scholarly journals The Systematic Evaluation of Instruments Designed to Assess Pain in Persons with Limited Ability to Communicate*

2007 ◽  
Vol 12 (3) ◽  
pp. 195-203 ◽  
Author(s):  
Michèle Aubin ◽  
Anik Giguère ◽  
Thomas Hadjistavropoulos ◽  
René Verreault
Keyword(s):  
Older Persons ◽  
Long Term Care ◽  
Self Report ◽  
Systematic Evaluation ◽  
Severe Dementia ◽  
Term Care ◽  
Observational Measures ◽  
High Prevalence ◽  
Care Facilities

Chronic pain is often underdetected and undertreated in long-term care facilities. The use of self-report measures of pain (such as the visual analogue scale) is often problematic for older adults residing in long-term care because of the high prevalence of visual and auditory deficits and severe cognitive impairment. Observational measures of pain have been developed to address this concern. A systematic grid designed to assess the properties of existing observational measures of pain was used for seniors with dementia. The grid focused on the evaluation of content validity (12 items), construct validity (12 items), reliability (13 items) and clinical utility (10 items). Among the 24 instruments that were evaluated, several were deemed to be promising in the assessment of pain among older persons with severe dementia. Nonetheless, additional research is needed before their routine integration in the practices of long-term care settings.

scholarly journals High death rate of older persons from COVID-19 in Quebec (Canada) long-term care facilities: chronology and analysis

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Marie Beaulieu ◽  
Julien Cadieux Genesse ◽  
Kevin St-Martin
Keyword(s):  
Older Persons ◽  
Excess Mortality ◽  
Long Term Care ◽  
Human Resources Management ◽  
Armed Forces ◽  
Term Care ◽  
Content Type ◽  
Canadian Armed Forces ◽  
Care Facilities

Purpose Among the ten Canadian provinces, Quebec has experienced the most significant excess mortality of older persons during COVID-19. This practice paper aims to present the chronology of events leading to this excess mortality in long-term care facilities (LTCFs) and a comprehensive analysis of the phenomenon. Design/methodology/approach Documented content from three official sources: daily briefings by the Quebec Premier, a report from the Canadian Armed Forces and a report produced by Royal Society of Canada experts were analysed. Findings Two findings emerge: the lack of preparation in LTCFs and a critical shortage of staff. Indeed, the massive transfer of older persons from hospitals to LTCFs, combined with human resources management and a critical shortage of permanent staff before and during the crisis, generates unhealthy living conditions in LTCFs. Originality/value To our knowledge, this paper is the first to analyse official Quebec and Canadian statements concerning COVID-19 from the angle of quality of life and protection of older adults in LTCFs.

scholarly journals Association Between Length of Residence and Prevalence of Mrsa Colonization Among Residents in Geriatric Long-term Care Facilities

2020 ◽  
Author(s):  
Teppei Sasahara ◽  
Ryusuke Ae ◽  
Akio Yoshimura ◽  
Koki Kosami ◽  
Kazumasa Sasaki ◽  
...  
Keyword(s):  
Long Term Care ◽  
Length Of Residence ◽  
Term Care ◽  
Initial Testing ◽  
High Prevalence ◽  
Care Facilities ◽  
Cross Transmission ◽  
Mrsa Colonization ◽  
Geriatric Long Term Care

Abstract Background: A high prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization has been reported among residents in geriatric long-term care facilities (LTCFs). Some studies indicate that MRSA might be imported from hospitals into LTCFs via resident transfer; however, other studies report that high MRSA prevalence might be caused by cross-transmission inside LTCFs. We aimed to assess which factors have a large impact on the high MRSA prevalence among residents of geriatric LTCFs.Methods: We conducted a cohort study among 260 residents of four geriatric LTCFs in Japan. Dividing participants into two cohorts, we separately analyzed (1) the association between prevalence of MRSA carriage and length of LTCF residence (Cohort 1: n=204), and (2) proportion of residents identified as MRSA negative who were initially tested at admission but subsequently identified as positive in secondary testing performed at ≥2 months after their initial test (Cohort 2: n=79).Results: Among 204 residents in Cohort 1, 20 (9.8%) were identified as positive for MRSA. Compared with residents identified as MRSA negative, a larger proportion of MRSA-positive residents had shorter periods of residence from the initial admission (median length of residence: 5.5 vs. 2.8 months), although this difference was not statistically significant (p=0.084). Among 79 residents in Cohort 2, 60 (75.9%) were identified as MRSA negative at the initial testing. Of these 60 residents, only one (1.7%) had subsequent positive conversion in secondary MRSA testing. In contrast, among 19 residents identified as MRSA positive in the initial testing, 10 (52.6%) were negative in secondary testing.Conclusions: The prevalence of MRSA was lower among residents with longer periods of LTCF residence than among those with shorter periods. Furthermore, few residents were found to become MRSA carrier after their initial admission. These findings highlight that MRSA in LTCFs is most likely to be associated with resident transfer rather than spread via cross-transmission inside LTCFs.

scholarly journals High prevalence of multidrug resistant Enterobacteriaceae among residents of long term care facilities in Amsterdam, the Netherlands

PLoS ONE ◽  
2019 ◽  
Vol 14 (9) ◽  
pp. e0222200 ◽  
Author(s):  
Eline van Dulm ◽  
Aletta T. R. Tholen ◽  
Annika Pettersson ◽  
Martijn S. van Rooijen ◽  
Ina Willemsen ◽  
...  
Keyword(s):  
The Netherlands ◽  
Long Term Care ◽  
Multidrug Resistant ◽  
Term Care ◽  
High Prevalence ◽  
Care Facilities

scholarly journals 1238. A National Comparison of Antibiograms Between Veterans Affairs Long-Term Care Facilities and Affiliated Hospitals

