ADVANCE Perspective: LTC : Clinical

Researcher Develops Healing Bandage

Maureen Salera — Fri, 20 Nov 2009 02:48:00 GMT

A Penn State researcher has developed a bandage material made from microbial cellulose that the body can absorb. He has developed a method to incorporate enzymes with the bandage that break down the cellulose in a controlled way, according to the Penn State Live news source.

In 2007, Jeffrey Catchmark, associate professor of agricultural and biological engineering in Penn State's College of Agricultural Sciences, presented a seminar on a new approach for "bioresorbable" materials. This presentation caught the attention of health care company representatives who were in attendance, and the idea took off from there.

To read the article, click here.

Fighting off Germs

Maureen Salera — Fri, 30 Oct 2009 16:40:00 GMT

We all know that washing our hands is the best way to guard against the spread of germs. But there are several other measures that can also help protect us from contamination.

In this Washington Post article, health care professionals share some other tips on how they stop the spread of infection.

Futile end-of-life care

Maureen Salera — Fri, 16 Oct 2009 17:42:00 GMT

Two new studies from The New England Journal of Medicine indicate that nursing home residents may be receiving futile care measures at the end of their lives.

In one study, doctors examined health records of 3,702 nursing-home residents across the nation who started dialysis between 1998 and 2000. While the average age was 73, many had other health problems, including diabetes, heart disease and cancer. Within the first year, 58 percent died and 29 percent declined in their ADL ability.

The second study followed 323 people with advanced dementia from nursing homes in the Boston area. Their average age was 85 and they could not recognize loved ones or walk or talk. One out of four died within six months and half died during the 18 months they were followed.

As this article points out, experts agree that these two studies point back to the need for more palliative care in nursing homes.

Proper Handwashing Technique

Liz Rosto — Fri, 16 Oct 2009 14:44:00 GMT

With the H1N1 virus lurking in our office (so far, one confirmed case), experts agree that aside from vaccination, the best defense is thorough handwashing. Check out this video from the Washington Post that shows proper handwashing technique.

We hear these messages all the time, but truthfully, we could all probably do a better job following through. In fact, a recent Australian study found that three out of ten men and one out of ten women didn;t wash their hands after using the restroom.

On a related note, did you know yesterday (October 15) was Global Handwashing Day? www.globalhandwashingday.org

Nurses Against H1N1 Vaccination

Maureen Salera — Fri, 09 Oct 2009 17:41:00 GMT

A letter to the editor in today's Philadelphia Inquirer details the reasons why two Philadelphia-area registered nurses are rejecting the swine flu vaccine after attending a conference on the subject. Read the letter to the editor here.

Given the recent push to vaccinate, this statement is sure to become controversial. One of the points mentioned is the pre-existing H1N1 immunity that some elderly people may have.

To those of you who work in senior living facilities: What do you plan to do about vaccination?

Not Just Part of the Job

Maureen Salera — Fri, 18 Sep 2009 02:24:00 GMT

Most people figure that work-related injuries are just part of the job for nurses. With all that lifting, turning, repositioning and transferring that nurses do, injuries abound. In fact, a report on the American Nurses Association Web site indicates that an estimated 12 percent of nurses leave the profession every year because of back injuries and more than 52 percent experience chronic back pain.

But it doesn't have to be this way. As I've learned from researching this topic for an upcoming Safety column, no-lift policies--which can help prevent these injuries--are increasingly becoming a mandated policy at many types of health care facilities.

To learn more about safer patient handling, look for an article in the Safety column in an upcoming issue of ADVANCE.

AAHSA to Study Telehealth Blood Pressure Monitoring

Maureen Salera — Thu, 18 Jun 2009 17:42:00 GMT

The American Association of Homes and Services for the Aging has been awarded a contract from the Agency for Healthcare Research and Quality to investigate the impact of telehealth monitoring for blood pressure management among older adults, according to a news release from AAHSA.

The study is centered on establishing telehealth kiosks at rural nutrition centers that serve low income seniors. Seniors with hypertension will be encouraged to use these kiosks to monitor their blood pressure when they visit these centers for meals. The data will then be sent to a central server where it will be monitored by nurse-researchers who collaborate with participants' primary care physicians.

