Other commentaries in this issue of the North Carolina Medical Journal describe innovative food and dining practices in some of our state's long-term care facilities. Federal and state regulations do not prohibit these innovations, and DFS supports the concept of "enhancements" of the dining experience in these facilities. The Division of Facilities Services, therefore, encourages facilities to...

The purpose of this paper is to examine the alternative explanatory factors of the so-called long term care insurance puzzle, namely the fact that so few people purchase a long term care insurance whereas this would seem to be a rational conduct given the high probability of dependence and the high costs of long term care. For that purpose, we survey various theoretical and empirical studies of...

OBJECTIVES As in nearly all European countries, demographic developments in Germany have led to both a relative and an absolute increase in the country's elderly population. The care and support needed by these people is primarily provided by relatives or friends and close acquaintances within the home environment. The major challenges for society are to sustain, promote and support these infor...

BACKGROUND To determine if the more interventionist approach of screening with the tuberculin test and chemoprophylaxis for high-risk positive reactors to control tuberculosis in long-term care facilities is cost-effective when compared to the case-finding and treatment approach. METHOD A decision-analysis model was designed wherein systematic screening with the tuberculin skin test of all el...

Aged care has been in the news frequently this year, often not in the most positive light. Reports of facilities failing to provide basic care have hit the media regularly. In September, the Dominion Post reported incidents of neglect, preventing the elderly receiving appropriate care.1 Conflicting opinions on whether the number of complaints is increasing or not, only add to the confusion abou...

LEADERSHIP ROLE Catholic Memorial Home, a 300-bed, skilled long-term care facility, assumed a leadership role in treating pain for the elderly by developing a dynamic interdisciplinary pain management program in 1997. The home is part of the Diocesan Health Facilities (www.dhfo.org), a system of five, long-term care facilities sponsored by the Roman Catholic Diocese of Fall River, Mass. The pai...

Prolonged outbreaks of multidrug-resistant Streptococcus pneumoniae in health care facilities are uncommon. We found persistent transmission of a fluroquinolone-resistant S. pneumoniae clone during 2006-2011 in a post-acute care facility in Israel, despite mandatory vaccination and fluoroquinolone restriction. Capsular switch and multiple antimicrobial nonsusceptibility mutations occurred withi...

Meticillin-resistant Staphylococcus aureus (MRSA) and other multiply resistant bacteria are frequently isolated in long-term care facilities (LTCFs). This study evaluated the contamination of staff clothing in three LTCFs. Over 500 samples were taken from uniforms and their pockets and these samples showed a high level of MRSA contamination. Wearing plastic aprons and managing pocket contents i...

The findings of a study of long-term care policies in 18 countries are reported in this article. Initial data were collected by a questionnaire survey under the auspices of the International Social Security Association. These data were supplemented by published documents and government statistics obtained while researching long-term care for the International Social Security Association and, su...

OBJECTIVES To explore healthcare professionals' views of antibiotic prescribing in long-term care facilities (LTCFs). To use the findings to recommend intervention strategies for antimicrobial stewardship in LTCFs. DESIGN Qualitative semistructured interviews were conducted. The data were analysed by thematic content analysis. After the interviews, the emerging findings were mapped to the the...