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Updated: 18 hours 8 min ago

Saying “Hello” to Age-Friendly Health Systems

Mon, 06/01/2020 - 00:00
Speaking virtually to her audience at the Annual Conference of AMDA – The Society for Post-Acute and Long-Term Care Medicine, closing keynote speaker and the Society board member Alice Bonner, PhD, APRN, GNP, said, “Keep focusing on things that are positive. We need that more than ever.” In her presentation, “Adventures in Aging During a Difficult Time,” Dr. Bonner shared some stories and personal reflection while talking about the world of Age-Friendly Health Systems.

Are Your Quality Assessment and Assurance Documents Safe From Prying Eyes?

Mon, 06/01/2020 - 00:00
Federal regulations require that all skilled nursing facilities must have a functioning Quality Assurance Performance Improvement (QAPI) program and a Quality Assessment and Assurance (QAA) committee (Medicaid and Medicare Programs; Reform of Requirements for Long Term Care Facilities, Fed Regist 2016;81:68688–68872; codified at 42 CFR § 483.75, effective November 28, 2017; http://bit.ly/38fnRmx). To help surveyors determine whether nursing facilities are in substantial compliance with the applicable federal regulations, the Centers for Medicare & Medicaid Services provides guidance in the form of the State Operations Manual (SOM).

Proactive Communication and Collaboration With Families During COVID-19

Mon, 06/01/2020 - 00:00
These are frightening, insecure times. More than likely, families are reading multiple stories about coronavirus infectious disease 2019 (COVID-19), some of which conflict and may cause even more fear and alarm. Proactive and transparent communication with families can help minimize some of the fear and counter misinformation. A trauma-informed organization demonstrates trustworthiness and transparency, which is reinforced by clear, timely, and accurate communication.

Strategies for Protecting Patients and Staff From COVID-19

Mon, 06/01/2020 - 00:00
Post-acute and long-term care patients are at increased risk for COVID-19 morbidity and mortality due to frailty, significant functional limitations, and the presence of more chronic and complex conditions than most community-dwelling older adults. Additionally, the congregate nature of PALTC settings and the need for close interpersonal contact during care interactions also increase the risk of COVID-19 transmission. As a result of the frailty of this patient population, the supportive activities required, and the community environment, LTC settings have the highest risk of COVID-19 infection, so special processes are needed to safeguard our patients and staff as much as possible.

Thoughts in a Pandemic

Mon, 06/01/2020 - 00:00
As a geriatrician working in a long-term care facility, I realized early on that if there was an outbreak of COVID-19 with my older patients, there was a high possibility of poor outcomes. With all of the data showing most COVID-19 mortality in patients above the age of 65, I felt that this was a pandemic that we would have to face sooner or later. But the problem seemed far away as things seemed quiet at the skilled nursing facility where I was practicing. “It’s happening in another nursing home,” I thought.

Sharing Resources: The ABCs of Combating Isolation

Fri, 05/01/2020 - 00:00
Pioneer Network began 23 years ago when a group of committed, innovative, and creative disruptors got together and began to spread the word that the world of aging, and care and support needed to be focused on people, not on institutions. They decided on the name Pioneer Network — with network being the key — and brought together like-minded people and organizations to be involved, disseminate best practices, share information, and provide a place to go when resources and assistance were needed.

Conference Spotlight: Navigating the COVID-19 Pandemic

Fri, 05/01/2020 - 00:00
For those trying to keep track of developments and news regarding the COVID-19 pandemic, there are constant updates as the situation is evolving rapidly. The leaders of AMDA – The Society for Post-Acute and Long-Term Care Medicine on the frontlines of the COVID-19 response came together virtually during the opening general session of the Society’s 2020 Annual Conference to provide updates, share stories and solutions, and offer encouragement and resources. “We are building this airplane as it goes down the runway and is taking off,” said David Nace, MD, MPH, CMD, the Society’s president.

PALTC Practitioners Hit the Field on Population Health

Fri, 05/01/2020 - 00:00
New models of care are challenging the way practitioners work, but they also present welcoming opportunities for physicians and others to use their clinical knowledge, experience, and skills. In many ways, this is the game post-acute and long-term care practitioners have been training for their whole careers, and many are eager to take the field.

