Pain under-documented in nursing home residents with severe cognitive impairment

2018 ◽  
Vol 33 (3) ◽  
pp. 36-36
Keyword(s):  
Nursing Home ◽  
Cognitive Impairment ◽  
Nursing Home Residents ◽  
Severe Cognitive Impairment

Agitation and Touch in the Nursing Home

1989 ◽  
Vol 64 (3_suppl) ◽  
pp. 1019-1026 ◽  
Author(s):  
Marcia S. Marx ◽  
Perla Werner ◽  
Jiska Cohen-Mansfield
Keyword(s):  
Nursing Home ◽  
Cognitive Impairment ◽  
Positive Relationship ◽  
Nursing Home Residents ◽  
Personal Space ◽  
Interpersonal Distance ◽  
Aggressive Behaviors ◽  
Severe Cognitive Impairment ◽  
The Relationship

The relationship between manifestations of agitated behaviors and interpersonal distance was examined in 24 nursing home residents with high agitation and severe cognitive impairment. Analysis indicated that agitated residents displayed divergent responses to touch: touch was related to an increase in aggressive behaviors and to a decrease in physically nonaggressive behaviors (e.g., strange movements). The positive relationship between aggressiveness and touching suggests that residents may interpret touching as a violation of their personal space. The finding that residents exhibited fewer strange movements when touched suggests that touching can act as a quieting and comforting form of communication. The implications of these findings for caregivers are discussed.

Polypharmacy in nursing home residents with severe cognitive impairment: Results from the shelter study

2012 ◽  
Vol 3 ◽  
pp. S118
Author(s):  
D.L. Vetrano ◽  
M. Tosato ◽  
G. Colloca ◽  
D. Fialova ◽  
E. Topinkova ◽  
...  
Keyword(s):  
Nursing Home ◽  
Cognitive Impairment ◽  
Nursing Home Residents ◽  
Severe Cognitive Impairment

scholarly journals Adherence of Pain Assessment to the German National Standard for Pain Management in 12 Nursing Homes

2014 ◽  
Vol 19 (3) ◽  
pp. 133-140 ◽  
Author(s):  
Jürgen Osterbrink ◽  
Zsuzsa Bauer ◽  
Barbara Mitterlehner ◽  
Irmela Gnass ◽  
Patrick Kutschar
Keyword(s):  
Nursing Home ◽  
Cognitive Impairment ◽  
Pain Management ◽  
Nursing Homes ◽  
Pain Assessment ◽  
Survey Methodology ◽  
Nursing Home Residents ◽  
Assessment Tools ◽  
National Standard ◽  
Severe Cognitive Impairment

BACKGROUND: Pain is very common among nursing home residents. The assessment of pain is a prerequisite for effective multiprofessional pain management. Within the framework of the German health services research project, ‘Action Alliance Pain-Free City Muenster’, the authors investigated pain assessment adherence according to the German national Expert Standard for Pain Management in Nursing, which is a general standard applicable to all chronic/acute pain-affected persons and highly recommended for practice.OBJECTIVES: To evaluate the state of pain assessment and to identify need for improvement in 12 nursing homes in a German city.METHODS: In the present study, the authors used an ex-post-facto design (survey methodology). Available written policies for routine pain assessment in residents ≥65 years of age were reviewed and a standardized online survey completed by 151 of 349 nurses in 12 nursing home facilities was conducted between September 2010 and April 2011.RESULTS: Most of the included nursing homes provided written policies for pain assessment, and the majority of nurses reported that they assess and regularly reassess pain. However, observational tools for residents with severe cognitive impairment and written reassessment schedules were lacking in many facilities or were inconsistent.CONCLUSIONS: Essentially, pain assessment appeared to be feasible in the majority of the German nursing homes studied. However, the absence or inconsistency of reassessment schedules indicate that pain management guidelines should include a detailed and explicit reassessment schedule for the heterogenic needs of nursing home residents. For residents with severe cognitive impairment, assessment tools are needed that are simple to use and clearly indicate the presence or absence of pain.

scholarly journals Predictors of incident malnutrition—a nutritionDay analysis in 11,923 nursing home residents

2021 ◽  
Author(s):  
Gabriel Torbahn ◽  
Isabella Sulz ◽  
Franz Großhauser ◽  
Michael J. Hiesmayr ◽  
Eva Kiesswetter ◽  
...  
Keyword(s):  
Nursing Home ◽  
Cognitive Impairment ◽  
High Risk ◽  
Nursing Home Residents ◽  
Risk Groups ◽  
Final Model ◽  
Severe Cognitive Impairment ◽  
Meal Intake ◽  
Low Bmi

