BACKGROUND Many older persons with advanced dementia receive terminal care in nursing homes, others remain in the community with home care services. OBJECTIVES To describe and compare the end-of-life experience of persons dying with advanced dementia in the nursing home and home care settings. DESIGN Retrospective cohort study. SETTING/SUBJECTS Persons 65 years or older with advanced deme...

INTRODUCTION Pneumonia is the leading cause of mortality, morbidity, and transfers to acute care facilities among residents of nursing homes. With the expected growth of the nursing home population over the next 30 years, the annual incidence of nursing home-acquired pneumonia (NHAP) is expected to reach 1.9 million cases. Yet there is growing evidence to suggest that the transfer of nursing ho...

OBJECTIVES We hypothesised that among nursing home decedents, nursing home for-profit status and poor quality-of-care ratings, as well as patient characteristics, would lower the likelihood of transfer to hospital prior to heart disease death. METHODS Using death certificates from a large metropolitan area (Tampa Florida Metropolitan Statistical Area) for 1998-2002, we geocoded residential st...

Is there Seasonal Variation in Nursing Home Acquired Pneumonia? Shelli Farhadian, M.D., Ph.D., Peter Van Ness, Ph.D., M.P.H., Vincent Quagliarello, M.D. Background: Pneumonia is a leading cause of hospitalization among elderly adults, and particularly among nursing home residents. The seasonal variation in nursing home acquired pneumonia is not yet known. Studies to date on seasonal variation i...

Because Government policy does much to determine the return available to nursing home investment, the profitability of the nursing home industry has been a subject of controversy since Government agencies began paying a large portion of the Nation's nursing home bill. Controversy appears at several levels. First is the rather narrow concern, often conceived in accounting terms, of the appropria...

OBJECTIVES To determine the reason for an increase in tuberculin skin test (TST) conversion in employees in a nursing home and to determine the source case responsible for spread of tuberculosis (TB) in two nursing homes and a hospital in a rural part of Arkansas using molecular and traditional epidemiological methods. DESIGN TB contact investigation of residents and employees of two nursing ...

Comparison was made between patients admitted from a nursing home and all other patients admitted to a geriatric medical unit in 1990 and 1993. The number of nursing home patient admissions rose from 26 in 1990 to 106 in 1993. Nursing home patients were frailer both physically and mentally with a dementia rate of 78% (in those who survived, 1993) and a mortality rate of 19.8% (1993), compared w...

Antipsychotics are indicated to treat schizophrenia and other psychotic disorders, but nursing homes have been criticized previously for using them as chemical restraints to treat behavior problems, especially for residents with dementia. We find that nearly one-in-four nursing home residents with dementia that lack severe behavioral symptoms are prescribed an antipsychotic medication. Using an...

BACKGROUND Most nursing home residents spend the remainder of their life, until death, within a nursing home. As preserving dignity is an important aim of the care given here, insight into the way residents experience their dignity throughout their entire admission period is valuable. AIM To investigate if and how nursing home residents' personal dignity changes over the course of time, and w...