According to the U.S. Centers for Disease Control and Prevention, 45.8% of all Americans and 85% of those older than 60 use prescription medications (NCHS Data Brief 2019;334:1–8). Pharmacists have the responsibility to ensure that these Americans who rely on medications are achieving their health-related goals safely. This responsibility has put pharmacists on the front line in any health emergency, including the COVID-19 pandemic.

May 19, 2022

Although “timely and proactive palliative care can improve quality of life,” identifying patients in the palliative phase remains a challenge, as shown by two studies in the Netherlands.

Barbara Resnick, PhD, CRNP, always knew she wanted to work in the geriatrics field. From her earliest memories, she visited her grandparents daily in the nursing home where they resided and felt a strong calling to care for older adults and those in need.

“Purpose is not about what we do and how fast we do it; but why we do it, and how we do it.”Paolo Gallo

Although better wages are one solution to the certified nursing assistant (CNA) shortage in post-acute and long-term care facilities, there are many other reasons CNAs are leaving their jobs. Lori Porter, CEO and cofounder of the National Association of Health Care Assistants (NAHCA), said, “It was never all about pay. It’s about respect, benefits, appreciation, and opportunities.”

Workforce shortages in post-acute and long-term care have been like a snowball rolling down a hill. They started before anyone had heard of COVID-19, but they were exacerbated during the pandemic, picking up speed and getting bigger and bigger. Today, the staffing crisis is an enormous challenge and a problem that everyone is trying to reduce to a manageable size and eventually dissolve completely.

Asking staff for their opinions of their work and workplace, says skilled nursing facility administrator Gail Cushing, is “always nerve-wracking because you’re afraid of what you’re going to hear.”

A few weeks ago, I was conducting staff training on the assessment and care of individuals living with dementia at a local post-acute and long-term care (PALTC) facility that I collaborated with intermittently over the past several years. One of the caring, highly qualified, and optimistic nurse managers shared her concerns related to the increasing challenges with staff recruitment. She said, “I guess no one wants to work in long-term care anymore.” This facility and many others have been experiencing staffing shortages, which are now widespread in nursing, recreation, environmental and dining services.

Dear Dr. Steve: During the COVID pandemic, my facility lost many staff and is still straining to find enough qualified and willing individuals to provide direct care. Also, it seems that capable and willing medical practitioners (physicians, nurse practitioners) are in short supply. Is this all related to the pandemic? What can we do about it at our facility?

President Biden has released his fiscal year (FY) 2023 budget for the Department of Health and Human Services (HHS). Key highlights relevant to post-acute and long-term care include:

Wayne Saltsman, MD, PhD, CMD, talks about how and why family members should be involved in their loved one’s care planning.

Actions Taken to Retain Staff: What Three Facilities Are Doing

AMDA – The Society for Post-Acute and Long-Term Care (PALTC) Medicine has elected its 2022–2023 Board of Directors.

We are all aware of the staffing crisis that post-acute and long-term care (PALTC) communities are experiencing across the nation. It is discussed in webinars, during meetings, in articles, and in casual conversations among exhausted clinicians, concerned industry leaders, and policymakers who are now seeing what all of us knew was a looming problem long before the pandemic.

We all know the story of the three little pigs and the big bad wolf. Each of the pigs built a home with the same goal: keeping all who lived within safe from the big bad wolf. One home was made of straw, one of wood, and one of brick. We also know which of these homes fared best when faced with the huffing and puffing of the big bad wolf: the house of brick. The first two little pigs picked cheaper materials to offer shelter, but the third pig planned well and was more resourceful: he learned from what the others had done, made a deliberate decision to use the best material possible, and likely even consulted with experts in the design.

Just a few weeks before assuming the role of president of AMDA – The Society for Post-Acute and Long-Term Care Medicine, I sat on the sofa in my family room watching President Biden give the State of the Union address. During the speech, he announced his administration’s exciting plan to improve quality and safety in nursing homes. The plan includes five pillars that target ensuring safe, adequate, and dignified care; enhancing accountability and oversight; increasing transparency; strengthening the workforce; and ensuring pandemic and emergency preparedness.

Few issues regarding skilled nursing facilities are as controversial as pre-dispute, binding arbitration agreements. Moreover, even fewer issues have been litigated as much as binding arbitration agreements. The Federal Arbitration Act (FAA), enacted by Congress almost a century ago in 1925, facilitates dispute resolution by having a neutral and objective third party render a decision on the disputed issue that “shall be valid, irrevocable, and enforceable” (9 U.S.C. §§ 1–16). Neither a judge nor jury is involved with an arbitration, which allows the parties to resolve their disputes in a fair, efficient, and cost-effective manner without the considerable expense and protracted time that litigation requires.

Dotlin Powell learned to knit while growing up in Saint Elizabeth, Jamaica, where girls in primary school were taught the skills of knitting, embroidery, and other arts and crafts. Knitting became part of her life. Into adulthood she decorated her Jamaican home with knitted throws, tablecloths, and runners.

My mother was widowed for 11 years after my father died of Alzheimer’s disease. In the years before her own death at 93, she would often turn to me — her son, the geriatrician — and plaintively ask, “What will become of me?”