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1 Welcome to mosaic s Regular Reads* This list contains links to free journal articles on: Updated: Do also check out our other Regular Read lists on: Gerontology s Psycho-s Nursing, Infection Control, Integrated Care, Management Skills, Palliative Care, Quality Improvement, and Technology Applications Innovations at aic-learn.sg/resources/regular-reads *Regular Reads is a supplement of mosaic, the Agency for Integrated Care s publication for the community care sector. Filled with information such as programmes, good practices, book and journal summaries as well as stories from the sector, mosaic is available free for community care staff. For more information, visit aic.sg/mosaic

2 Table of Contents Updated in NEW! pg4 Preventing falls among older people with mental health problems: A systematic review Strategies for reducing falls in long-term care Evaluation of the prevalence of chronic kidney disease and rates of oral antidiabetic prescribing in accordance with guidelines and manufacturer recommendations in type 2 diabetic patients within a long-term care setting Updated in October 2014 pg5 Prevalence and treatment of heart failure in Swedish nursing homes Home remedy for fall risk Putting the nutrition-focused physical assessment into practice in long-term care settings Updated in July 2014 pg6 Evidence for the long term cost effectiveness of home care reablement programs Venous thromboembolism prophylaxis for chronically immobilized long-term care residents Aortic stenosis: What long-term care providers need to know Updated in April 2014 pg7 It s somebody else s responsibility Perceptions of general practitioners, heart failure nurses, care home staff, and residents towards health failure diagnosis and management for older people in long-term care: A qualitative interview study Nurses role in care home rehabilitation Robot-guided exercise program for the rehabilitation of older nursing home residents Updated in January 2014 pg8 A preliminary study of aged care facility staff indicates limitations in awareness of the link between depression and physical morbidity Can progressive resistance training twice a week improve mobility, muscle strength, and quality of life in very elderly nursing-home residents with impaired mobility? A pilot study Small changes have big impact on LTC residents sense of control, autonomy Updated in September 2013 pg9 Does the care dependency of nursing home residents influence their health-related quality of life? - A cross-sectional study Page 2 of 15

3 Table of Contents Factors associated with falls among older adults living in institutions The relationship between pain and disruptive behaviors in nursing home residents with dementia Updated in June 2013 pg10 Effectiveness of an exercise programme on postural control in frail older adults Postural control in elderly women with osteoporosis: Comparison of balance, strengthening and stretching exercises. A randomised controlled trial The effects of a long-term care walking programme on balance, falls and well-being Updated in March 2013 pg11 Charles Bonnet Syndrome in a nonagenarian Meeting oral health challenges in long-term care facilities Whole-body vibration in addition to strength and balance exercise for falls-related functional mobility of frail older adults: A single-blind randomised controlled trial Updated in December 2012 pg12 Borderline personality disorder in residential care facilities There s a monster under my bed : Hearing aids and dementia in long-term care settings Undetected sight loss in care homes: An evidence review Updated in October 2012 pg13 Effects of circuit training as alternative to usual physiotherapy after stroke: Randomised controlled trial Enhancing physical activity in older adults receiving hospital based rehabilitation: A phase II feasibility study Effects of comprehensive geriatric assessment and targeted intervention on mobility in persons aged 75 years and over: A randomised controlled trial Updated in August 2012 pg14 Community Care Dietitian Project: Nutritional care improves client outcomes and reduces hospital admissions Comparison of people with ABI living in two accommodation settings: Shared supported accommodation and residential aged care How can we improve targeting of frail elderly patients to a geriatric day-hospital rehabilitation programme? Parkinson s safety net Page 3 of 15

