scholarly journals CHALLENGES AND STRATEGIES FOR SUSTAINING A NEW DEMENTIA BEHAVIORAL CARE APPROACH IN NURSING HOMES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S380-S380
Author(s):  
Michele J Karel ◽  
Karen M Benson ◽  
Youliana Piscopo ◽  
Susan Maataoui ◽  
Kimberly Curyto
Keyword(s):  
Behavioral Assessment ◽  
Lessons Learned ◽  
Veterans Health ◽  
Health Administration ◽  
Home Setting ◽  
Team Meetings ◽  
Care Plans ◽  
Care Approach ◽  
Nursing Home Setting ◽  
Multiple Challenges

Abstract The STAR-VA training program in Veterans Health Administration Community Living Centers (CLCs) has been helping interdisciplinary care teams understand and manage dementia-related behaviors in the nursing home setting, with promising clinical outcomes. However, sustaining a new care approach in a health care system poses multiple challenges. This presentation will discuss facilitators and barriers to STAR-VA sustainability based on CLC team and nurse leader feedback. Findings are informing development of a new site coaching program and a sustainability toolkit. Feedback to date suggests that critical STAR-VA implementation and sustainability strategies include: regularly scheduled team meetings to discuss behavioral assessment and care plans; ongoing staff training (e.g., new staff orientation); communicating care plans across shifts and in the health record; multiple nurse/shift champions; impromptu huddles; acknowledging staff successes; leadership engagement. The coaching program engages teams in setting and tracking site sustainability goals. Lessons learned will be discussed.

Telehealth During COVID-19 for Remote Vision Rehabilitation of a Patient with mTBI

2020 ◽  
pp. 191-198
Keyword(s):  
Veterans Health ◽  
Health Administration ◽  
Web Based ◽  
Home Setting ◽  
Therapeutic Goals ◽  
Vision Rehabilitation ◽  
Novel Coronavirus ◽  
Performance Challenges ◽  
Perception Of Performance

Background: Binocular and accommodative vision problems are common after mild traumatic brain injury (mTBI). Traditionally, the management of visual dysfunctions following mTBI included in-office vision rehabilitation with a trained eye care provider. The concept of providing telehealth for remote vision rehabilitation in mTBI patients is a relatively novel practice that has not been widely utilized until the recent outbreak of the 2019 novel coronavirus (COVID-19) pandemic. Case Report: We describe the implementation of telehealth for remote vision rehabilitation during COVID-19 within the Veterans’ Health Administration (VHA) system in an adult patient with multiple confirmed histories of mTBI. Conclusion: Our telehealth remote vision rehabilitation was successfully implemented utilizing established VHA’s web-based videoconferencing tools. Therapeutic goals identified prior to COVID 19 were addressed without any challenges. The delivery of vision rehabilitation intervention via telehealth allowed for the continuance of services within the home setting that led to improvements in functional vision, decreased perception of performance challenges, and improved quality of life.

scholarly journals Between Social Inclusion and Exclusion: Integration of Daycare Guests in the Nursing Home Setting

2020 ◽  
Author(s):  
Kerstin Hämel ◽  
Gundula Röhnsch
Keyword(s):  
Nursing Home ◽  
Social Inclusion ◽  
Nursing Home Residents ◽  
Community Dwelling ◽  
Cognitive Capacity ◽  
Home Setting ◽  
Residential Care Facilities ◽  
Care Approach ◽  
Nursing Home Setting ◽  
Close Relatives

Abstract Background and Objectives In integrated daycare, community-dwelling older people in need of care join existing groups in residential care facilities during the day. This study focuses on how nursing home residents experience the integrative care approach, exploring opportunities for social inclusion and mechanisms of exclusion. Research Design and Methods A purposive sample of residents differing in cognitive capacity and level of (non)conflictual interaction with daycare guests was selected. Episodic interviews with residents (N = 10) and close relatives (N = 2) were conducted in 3 pilot facilities in Germany and analyzed using thematic coding. Results The analysis revealed different orientation patterns towards the presence of daycare guests: respondents (a) demonstrated indifference to the daycare guests, (b) saw bonding with guests as a means to connect to the outside world, and (c) perceived incompatibility between in-group and out-group. Criticisms included disruption of daily routines and loss of privacy. Most interviewees came to terms with the care situation using rational and moral arguments. Discussion and Implications The study reveals the importance of residents’ participation when integrating daycare guests. Institutional procedures are required to prevent exclusion of daycare guests and avoid overtaxing residents.

scholarly journals PREVALENCE AND PREDICTORS OF STATIN USE IN LONG-STAY NURSING HOME RESIDENTS WITH LIFE-LIMITING ILLNESSES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S861-S861
Author(s):  
Deborah S Mack ◽  
Kate L Lapane
Keyword(s):  
Palliative Care ◽  
Nursing Home ◽  
Nursing Home Residents ◽  
The United States ◽  
Veterans Health ◽  
Health Administration ◽  
Home Setting ◽  
Palliative Care Consultation ◽  
Care Consultation ◽  
Statin Use

Abstract Statins are one of the most commonly prescribed medications in the United States. While statin use has been studied extensively in the general population, national data on statin use in US nursing homes do not exist. This study estimated the point prevalence of statin use on September 1, 2016 and identified predictors of statin use in nursing home residents with life limiting illness. We conducted a cross-sectional analysis using national MDS 3.0 data linked to Medicare claims. We identified 424,312 long-stay residents with life limiting illnesses defined as a palliative care consultation (ICD-10 Z51.5), prognosis <6 months on MDS, the Veterans Health Administration palliative care index (PCI), or a diagnosis of a serious illness (e.g., cancer, stroke, heart failure, etc.). Poisson models accounted for clustering of residents within facilities. Overall, 34% were on statins which varied by age (65-75 years: 44.1%; >75 years: 31.5%). The strongest positive predictor of statin use was hyperlipidemia, while coronary artery disease and stroke were only marginally predictive across age. The strongest negative predictors were a palliative care consultation or a prognosis <6 months, while PCI was not strongly associated with use. A substantial proportion of long stay nursing home residents with life limiting illnesses continue statin therapy despite evidence of net harm. Efforts to deprescribe statins in the nursing home setting may be warranted. These findings can be used to help identify and target missed opportunities to reduce the therapeutic burden and improve end-of-life care for the US nursing home population.

ICE: Introducing Interprofessional Team Meetings to Trainees in a Nursing Home Setting

2012 ◽  
Vol 13 (3) ◽  
pp. B11-B12
Author(s):  
Kendra D. Sheppard ◽  
Kendra D. Sheppard ◽  
Channing Ford ◽  
Angela Rothrock ◽  
Patricia Sawyer ◽  
...  
Keyword(s):  
Nursing Home ◽  
Home Setting ◽  
Interprofessional Team ◽  
Team Meetings ◽  
Nursing Home Setting

Anesthesia Adverse Events Voluntarily Reported in the Veterans Health Administration and Lessons Learned

2018 ◽  
Vol 126 (2) ◽  
pp. 471-477 ◽  
Author(s):  
Julia Neily ◽  
Elda S. Silla ◽  
Sam (John) T. Sum-Ping ◽  
Roberta Reedy ◽  
Douglas E. Paull ◽  
...  
Keyword(s):  
Adverse Events ◽  
Veterans Health Administration ◽  
Lessons Learned ◽  
Veterans Health ◽  
Health Administration
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