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Understanding the Variability in Care of Nursing Home Residents with Advanced Dementia

GeriPal

If you develop dementia, odds are you will spend the last months to years of your life in a nursing home or assisted living facility. This study explored nursing home organizational factors and staff perceptions that are associated with the variation in care for residents with advanced dementia. Rehabbed to Death.

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Dysphagia Revisited: A Podcast with Raele Donetha Robison and Nicole Rogus-Pulia

GeriPal

Summary Transcript Summary Almost a decade ago, our hospice and palliative care team decided to do a “Thickened Liquid Challenge.” I got a question then, because I see one in 12 nursing home patients with dementia are placed on thickened liquids. I think it’s around one in 12 nursing home patients But it’s a lot.

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Surrogate Decision Making: Bernie Lo and Laurie Dornbrand

GeriPal

In 1988, Cruzan’s parents requested that her feeding tube be removed, arguing that she would not want to continue in this state. On the one hand, this was unfortunate, as it meant Nancy Cruzan could not be disconnected from the feeding tube immediately. In 1990 the Supreme Court ruled…for the state of Missouri.

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GeriPal 300th Episode: Ask Me Anything Hot Ones Style

GeriPal

The ones who are publishing interesting articles are easy as we knew MAID is always going to be a controversial topic. He wants to know what do you guys think about the effect of private equity on hospice and long-term care? So, we did try to get some breadth of guests on our show. ” Eric: Well, Alex and I love him.

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Diabetes in Late Life: Nadine Carter, Tamryn Gray, Alex Lee

GeriPal

When I’m on nursing home call, the most common page I receive is for a blood sugar value. When I’m on palliative care consults and attending in our hospice unit we have to counsel patients about deprescribing and de-intensifying diabetes medications. Summary Transcript Summary Diabetes is common. How high is too high?

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Substance Use Disorder in Aging and Serious Illness: A Podcast with Katie Fitzgerald Jones, Jessica Merlin, Devon Check

GeriPal

Devon, I see that you have an R21 to study concurrent prescribing of opioids and benzodiazepines, which are like the second most common thing I prescribe in combination after opioids and laxatives for people in hospice. We got a couple of articles to discuss and a lot of different components of this. Devon, welcome to GeriPal.

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POLST Evidence and Update: Kelly Vranas, Abby Dotson, Karl Steinberg, and Scott Halpern

GeriPal

For a trial to have value, it should not exclude patients over age 80, or those with dementia, or patients residing in nursing homes. Additional links mentioned in the podcast: Recent JGIM article on POLST in California nursing homes, hospitalization, and nursing home care Karl’s GeriPal post on appropriate use of POLST Enjoy!

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