scholarly journals Policy Series: The Elder Justice Act, Nursing Home Reform, and Funding Legislation

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 720-721
Author(s):  
Brian Lindberg

Abstract This session will provide updates on major federal efforts to address elder abuse, neglect, and exploitation, including strategies for prevention, intervention, services, and prosecution. Congress has been working on both reauthorizing the Elder Justice Act and policies to address poor long-term care facility quality issues, and this panel will provide an update on those efforts and what lies ahead in2021. The panel will include elder justice and nursing home advocates and congressional staff.

1988 ◽  
Vol 1 (3) ◽  
pp. 225-234
Author(s):  
Ruthanne R. Ramsey ◽  
Lawrence J. Lutz

Clinical research in geriatrics, to date, has focused on the ambulatory and acutely ill patient populations. However, the unique host, disease, and environmental factors common to the nursing home resident and facility underline the need to study drug use and response in the long-term care facility. Five specific areas require investigation: efficacy, safety, dosages, utilization, and cost. To adequately study these topics, interdisciplinary research teams may use methodologies from various backgrounds, including the biologic, agricultural, epidemiologic, economic, and ethnographic research traditions. Even with the numerous methodologies available, significant procedural and design issues confront the development and performance of long-term care research. While procedural problems usually involve legal and administrative issues, methodologic concerns often stem from the need to deal with multiple confounding variables or the limitations of available research tools and clinical data bases. Continued improvement in the existing quality-of-life and functional assessment instruments as well as the development of computerized nursing home data bases will enhance clinical research in the long-term care facility.


2019 ◽  
Vol 47 (1) ◽  
pp. 59-64 ◽  
Author(s):  
Andrew W. Dick ◽  
Jeneita M. Bell ◽  
Nimalie D. Stone ◽  
Ashley M. Chastain ◽  
Mark Sorbero ◽  
...  

2016 ◽  
Vol 25 (3) ◽  
pp. 553-553
Author(s):  
RUCHIKA MISHRA

Mr. Hope is a 40-year-old man who has resided at a long-term care facility for the past 10 years. The resident was originally admitted to the nursing home for his inability to care for himself secondary to advanced AIDS and complications from progressive multifocal leukoencephalopathy (PML). When he initially arrived at the nursing home, Mr. Hope was able to smile and appeared to respond to some of the staff’s requests. Now, he responds by wincing when told that procedures are being performed and especially when he is told that he has to go back to the hospital. He is extremely contracted, with his arms wedded to his chest in a crossed fashion, as though he is protecting himself from blows. Mr. Hope’s family consists of a partner, his parents, and one sibling. Numerous conversations have been had with the family, and according to the facility staff, “they persist in continuing aggressive measures with the hope that the patient will wake up and walk out of the facility.” What had been frequent visits to the local hospital ER have increased substantially in the last few months, for what appear to be new infections and pneumonia. During most visits he ultimately spends a few days in the hospital to resolve his acute issues. On his most recent return to the long-term care facility, the medical staff approached the family about Mr. Hope’s code status. The family continues to insist on a full code status and that he be provided every opportunity to “live.” The staff is very concerned about Mr. Hope and his welfare. Many of the nursing staff have grown attached to him over the years, and watching him deteriorate has been distressing. They see part of their role as being his advocate and supporting him in ways that his own family has not. They express very strong reservations about performing CPR on Mr. Hope because they think it will be ineffective and they will have to break his upper extremities in order to gain access to his chest for resuscitation. The staff has contacted the ethics consultation service with the request that Mr. Hope needs protection and that his own family is not making the best decisions for him.


2021 ◽  
Vol 36 (3) ◽  
pp. 287-298
Author(s):  
Jonathan Bergman ◽  
Marcel Ballin ◽  
Anna Nordström ◽  
Peter Nordström

AbstractWe conducted a nationwide, registry-based study to investigate the importance of 34 potential risk factors for coronavirus disease 2019 (COVID-19) diagnosis, hospitalization (with or without intensive care unit [ICU] admission), and subsequent all-cause mortality. The study population comprised all COVID-19 cases confirmed in Sweden by mid-September 2020 (68,575 non-hospitalized, 2494 ICU hospitalized, and 13,589 non-ICU hospitalized) and 434,081 randomly sampled general-population controls. Older age was the strongest risk factor for hospitalization, although the odds of ICU hospitalization decreased after 60–69 years and, after controlling for other risk factors, the odds of non-ICU hospitalization showed no trend after 40–49 years. Residence in a long-term care facility was associated with non-ICU hospitalization. Male sex and the presence of at least one investigated comorbidity or prescription medication were associated with both ICU and non-ICU hospitalization. Three comorbidities associated with both ICU and non-ICU hospitalization were asthma, hypertension, and Down syndrome. History of cancer was not associated with COVID-19 hospitalization, but cancer in the past year was associated with non-ICU hospitalization, after controlling for other risk factors. Cardiovascular disease was weakly associated with non-ICU hospitalization for COVID-19, but not with ICU hospitalization, after adjustment for other risk factors. Excess mortality was observed in both hospitalized and non-hospitalized COVID-19 cases. These results confirm that severe COVID-19 is related to age, sex, and comorbidity in general. The study provides new evidence that hypertension, asthma, Down syndrome, and residence in a long-term care facility are associated with severe COVID-19.


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