Journal of the American Geriatrics Society
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Randomized Controlled Trial Clinical Trial
Effect of person-centered showering and the towel bath on bathing-associated aggression, agitation, and discomfort in nursing home residents with dementia: a randomized, controlled trial.
To evaluate the efficacy of two nonpharmacological techniques in reducing agitation, aggression, and discomfort in nursing home residents with dementia. The techniques evaluated were person-centered showering and the towel bath (a person-centered, in-bed bag-bath with no-rinse soap). ⋯ Person-centered showering and the towel bath constitute safe, effective methods of reducing agitation, aggression, and discomfort during bathing of persons with dementia.
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Randomized Controlled Trial Clinical Trial
Operationalizing a frailty index from a standardized comprehensive geriatric assessment.
To construct and validate a frailty index (FI) that is clinically sensible and practical for geriatricians by basing it on a routinely used comprehensive geriatric assessment (CGA) instrument. ⋯ The FI-CGA is a valid, reliable, and sensible clinical measure of frailty that permits risk stratification of future adverse outcomes.
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Randomized Controlled Trial Clinical Trial
Effectiveness of a group outpatient visit model for chronically ill older health maintenance organization members: a 2-year randomized trial of the cooperative health care clinic.
To compare the effectiveness of Cooperative Health Care Clinic ((CHCC) group outpatient model for chronically ill, older health maintenance organization (HMO) patients) with usual care. ⋯ The CHCC model resulted in fewer hospitalizations and emergency visits, increased patient satisfaction, and self-efficacy, but no effect on outpatient use, health, or functional status.
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Randomized Controlled Trial Clinical Trial
A randomized, controlled trial of comprehensive geriatric assessment and multidisciplinary intervention after discharge of elderly from the emergency department--the DEED II study.
To study the effects of comprehensive geriatric assessment (CGA) and multidisciplinary intervention on elderly patients sent home from the emergency department (ED). ⋯ CGA and multidisciplinary intervention can improve health outcomes of older people at risk of deteriorating health and admission to hospital. Patients aged 75 and older should be referred for CGA after an ED visit.
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Randomized Controlled Trial Clinical Trial
A clinical trial of the effectiveness of regularly scheduled versus as-needed administration of acetaminophen in the management of discomfort in older adults with dementia.
To determine in a sample of nursing home patients with dementia and a painful condition whether the regularly scheduled administration of acetaminophen (650 mg four times a day (qid)) was more or less effective than as-needed (prn) administration of acetaminophen in reducing discomfort. ⋯ Although this trial was negative in terms of the analgesic effects of acetaminophen, the findings have important implications for clinical practice. Prn administration of acetaminophen is sometimes the standard of care for pain management in nursing homes or is offered as an intervention to assess effectiveness. Findings from this study suggest that a 2,600-mg/d dose of acetaminophen is inadequate for elderly nursing home patients with degenerative joint disease, fractures, or back pain who have significant discomfort.