Transitions in Care for Older Adults with and without Dementia

Callahan, Christopher M.; Arling, Greg; Tu, Wanzhu; Rosenman, Marc B.; Counsell, Steve; Stump, Timothy E.; Hendrie, Hugh C.

doi:10.1111/j.1532-5415.2012.03905.x

Cited by 207 publications

(247 citation statements)

References 47 publications

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“…Copyright © SLACK Incorporated cne ARTICLE iors, physiological instability, and safety concerns result in increased risk of hospitalizations (Callahan et al, 2012;Toot, Devine, Akporobaro, & Orrell, 2013). In the hospital, staff often confront behavioral challenges, for which little formal training is provided.…”

mentioning

confidence: 99%

Knowing Versus Doing: Education and Training Needs of Staff in a Chronic Care Hospital Unit for Individuals With Dementia

Marx¹,

Stanley²,

Haitsma³

et al. 2014

J Gerontol Nurs

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ARTICLEHOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE Instructions 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certifi cate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. To obtain contact hours you must:1. Read the article, "Knowing Versus Doing: Education and Training Needs of Staff in a Chronic Care Hospital Unit for Individuals With Dementia" found on pages 26-34, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz.2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study.3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certifi cate will be automatically generated.This activity is valid for continuing education credit until November 30, 2016. Contact HoursThis activity is co-provided by Villanova University College of Nursing and SLACK Incorporated.Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. Activity Objectives1. Discuss the learning needs of staff on a dementia care unit.2. Describe challenging behaviors that occur in patients with dementia. Disclosure StatementNeither the planners nor the authors have any confl icts of interest to disclose. of Gerontological Nursing, 40(12),[26][27][28][29][30][31][32][33][34] 26Copyright © SLACK Incorporated cne ARTICLE iors, physiological instability, and safety concerns result in increased risk of hospitalizations (Callahan et al., 2012;Toot, Devine, Akporobaro, & Orrell, 2013). In the hospital, staff often confront behavioral challenges, for which little formal training is provided. Common behavioral challenges include medication refusal, rejection of needed assistance, fearfulness of medical procedures, heightened confusion, agitation, and verbal/ physical aggression toward staff (Galvin et al., 2010).Managing behaviors is associated with low job satisfaction and burnout (Brodaty, Draper, & Low, 2003;Miyamoto, Tachimori, & Ito, 2010 Dementia, 2014;Sadowsky & Galvin, 2012). Although nonpharmacological approaches to managing behaviors are endorsed by medical organizations a...

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mentioning

confidence: 99%

Knowing Versus Doing: Education and Training Needs of Staff in a Chronic Care Hospital Unit for Individuals With Dementia

Marx¹,

Stanley²,

Haitsma³

et al. 2014

J Gerontol Nurs

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“…3 Care transitions have become a target for reform efforts; yet, our current understanding of how to optimize care transitions remains incomplete. Most improvement efforts have focused on the hospital discharge process and the immediate post-discharge period.…”

Section: The Challenge Of Ensuring Optimal Care During Transitionsmentioning

confidence: 99%

Regardless of Age: Incorporating Principles from Geriatric Medicine to Improve Care Transitions for Patients with Complex Needs

et al. 2014

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With its focus on holistic approaches to patient care, caregiver support, and delivery system redesign, geriatrics has advanced our understanding of optimal care during transitions. This article provides a framework for incorporating geriatrics principles into care transition activities by discussing the following elements: (1) identifying factors that make transitions more complex, (2) engaging care "receivers" and tailoring home care to meet patient needs, (3) building "recovery plans" into transitional care, (4) predicting and avoiding preventable readmissions, and (5) adopting a palliative approach, when appropriate, that optimizes patient and family goals of care. The article concludes with a discussion of practical aspects of designing, implementing, and evaluating care transitions programs for those with complex care needs, as well as implications for public policy.

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“…The data set was created by merging electronic medical record data from a single safety net health care system with Medicare claims, Indiana Medicaid claims, and Minimum Data Set (MDS) reports. 16,17 MDS assessments are required on admission and repeated at specified intervals for all nursing home residents who reside at facilities that accept Medicare and Medicaid. MDS data allows us to identify nursing home utilization regardless of payer.…”

Section: Methodsmentioning

confidence: 99%

Hospice Use Among Nursing Home and Non-Nursing Home Patients

et al. 2014

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BACKGROUND:For nursing home patients, hospice use and associated costs have grown dramatically. A better understanding of hospice in all care settings, especially how patients move across settings, is needed to inform debates about appropriateness of use and potential policy reform. OBJECTIVE: Our aim was to describe characteristics and utilization of hospice among nursing home and nonnursing home patients. DESIGN AND PARTICIPANTS: Medicare, Medicaid and Minimum Data Set data, 1999-2008, were merged for 3,771 hospice patients aged 65 years and above from a safety net health system. Patients were classified into four groups who received hospice: 1) only in nursing homes; 2) outside of nursing homes; 3) crossover patients utilizing hospice in both settings; and 4) "near-transition" patients who received hospice within 30 days of a nursing home stay. MAIN MEASURES: Differences in demographics, hospice diagnoses and length of stay, utilization and costs are presented with descriptive statistics. KEY RESULTS: Nursing home hospice patients were older, and more likely to be women and to have dementia (p<0.0001). Nearly one-third (32.3 %) of crossover patients had hospice stays > 6 months, compared with the other groups (16 % of nursing home hospice only, 10.7 % of nonnursing home hospice and 7.6 % of those with near transitions) (p<0.0001). Overall, 27.7 % of patients had a hospice stay <1 week, but there were marked differences between groups-48 % of near-transition patients vs. 7.4 % of crossover patients had these short hospice stays (p<0.0001). Crossover and near-transition hospice patients had higher costs to Medicare compared to other groups (p<0.05). CONCLUSIONS: Dichotomizing hospice users only into nursing home vs. non-nursing home patients is difficult, due to transitions across settings. Hospice patients with transitions accrue higher costs. The impact of changes to the hospice benefit on patients who live or move through nursing homes near the end of life should be carefully considered.

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Transitions in Care for Older Adults with and without Dementia

Cited by 207 publications

References 47 publications

Knowing Versus Doing: Education and Training Needs of Staff in a Chronic Care Hospital Unit for Individuals With Dementia

Knowing Versus Doing: Education and Training Needs of Staff in a Chronic Care Hospital Unit for Individuals With Dementia

Regardless of Age: Incorporating Principles from Geriatric Medicine to Improve Care Transitions for Patients with Complex Needs

Hospice Use Among Nursing Home and Non-Nursing Home Patients

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