Resources for Health Care Providers Managing Stress and Anxiety During the COVID-19 Crisis

Fri, 05/01/2020 - 00:00
In a crisis, self-care may be the last thing on the minds of those caring for others. But now more than ever patients and residents depend on the providers’ inner strength, resilience, and clarity of mind. The following tools will help health care providers foster these qualities now and develop skills and habits for continued self-care beyond these challenging times.

Anxiety About COVID-19: How to Support Your Loved Ones

Fri, 05/01/2020 - 00:00
Crises can increase fears, panic, and anxiety for older adults. David Smith, MD, CMD, a Texas-based geriatrician, talks about how you can help.

Who Gets What and Why?

Fri, 05/01/2020 - 00:00
Dear Dr. Jeff: We received an email from our local hospital emergency room directing us not to send patients with fever and respiratory symptoms to them as they were already overwhelmed with COVID-19 patients and our patients would not be offered a hospital isolation room or mechanical ventilation due to their advanced age and preexisting conditions. Do you think this is fair? Or ethical? Or even legal?

News From the Society

Fri, 05/01/2020 - 00:00
AMDA – The Society for Post-Acute and Long-Term Care Medicine has many members who are passionate leaders, respected educators, and inspiring innovators. Each year we recognize two of these with the William Dodd Founder’s Award for Distinguished Service and the James Pattee Award for Excellence in Education.

Journal Highlights From the May Issue of JAMDA

Fri, 05/01/2020 - 00:00
Nearly one in five older adults develop fear of falling, according to a longitudinal study that also suggests older age, use of a walking aid, and symptoms of depression can help predict who is more likely to develop this fear.

The MDS and Silos, in Theory and Practice

Fri, 05/01/2020 - 00:00
In theory, there is no difference between practice and theory, while in practice there is.— Benjamin Brewster

We’re All In — Are You?

Fri, 05/01/2020 - 00:00
Two months ago, we were eagerly planning on another Annual Conference of AMDA – The Society for Post-Acute and Long-Term Care Medicine. We were anticipating how we would renew old Society friendships, learn how to be better clinicians, and have therapeutic conversations with the only people on the planet who know exactly what our world is like. What a difference a pandemic makes, huh?

Short Delirium Screening Tool Wins Morley Award

Fri, 05/01/2020 - 00:00
A research paper that describes a three-question screening tool for detecting delirium in patients with dementia has won JAMDA’s 2020 Morley Award for its potential to impact practice and policy in post-acute and long-term care medicine. Once validated, the screening tool could assist clinicians who practice in settings with a high prevalence of dementia to quickly exclude patients without delirium and to identify those who need further assessment, its authors say.

In This Issue

Fri, 05/01/2020 - 00:00
This year’s award recipient, Fred Feinsod, MD, MPH, DSc, CMD, FACP, touches the lives of those around him in a powerful way. 3

The Medical Model and Person-Centered Care: A Blended Approach

Fri, 05/01/2020 - 00:00
Nursing homes have been a part of our history since the 17th century. They began as almshouses, and then in the 20th century transitioned into “convalescent homes” that provided basic care and meals. The Omnibus Budget Reconciliation Act (OBRA) in 1987 introduced new government provisions, oversight, and regulation to address improved quality of care in nursing homes, so the nursing home that we are familiar with today is actually a relatively new concept. Our “industry” is only 33 years old! We’ve certainly come a long way in these few decades, and the journey of creating a sustainable culture founded on integrated and person-centered practices has a long way to go.

Caring Collaborative in the Time of COVID-19

Fri, 05/01/2020 - 00:00
It is difficult to imagine a time without COVID-19, even though it has only been a few months. As health care providers, we serve a population vulnerable not only to deleterious physical effects of the virus but also to the psychological impact of the many restrictions put in place to protect our patients’ health. As health care providers, we are called to lead, protect, care, heal, advise, teach, and reassure our patients, their families, staff, and other colleagues. Many of us also care for small children, parents, or grandparents, and we check in on neighbors during these stressful times.

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