Comprehensive Geriatric Assessment

The 4 M model

Potential patient reported measures include a return to prior function, receiving enough support to perform self-care during the HaH stay, and effective transitional care education, over sight, and handoffs. Adding to this pragmatically collected patient-centered measures such as deprescribing and sim plifying medication regimens, documentation of an advance care planning or serious illness communication discussion, and emergent transfers could provide a multi layered PCC quality and safety approach all the while minimizing regulatory burdens and expense.

Providing flexibility in how programs provide skilled care while creating limits around the number, timing, amount, and in-person versus virtual care required by skilled clini cians needs balance and careful crafting in order to ensure efficiency, safety, and thus the viability of HaH programs.

Abstract Background Current guidelines recommend a comprehensive geriatric assessment (CGA) for the management of older adults with cancer. We evaluated the effect of CGA conducted by a geriatri

IntroducciónEl suero salino hipertónico (SSH) nebulizado mejora la calidad de vida

IntroductionPost-COVID olfactory dysfunction continues to be studied due to the controversy of the

.- Clinicians are increasingly providing telehealth care to older adults despite a lack of comprehensive guidance on age-friendly implementation and practice.

.- The reach of telehealth for older adults remains limited due to several factors, including existing or perceived challenges around physical and cognitive limitations, and a lack of comprehensive guidance on older-adult- focused implementation.

.- This is the first comprehensive set of provider- focused telehealth principles and guidelines, developed by aging and telehealth experts, to address the specific needs of an aging population.

The Centers for Medicare & Medicaid Services (CMS) Acute Hospital Care at Home (AHCaH) waiver resulted in the largest expansion of the Hospital-at-Home (HaH) to date. HaH programs allowed older adults at high risk for adverse out- comes from COVID-19 to receive high-quality acute hospital-level care at home. HaH is a com- plex care delivery model. Using a qualitative approach, we examined issues related to estab- lishing HaH programs under the CMS waiver. We found that HaH leaders were enthusiastic about advantages of HaH for patients and fami- lies. Program leaders reported concerns about the future of the CMS waiver given that its existence is tied to the COVID-19 public health emergency. Key implementation issues included building

electronic health records components for HaH and having the sufficient staff to support HaH pro- grams. The stage between planning and imple- mentation represented the largest hurdle and technical assistance should be most focused in this stage

Abstract Background Antiepileptics are commonly prescribed to nursing home residents with Alzheimer's disease and related dementias (ADRD) but there is little scientific support for their use i

There is no consensus on which test is more suited to outline the cognitive deficits of cerebral small vessel disease (cSVD) patients. We explored the ability of eight cognitive tests, selected in a previous systematic review as the most commonly used in this population, to differentiate among cSVD patients, controls, and other dementing conditions performing a meta-analysis of 86 studies. We found that cSVD patients performed worse than healthy controls in all tests while data on the comparison to neurodegenerative diseases were limited. We outlined a lack of data on these tests’ accuracy on the diagnosis. Cognitive tests measuring processing speed were those mostly associated with neuroimaging cSVD markers. There is currently incomplete evidence that a single test could differentiate cSVD patients with cognitive decline from other dementing diseases. We make preliminary proposals on possible strategies to gain information about the clinical definition of cSVD that currently remains a neuroimaging-based one.

This editorial comments on the article by Gorbenko et al. in this issue.

The 4M Framework could be a cornerstone of quality metrics for the HaH population. Potential patient- reported measures include a return to prior function, receiving enough support to perform self-care during the HaH stay, and effective transitional care education, over- sight, and handoffs. Adding to this pragmatically collected patient-centered measures such as deprescribing and sim- plifying medication regimens, documentation of an advance care planning or serious illness communication discussion, and emergent transfers could provide a multi- layered PCC quality and safety approach all the while minimizing regulatory burdens and expense.