scholarly journals Stranded beluga (Delphinapterus leucas) calf response and care: reports of two cases with different outcomes

2021 ◽  
Vol 40 ◽  
Author(s):  
Caroline E.C. Goertz ◽  
Kathy Woodie ◽  
Brett Long ◽  
Lisa Hartman ◽  
Eric Gaglione ◽  
...  
Keyword(s):  
Supportive Care ◽  
Delphinapterus Leucas ◽  
Close Monitoring ◽  
Cook Inlet ◽  
Bristol Bay ◽  
Term Care ◽  
Care Plans ◽  
Complete Blood Counts ◽  
Systemic Health

Given the remote, rugged areas belugas typically inhabit and the low rehabilitation success rate with any cetacean, it is rare to have the opportunity to rescue a live-stranded beluga. The Alaska SeaLife Center cared for two stranded beluga calves with two different outcomes. In 2012, a neonatal male beluga calf (DL1202) stranded following intense storms in Bristol Bay. In 2017, a helicopter pilot discovered a stranded male beluga calf (DL1705) during a flight over Cook Inlet. The Alaska SeaLife Center transported both calves for rehabilitation and utilized supportive care plans based on those for other species of stranded cetaceans and care of neonatal belugas at zoological facilities. Diagnostics included complete blood counts, serum chemistries, microbial cultures, hearing tests, imaging and morphometric measurements to monitor systemic health. Treatments included in-pool flotation support; antimicrobials; gastrointestinal support; and close monitoring of respirations, urination, defecation and behaviour. After three weeks of supportive care, the Bristol Bay calf (DL1202) succumbed to sepsis secondary to a possible prematurity-related lack of passive transfer of antibodies. After seven weeks, the Cook Inlet calf (DL1705) recovered and all medications were discontinued. Unable to survive on his own, he was declared non-releasable and placed in long-term care at a zoological facility, to live with other belugas. Aspects and details from successful cases of cetacean critical care become important references especially vital for the survival of essential animals in small, endangered populations.

A scoping review to inform care coordination strategies for youth with traumatic brain injuries: Care coordination tools

2021 ◽  
pp. 205343452110706
Author(s):  
Brandy Shook ◽  
Cara Palusak ◽  
Susan C Davies ◽  
Jennifer P Lundine
Keyword(s):  
Scoping Review ◽  
Care Coordination ◽  
Brain Injuries ◽  
Unmet Needs ◽  
Chronic Health Condition ◽  
Service Access ◽  
Care Needs ◽  
Term Care ◽  
Care Plans

Introduction & importance Children with traumatic brain injury (TBI) report unmet needs several years after their injury and may require long-term care. However, this chronic health condition is often only treated and monitored in the short-term. Care for young persons with TBI often relies on parents to manage their child's complex care network. Effective care coordination can close these gaps and facilitate continuity of care for children with TBI. The purpose of this scoping review was to develop a better understanding of tools that improve care coordination for Children with Special Health Care Needs (CSHCN). This, in turn, can inform care for children with TBI. Methods A scoping review was conducted following the PRISMA framework and methodology. OVID/Medline, CINAHL, PsycINFO, EMBASE, and ERIC databases were searched for articles relevant to care coordination tools used with CSHCN. Results 21 articles met the criteria for inclusion in the review, and 6 major categories of care coordination tools were identified: telehealth, online health records and tools, care plans, inpatient discharge protocols, family training, and reminders. Discussion Studies examining telehealth, online tools, care plans, and family training care coordination interventions for CSHCN have shown positive outcomes and would be relevant strategies to improve the care of children with TBI. Future prospective research should investigate these tools to explore whether they might improve communication, reduce unmet needs, increase service access, and improve long-term outcomes for children with TBI.

