Journal of the American Medical Directors Association

OBJECTIVES: To examine whether facility-reported staff shortages and total staff levels were independently associated with changes in nursing home (NH) outcomes in 2020. DESIGN: Longitudinal cohort study. SETTING AND PARTICIPANTS: A total of 8466 NHs with staffing and outcome data. METHODS: This study used NH COVID-19 Public File (2020), Nursing Home Compare (2019-2020), and Payroll-Based Journal data (2019-2020)...

OBJECTIVES: This article explores expert insights into residential long-term care (RLTC), specifically regarding the built environment, its impact on infection control (IC) measures and on resident, staff, and family member quality of life. DESIGN: The interviews discussed in this report form part of a larger mixed methods research design, examining the planning, design, and operation of RLTC. Specifically, this report discusses findings from one aspect of this research, a series of semistructured interviews...

No abstract text is available yet for this article.

OBJECTIVES: To describe acute seizure treatment for the long-term care setting, emphasizing rescue (acute abortive) medications for on-site management of acute unexpected seizures and seizure clusters. DESIGN: Narrative review. SETTING AND PARTICIPANTS: People with seizures in long-term care, including group residences. METHODS: PubMed was searched using keywords that pertained to rescue medications, seizure emergencies/epilepsy, seizure action plans, and long-term care...

OBJECTIVE: This study examines how measures of staffing-turnover and instability-are associated with one another and how they independently contribute to quality of care in nursing homes. DESIGN: Cross-sectional analysis of 2021-2022 administrative data. Data included the Payroll Based Journal for daily staffing information, merged with Nursing Home Care Compare (NHCC) data for nursing home characteristics, total staffing turnover, and nursing home quality. SETTING AND PARTICIPANTS: A total of 11,840 nursing homes nationally reporting data on daily staffing and staffing turnover...

OBJECTIVES: To identify perceived facilitators and barriers to implementing culturally inclusive foods into hospitals and long-term care (LTC) from the perspectives of registered dietitians and food service directors. DESIGN: Cross-sectional survey. SETTING AND PARTICIPANTS: Online nationwide survey of registered dietitians and food service directors working in hospitals or LTC. METHODS: We analyzed and compared participants' perceived barriers to implementing culturally inclusive foods in hospitals and LTC, assessed through a question in which we provided respondents with 13 different barriers and asked them to report the top 3...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

OBJECTIVES: Self-monitoring of physical, cognitive, and social activities may be a means of helping older adults to adopt or maintain an active lifestyle, but its effect on disability onset is unknown. This study aimed to examine the association between self-monitoring of the activities and disability onset in older adults. DESIGN: Longitudinal, observational study. SETTING AND PARTICIPANTS: General community setting. Participants were 1399 older adults aged ≥75 years (mean age: 79...

OBJECTIVES: Aspiration pneumonia (AsP), a leading cause of death in older people, remains poorly studied. We aimed to evaluate short- and long-term prognosis after AsP in older inpatients. DESIGN: Retrospective cohort study. SETTING AND PARTICIPANTS: All consecutive patients aged ≥75 years hospitalized in a 62-bed acute geriatric unit during a 1-year period. METHODS: We compared clinical characteristics and overall 2-year survival between patients with a main diagnosis of AsP, patients with other types of acute pneumonia (non-AsP), and patients hospitalized for another cause...

OBJECTIVES: A large body of literature addresses experiences of spouse and adult-children caregiver of individuals with dementia (IWDs) but has not examined the role and strength of social networks in associations between spouses and adult-children caregivers' experience. Based on the stress process model, we aimed to explore the strength levels of social networks and their association with spouses/adult-children caregivers for IWDs. DESIGN: A cross-sectional study...

OBJECTIVES: To determine if digital gait biomarkers captured by a wrist-worn device can predict the incidence of depressive episodes in middle-age and older people. DESIGN: Longitudinal cohort study. SETTING AND PARTICIPANTS: A total of 72,359 participants recruited in the United Kingdom. METHODS: Participants were assessed at baseline on gait quantity, speed, intensity, quality, walk length distribution, and walk-related arm movement proportions using wrist-worn accelerometers for up to 7 days...

OBJECTIVES: Benzodiazepine and antipsychotic medications are common components of the hospice toolkit and are routinely prescribed for behavioral symptom management at end of life. These medications have significant associated risks but, despite their frequent use, little is known about how clinicians weigh prescribing decisions for individuals in hospice. In this qualitative study, we examined the key factors that influence the decision to initiate a benzodiazepine and antipsychotic medication for management of behavioral symptoms at end of life...

OBJECTIVES: The use of antipsychotics in persons with Parkinson's disease (PD) is common, although their use may aggravate the symptoms of PD. Clozapine and quetiapine are the only antipsychotics recommended in PD treatment guidelines. Information on factors associated with initiation of antipsychotics is needed. We investigated whether recent hospitalization is associated with initiation of antipsychotics in persons with PD, and whether discharge diagnoses differ between those who had antipsychotics initiated and those who did not...

OBJECTIVES: This study aimed to investigate the association between combinations of sarcopenia criteria by the Asian Working Group of Sarcopenia (AWGS) 2019 guideline and incident adverse health outcomes. DESIGN: Longitudinal analyses of a cohort study. SETTING AND PARTICIPANTS: We conducted prospective 2-year follow-up analyses (N = 1959) among community-dwelling older adults enrolled in the nationwide Korean Frailty and Aging Cohort Study (KFACS)...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

OBJECTIVES: As people age, rates of morbidity and mortality are heterogenous. Balance and strength performance may contribute to this, offering modifiable risk factors for mortality. We aimed to compare relationships of balance and strength performance with all-cause and cause-specific mortality. DESIGN: The Health in Men Study, a cohort study, using wave 4 as baseline for analyses (2011-2013). SETTING AND PARTICIPANTS: 1335 older men (>65 years old), initially recruited April 1996-January 1999 in Western Australia, were included...

OBJECTIVES: Staffing shortages at nursing homes during the COVID-19 pandemic may have impacted care providers' staffing hours and affected residents' care and outcomes. This study examines the association of staffing shortages with staffing hours and resident deaths in nursing homes during the COVID-19 pandemic. DESIGN: This study measured staffing hours per resident using payroll data and measured weekly resident deaths and staffing shortages using the Centers for Disease Control and Prevention's National Healthcare Safety Network data...

OBJECTIVE: To investigate mental health needs and barriers to seeking mental health support in Medicaid-funded Assisted Living Facility (M-ALF). DESIGN: A multimethod, qualitative-dominant descriptive design using questionnaires and semistructured interviews. SETTING AND PARTICIPANTS: The study occurred at a M-ALF in the Bronx, New York. A researcher in residence recruited 13 residents (11 Black or African American, 2 Asian) using purposive sampling...