. In contrast, only 11% of these deaths occurred in children <5 years old (ie, the vast majority of deaths occurred in older Americans rather than in children). For both the very young and the very old, there were winter peaks in the mortality rates consistent with the presumption that infectious illnesses led to death, and one of the major risk factors for dying from diarrhea was being a resident of a nursing home. In a subsequent study in which 87,181 hospitalizations were analyzed, 85% of 514 diarrhea-related deaths occurred in adults over 65 years old. The odds ratio of dying during a hospitalization involving gastroenteritis was 52.6 (CI95, 37.0 to 76.9) for adults ≥70 years old as compared with children <5 years old.

scholarly journals The Impact of COVID-19 Pandemic on Long-Term Care Facilities Worldwide: An Overview on International Issues

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Dana-Claudia Thompson ◽  
Madalina-Gabriela Barbu ◽  
Cristina Beiu ◽  
Liliana Gabriela Popa ◽  
Mara Madalina Mihai ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Long Term Care ◽  
Negative Impact ◽  
Nursing Home Residents ◽  
The United States ◽  
Term Care ◽  
Care Facilities ◽  
National Databases ◽  
The Impact

The COVID-19 pandemic had a great negative impact on nursing homes, with massive outbreaks being reported in care facilities all over the world, affecting not only the residents but also the care workers and visitors. Due to their advanced age and numerous underlying diseases, the inhabitants of long-term care facilities represent a vulnerable population that should benefit from additional protective measures against contamination. Recently, multiple countries such as France, Spain, Belgium, Canada, and the United States of America reported that an important fraction from the total number of deaths due to the SARS-CoV-2 infection emerged from nursing homes. The scope of this paper was to present the latest data regarding the COVID-19 spread in care homes worldwide, identifying causes and possible solutions that would limit the outbreaks in this overlooked category of population. It is the authors’ hope that raising awareness on this matter would encourage more studies to be conducted, considering the fact that there is little information available on the impact of the SARS-CoV-2 pandemic on nursing homes. Establishing national databases that would register all nursing home residents and their health status would be of great help in the future not only for managing the ongoing pandemic but also for assessing the level of care that is needed in this particularly fragile setting.

Clostridium difficilein Long-Term–Care Facilities for the Elderly

2002 ◽  
Vol 23 (11) ◽  
pp. 696-703 ◽  
Author(s):  
Andrew E. Simor ◽  
Suzanne F. Bradley ◽  
Larry J. Strausbaugh ◽  
Kent Crossley ◽  
Lindsay E. Nicolle ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Nursing Homes ◽  
Antimicrobial Agents ◽  
Long Term Care ◽  
The Elderly ◽  
Position Paper ◽  
Term Care ◽  
Common Cause ◽  
Care Facilities

AbstractAntimicrobial agents are among the most frequently prescribed medications in long-term–care facilities (LTCFs). Therefore, it is not surprising thatClostridium difficilecolonization andC. difficile-associated diarrhea (CDAD) occur commonly in elderly LTCF residents.C. difficilehas been identified as the most common cause of non-epidemic acute diarrheal illness in nursing homes, and outbreaks of CDAD in LTCFs have also been recognized. This position paper reviews the epidemiology and clinical features of CDAD in elderly residents of LTCFs and, using available evidence, provides recommendations for the management ofC. difficilein this setting.

Uitbraak COVID-19 in de verpleeghuiszorg

2020 ◽  
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Nursing Homes ◽  
Long Term Care ◽  
Informal Caregivers ◽  
Rapid Review ◽  
Daily Routine ◽  
Term Care ◽  
Care Facilities

