Journal of Gerontological Nursing

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Abstract

A statistical meta-analysis of 82 individual research studies has revealed that nonprofit nursing homes deliver, on average, higher quality care than for-profit nursing homes. The review, published online in BMJ, compared quality-of-care measurements in 82 separate studies that collected data from 1965 to 2003 involving tens of thousands of nursing homes, mostly in the United States. In 40 of the studies, all statistically significant comparisons favored nonprofit facilities. In three studies, all significant comparisons favored for-profit facilities. The remaining studies had less consistent findings.

The meta-analysis showed that nonprofit facilities delivered higher quality care than for-profit facilities for two of the four most frequently reported quality measures: more or higher quality staffing and less prevalence of pressure ulcers. The results also suggest better performance of nonprofit homes in two other quality measures: less frequent use of physical restraints and fewer noted deficiencies in governmental regulatory assessments.

In addition, the study suggests that of the estimated 80,000 U.S. nursing home residents who currently have pressure ulcers, 7,000 of these cases are attributable to for-profit ownership. Similarly, the results suggest U.S. residents would receive approximately 500,000 more hours of nursing care per day if nonprofit institutions replaced for-profit nursing homes.

Source.“Nonprofit Nursing Homes Provide Better Care, Major Study Finds.” (2009, August 19). Retrieved September 2, 2009, from http://www.pnhp.org/news/2009/august/nonprofit_nursing_ho.php.

According to findings released by the AAA Foundation for Traffic Safety, most older drivers are unaware of the potential impact on driving performance associated with taking medications. The study found that 95% of those age 55 and older have one or more medical conditions, 78% take one or more medications, and only 28% have an awareness of the risks those medications might have related to driving ability.

Researchers at the Center for Injury Sciences at the University of Alabama at Birmingham surveyed 630 drivers ages 56 to 93. Only 18% reported receiving a warning from a health care professional about potential driver-impairing (PDI) medications such as angiotensin-converting enzyme inhibitors, sedative agents, and beta-blockers. The study found that such warnings do not increase with increasing numbers of medications used or increasing numbers of medical conditions.

According to the study’s lead author, other research has shown that certain medications are known to be associated with an increased risk for vehicle collision. Among survey respondents age 75 and older, 77% said they had no awareness of the risks presented from PDI medication and had not received any information on risk from health care providers. Yet this group was most likely to have multiple medical conditions and be taking multiple medications.

© 2009 Jupiterimages Corporation, a Getty Images Company

Source.“Older Drivers Unaware of Risks from Driving and Medications.” (2009, August 11). Retrieved September 2, 2009, from http://www.medicalnewstoday.com/articles/160419.php.

Research published in the Journal of the American Medical Association indicates that older adults who are subjected to abuse or self-neglect face a greater risk of premature death than other older adults. The researchers examined records for 9,318 individuals age 65 and older who were enrolled between 1993 and 2005 in the Chicago Health and Aging Project. In-person interviews were conducted to assess participants’ health history, physical function, cognitive function, health behaviors, and psychosocial factors.

Of the 9,318 participants, 1,657 came to the attention of social agencies because of reports of abuse or self-neglect. The study found that elder abuse was associated with a more than two-fold increased risk of premature death from all causes and an almost fourfold increased risk of premature death from heart disease specifically. Self-neglect was associated with an even greater risk of premature death, particularly during the first year after self-neglecting behavior was identified. During that…

Meta-Analysis Indicates Benefits of Nonprofit Nursing Homes

A statistical meta-analysis of 82 individual research studies has revealed that nonprofit nursing homes deliver, on average, higher quality care than for-profit nursing homes. The review, published online in BMJ, compared quality-of-care measurements in 82 separate studies that collected data from 1965 to 2003 involving tens of thousands of nursing homes, mostly in the United States. In 40 of the studies, all statistically significant comparisons favored nonprofit facilities. In three studies, all significant comparisons favored for-profit facilities. The remaining studies had less consistent findings.

The meta-analysis showed that nonprofit facilities delivered higher quality care than for-profit facilities for two of the four most frequently reported quality measures: more or higher quality staffing and less prevalence of pressure ulcers. The results also suggest better performance of nonprofit homes in two other quality measures: less frequent use of physical restraints and fewer noted deficiencies in governmental regulatory assessments.

In addition, the study suggests that of the estimated 80,000 U.S. nursing home residents who currently have pressure ulcers, 7,000 of these cases are attributable to for-profit ownership. Similarly, the results suggest U.S. residents would receive approximately 500,000 more hours of nursing care per day if nonprofit institutions replaced for-profit nursing homes.

Source.“Nonprofit Nursing Homes Provide Better Care, Major Study Finds.” (2009, August 19). Retrieved September 2, 2009, from http://www.pnhp.org/news/2009/august/nonprofit_nursing_ho.php.

Not All Medications Are Driver Friendly

According to findings released by the AAA Foundation for Traffic Safety, most older drivers are unaware of the potential impact on driving performance associated with taking medications. The study found that 95% of those age 55 and older have one or more medical conditions, 78% take one or more medications, and only 28% have an awareness of the risks those medications might have related to driving ability.