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S376-S377 ◽  
Author(s):  
Maria-Stephanie Tolg ◽  
Aisling Caffrey ◽  
Haley Appaneal ◽  
Robin Jump ◽  
Vrishali Lopes ◽  
...  
Keyword(s):  
Long Term Care ◽  
Veterans Affairs ◽  
Self Report ◽  
Chi Square ◽  
Term Care ◽  
E Coli ◽  
Care Facilities ◽  
National Comparison ◽  
Research Grant

Abstract Background Long-term care facilities (LTCFs) face several barriers to creating antibiograms. Here, we evaluate if LTCFs can use antibiograms from affiliated hospitals as their own antibiogram. Methods Facility-specific antibiograms were created for all Veterans Affairs (VA) LTCFs and VA Medical Centers (VAMCs) for 2017. LTCFs and affiliated VAMCs were paired and classified as being on the same campus or geographically distinct campuses based on self-report. For each pair, Escherichia coli susceptibility rates (%S) to cefazolin, ceftriaxone, cefepime, ciprofloxacin, nitrofurantoin, sulfamethoxazole/trimethoprim, ampicillin/sulbactam, piperacillin/tazobactam, and imipenem were compared. As guidelines discourage empiric use of antibiotics if susceptibility rates are <80%, we assessed clinical discordance between each LTCF and affiliated VAMC antibiogram at a threshold of 80% susceptible. The proportions of concordant susceptibilities between LTCFs and VAMCs on the same campus vs. geographically distinct campuses were compared using Chi-square tests. Results A total of 119 LTCFs and their affiliated VAMCs were included in this analysis, with 70.6% (n = 84) of facilities located on the same campus and 29.4% (n = 35) on geographically distinct campuses. The table below shows the overall clinical concordance (agreement) of LTCFs with their affiliated VAMC in regards to E. coli %S to the compared antibiotics. No significant differences were found when comparing LTCFs on the same campus vs. geographically distinct campuses. Conclusion Antibiograms between LTCFs and affiliated VAMCs had a high concordance, except for sulfamethoxazole/trimethoprim, cefazolin and ceftriaxone in regards to susceptibility rates of E. coli. Facilities on the same campus were found to have similar concordance rates to geographically distinct facilities. Future studies are needed to investigate how the various approaches to creating LTCF-specific antibiograms are associated with clinical outcomes. Disclosures M. S. Tolg, Veterans Affairs: Investigator, Research grant. A. Caffrey, Veterans Affairs: Investigator, Research grant. H. Appaneal, Veterans Affairs: Grant Investigator, Research grant. R. Jump, Veterans Affairs: Investigator, Research grant. V. Lopes, Veterans Affairs: Investigator, Research grant. D. Dosa, Veterans Affairs: Grant Investigator, Research grant. K. LaPlante, Veterans Affairs: Investigator, Research grant.

Antibiotic Resistance in Long-Term Care Facilities

1991 ◽  
Vol 12 (4) ◽  
pp. 245-250 ◽  
Author(s):  
David W. Bentley ◽  
Joseph F. John ◽  
Bruce S. Ribner
Keyword(s):  
Bacterial Infections ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Long Term Care Facility ◽  
Rehabilitation Centers ◽  
High Prevalence ◽  
Care Facilities ◽  
Hospital Wards

Long-term care facilities are comprised of a heterogeneous group of institutions caring for residential patients over prolonged periods of time. Included as long-term care facilities in this review are private and Veterans' Affairs (VA) nursing homes, rehabilitation centers, institutions for the developmentally disabled, and hospital wards for both long-term and intermediate care. Patients in long-term care facilities incur bacterial infections at a prevalence of 10% to 16%. These infections usually are caused by common bacterial pathogens that invade the compromised host residing within a complex physical environment. The high prevalence of institutional infections leads, in turn, to the need for multiple courses of antimicrobials or for hospitalization. This process selects strains more resistant to antibiotics, which are then available for repeated dispersal in the long-term care facility.

Multiple perspectives on quality of life for residents with dementia in long term care facilities: protocol for a comprehensive Australian study

2015 ◽  
Vol 27 (10) ◽  
pp. 1739-1747 ◽  
Author(s):  
Elizabeth Beattie ◽  
Maria O’Reilly ◽  
Wendy Moyle ◽  
Lynn Chenoweth ◽  
Deirdre Fetherstonhaugh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Long Term Care ◽  
Self Report ◽  
Care Staff ◽  
National Study ◽  
Term Care ◽  
People With Dementia ◽  
Care Facilities

ABSTRACTBackground:Dementia is a chronic illness without cure or effective treatment, which results in declining mental and physical function and assistance from others to manage activities of daily living. Many people with dementia live in long term care facilities, yet research into their quality of life (QoL) was rare until the last decade. Previous studies failed to incorporate important variables related to the facility and care provision or to look closely at the daily lives of residents. This paper presents a protocol for a comprehensive, multi-perspective assessment of QoL of residents with dementia living in long term care in Australia. A secondary aim is investigating the effectiveness of self-report instruments for measuring QoL.Methods:The study utilizes a descriptive, mixed methods design to examine how facility, care staff, and resident factors impact QoL. Over 500 residents with dementia from a stratified, random sample of 53 facilities are being recruited. A sub-sample of 12 residents is also taking part in qualitative interviews and observations.Conclusions:This national study will provide a broad understanding of factors underlying QoL for residents with dementia in long term care. The present study uses a similar methodology to the US-based Collaborative Studies of Long Term Care (CS-LTC) Dementia Care Study, applying it to the Australian setting.

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