ADVANTAGE: Long Term & Post Acute Care

Seniors prevented from having sex, report finds
by Robert Walker, June 26, 2012 reported yesterday that one of the most common misconceptions about aging is that older people don’t have sex. However, an Australian study, as reported by theTelegraph newspaper, found that in many Australian nursing care homes, elderly residents are effectively being prevented from having sex by staff. The study, commissioned by the Australian Centre for Evidence-Based Aged Care, discovered that a combination of age discrimination, lack of privacy, and even worry about legal consequences on the part of nursing care homes, have contributed to the practical prevention of sexual activity among residents. “For residents withdementia, sexuality is viewed with even greater anxiety, either being labeled ‘inappropriate’ or a‘challenging’ behavior or as a risk to the resident,” according to the study. The newspaper cited the study, which mentioned that there are legal implications for many nursing care communities for residents with cognitive decline, but because there are stages to dementia, not everyone with mental decay should be treated the same way, and that there should be multiple approaches to sexuality among seniors. For example, the study said, people with early stage dementia may be impacted by simply being forgetful, while people with more developed dementia may besignificantly less capable of taking care of themselves.

Examining Bed Width as a Contributor to Risk of Falls From Bed in Long-TermCare
By Guy Fragala, PhD, PE, CSP, CSPHP • Bonnie Perry, MS • Maren Fragala, PhD, CSCSD

Healthcare practitioners are discovering that the concepts of ergonomics can provide much value when used to create safer environments in healthcare facilities. Through the application of ergonomic principles, progress has been made in healthcare safety, benefitting both patients and caregivers; however, the long-term care (LTC) environment continues to expose residents tomany hazards, despite striving to provide quality care to the aging population. One such hazard, especially among LTC residents with deteriorating functional abilities, is falls. Prevention of resident falls demands serious attention, and healthcare practitioners need to continue to seek effective solutions to reduce falls risk in this population. This article examines the issue of falls from bed, a major contributor to the overall falls problem. Background information on the magnitude of the problem is provided and thoughts about causation are discussed. We also describe the results of our small pilot laboratory study, which was conducted to investigate howbed surface width might impact falls risk. This study sheds light on how equipment design improvements can reduce risk of falls among high-risk populations.
The Magnitude of Resident Falls
Residents’ high risk of falling and the frequent occurrence of falls in the LTC setting have beenwell documented. It has been estimated that 45% to 70% of residents fall each year, of whom 50% experience multiple falls.1,2 It has also been determined that older adults residing in LTC settings are two to three times more likely to experience multiple falls than their community-dwelling counterparts.2-6 Approximately 50% of the falls that occur in LTC settings involve falling from bed. 7,8 Bedside falls are associated with significant physical and psychological complications, including hip injuries, fractures, immobility resulting in muscle weakness, functional disability, and psychological distress, such as depression and fear of falling. 7 They are also associated with an increased risk of subsequent falls. Please continue reading at:,0&goback=%2Egde_134913_member_126485789

Hospitalization increases chances of poor outcomes in Alzheimer’s patients
By Carolyne Krupa

Staying in a hospital can be a difficult and unsettling experience for anybody, but it can be especially problematic for dementia patients — who have a harder time coping in unfamiliar surroundings. Hospitalization of individuals with Alzheimer’s disease greatly increases their riskof adverse outcomes, such as institutionalization, mental decline or death, according to a June 19Annals of Internal Medicine study. The risk is amplified for those who develop delirium duringan inpatient stay. Knowing this, Alzheimer’s experts recommend that physicians try to keep people with the disease out of the hospital. When such patients are hospitalized, physicians should work with other medical staff to help keep patients oriented and avoid medications or procedures that can contribute to delirium.  Please continue reading at:

Competition Heats Up As Senior Living Providers Prepare for Boomers
Alyssa Gerace, Boston Globe

Providing plenty of choice for the coming generation of senior living residents seems to be a key component of differentiating communities and rising above the competition, and a Boston Globe article suggests that current residents in many communities are getting a first taste of what’s to come. That first taste, unlike in times past, won’t be Jell-O, says the article: Choice is the buzzword for a wave of high-end senior communities opening or expanding in area communities. As the industry prepares for the aging baby boomers, it’s starting to practice on their elders, who increasingly demand more options and financial flexibility. The products are not just indoor swimming pools and granite countertops but also a la carte pricing that allows retirees to tailor their services. “The traditional ways aren’t necessarily the best ways,” said Patrick McShane, a spokesman for the Groves in Lincoln, a $130 million independent-living development that offers residents the nursing or personal care they need to stay in whichever apartment or cottage they choose.  “As the boomers continue to age, this is certainly a segment of the population that is very used to having choice and being able to shape where they live and what they drive and what they eat, and that should never end.”  From wine-tastings and day spas to more flexible accommodations for couples who may require different levels of care, senior living communities are ramping up their product offerings as they try to persuade older adults to leave their homes.

As Medicaid enrollments and healthcare costs rise, state budgets reach breaking point

In a new report, findings concluded that whether or not states decided to expand Medicaid, states are in the midst of a fiscal crisis relating to rising healthcare costs and government pension obligations. Medicaid currently pays for the bulk of care in skilled nursing facilities. With increasing Medicaid enrollments and rising healthcare costs, Medicaid cost growth will surpass revenue growth by a wide margin.  The authors point out that a larger problem than healthcare is unfunded state government pension obligations that could end up totaling as much as $3 trillion. In addition, the authors said that states cannot control Medicaid spending without assistance of the federal government. “Reaching agreement on how to control federal and state costs, while assuring the basic goals of enlarging and improving healthcare for persons who cannot now afford private insurance, is a major political and economic challenge that should be addressed sooner rather than later,” the authors stated. The State Budget Crisis Task Force panel was organized by Former Federal Reserve Chairman Paul Volcker and former New York Lt. Gov.Richard Ravitch (D). The task force focused on six states’ budgets: California, Illinois, New Jersey, New York, Texas and Virginia.