ADVANTAGE: Long Term and Post Acute Care

Many nursing students manifest “older patient avoidance syndrome”

Ask a group of first semester nursing students if they intend to care for older adults and thenumber of hands raised will be small. Unfortunately, too many students manifest “older patientavoidance syndrome”. This is marked by ageist attitudes, a fear of old persons and a statedpreference to work in pediatrics, labor, delivery, ICU or ED. This syndrome is not unique tonurses as many health professions students, including medical students, manifest it too. It doesshow a gap between our societal culture and the reality of our health care practice environments. How did attitudes and expectations become so disconnected from the reality of nursing practice?What underlies this bizarre syndrome? Please continue reading at

Program to reduce hospital readmissions would link nursing homes with partners

The federal government announced a new program intended to reduce hospital readmissions onThursday. The Centers for Medicare & Medicaid Services is setting aside $128 million fororganizations that collaborate with nursing homes to establish programs that prevent residentsfrom going back to hospitals within a month. Physician groups, accountable care organizationsand other independent entities would be eligible. “We are tremendously excited about theopportunity here” said Melanie Bella, Director of CMS’s Medicare-Medicaid CoordinationOffice. She said that nursing homes can benefit by improving their quality scores during surveys.Please continue reading at

Why one-third of hospitals will close by 2020

by David Houle and Jonathan Fleece

For centuries, hospitals have served as a cornerstone to the U.S. health care system. Duringvarious touch points in life, Americans connect with a hospital during their most intimate andextraordinary circumstances. Most Americans are born in hospitals. Hospitals provide care afterserious injuries and during episodes of severe sickness or disease. Hospitals are predominatelywhere our loved ones go to die. Across the nation, hospitals have become embedded into thesacred fabric of communities. According to the American Hospital Association, in 2011approximately 5,754 registered hospitals existed in the U.S., housing 942,000 hospital beds alongwith 36,915,331 admissions. More than 1 in 10 Americans were admitted to a hospital last year.

Hospitals make a substantial imprint on local economies. In many communities, hospitalsrepresent one of the largest employers and economic drivers. Of the total annual American healthcare dollars spent, hospitals are responsible for more than $750 billion. Despite a history ofstrength and stature in America, the hospital institution is in the midst of massive and disruptivechange. Please continue reading at


Have you heard about the new athrombic compression device that is totally portable? It is the first of its kind … a battery operated Sequential Compression Device (SCD)that weighs under one pound. To read more click on the “Prophylaxis of deep vein thrombosis”link found on our home page.


NEWS FROM THE U.K.: The Sunday Telegraph: Nursing homes caught up in bank rate swap scandal

By Richard Tyler

The firms say they trusted their banks to suggest suitable loan products and did not realise theinterest rate swaps could cost hundreds of thousands of pounds to cancel. Contacting The SundayTelegraph following our investigation into the sale of interest rate swaps to small companies, one25-bed home in Worthing, West Sussex, said it had been told to buy a swap when it took out aloan with Royal Bank of Scotland. Louise Bruce, who owns the award-winning home, said theextra interest costs imposed by the swap had forced her to raise her fees. “They came up with areally good loan rate – a 1.5pc margin for them. But part of the condition for the loan was that wehad to buy a hedging product,” she said. “The relationship manager put us in touch with the guyfrom the City. We barely understood what he was saying – it was really jargonistic.   Pleasecontinue reading at

Infection May Trigger Venous Clots

By Todd Neale, Senior Staff Writer, MedPage Today

Infections preceded slightly more than half of hospitalizations for venous thromboembolism(52.4%) in a study of older individuals, researchers found. After adjustment for other factors,infection was associated with nearly three times the risk of being hospitalized for deep veinthrombosis or pulmonary embolism (incidence rate ratio 2.9, 95% CI 2.13 to 3.94), according toMary Rogers, PhD, of the University of Michigan in Ann Arbor, and colleagues. Less common than infection but a significant predictor of hospitalization for venous clots wereblood transfusions (IRR 2.57, 95% CI 1.17 to 5.64), while the use of erythropoiesis-stimulatingagents was nearly statistically significant (IRR 9.33, 95% CI 1.19 to 73.42), the researchersreported online in Circulation: Journal of the American Heart Association. Risk algorithms forvenous thromboembolism should be reevaluated and possibly updated to include these threefactors,  Please continue reading at[email protected]&mu_id=5386199
The important message from this for LTC facilities: ask the doctor to consider prescribing an athrombic compression pump for your residents with infections!

