Terri J Huh, Patricia A Areán, Heather Bornfeld, Alexandra Elite-Marcandonatou
{"title":"The Effectiveness of an Environmental and Behavioral Approach to Treat Behavior Problems in a Patient with Dementia with Lewy Bodies: A Case Study.","authors":"Terri J Huh, Patricia A Areán, Heather Bornfeld, Alexandra Elite-Marcandonatou","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This case describes and reports the effects of a multi-component collaborative intervention to treat difficult behaviors in a 79-year-old woman with dementia with Lewy bodies (DLB). To assess for cognitive status and disruptive behavior patterns, we collected a cognitive screen, history of presenting illness, and measures of behavior problems prior to the intervention. The intervention included 32 weekly 1-hour sessions with the patient, 1-hour sessions with the patient's assigned caregiver and regular interactions with the patient's family and medical treatment team. All sessions were conducted at the patient's long-term residential care facility. We assessed behavior disturbances with the Cohen-Mansfield Agitation Inventory (CMAI). We assessed functional abilities with the Katz Activities of Daily Living (K-ADL), and assessed cognitive function with the Mini-Mental Status Exam (MMSE). At the closing session (week 32) caregiver ratings indicated significantly reduced scores on the CMAI (Baseline = 75 to Endpoint = 30) and maintenance in ADLs (Baseline=3 to Endpoint=3). Caregivers reported enhanced efficacy in treating behaviors and improvement in their relationship with the patient. Results demonstrate the benefits of a multi-component collaborative intervention, based on an enhanced environment and behavioral approach, in treating behavior problems related to DLB.</p>","PeriodicalId":87367,"journal":{"name":"The annals of long-term care : the official journal of the American Medical Directors Association","volume":"16 11","pages":"17-21"},"PeriodicalIF":0.0,"publicationDate":"2008-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3222095/pdf/nihms123303.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30281355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alice F Bonner, Nicholas G Castle, Subashan Perera, Steven M Handler
{"title":"Patient Safety Culture: A Review of the Nursing Home Literature and Recommendations for Practice.","authors":"Alice F Bonner, Nicholas G Castle, Subashan Perera, Steven M Handler","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Patient safety culture (PSC) is a critical factor in creating high-reliability health-care organizations. Most PSC research studies to date have been conducted in acute care settings; however, nursing home studies have recently begun to appear in the literature. Nursing homes differ from hospitals in a number of ways, including the population they serve, the medical model of care, and having the vast majority of direct care provided by non-licensed certified nursing assistants. Research has shown that nursing home PSC differs in important ways from PSC in acute care institutions. Recent PSC studies conducted in nursing homes and related quality and safety research can guide recommendations for nursing homes wishing to evaluate their own PSC. Relationships between PSC measurement, quality improvement, and workforce issues are potentially important and may influence clinical outcomes.</p>","PeriodicalId":87367,"journal":{"name":"The annals of long-term care : the official journal of the American Medical Directors Association","volume":"16 3","pages":"18-22"},"PeriodicalIF":0.0,"publicationDate":"2008-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3119574/pdf/nihms235056.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30261945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Epilepsy and the elderly","authors":"A. V. Cott, M. Pugh","doi":"10.1093/med/9780195369298.003.0040","DOIUrl":"https://doi.org/10.1093/med/9780195369298.003.0040","url":null,"abstract":"","PeriodicalId":87367,"journal":{"name":"The annals of long-term care : the official journal of the American Medical Directors Association","volume":"8 1","pages":"28-32"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91156857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The POLST paradigm: Respecting the wishes of patients and families","authors":"P. Dunn, S. Tolle, A. Moss, Judith S. Black","doi":"10.13016/33DO-LZZK","DOIUrl":"https://doi.org/10.13016/33DO-LZZK","url":null,"abstract":"Despite the hope that traditional advance directives would ensure that patients' end-of-life treatment preferences are honored, numerous studies have found that only 20-30 percent of U.S. adults have an advance directive, and that these documents have limited effect on treatment decisions near the end of life. Some of the limitations associated with traditional advance directives are that they may not be available when needed, are not transferred with the patient, may not be specific enough, may be overridden by a treating physician, and do not immediately translate into a physician order.","PeriodicalId":87367,"journal":{"name":"The annals of long-term care : the official journal of the American Medical Directors Association","volume":"44 1","pages":"33-40"},"PeriodicalIF":0.0,"publicationDate":"2007-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78468517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}