Multimorbidity, Consumer-Directed Care, and Drug-Related Harm

2021 ◽  
Vol 36 (3) ◽  
pp. 125-126
Author(s):  
Chris Alderman
Keyword(s):  
Health Care Providers ◽  
Developed Countries ◽  
Care Practice ◽  
Care Providers ◽  
Term Care ◽  
Societal Challenges ◽  
Psychiatric Conditions ◽  
New Treatments ◽  
Related Harm

People from developed countries around the world now routinely live into their 80s and beyond, and this is associated with a range of medical and societal challenges that must be addressed. It is relatively rare to encounter older people who are not affected by one or more chronic diseases, including conditions such as osteoarthritis, gastroesophageal reflux disease (GERD), hypertension, and depression. The concurrence of a number of medical and/or psychiatric conditions in the same patient has come to be referred to as multimorbidity, and it is a particularly familiar phenomenon observed by health care providers in settings such as the Emergency Department (ED), primary care practice, and long-term care facilities. Given that life expectancy continues to increase, and that there is considerable further investment in research for the development of new treatments, which will achieve adoption and be promoted to consumers, it is clear that multimorbidity is likely to be a driver for problems arising from medications that are vigorously promoted to consumers.

Multimorbidity, Consumer- Directed Care, and Drug-Related Harm

2021 ◽  
Vol 36 (3) ◽  
pp. 125-126
Author(s):  
Chris Alderman
Keyword(s):  
Health Care Providers ◽  
Developed Countries ◽  
Care Practice ◽  
Care Providers ◽  
Term Care ◽  
Societal Challenges ◽  
Psychiatric Conditions ◽  
New Treatments ◽  
Related Harm

People from developed countries around the world now routinely live into their 80s and beyond, and this is associated with a range of medical and societal challenges that must be addressed. It is relatively rare to encounter older people who are not affected by one or more chronic diseases, including conditions such as osteoarthritis, gastroesophageal reflux disease (GERD), hypertension, and depression. The concurrence of a number of medical and/or psychiatric conditions in the same patient has come to be referred to as multimorbidity, and it is a particularly familiar phenomenon observed by health care providers in settings such as the Emergency Department (ED), primary care practice, and long-term care facilities. Given that life expectancy continues to increase, and that there is considerable further investment in research for the development of new treatments, which will achieve adoption and be promoted to consumers, it is clear that multimorbidity is likely to be a driver for problems arising from medications that are vigorously promoted to consumers.

scholarly journals Visual process maps to support implementation efforts: a case example

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Jennifer Kononowech ◽  
Zach Landis-Lewis ◽  
Joan Carpenter ◽  
Mary Ersek ◽  
Robert Hogikyan ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Long Term Care ◽  
Process Mapping ◽  
Care Providers ◽  
Term Care ◽  
Goals Of Care ◽  
Process Maps ◽  
Time Burden ◽  
Centered Care

Abstract Background Process mapping is often used in quality improvement work to examine current processes and workflow and to identify areas to intervene to improve quality. Our objective in this paper is to describe process maps as a visual means of understanding modifiable behaviors and activities, in this case example to ensure that goals of care conversations are part of admitting a veteran in long-term care settings. Methods We completed site visits to 6 VA nursing homes and reviewed their current admission processes. We conducted interviews to document behaviors and activities that occur when a veteran is referred to a long-term care setting, during admission, and during mandatory VA reassessments. We created visualizations of the data using process mapping approaches. Process maps for each site were created to document the admission activities for each VA nursing home and were reviewed by the research team to identify consistencies across sites and to identify potential opportunities for implementing goals of care conversations. Results We identified five consistent behaviors that take place when a veteran is referred and admitted in long-term care. These behaviors are assessing, discussing, decision-making, documenting, and re-assessing. Conclusions Based on the process maps, it seems feasible that the LST note and order template could be completed along with other routine assessment processes. However, this will require more robust multi-disciplinary collaboration among both prescribing and non-prescribing health care providers. Completing the LST template during the current admission process would increase the likelihood that the template is completed in a timely manner, potentially alleviate the perceived time burden, and help with the provision of veteran-centered care.

scholarly journals EVENT-SPECIFIC EMOTIONAL EXPRESSION OF PERSONS WITH DEMENTIA IN LONG-TERM CARE: PRELIMINARY RESULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S420-S420
Author(s):  
Kyung Hee Lee ◽  
Ji Yeon Lee ◽  
Bora Kim ◽  
Marie Boltz
Keyword(s):  
Health Care Providers ◽  
Emotional Expression ◽  
Long Term Care ◽  
Well Being ◽  
Emotional Expressions ◽  
Care Providers ◽  
Personal Care ◽  
Term Care ◽  
Meal Time