Abstract Background/Objectives Malnutrition (MN) in nursing home (NH) residents is associated with poor outcome. In order to identify those with a high risk of incident MN, the knowledge of predictors is crucial. Therefore, we investigated predictors of incident MN in older NH-residents. Subjects/Methods NH-residents participating in the nutritionDay-project (nD) between 2007 and 2018, aged ≥65 years, with complete data on nutritional status at nD and after 6 months and without MN at nD. The association of 17 variables (general characteristics (n = 3), function (n = 4), nutrition (n = 1), diseases (n = 5) and medication (n = 4)) with incident MN (weight loss ≥ 10% between nD and follow-up (FU) or BMI (kg/m2) < 20 at FU) was analyzed in univariate generalized estimated equation (GEE) models. Significant (p < 0.1) variables were selected for multivariate GEE-analyses. Effect estimates are presented as odds ratios and their respective 99.5%-confidence intervals. Results Of 11,923 non-malnourished residents, 10.5% developed MN at FU. No intake at lunch (OR 2.79 [1.56–4.98]), a quarter (2.15 [1.56–2.97]) or half of the meal eaten (1.72 [1.40–2.11]) (vs. three-quarter to complete intake), the lowest BMI-quartile (20.0–23.0) (1.86 [1.44–2.40]) (vs. highest (≥29.1)), being between the ages of 85 and 94 years (1.46 [1.05; 2.03]) (vs. the youngest age-group 65–74 years)), severe cognitive impairment (1.38 [1.04; 1.84]) (vs. none) and being immobile (1.28 [1.00–1.62]) (vs. mobile) predicted incident MN in the final model. Conclusion 10.5% of non-malnourished NH-residents develop MN within 6 months. Attention should be paid to high-risk groups, namely residents with poor meal intake, low BMI, severe cognitive impairment, immobility, and older age.

scholarly journals Physical frailty and cognitive impairment in older nursing home residents: a latent class analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yiyang Yuan ◽  
Kate L. Lapane ◽  
Jennifer Tjia ◽  
Jonggyu Baek ◽  
Shao-Hsien Liu ◽  
...  
Keyword(s):  
Nursing Home ◽  
Cognitive Impairment ◽  
Latent Class Analysis ◽  
Latent Class ◽  
Nursing Home Residents ◽  
Class Analysis ◽  
Physical Frailty ◽  
Data Set ◽  
Severe Cognitive Impairment ◽  
Moderate Cognitive Impairment

Abstract Background Little is known about the heterogeneous clinical profile of physical frailty and its association with cognitive impairment in older U.S. nursing home (NH) residents. Methods Minimum Data Set 3.0 at admission was used to identify older adults newly-admitted to nursing homes with life expectancy ≥6 months and length of stay ≥100 days (n = 871,801). Latent class analysis was used to identify physical frailty subgroups, using FRAIL-NH items as indicators. The association between the identified physical frailty subgroups and cognitive impairment (measured by Brief Interview for Mental Status/Cognitive Performance Scale: none/mild; moderate; severe), adjusting for demographic and clinical characteristics, was estimated by multinomial logistic regression and presented in adjusted odds ratios (aOR) and 95% confidence intervals (CIs). Results In older nursing home residents at admission, three physical frailty subgroups were identified: “mild physical frailty” (prevalence: 7.6%), “moderate physical frailty” (44.5%) and “severe physical frailty” (47.9%). Those in “moderate physical frailty” or “severe physical frailty” had high probabilities of needing assistance in transferring between locations and inability to walk in a room. Residents in “severe physical frailty” also had greater probability of bowel incontinence. Compared to those with none/mild cognitive impairment, older residents with moderate or severe impairment had slightly higher odds of belonging to “moderate physical frailty” [aOR (95%CI)moderate cognitive impairment: 1.01 (0.99–1.03); aOR (95%CI)severe cognitive impairment: 1.03 (1.01–1.05)] and much higher odds to the “severe physical frailty” subgroup [aOR (95%CI)moderate cognitive impairment: 2.41 (2.35–2.47); aOR (95%CI)severe cognitive impairment: 5.74 (5.58–5.90)]. Conclusions Findings indicate the heterogeneous presentations of physical frailty in older nursing home residents and additional evidence on the interrelationship between physical frailty and cognitive impairment.

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