Role of body temperature in diagnosing bacterial infection in nursing home residents.

Objectives: To provide empirically based recommendations for incorporating body temperature into clinical decision-making regarding diagnosing infection in nursing home (NH) residents.

Design: Retrospective.

Setting: Twelve North Carolina NHs.

Successfully reducing antibiotic prescribing in nursing homes.

Objectives: To determine whether antibiotic prescribing can be reduced in nursing homes using a quality improvement (QI) program that involves providers, staff, residents, and families.

Design: A 9-month quasi-experimental trial of a QI program in 12 nursing homes (6 comparison, 6 intervention) conducted from March to November 2011.

Setting: Nursing homes in two regions of North Carolina, roughly half of whose residents received care from a single practice of long-term care providers.

Does adherence to the Loeb minimum criteria reduce antibiotic prescribing rates in nursing homes?

Objectives: The Loeb minimum criteria (LMC), developed by a 2001 consensus conference, are minimum standards for initiation of antibiotics in long term care settings, intended to reduce inappropriate prescribing. This study examined the relationship between nursing home prescriber adherence to the LMC and antibiotic prescribing rates, overall and for each of three specific conditions (urinary tract infections, respiratory infections, and skin and soft tissue infections).

Design: We performed a cross-sectional analysis at the resident-day level.

Caregiving and cognitive function in older women: evidence for the healthy caregiver hypothesis.

Objectives: Recent findings of better health outcomes in older caregivers than noncaregivers suggest a healthy caregiver hypothesis (HCH) model may be more appropriate than the stress process model for evaluating the health effects of caregiving. In a cross-sectional study, we tested the HCH on two cognitive domains: verbal memory and processing speed.

Method: Participants from the Caregiver Study of Osteoporotic Fractures who had a 2-year follow-up interview were categorized as continuous caregivers (n = 194), former caregivers (n = 148), or continuous noncaregivers (n = 574).

The nursing home dining assistant program: a demonstration project.

The purpose of this study was to extend earlier research on the dining assistant (DA) federal regulation allowing trained non-nursing staff to provide feeding assistance care in nursing homes. Observations were conducted pre- and post-implementation, with periodic observations during implementation. To assess sustainability, data were analyzed at 12 months post-implementation.

The importance of standardized observations to evaluate nutritional care quality in the survey process.

Objective: Guidelines written for government surveyors who assess nursing home (NH) compliance with federal standards contain instructions to observe the quality of mealtime assistance. However, these instructions are vague and no protocol is provided for surveyors to record observational data. This study compared government survey staff observations of mealtime assistance quality to observations by research staff using a standardized protocol that met basic standards for accurate behavioral measurement.

Resident choice and the survey process: the need for standardized observation and transparency.

Purpose: To describe a standardized observation protocol to determine if nursing home (NH) staff offer choice to residents during 3 morning activities of daily living (ADL) and compare the observational data with deficiency statements cited by state survey staff.

Design And Methods: Morning ADL care was observed in 20 NHs in 5 states by research staff using a standardized observation protocol. The number of observations in which choice was not offered was documented for 3 morning ADL care activities and compared with deficiency statements made by surveyors.

A preliminary evaluation of the paid feeding assistant regulation: impact on feeding assistance care process quality in nursing homes.

Purpose: The Centers for Medicare and Medicaid Services and the Agency for Healthcare Research and Quality sponsored a nationwide study to evaluate the federal paid feeding assistant (PFA) regulation that allows nursing homes to hire single-task workers to provide feeding assistance to nursing home residents. Organizers designed the PFA regulation to increase the number of staff available to provide assistance with eating and improve nutritional care process quality.

Design And Methods: Trained research staff used standardized protocols to conduct direct observations during meals and face-to-face staff interviews in a convenience sample of seven facilities with PFA programs to evaluate care process quality.

Elderly patients with hip fracture with positive affect have better functional recovery over 2 years.

Objectives: To evaluate whether patients with hip fracture with high positive affect had better functioning than those with low positive affect or depressive symptoms in three performance-based measures over 2 years after the fracture.

Design: Longitudinal study with assessments at baseline and 2, 6, 12, 18, and 24 months posthospitalization.

Setting: Community.

Are all caregivers created equal? Stress in caregivers to adults with and without dementia.

Objective: Caregiving for older adults is stressful; however, by treating caregivers as a homogenous group, it is possible that stress-related factors are misrepresented for some. This study of 349 elderly caregivers explored mediators of the caregiving / stress relationship for caregivers to adults with (n = 106), and without (n = 243) dementia.

Methods: The sample was from the Caregiver Study of Osteoporotic Fractures (CG-SOF), ancillary to SOF, a four-site cohort of 9,704 women.

Leisure-time exercise and overall physical activity in older women caregivers and non-caregivers from the Caregiver-SOF Study.

Background: Elderly caregivers report less leisure-time physical activity than same-aged non-caregivers. However, through caregiving tasks, caregivers may be as physically active as non-caregivers. This study compared leisure-time exercise and overall physical activity in elderly women caregivers and non-caregivers.

The effects of strength training on memory in older adults.

The authors examined whether resistance training has an effect on working memory span. Participants included 210 community-residing older adults with at least one disability from the Strong for Life program, a randomized controlled trial that examined the effects of home-based resistance exercise. Memory was assessed with the WAIS backward digit span at baseline and 3 and 6 months into the intervention.

Age, hormones, and cognitive functioning among middle-aged and elderly men: cross-sectional evidence from the Massachusetts Male Aging Study.

Background: This study examines interrelationships among age, hormones, and cognition for middle-aged and elderly men, and tests whether hormones predict lower cognitive functioning and mediate the age-cognition relationship.

Methods: We analyzed Time 2 data from the Massachusetts Male Aging Study, a population-based cohort study. Selection criteria included complete information on cognition and hormones (n = 981).