Abstract Although dementia-related language, comprehension, and memory deficits occur fairly early stage in dementia, persons with dementia retain the ability to express their emotion even in the late stage of disease. However, health care providers do not know how to interpret emotional expressions that could be utilized as important signals of underlying needs and care preferences in persons with dementia. The purpose of this study was to explore the event-specific emotional expressions of persons with dementia in long-term care over a 6-month period. This was a longitudinal study using repeated observations. Emotional expressions were videotaped when three specific events (personal care, meal time, and activity) occurred at baseline, month 3 and month 6. A total of nine observations was made for each participant. We enrolled 13 participants so far; ten participants were completed 6 month follow up. The mean score of MMSE at baseline was 4.38; that of ADL was 16.62. On average, persons with dementia showed 9.93 episodes of positive emotional expression (PEE) per minute and 1.81 episodes of negative emotional expression (NEE) per minute. We found between person variations for both PEE and NEE. PEE and NEE were different by three types of events. Specifically, persons with dementia showed more PEE with activity than personal care and meal time and more NEE with personal care than the other two events. This study will provide better understanding of event-specific emotional expressions, and inform the development of emotion-oriented interventions programs to improve the psychological well-being of persons with dementia.

Intercultural Collaboration: An Approach to Long Term Care for Urban American Indians

2003 ◽  
Vol 4 (1) ◽  
pp. 46-52 ◽  
Author(s):  
Levanne R. Hendrix
Keyword(s):  
American Indian ◽  
American Indians ◽  
Health Care Providers ◽  
Long Term Care ◽  
Extended Family ◽  
Care Providers ◽  
Indian Culture ◽  
Term Care ◽  
Urban American Indians

Most long term care of older urban American Indians is provided in the community by family, extended family, or fictive kin, and American Indians are rarely found in long term care facilities. An approach to American Indian elderly requires some understanding of Indian ways in order to be effective therapeutically and acceptable to the older Indian. Multiple interviews, a focus group, and a survey conducted in an urban Indian community revealed the consistent perception by American Indian elderly and their families that health care providers lacked information, understanding, and respect for Indian culture.

scholarly journals Linking Incidents in Long-Term Care Facilities to Worker Activities

2017 ◽  
Vol 65 (10) ◽  
pp. 457-466
Author(s):  
Rose McCloskey ◽  
Cindy Donovan ◽  
Alicia Donovan
Keyword(s):  
Health Care Providers ◽  
Long Term Care ◽  
Occupational Injury ◽  
Worker Safety ◽  
Care Providers ◽  
Cross Sectional ◽  
Term Care ◽  
Care Facilities ◽  
The Impact

This article reports on a study examining staff activities being performed when incidents were reported to have occurred. The risk for injury among health care providers who engage in patient handling activities is widely acknowledged. For those working in long-term care, the risk of occupational injury is particularly high. Although injuries and injury prevention have been widely studied, the work has generally focused on incident rates and the impact of specific assistive devices on worker safety. The purpose of this study was to examine reported staff incidents in relation to staff activities. A multicenter cross-sectional exploratory study used retrospective data from reported staff incidents (2010, 2011, and 2012) and prospective data from 360 hours of staff observations in five long-term care facilities during 2013. Descriptive statistics were used to analyze data. A total of 898 staff incidents were reviewed from the facilities. Incidents were most likely to occur in resident rooms. Resident aides were more likely to be engaged in high-risk activities than other care providers. Times when staff incidents were reported to have occurred were not associated with periods of high staff-to-resident contact. Safe handling during low and moderate risk activities should be promoted. Education on what constitutes a reportable incident and strategies to ensure compliance with reporting policies and procedures may be needed to ensure accuracy and completeness of incident data.

scholarly journals Keperawatan Pasien Berpenyakit Kronis

2014 ◽  
Vol 1 (2) ◽  
pp. 45-50
Author(s):  
Elly Nurachmah
Keyword(s):  
Chronic Illness ◽  
Health Care Providers ◽  
Nursing Practice ◽  
Long Term Care ◽  
Care Providers ◽  
Term Care ◽  
Caring Behavior ◽  
Pathological Alteration ◽  
Factors Influencing