Developing a Rule-Based Expert System to Infer Customized Care Plans for Long Term Care Patients

2021 ◽  
Author(s):  
Chih-Hsuan Yeh ◽  
Chiao-Ling Hsu ◽  
Polan Chang
Keyword(s):  
Expert System ◽  
Long Term Care ◽  
Health Providers ◽  
Term Care ◽  
Rule Based ◽  
Care Plans ◽  
Aging Society ◽  
Increasing Demand

Systems of long-term care are needed in aging society to meet the needs of older people. In rapidly increasing demand for long-term care, how to ensure the quality of long-term care is an important issue. Therefore, we designed a rule-based expert system that automatically generates customized care plans based on the assessment results. Aims to provide health providers a useful tool in long term patients management.

scholarly journals Longitudinal Follow-Up of Long-Term Care Planning Using PlanYourLifespan.org

2020 ◽  
pp. 073346482094306
Author(s):  
Vanessa Ramirez-Zohfeld ◽  
Anne Seltzer ◽  
Ana Ramirez ◽  
Ruqayyah Muhammad ◽  
Lee A. Lindquist
Keyword(s):  
Older Adults ◽  
Long Term Care ◽  
Long Term Effects ◽  
Care Needs ◽  
Term Care ◽  
User Perceptions ◽  
Care Plans ◽  
Age In Place ◽  
Care Services

Many older adults wish to age-in-place but do not have long-term care plans for when they may require more assistance. PlanYourLifespan.org (PYL) is an evidence-based tool that helps older adults understand and plan for their long-term care needs. We examined the long-term effects of PYL use on user perceptions and planning of long-term care services. Individuals who previously accessed PYL were invited to complete an online, nation-wide mixed methodology survey about end-user outcomes related to PYL. Among 115 completed surveys, users found PYL helpful with long-term planning for their future needs. Over half of website users reported having conversations with others because of PYL use. However, 40% of respondents reported not having a conversation with others about their plans; common themes for barriers to planning included procrastination and a lack of immediate support needs. Although PYL helps with planning, many people are still not communicating their long-term care plans.

Caring About Residents’ Experiences and Symptoms (CARES) Program: A Model of Palliative Care Consultation in the Nursing Home

2016 ◽  
Vol 34 (5) ◽  
pp. 466-469 ◽  
Author(s):  
Deborah A. Morris ◽  
Marissa Galicia-Castillo
Keyword(s):  
Palliative Care ◽  
Nursing Home ◽  
Long Term Care ◽  
Descriptive Analysis ◽  
Nursing Home Residents ◽  
Term Care ◽  
Code Status ◽  
Care Plans ◽  
Palliative Care Consultation

Objectives: To describe the CARES program, a model of palliative care for nursing home residents. Design: Descriptive analysis of the Caring About Residents’ Experiences and Symptoms (CARES) Program that provides palliative care services to nursing home residents. Program evaluation: The CARES Program serves as an example of collaborative efforts to meet community needs. To evaluate the program, we document the services provided as well as process outcomes (changes to care plans, hospitalizations, location of death, and hospice utilization) for residents referred. Results: 170 nursing home residents were seen by CARES Program between February 2013 to December 2015, 48% for skilled services, and 52% for long term care. Majority of referrals were for goals of care and concurrent symptom management. Following consultation, 67% of residents had a change in code status. Of residents desiring a palliative course 90% were never hospitalized. Overall, 53% of residents died; and those in long term care dying more often with hospice. Conclusion: The CARES program of palliative consultation addresses the needs of nursing home residents. The model has potential to be reproducible in in other communities.

scholarly journals Knowing the person of the resident – a theoretical framework for Person-centred Practice in Long-term Care (PeoPLe)

2020 ◽  
Vol 10 (2) ◽  
pp. 1-16
Author(s):  
Hanna Mayer ◽  
◽  
Brendan McCormack ◽  
Christiane Hildebrandt ◽  
Sabine Köck-Hódi ◽  
...  
Keyword(s):  
Older People ◽  
Long Term Care ◽  
Healthcare Delivery ◽  
Theoretical Framework ◽  
Term Care ◽  
Care Plans ◽  
Starting Point ◽  
Practice Framework ◽  
Practice Development

