Journal of the American Geriatrics Society
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To develop an internationally accepted research definition of physical restraint. ⋯ A multidisciplinary, internationally representative panel of experts reached consensus on a research definition for physical restraints in older persons. This is a necessary step toward improved comparisons of the prevalence of physical restraint use across studies and countries. This definition can further guide research interventions aimed at reducing use of physical restraints.
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To determine whether 30-day readmissions were associated with presence of cognitive impairment more in elderly adults with heart failure (HF) than in those with other diagnoses and whether medical teams recognized cognitive impairment. ⋯ Cognitive impairment, which is frequently undocumented, may indicate greater risk of readmission for individuals with HF than those without. Screening for cognitive impairment, adapting discharge for it, and involving family and caregivers in discharge education may help reduce readmissions.
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To compare the FRAIL-NH scale with the Frailty Index in assessing frailty in residential aged care facilities. ⋯ The FRAIL-NH scale is a simple and practical method to screen for frailty in residential aged care facilities.
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To investigate factors associated with place of death of individuals in the Mount Sinai Visiting Doctors Program (MSVD). ⋯ Home-based primary and palliative care results in a high likelihood of nonhospital death, although certain demographic characteristics are strong predictors of death in the hospital. For MSVD participants, home visits in the last month of life were not associated with death outside the hospital.
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Observational Study
Effect of a Home-Based Palliative Care Program on Healthcare Use and Costs.
To evaluate the nonclinical outcomes of a proactive palliative care program funded and operated by a health system for Medicare Advantage plan beneficiaries. ⋯ In the context of an alternative payment model in which the provider was "at risk" of bearing the costs of care, a proactive PC program helped to avoid the escalation in hospital use and costs commonly seen in the final months of life.