Dementia cases ‘to double by 2030’: WHO

By Lucy Christie, AFP

The number of people with dementia is expected to almost double to 65.7 million by 2030 as theworld population ages, according to a World Health Organisation report published Wednesday. And by 2050 the number of sufferers could be more than three times the current figure of 35.6million, the UN body said. The report released by WHO and Alzheimer’s Disease Internationalestimates the current cost of treating and caring for those with the condition at $604 billion (461billion euros) a year. Dementia is caused by a variety of brain illnesses that affect memory,thinking, behaviour and the ability to perform everyday activities. Alzheimer’s disease is the mostcommon cause of dementia and accounts for about 70 percent of cases. More than half ofsufferers (58%) live in low and middle income countries but this could rise to 70 percent by2050. The report said far more effective diagnosis was needed, as even in high income countriesonly 20 to 50 percent of dementia cases are routinely recognized. “Since we know the prevelenceof the disease will explode in this century as we all live longer — the risk of dementia is 1 in 8 forthose over 65 and a shocking 1 in 2.5 for those over 85 — its impact will become greater as thedecades go by,” according to Shekhar Saxena, head of the mental health department at WHO.”We need to increase our capacity to detect dementia early and to provide the necessary healthand social care,” said Oleg Chestnov, assistant director general of Noncommunicable Diseasesand Mental Health at WHO.  “Much can be done to decrease the burden of dementia. Health-careworkers are often not adequately trained to recognise dementia.” Only eight countries worldwide– Australia, Britain, Denmark, France, Japan, South Korea, the Netherlands and Norway –currently have national programmes in place to address dementia, according to the report”Dementia: a public health priority”. Germany and Sweden have set out lists ofrecommendations. The study also highlights a general lack of information and understandingabout the disease, fuelling stigma with the result that people sometimes delay seeking support. “Itis now vital to tackle the poor levels of public awareness and understanding, and to drasticallyreduce the stigma associated with dementia,” said Marc Wortmann, executive director ofAlzheimer’s Disease International. “We need to act, we need to stop this epidemic.” In its report,the WHO recommends that authorities seek to reduce the stigma that has long been associatedwith dementia, and improve general care for victims, along with support for caregivers. It iscurrently not possible to treat dementia, but progress of the disease can in some cases be sloweddown.

Keeping Seniors Fit: How Health Care Professionals Can Assist Older Adults toAvoid Sarcopenia

By Becky Dorner

Health care professionals who care for older adults can help prevent and treat Sarcopenia.Approximately 45% of the older adults in the U.S. are affected by sarcopenia, the progressiveloss of muscle mass, function, quality, and strength driven by the aging process (1). Sarcopeniacan lead to diminished strength and decreased activity levels, and can contribute to mobilityissues, osteoporosis, falls and fractures, frailty, loss of physical function and independence (2).
From age thirty to sixty the average adult will gain a pound of weight and lose half a pound ofmuscle yearly for a total gain of 30 pounds of fat and a loss of 15 pounds of muscle. After the ageof seventy, muscle loss accelerates to 15% per decade. Factors that accelerate loss of musclemass in older adults include decreased physical activity, testosterone and growth hormonedeficiency, possibly mild cytokine excess, and the stress response (3). Physiological anorexia,decreased caloric intake and weight loss are all related to aging, which in turn is associated withdecline in muscle mass and increased mortality.  Please continue reading at: