RT Book, Section
A1 Kane, Robert L.
A1 Ouslander, Joseph G.
A1 Resnick, Barbara
A1 Malone, Michael L.
SR Print(0)
ID 1149537206
T1 Nursing Home Care
T2 Essentials of Clinical Geriatrics, 8e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9781259860515
LK accessmedicine.mhmedical.com/content.aspx?aid=1149537206
RD 2024/04/24
AB The  focus  of  this  chapter  is  the  clinical  care  of  nursing  home  (NH)  residents.  “Nursing  home”  refers  to  facilities  that  are  also  often  called  “skilled  nursing  facilities”,  “nursing  facilities”,  and  “long-term  care  facilities”.  Many  older  people  who  would  have  otherwise  been  in  NHs  are  now  residing  in  assisted  living  facilities  or  in  their  own  homes.  Issues  discussed  in  this  chapter  may  also  apply  to  these  other  settings  of  care,  but  the  role  of  the  physician  and  the  availability  of  trained  health  professionals  vary  between  these  setting.  Most  NHs  have  two  distinct  populations.  One  is  there  for  postacute  care  (PAC)  after  a  hospitalization.  The  focus  of  care  for  these  “patients”  is  rehabilitation  and  management  of  unstable  medical  conditions,  generally  with  the  goal  of  achieving  a  higher  level  of  function  and  discharge  back  to  the  community,  if  feasible.  The  average  length  of  stay  for  PAC  patients  is  close  to  25  days,  but  changes  in  reimbursement  are  driving  even  shorter  lengths  of  stay.  The  second  population  are  long-stayers,  who  have  a  stay  over  100  days,  with  an  average  duration  of  between  1  and  2  years.  The  focus  of  care  for  these  “residents”  is  managing  chronic  medical  and  neuropsychiatric  conditions,  and  maintaining  function  and  a  good  quality  of  life.