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RECOMMENDATIONS ON PHYSICAL ACTIVITY AND EXERCISE FOR OLDER ADULTS LIVING IN LONG-TERM CARE FACILITIES: A TASKFORCE REPORT
P. de Souto Barreto, J.E. Morley, W. Chodzko-Zajko, K.H. Pitkala, E. Weening-Djiksterhuis, L. Rodriguez-Mañas, M. Barbagallo, E. Rosendahl, A. Sinclair, F. Landi, M. Izquierdo, B. Vellas, Y. Rolland, under the auspices of The International Association of Gerontology and Geriatrics – Global Aging Re
Jour Nursing Home Res 2016;2:7-20Show summaryHide summary
A taskforce, under the auspices of The International Association of Gerontology and Geriatrics – Global Aging Research Network (IAGG-GARN) and the IAGG European Region Clinical Section, composed of experts from the fields of exercise science and geriatrics met in Toulouse, in December 2015, with the aim of establishing recommendations of physical activity and exercise for older adults living in long-term care facilities (LTCF). Due to the high heterogeneity in terms of functional ability and cognitive function that characterizes older adults living in LTCFs, taskforce members established two sets of recommendations: recommendations for reducing sedentary behaviors for all LTCF residents and recommendations for defining specific, evidence-based guidelines for exercise training for subgroups of LTCF residents. In order to promote a successful implementation of recommendations, taskforce experts highlighted the importance of promoting residents’ motivation and pleasure, the key factors that can be increased when taking into account residents’ desires, preferences, beliefs and attitudes toward physical activity and exercise. The importance of organizational factors related to LTCFs and healthcare systems were recognized by the experts. In conclusion, this taskforce report proposes standards for the elaboration of strategies to increase physical activity as well as to prescribe exercise programs for older adults living in LTCFs. This report should be used as a guide for professionals working in LTCFs settings.
P. de Souto Barreto ; J.E. Morley ; W. Chodzko-Zajko ; K.H. Pitkala ; E. Weening-Djiksterhuis ; L. Rodriguez-Mañas ; M. Barbagallo ; E. Rosendahl ; A. Sinclair ; F. Landi ; M. Izquierdo ; B. Vellas ; Y. Rolland ; under the auspices of The International Association of Gerontology and Geriatrics – Global Aging Research Network (IAGG-GARN) and the IAGG European Region Clinical Section (2016): Recommendations on physical activity and exercise for older adults living in long-term care facilities: a taskforce report. The Journal of Nursing Home Research Science (JNHRS). http://dx.doi.org/10.14283/jnhrs.2016.2
WORKER INJURIES IN NURSING HOMES: IS SAFE PATIENT HANDLING LEGISLATION THE SOLUTION?
K.L. Lapane, C.E. Dubé, B.M. Jesdale
Jour Nursing Home Res 2016;2:110-117Show summaryHide summary
In 2012, nursing homes were considered the most dangerous workplaces in the United States. While other industries have guidelines that limit manual lifting of stable objects to ≤50 pounds, the same is not so in the nursing home industry where residents requiring physical assistance may weigh over 250 pounds and where the prevalence of obesity among residents is increasing. Safe patient handling legislation in nursing homes has been enacted in nine of the United States since 2005 (Hawaii, Illinois, Maryland, Minnesota, New Jersey, New York, Ohio, Rhode Island, and Texas). This paper reviews the problem of worker injuries in nursing homes, describes the legislation passed to address the problem, and reviews the data available on the effectiveness of the legislation. No national studies evaluating the effectiveness of safe patient handling state policies on nursing home injuries exists, although the National Institute on Occupational Safety and Health has recently funded a national evaluation.
K.L. Lapane ; C.E. Dubé ; B.M. Jesdale (2016): WORKER INJURIES IN NURSING HOMES: IS SAFE PATIENT HANDLING LEGISLATION THE SOLUTION?. The Journal of Nursing Home Research Science (JNHRS). http://dx.doi.org/10.14283/jnhrs.2016.17
PREVALENCE OF RISK OF MALNUTRITION AND ASSOCIATED FACTORS IN HOME CARE CLIENTS
T. Kaipainen, M. Tiihonen, S. Hartikainen, I. Nykänen
Jour Nursing Home Res 2015;1:47-51Show summaryHide summary
Objectives: To describe nutritional status and to detect factors associated with it in home care clients aged 75 years or older. Design: A cross-sectional study with a population-based sample. Setting: Home care.Participants: The study included 267 home care clients in three cities in Finland. Measurements: The outcomes were nutritional status (Mini Nutritional Assessment, MNA), body mass index (BMI), functional ability (Barthel Index, Instrumental Activities of Daily Living, IADL), cognitive function (Mini Mental State Examination, MMSE), depression (Geriatric Depression Scale, GDS-15), comorbidity (Functional Comorbidity Index, FCI), Vitamin D and drug use and levels of blood albumin and haemoglobin. Chewing problems and dry mouth were assessed by using a structured interview. Results: According to the MNA, a majority (86%, n = 229) of all home care clients were at risk of malnutrition or were malnourished. Persons at risk of malnutrition or who were malnourished used more drugs and had a higher depressive score and lower Barthel Index, IADL and MMSE scores than well-nourished participants. Multivariate analysis showed that excessive polypharmacy (OR 3.63, 95% CI:1.51–8.74), a lower MMSE score (OR 1.29, 95% CI:1.12–1.48) and a higher GDS-15 score (OR 1.32, 95% CI:1.07–1.63) appeared to be independently connected to malnutrition or a risk of malnutrition. Conclusions: Malnutrition or a risk of malnutrition is a common problem among home care clients. Excessive polypharmacy, cognitive impairment and depressive symptoms increase malnutrition or the risk of malnutrition. To prevent a further decline in their health status, home care clients should be screened for malnutrition and the risk of malnutrition.