Keperawatan merupakan falsafah mendasar praktik keperawatan. Dikembangkan oleh Watson (1985), keperawatan terdiri atas 10 faktor karatif yang menganjurkan perawat memberikan asuhan keperawatan paripurna kepada para pasien  sehubung dengan kondisi penyakit mereka, termasuk pasien berpenyakit kronis. Penyakit kronis ialah penyakit yang karena cirri-cirinya membutuhkan perawatan jangka panjang. Biasanya disebabkan oleh perubhan patologi yang “irreversible” dimana mengarahkan kemampuan seseorang karena kegagalan fungsi tubuh. Penyakit kronis menciptakan banyak masalah tidak hanya pada individu dan keluarga tetapi juga pada pemberi pelayanan kesehatan termasuk perawat. Mereka harus “hidup” dengan pasien dari hari ke hari dan mengatasinya. Mereka berada pada status kematian yang datangnya tidak dapat diperkirakan dengan tepat. Perawat merasa putus asa terhadap prognosa penyakit menyebabkan mereka sulit merawat pasien berpenyakit kronis. Hal ini juga merupakan salah satu alasan mengapa perawat tidak mampu memperlihatkan perilaku merawat seperti yang dikatakan Watson. Artikel ini mencoba menguraikan teori merawat berdasarkan kasih sayang, factor yang mempengaruhi perawat dalam merawat, dan alasan pemberian perawatan pada pasien berpenyakit kronis dengan menggunakan sikap merawat yang tepat. Caring is a fundamental philosophy of nursing practice. It was developed by Watson (1985). It consist of ten carrative factors that allow nurses to provide a comprehensive nursing care to patients regardless of their condition of illness including patients with chronic illness. Chronic illness is a variety of illness that because of its characteristic needs long term care. It is usually caused by non-reversible pathological alteration that lead to incapacity of a person due to impairment of body function. Chronic illness has created many problems not only for individuals and families but also for health care providers including nurses. They have to “live” with the patient day to day and cope with it. Following the chronicity of disease, death will come unpredictably. Nurses feel a sense of hopelessness with regard to the prognosis that make them difficult to care for individuals with chronic illness. This is also one of the reasons why nurses are unable to demonstrate caring behavior as stated by Watson. This article attempts to describe about theory of caring, factors influencing nurses caring behavior, and reasons to provide care to patients with chronic illness using appropriate caring behavior.

PTSD Symptoms and Dementia in Older Veterans Who are Living in Long-Term Care

2021 ◽  
pp. 104973232110613
Author(s):  
Kim Ritchie ◽  
Heidi Cramm ◽  
Alice Aiken ◽  
Catherine Donnelly ◽  
Catherine Goldie
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Health Care Providers ◽  
Long Term Care ◽  
Stress Disorder ◽  
Care Providers ◽  
Chart Audit ◽  
Term Care ◽  
Posttraumatic Stress Disorder Symptoms

Co-occurring posttraumatic stress disorder symptoms and dementia can result in increased symptoms, such as suspicion, aggression, and nightmares in Veterans that can be difficult to manage in long-term care environments. The objective of the study was to explore how the co-occurrence of posttraumatic stress disorder symptoms and dementia are understood in Canadian Veterans who are living in long-term care. A descriptive multiple case study was conducted in two Veteran long-term care facilities in Canada. Data collection consisted of semi-structured interviews with Veterans, their family caregivers, and health care providers, non-participant observation, and a chart audit. Three major themes emerged relating to symptom expression and care approach: a) symptoms are the same but different; b) differences in the complexity of care; and c) added dimensions involved in care. The results of this study contribute foundational information about co-occurring posttraumatic and dementia symptoms that can inform policy, care approaches, and potential interventions.

The Importance of a Complete Allergy Assessment in Clinical Stewardship

2019 ◽  
Vol 34 (8) ◽  
pp. 510-513
Author(s):  
Vanessa Moreno ◽  
Charlie L. Nguyen ◽  
Amie Taggart Blaszczyk
Keyword(s):  
Health Care Providers ◽  
Long Term Care ◽  
Care Providers ◽  
Opioid Use ◽  
Term Care ◽  
Care Facilities ◽  
The Right ◽  
Potential Challenge ◽  
Selection Of

National agencies have championed stewardship initiatives to enhance antimicrobial and opioid use in long-term care facilities. Health care providers for these residents have been given the task to ensure "the right drug is used for the right indication at the right time and duration." One potential challenge to this is incorrect or incomplete documentation of allergies. Many long-term care facilities have traditionally, and currently, used a "list format" of allergies in, or on, the resident's chart. This approach is incomplete as it rarely provides detailed information about the reaction to a particular drug. Senior care pharmacists and their students can play a role within long-term care facilities by helping ensure the optimal selection of drugs by providing a detailed allergy assessment that documents detailed reaction information, whenever possible.

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