Journal of the American Geriatrics Society
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To examine the effect of hospital readmission on functional recovery after elective surgery in older adults. ⋯ Readmission after elective surgery may contribute to delays in functional recovery and persistent functional deficits in older adults.
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To understand the perspectives of both patients and the person who would make medical decisions for them if they were unable (surrogates) on their participation in advance care planning (ACP). ⋯ Surrogates can both impede and facilitate engagement in ACP, and they can hold different perceptions from patients regarding this engagement. Efforts to promote ACP may be most successful if they assess and address both patients' and surrogates' attitudes and help to facilitate clear communication between them.
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To examine perspectives on antibiotic use and antibiotic stewardship of nurses and medical providers in nursing homes (NHs). ⋯ Nursing staff and medical providers share a commitment to reducing unnecessary antibiotic use. Antibiotic stewardship interventions should foster cooperation and build competency to implement alternative management approaches and to educate residents and families. Nurse leaders and medical providers with long-term care training may be especially effective champions for antibiotic stewardship.
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The population is aging, and breast cancer incidence increases with age, peaking between the ages of 75 and 79. However, it is not known whether mammography screening helps women aged 75 and older live longer because they have not been included in randomized controlled trials evaluating mammography screening. Guidelines recommend that older women with less than a 10-year life expectancy not be screened because it takes approximately 10 years before a screen-detected breast cancer may affect an older woman's survival. ⋯ To inform decision-making, tools are available to estimate life expectancy and to educate older women about the benefits and harms of mammography screening. Guides are also available to help clinicians discuss stopping screening with older women with less than a 10-year life expectancy. Ideally, screening decisions would consider an older woman's life expectancy, breast cancer risk, and her values and preferences.
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Randomized Controlled Trial
Effect of Cognitively Stimulating Activities on Symptom Management of Delirium Superimposed on Dementia: A Randomized Controlled Trial.
To determine whether cognitively stimulating activities would reduce duration and severity of delirium and improve cognitive and physical function to a greater extent than usual care. ⋯ Cognitively stimulating activities did not improve delirium but improved executive function and reduced length of stay. Resolution of delirium may require more-intense nonpharmacological management when the individual has dementia.