Background: Demographic change and a shift of values in society bring new challenges for the long-term care of older people, suggesting the institutional model of care should give way to one that places the person at the centre of decision making. Aim: To describe the development of a theoretical framework for person-centred practice with older people in long-term care. Development process: The framework was developed by synthesising original empirical research, existing evidence and existing theory, using an iterative and integrated approach to theory development based on a dialogical understanding of knowledge construction. The project formed part of a five-year research and practice development programme on person-centred practice in long-term care in Austria. Results: The Person-centred Practice Framework for Long-Term Care (PeoPLe) is a theoretical framework of person-centred practice, consisting of five constructs: prerequisites, practice environment, person-centred processes, fundamental principles of care, and outcome. It is dependent on the macro-context of healthcare delivery. Conclusion: PeoPLe provides a comprehensive theoretical framework for the development of person-centred practice in long-term care. The framework can be used to guide empirical inquiry, education and practice development. Implications for practice: The Person-centred Practice Framework for Long-term Care (PeoPLe) is a comprehensive theoretical framework that sets out principles for the operationalisation of person-centred practice with older people in long-term care The Fundamental Principles of Care component of the PeoPLe framework is reported to appeal to many practitioners and may serve also as a low-threshold starting point for practice development The Fundamental Principles of Care component may steer the development of person-centred processes and individual care plans with persons in care. It can, for example, be used to guide assessment, case conferences and documentation

scholarly journals DNR Linked to Reduced Depressive Symptoms in Nursing Home Residents During COVID-19 Illness

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 720-721
Author(s):  
Wingyun Mak ◽  
Orah Burack ◽  
Joann Reinhardt ◽  
Himali Weerahandi ◽  
Benjamin Canter ◽  
...  
Keyword(s):  
Nursing Home ◽  
Depressive Symptoms ◽  
Functional Status ◽  
Long Term Care ◽  
Nursing Home Residents ◽  
Do Not Resuscitate ◽  
Term Care ◽  
Data Set ◽  
Care Plans

Abstract Prior work shows that older adults who establish future care plans have a lower risk of depression. Residents in long-term care may benefit from establishing a do-not-resuscitate (DNR) order when cardiopulmonary resuscitation is unlikely to provide medical benefit. The current study examines whether having a DNR order in place prior to COVID-19 diagnosis was associated with fewer depressive symptoms during the illness course. Residents at a NYC skilled nursing facility with a positive COVID-19 PCR test between 3/1/2020 – 6/1/2020 were included (N=338). The Minimum Data Set (3.0) was used to examine residents’ Patient Health Questionnaire-9 (PHQ-9) scores 1-30 days after diagnosis, functional status, cognition, age, and sex. A retrospective chart review was conducted to determine whether participants had an established DNR, DNI, and/or DNH order before developing COVID-19. Forty-eight percent, 46%, and 12% of participants had a DNR, DNI, or DNH order prior to COVID-19 illness, respectively. Average PHQ-9 score was 1.65 (SD=2.37). A hierarchical regression showed that after controlling for age (β=-.13, p=.06), sex (β=-.08, p=.28), cognition (β=.14, p=.04), and functional status (β=.23, p=.001; R2=.10, p=.001), having a DNR (β=-.22, p=.006) order in place prior to COVID illness was associated with lower endorsement of depressive symptoms during illness (ΔR2=.04, p=.01). Results suggest that establishing a DNR in long-term care residents when appropriate may potentially buffer depressive symptoms during illness in nursing home residents regardless of their age, sex, cognitive abilities, and functional status. Future examination of the underlying mechanism is warranted.

Long-Term Care/Residential Care

2018 ◽  
Author(s):  
Tahira I. Lodhi ◽  
Tania Alchalabi
Keyword(s):  
Assisted Living ◽  
Independent Living ◽  
Long Term Care ◽  
Assisted Living Facilities ◽  
Geriatric Population ◽  
Term Care ◽  
Levels Of Care ◽  
Care Plans ◽  
Care Systems

Given the increase in the geriatric population, the norms of long-term care systems will be forced to change in societies all over the world. This chapter provides an overview of the different levels of care available, from independent living to inpatient, subacute, rehab, assisted living facilities, group homes, and long-term care. A case study is provided of a couple’s declining health trajectory and worsening functional status, identifying resources that pay for various levels of care. Given that care plans must be tailored to the patient’s needs and circumstance, this review provides the foundation to build the structure of a transition or discharge plan. The use of complementary and alternative medicine in long-term care facilities is briefly covered.

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