Long-term care for older adults is highly affect by the COVID-19 outbreak. The objective of this rapid review is to understand what we can learn from previous crises or disasters worldwide to optimize the care for older adults in long term care facilities during the outbreak of COVID-19. We searched five electronic databases to identify potentially relevant articles. In total, 23 articles were included in this study. Based on the articles, it appeared that nursing homes benefit from preparing for the situation as best as they can. For instance, by having proper protocols and clear division of tasks and collaboration within the organization. In addition, it is helpful for nursing homes to collaborate closely with other healthcare organizations, general practitioners, informal caregivers and local authorities. It is recommended that nursing homes pay attention to capacity and employability of staff and that they support or relieve staff where possible. With regard to care for the older adults, it is important that staff tries to find a new daily routine in the care for residents as soon as possible. Some practical tips were found on how to communicate with people who have dementia. Furthermore, behavior of people with dementia may change during a crisis. We found tips for staff how to respond and act upon behavior change. After the COVID-19 outbreak, aftercare for staff, residents, and informal caregivers is essential to timely detect psychosocial problems. The consideration between, on the one hand, acute safety and risk reduction (e.g. by closing residential care facilities and isolating residents), and on the other hand, the psychosocial consequences for residents and staff, were discussed in case of other disasters. Furthermore, the search of how to provide good (palliative) care and to maintain quality of life for older adults who suffer from COVID-19 is also of concern to nursing home organizations. In the included articles, the perspective of older adults, informal caregivers and staff is often lacking. Especially the experiences of older adults, informal caregivers, and nursing home staff with the care for older adults in the current situation, are important in formulating lessons about how to act before, during and after the coronacrisis. This may further enhance person-centered care, even in times of crisis. Therefore, we recommend to study these experiences in future research.

scholarly journals Reducing Morbidity and Mortality Rates from COVID-19, Influenza and Pneumococcal Illness in Nursing Homes and Long-Term Care Facilities by Vaccination and Comprehensive Infection Control Interventions

Geriatrics ◽  
2021 ◽  
Vol 6 (2) ◽  
pp. 48
Author(s):  
Roger E. Thomas
Keyword(s):  
Nursing Homes ◽  
Infection Control ◽  
Strong Evidence ◽  
Disease Transmission ◽  
Long Term Care ◽  
Term Care ◽  
Care Facilities ◽  
Meta Analyses ◽  
Tract Infections

The COVID-19 pandemic identifies the problems of preventing respiratory illnesses in seniors, especially frail multimorbidity seniors in nursing homes and Long-Term Care Facilities (LCTFs). Medline and Embase were searched for nursing homes, long-term care facilities, respiratory tract infections, disease transmission, infection control, mortality, systematic reviews and meta-analyses. For seniors, there is strong evidence to vaccinate against influenza, SARS-CoV-2 and pneumococcal disease, and evidence is awaited for effectiveness against COVID-19 variants and when to revaccinate. There is strong evidence to promptly introduce comprehensive infection control interventions in LCFTs: no admissions from inpatient wards with COVID-19 patients; quarantine and monitor new admissions in single-patient rooms; screen residents, staff and visitors daily for temperature and symptoms; and staff work in only one home. Depending on the vaccination situation and the current risk situation, visiting restrictions and meals in the residents’ own rooms may be necessary, and reduce crowding with individual patient rooms. Regional LTCF administrators should closely monitor and provide staff and PPE resources. The CDC COVID-19 tool measures 33 infection control indicators. Hand washing, social distancing, PPE (gowns, gloves, masks, eye protection), enhanced cleaning of rooms and high-touch surfaces need comprehensive implementation while awaiting more studies at low risk of bias. Individual ventilation with HEPA filters for all patient and common rooms and hallways is needed.

scholarly journals FEDERAL POLICY SUPPORTS AND GAPS IN ADDRESSING RACIAL-ETHNIC HEALTH DISPARITIES IN U.S. LONG-TERM CARE FACILITIES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S161-S161
Author(s):  
Rebecca L Mauldin ◽  
Kathy Lee ◽  
Antwan Williams
Keyword(s):  
Long Term Care ◽  
Federal Policy ◽  
Care Facility ◽  
Well Being ◽  
The United States ◽  
Term Care ◽  
Long Term Care Facility ◽  
Care Facilities

Abstract Older adults from racial and ethnic minority groups face health inequities in long-term care facilities such as nursing homes and assisted living facilities just as they do in the United States as a whole. In spite of federal policy to support minority health and ensure the well-being of long-term care facility residents, disparities persist in residents’ quality of care and quality of life. This poster presents current federal policy in the United States to reduce racial and ethnic health disparities and to support long-term care facility residents’ health and well-being. It includes legislation enacted by the Patient Protection and Affordable Care Act of 2010 (ACA), regulations of the U.S. Department of Health and Human Services (DHHS) for health care facilities receiving Medicare or Medicare funds, and policies of the Long-term Care Ombudsman Program. Recommendations to address threats to or gaps in these policies include monitoring congressional efforts to revise portions of the ACA, revising DHHS requirements for long-term care facilities staff training and oversight, and amending requirements for the Long-term Care Ombudsman Program to mandate collection, analysis, and reporting of resident complaint data by race and ethnicity.

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