This project is a collaboration among AAHSA's Institute for the Future of Aging Services, Center for Aging Services Technologies, AHRQ, Wright State University College of Nursing, the Nursing Institute of West Central Ohio, Title III and private nutrition centers in the state of Ohio and HealthAnywhere, a technology company.

Penn State program aims to cut health care costs

Maureen Salera — Wed, 10 Jun 2009 13:44:00 GMT

A new Penn State program is attempting to give front line health care employees tools to improve efficiencies and cut waste, according to an article on the Penn State Newswire.

For example, clarifying medical orders, not having the right supplies and waiting for patients and lab results are all tasks that waste time, said Susan Sheehy, RN, director of education, innovation and implementation for Lean Healthcare West, in the article.

To address this, Sheehy, a doctoral candidate, will facilitate the first training program for 16 health care employees from long-term and acute-care facilities in north central Pennsylvania.

The training program adapts principles from the successful Toyota Production System to the health care industry using the "realizing exceptional VALUE IN EVERYDAY WORK" (reVIEW) curriculum. The focus is on examining current processes, taking the processes apart and finding ways to do things better, Sheehy explained.

Guest Blog - How Do You Handle End of Life Care?

Liz Rosto — Wed, 11 Mar 2009 14:26:00 GMT

This is a guest blog by Anthony Cirillo, FACHE, ABC:

A new study suggests that physicians are fairly ignorant about how to act toward patients when they run out of treatment options. According to Anthony Back, lead author and professor of medicine at the University of Washington, once doctors refer a patient to hospice care, they end all contact, leaving patients and their families feeling abandoned. The study is published in the Archives of Internal Medicine.

Back and his co-authors interviewed 31 doctors and 55 of their patients, all of whom had incurable cancer or advanced chronic obstructive pulmonary disease and were expected to die within a year. The researchers also interviewed 36 family caregivers and 25 nurses. Interviews took place at the year-long study's beginning, middle and end.

Participants kept raising the issue of abandonment even though the study was not designed to answer that question.

"I think it's important that you still have that contact with them even though there isn't anything they can do to make you better," one patient told the researchers. "But they can hold my hand, so to speak, to the very end." Family caregivers usually feel as close to the doctor as the patient.

Sean Morrison, a palliative care doctor at New York's Mount Sinai Medical Center, says doctors might not always realize it but "they need to have closure ... just as much as patients and families do."

While this study had to do with physicians, how do you handle end of life situations at your facility? Often, the end of life comes at a hospital so there is no closure. Paying attention to the end, communicating empathy and understanding and even keeping in touch with family afterwards is not just the right thing to do. It helps staff and builds relationships with the community. They will tell others and your facility will stand out for the way you handle the resident and family experience.

Anthony Cirillo is a healthcare consultant, ombudsman and expert blogger for Wellsphere in the area of aging and senior health. He consults with long-term care facilities and is available for management retreats and association keynotes. He is the author of "Who Moved My Dentures?" a book that dispels myths about long-term care. To read more, go to www.4wardfast.com and www.anthonyssong.com.

Multivitamins don’t protect against cancer, heart disease

Maureen McAndrews — Tue, 10 Feb 2009 16:20:00 GMT

Using multivitamins does not protect against cancers or heart disease, according to an eight-year study of 161,808 postmenopausal women, which appears in the Feb. 9th issue of The Archives of Internal Medicine.

The study analyzed data on women in their 50s and up who participated in long-running government studies on postmenopausal women. Almost 42 percent of the women said they used multivitamins regularly. After about eight years, roughly equal numbers of vitamin users and nonusers developed common cancers, heart attacks and other cardiovascular problems. Overall, there were 9,619 cases of cancer, including cancers of the breast, lung, ovary, colon and stomach; and 8,751 cardiovascular ailments including heart attacks and strokes. In addition, 9,865 women died, also at similar rates in multivitamin users and nonusers, according to an MSNBC article.

