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Filmmaker Michelle Memran became interested in therapeutic filmmaking after spending much of her twenties making a collaborative documentary with the visionary Cuban American playwright María Irene Fornés, who wrote more than three dozen plays and was the recipient of numerous prestigious grants and awards (https://fornesinstitute.com/about/biography). The documentary, entitled The Rest I Make Up (2018), chronicles Ms. Memran’s artistic collaboration with Ms. Fornés during the early stages of the playwright’s dementia and is a testament to the resilience of the creative spirit and the enduring pleasures of friendship, even — and especially — during cognitive change.

We would like to thank the readers of Caring for the Ages who took the time to respond to our 2022 Reader Survey. We were thrilled with the incredible number of responses and encouraged by your comments!

January 28, 2023

With the new year upon us, many of us make resolutions to improve our health and well-being. Popular resolutions include exercising more, eating healthier, losing weight, and taking better care of our oral health by regularly brushing for two minutes twice a day, flossing, and visiting the dentist and dental hygienist. Personally I have struggled to maintain many of my new year resolutions, but I have been fastidious about caring for my teeth and gums since I was a young adult.

“A & O × 3.” What exactly does that mean? Those of us in post-acute and long-term care will recognize this as shorthand for “Alert and Oriented times three,” which is often the extent of many residents’ “decisional capacity evaluation,” relegated to a portion of the clinical examination that is frequently glossed over and buried in a note.

Collaborative telepsychiatry can help reduce symptoms of depression and result in fewer trips to the hospital among older adults who have co-occurring chronic medical conditions, according to a study in southern California.

Excessive dietary salt intake can harm cognition in older adults, according to a prospective, population-based cohort study in the Shandong area of the People’s Republic of China.

Light therapy can improve the sleep quality of individuals in nursing homes, researchers found.

During the Futures Program in 2021, I learned a lot about how to manage long-term care patients, which included weighing the risks and potential rewards of aspirin in our older patient population, minimizing polypharmacy, and broaching palliative care as an ongoing discussion over several visits. But what struck me the most during this conference was how unique my experience as a nurse practitioner was compared with that of other providers — namely, physicians.

Alcohol consumption is a part of life for many people, and nearly half (43.9%) of Americans aged 65 and older consume alcohol. It’s not surprising that many want to continue to drink in some capacity after they enter a post-acute and long-term care facility. But this can present a challenge for practitioners and staff in their efforts to balance safety and choice.

In this new quarterly Caring column, National Association of Health Care Assistants (NAHCA) CEO and cofounder Lori Porter, NAHCA board chair and long-time certified nursing assistant (CNA) Sherry Perry, and CNA and member of the NAHCA board Branden Fillbrook share insights and guidance for post-acute and long-term care CNAs and other team members as a new year starts. Written by senior contributing writer Joanne Kaldy.

Addressing the issues, controversies, and challenges confronting post-acute and long-term care in this transitional time can be difficult and uncomfortable. Often there are no black or white answers or one definitive solution. That is where AMDA – the Society for Post-Acute and Long-Term Care Medicine’s EDGE Virtual Symposium steps in. The EDGE22 Symposium held in late October presented an overview of the current climate, including some hard facts and varied viewpoints, and it inspired participants to identity ways they can make a difference.

Nonpharmacological approaches to insomnia require a high-priority, team approach in which staff and family are respectful of sleep and can help validate and facilitate sleep hygiene practices and environmental needs, long-term care providers told Caring for the Ages.

For over half a century, medication management of behavior and psychiatric conditions (BPCs) in nursing home residents has been controversial. Over a decade ago, the Centers for Medicare & Medicaid Services launched a “National Partnership to Improve Dementia Care in Nursing Homes” (http://bit.ly/3ADBCwm) that included efforts to reduce the prescribing of antipsychotics.

All the sessions at the AMDA – The Society for Post-Acute and Long-Term Care Medicine Annual Conference are informative and thought provoking, but the keynote addresses set the tone, provide an important touchstone mid-meeting, and end the program on a high note. Details are now available for the keynotes at PALTC23 in Tampa, FL, March 9–12, 2023:

The Office of Inspector General (OIG) recently released a study report, “Long-Term Trends of Psychotropic Drug Use in Nursing Homes.” The study found that the Centers for Medicare & Medicaid Services (CMS) efforts since 2011 had reduced the use of antipsychotics among long-stay nursing home residents, but the prescribing of anticonvulsants had increased. This meant that overall psychotropic drug use remained relatively constant, with 80% of long-stay nursing home residents prescribed a psychotropic drug.

Dental Care in Older Adults

Nurse practitioners (NPs) and physician assistants (PAs) have been in clinical practice since the late 1960s. Yet there are still many misconceptions about scope of practice and the advanced practice provider (APP) role, particularly in post-acute and long-term care (PALTC). Three areas of frequent misconceptions include (1) initial admission visits, (2) legal risks, and (3) patient/resident satisfaction. Let’s take an in-depth look.

Not a week goes by these days when I don’t receive a call or an email from an old patient, friend, or family member with concerns about dementia. My mother has done this or that unusual thing or is exhibiting this or that bizarre behavior. Could she have dementia? How do I know for sure? What kind of tests should she have? What kind of doctor should she see?