T. Kaipainen ; M. Tiihonen ; S. Hartikainen ; I. Nykänen (2015): PREVALENCE OF RISK OF MALNUTRITION AND ASSOCIATED FACTORS IN HOME CARE CLIENTS. The Journal of Nursing Home Research Science (JNHRS). http://dx.doi.org/10.14283/jnhrs.2015.9
PROFILE OF USE OF VITAMIN AND MINERAL SUPPLEMENTS AMONG ELDERLY INSTITUTIONALIZED ADULTS: A SYSTEMATIC REVIEW
S. Goorang, L. Ausman, R. Houser, S.J. Whiting
Jour Nursing Home Res 2015;1:1-5Show summaryHide summary
Background: Although studies have evaluated the use of vitamin and mineral supplements in the general population and community-dwelling older adults, little is known about the use of these products among long-term care (LTC) facility residents. These individuals, who tend to take more medications and are particularly at risk of undernutrition and micronutrient deficiencies, may benefit from using vitamin and/or mineral supplements. Alternatively, getting too much of these nutrients may increase risk of excessive intake or drug-supplement interactions. Thus, it is important to document supplement use among elders living in institutions. Objective: To examine the prevalence of use of different types of vitamin and mineral supplements among institutionalized elderly people in nursing homes and assisted living facilities. Design: A systematic review was conducted in July 2013 of Medline and Embase databases using key terms for LTC facilities and vitamin-mineral supplements. Filters used to narrow down the results included publication year after 1997, English language, human studies, and adult/aged population. Results: Of the 1825 publications identified, 892 were excluded after applying filters. After eliminating duplicates, 676 records were screened by either title or abstract, excluding 617. Full text of the remaining 59 articles was reviewed and 5 studies were selected. Conclusions: Very few studies have provided comprehensive information about the use of vitamin and mineral supplements among institutionalized elderly people. There appears to be some challenges associated with conducting research among this vulnerable population who have advanced age and multiple chronic diseases, and further studies are warranted.
S. Goorang ; L. Ausman ; R. Houser ; S.J. Whiting (2015): Profile OF USE of vitamin and mineral supplements among elderly institutionalized adults: A systematic review. The Journal of Nursing Home Research Science (JNHRS). http://dx.doi.org/10.14283/jnhrs.2015.1
NOTHING VENTURED, NOTHING GAINED: ACCEPTABILITY TESTING OF MICRONUTRIENT FORTIFICATION IN LONG-TERM CARE
I.T.Y. Lam, H.H. Keller, L.M. Duizer, K.D. Stark, A.M. Duncan
Jour Nursing Home Res 2015;1:18-27Show summaryHide summary
Background: Purpose: Malnutrition is common in long-term care (LTC) residents, yet limited research exists on micronutrient deficiencies. Objective: This study used qualitative methods to explore the acceptability of a food-first micronutrient fortification strategy for LTC and further develop this strategy. Design & participants: Qualitative cross-sectional data collection based on eleven staff focus groups (n=45), ten expert key informant interviews, and five family/resident focus groups (n=71) were conducted. Data were triangulated during content analysis, completed by two coders. Results: Stakeholders provided insight into benefits, concerns and potential solutions to minimize barriers and promote adherence to the strategy. Suggested solutions included development of outsourced/pre-made fortified products, mandatory training and clear protocols. Stakeholders can envision food fortification as a strategy to improve micronutrient status if products are easy to access and incorporate into current production systems. Yet, residents and families wish to be informed and have the potential to ‘opt out’. Safety and efficacy also needs to be demonstrated before it is incorporated into standard practice. Conclusion: This work provides a strong foundation for developing a proof-of-concept micronutrient food fortification study for the prevention of deficiencies in LTC.
I.T.Y. Lam ; H.H. Keller ; L.M. Duizer ; K.D. Stark ; A.M. Duncan ; (2015): NOTHING VENTURED, NOTHING GAINED: ACCEPTABILITY TESTING OF MICRONUTRIENT FORTIFICATION IN LONG-TERM CARE. The Journal of Nursing Home Research Science (JNHRS). http://dx.doi.org/10.14283/jnhrs.2015.5