Researchers at the Center for Injury Sciences at the University of Alabama at Birmingham surveyed 630 drivers ages 56 to 93. Only 18% reported receiving a warning from a health care professional about potential driver-impairing (PDI) medications such as angiotensin-converting enzyme inhibitors, sedative agents, and beta-blockers. The study found that such warnings do not increase with increasing numbers of medications used or increasing numbers of medical conditions.

According to the study’s lead author, other research has shown that certain medications are known to be associated with an increased risk for vehicle collision. Among survey respondents age 75 and older, 77% said they had no awareness of the risks presented from PDI medication and had not received any information on risk from health care providers. Yet this group was most likely to have multiple medical conditions and be taking multiple medications.

© 2009 Jupiterimages Corporation, a Getty Images Company

© 2009 Jupiterimages Corporation, a Getty Images Company

Source.“Older Drivers Unaware of Risks from Driving and Medications.” (2009, August 11). Retrieved September 2, 2009, from http://www.medicalnewstoday.com/articles/160419.php.

Elder Abuse Focus of Study, NYC Center

Research published in the Journal of the American Medical Association indicates that older adults who are subjected to abuse or self-neglect face a greater risk of premature death than other older adults. The researchers examined records for 9,318 individuals age 65 and older who were enrolled between 1993 and 2005 in the Chicago Health and Aging Project. In-person interviews were conducted to assess participants’ health history, physical function, cognitive function, health behaviors, and psychosocial factors.

Of the 9,318 participants, 1,657 came to the attention of social agencies because of reports of abuse or self-neglect. The study found that elder abuse was associated with a more than two-fold increased risk of premature death from all causes and an almost fourfold increased risk of premature death from heart disease specifically. Self-neglect was associated with an even greater risk of premature death, particularly during the first year after self-neglecting behavior was identified. During that year, the risk of premature death from all causes was five times as likely as for older adults who did not neglect themselves, and the risk of premature death from heart disease specifically was eight times more likely.

The study also found that increased mortality was significant for older adults subjected to abuse or self-neglect no matter what their level of physical or cognitive function, except for one group: abused adults with the highest level of functioning.

To improve intervention and treatment for elder abuse cases in the New York City area, New York Presbyterian Hospital/Weill Cornell Medical Center are creating a New York City Elder Abuse Center. The first center in the New York area to focus on coordinating elder abuse cases, the Center has received grants totaling $375,250—$300,000 from the Fan Fox and Leslie R. Samuels Foundation and $75,250 from the FJC, A Foundation of Philanthropic Funds—to develop the first phase of the Center’s operations. It is expected to begin operations later this year.

The New York City Elder Abuse Center will take a case consultation approach, hosting regular meetings with clinicians, city agencies, and outreach organizations to decide on the best approach for each case. A given meeting might involve representatives from adult protective services, the district attorney’s office, a mental health provider, and a geriatrician.

The Center will initially coordinate cases in Brooklyn, with expansion to the other boroughs planned. For more information, visit http://www.cornellaging.com/elderabuse.

Sources.“NYC’s First Elder Abuse Center Created by NYP/Weill Cornell in Collaboration with Community Partners.” (2009, August 11). Retrieved September 2, 2009, from http://www.newswise.com/articles/view/555106.

“Older Adults Subjected to Abuse or Self-Neglect at Greater Risk of Mortality.” (2009, July 30). Retrieved September 2, 2009, from http://www.newswise.com/articles/view/554790.

Older Adult-Focused Technologies Reviewed in Paper

The Center for Technology and Aging has released “Technologies to Help Older Adults Maintain Independence: Advancing Technology Adoption,” a briefing paper that describes seven technology areas with significant potential of improving chronic health care and increasing the independence of older adults, while reducing health care costs. The paper focuses on areas that are ready for expansion, including two technology areas for the Center’s first round of grant making—remote patient monitoring and medication optimization.

The discussion of each technology area includes an overview, review of current applications, and an assessment of future opportunities. The focus areas are:

  • Medication optimization: Technologies designed to help manage medication information, dispensing, adherence, and tracking.
  • Remote patient monitoring: Technologies designed to manage and monitor a range of health conditions.
  • Assistive technologies: Devices and equipment that help individuals perform a task or prevent injury.
  • Remote training and supervision: Technologies used to train and supervise health and long-term care workers, and the potential for continuing education and quality assurance.
  • Disease management: Patient-centric, coordinated care processes for patients with chronic conditions and conditions that have a significant self-care component.
  • Cognitive fitness and assessment: Technologies that measure cognition or include cognitive practice regimens.
  • Social networking: Technologies that enable the building of communities of interest that help older adults communicate, organize, and share with other older adults and care providers.

The brief, available online at http://www.techandaging.org/briefingpaper.pdf, describes key factors contributing to the public health challenges of curbing long-term care costs and minimizing the burden of disease and disability for the aging population, including demographics, epidemiology, economics, and the health care workforce.

Source.“Center for Technology and Aging Brief Reviews Technologies that Improve Chronic Care and Help Older Adults Maintain Independence.” (2009, August 18). Retrieved September 2, 2009, from http://news.prnewswire.com/DisplayReleaseContent.aspx?ACCT=ind_focus.story&STORY=/www/story/08-18-2009/0005079555&EDATE=.

10.3928/00989134-20090916-02

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