Despite these results, study co-author Dr. JoAnn Manson said this research doesn't necessarily mean that multivitamins are useless. The data are observational, and it's unclear if taking vitamins could help prevent cancers that take several years to develop, said Manson, chief of preventive medicine at Harvard's Brigham & Women's Hospital.

She said multivitamins may still be useful "as a form of insurance" for people with poor eating habits, the article reports.

An Apple a Day….

Maureen McAndrews — Tue, 03 Feb 2009 15:32:00 GMT

You've surely heard the adage about an apple a day keeping the doctor away, but what about apple juice? New research is now touting the sweet beverage for its possible health benefits. In fact, the January issue of the Journal of Alzheimer's Disease suggests that drinking apple juice may help prevent the development of Alzheimer's disease.

By studying mice, researchers found that dietary supplementation with apple juice concentrate in drinking water alleviated the increase in beta-amyloid, a protein that causes the plaques commonly found in the brains of people with Alzeheimer's disease. Read the abstract here.

Is apple juice on the beverage menu at your facility?

Cutting Calories May Improve Memory

Liz Rosto — Mon, 02 Feb 2009 20:19:00 GMT

Cutting calories may improve memory among healthy seniors, according to a new study. German researchers found that people who cut their calorie intake by approximately 30 percent performed better on standard memory tests.

Diets low in calories and rich in unsaturated fatty acids have long been said to benefit brain function. In this study, a pool of 50 normal- to overweight individuals (average age 60) was divided into three groups: one group restricted by up to 30 percent the amount of calories they consumed; a second group increased their consumption of unsaturated fatty acids by up to 20 percent; and a third group made no changes.

The calorie-restricted group saw a 20 percent average increase in verbal memory scores after three months, while no significant changes in memory performance were documented in the two other groups.

With memory loss being such a complex problem, restricting calorie intake appears to be a viable potential solution. And a simple one, at that.

Click on the link to read the entire study from the National Academy of Sciences.

Reward Mechanism Diminishes With Age

Maureen McAndrews — Wed, 24 Sep 2008 17:59:00 GMT

As people age, their brains respond less strongly to rewards, according to a study appearing on The Proceedings of the National Academy of Sciences' Web site, the New York Times reports. The main difference lies in the brain's response to dopamine.

The shifts in brain response might be reflected in attitude changes that accompany aging, said Dr. Karen Faith Berman of the National Institutes of Health, an author of the study.

"It may explain anecdotal evidence that people are mellower," she said, "that they may not get the same highs from certain experiences, but they may not get the same lows, either."

As two groups of volunteers, one in their 60s and the other in their 20s, played a computer game similar to a slot machine, the researchers performed brain scans on them.

Differences between the groups emerged when volunteers anticipated winning money in the game and when they actually did so, the researchers found. It wasn't just a matter of how much dopamine was produced, but also which parts of the brain responded to it and how much, the study said.

When a reward was anticipated, the researchers said, three parts of a reward center in the younger people's brains lighted up, but only one part in the older people's brains.

Is Knee Surgery Necessary?

Maureen McAndrews — Wed, 10 Sep 2008 21:54:00 GMT

An article on MSNBC.com details how two studies, which were published in Thursday’s New England Journal of Medicine, question the value of arthroscopic knee surgery.

One of the studies found that surgery is no better than medication and physical therapy for relieving the pain and stiffness of moderate or severe arthritis. The other study showed that that tears in knee cartilage, which often prompt such surgeries, are very common without causing symptoms.

These new studies and other research shows arthroscopic knee surgery may still be helpful, such as after a recent injury, but it shouldn’t be done routinely for osteoarthritis.

The Forgetting

Liz Rosto — Wed, 06 Aug 2008 13:59:00 GMT

While it is a few years old, I urge everyone to watch the PBS documentary on Alzheimer's: The Forgetting. This powerful and touching program follows the lives of several families coping with the disease, and the work of scientists searching for a cure.

PBS has been re-airing it recenlty, but you can also order the DVD or watch it online. It only serves to reinforce the devastation of the disease, the important work long-term care providers do to help these residents, and the hope for future generations.