4 mosaic s Regular Reads aims to bring to community care providers attention knowledge that may be relevant and useful to their operations. This section features journal articles that highlight latest research findings as well as good, evidence-based and innovative practices. While the articles aim to keep community care providers informed of current developments in the sector, the views and opinions expressed or implied do not necessarily reflect those of the Agency for Integrated Care (AIC), its directors or editorial staff. Updated in Preventing falls among older people with mental health problems: A systematic review Falls are a leading cause of mortality and morbidity in older people. Those with mental health conditions are at a higher risk. This report evaluates the effectiveness of fall prevention interventions for older people with mental health problems being cared for across all settings. It analyses 17 randomised controlled trials and four uncontrolled studies to gather evidence related to fall reduction. Multifactorial, multi-disciplinary interventions and those involving exercise, medication review and increasing staff awareness appeared to reduce the risk of falls but the evidence was mixed. Environmental changes such as increased supervision or sensory stimulation to reduce agitation may be promising for patients with dementia but further evaluation is needed. Bunn, F., et. al. (2014, February 19). Preventing falls among older people with mental health problems: A systematic review. BMC Nursing. Retrieved 1. NEW! Strategies for reducing falls in long-term care A thorough falls risk assessment is conducted by an interdisciplinary care team at the nursing home on the first day of admission. Strategies to mitigate any identified risks are implemented. Despite these best efforts, some falls will occur. Any incidence of falls needs to be reviewed to develop a sustainable and effective fall prevention programme. This article provides two case studies Harold and Ruth that demonstrate why individual risks need to be carefully explored. Syncope among patients needs to be prevented. The risk of falls can be mitigated by training staff to recognise pain, discomfort and a desire to move inpatients; using visual and environmental factors to address visual and cognitive deficits; avoiding auditory clutter; using gravity-assisted seating; considering Vitamin D and calcium supplementation; equipping residents with protective gear such as footwear, helmets and hip protectors; promoting appropriate exercises; and addressing staff issues. Willy, B. & Osterberg, C. (2014, January 17). Strategies for reducing falls in long-term care. Annals of Long-Term Care: Clinical Care and Aging. 22(1): Retrieved 1. NEW! Evaluation of the prevalence of chronic kidney disease and rates of oral antidiabetic prescribing in accordance with guidelines and manufacturer recommendations in type 2 diabetic patients within a long-term care setting NEW! This study assesses the prevalence of moderate to severe chronic kidney disease (CKD) among nursing home residents with type 2 diabetes in the United States. It examines the pattern of oral antidiabetic drug (OAD) use, their concordance with the Page 4 of 15

5 National Kidney Foundation guideline and prescribing information (PI). It found that almost half of diabetic residents had moderate to severe CDA. A little over a quarter of residents using OAD received at least one NKF-discordant OAD; metformin being the most commonly misused OAD. Non-concordance of prescribing information was found in 58.6 per cent of the residents and highest in glipizide and metformin users. It suggests that given the high prevalence of CKD in nursing homes, physicians should evaluate residents renal function when choosing treatment plans and review treatments regularly to check compliance with NKF guidelines of PIs. Wu, N., Yu, X., Greene, M. & Oderda, G. (2014, February 25). Evaluation of the prevalence of chronic kidney disease and rates of oral antidiabetic prescribing in accordance with guidelines and manufacturer recommendations in type 2 diabetic patients within a long-term care setting. International Journal of Nephrology. Retrieved 1. Search for the full-text article at hindawi.com Updated in October 2014 Prevalence and treatment of heart failure in Swedish nursing homes This study seeks to explore the prevalence of heart failure and the risk of failure to diagnose heart failure in nursing homes in Sweden. It also examines the medication and the adherence to guidelines for the treatment of heart failure. Four hundred and ninety-two patients from 11 nursing homes were studied from It was found that the subjects with higher B-type natriuretic peptide (BNP) values were older and had lower estimating glomerular filtration rate (egfr), haemoglobin, diastolic blood pressure and body mass index. In many cases, patients with heart failure diagnoses were not treated according to guidelines. Loop diuretics were often used without concomitant ACE (angiotensin converting enzyme) inhibitors or angiotensin receptor blockers. Bolmsjo, B., Molstad, S., Ostgren, C. & Midlov, P. (2013, November 5). Prevalence and treatment of heart failure in Swedish nursing homes. BMC s. Retrieved January 2, Home remedy for fall risk This tool identifies risk factors for falls in homes and provides information on ways to prevent falls of older adults. It highlights the Centers for Disease Control and Prevention s simple strategy for reducing in-home falls: removing the hazards that may cause a fall. This would include modifications such as removing or securing throw rugs, increasing lighting and improving bathroom safety by installing grab bars. It suggests adapting the Home Safety Self-Assessment Tool developed by the University of Buffalo in New York to fit the person s requirements. Elders awareness on the risk of in-home falls can be done by health care providers along with highlighting the environmental factors that can increase the risk and home safety assessments to effectively help prevent falls. It encourages elders to regularly exercise and stay mobile inside their home to prevent the onset of disability that often results in depression and further inactivity. Tomita, M. & Nochajski, S. (2013, November/December). Home remedy for fall risk. Today s Medicine. 6(6):12. Retrieved January 2, Search for the full-text article at todaysgeriatricmedicine.com Page 5 of 15

6 Putting the nutrition-focused physical assessment into practice in long-term care settings This article describes the nutrition-focused physical assessment (NFPA) techniques and highlights how they can be used to identify characteristics of malnutrition, micronutrient deficiencies and other nutrition problems among older adults living in long-term care facilities. It explains how NFPA fits into the Nutrition Care Process, a systematic approach to providing high-quality nutrition care. It also looks at how NFPA techniques are incorporated into the comprehensive nutrition assessment. It concludes with a case study of a comprehensive nutrition assessment on a female nursing home resident. Litchford, M. (2013, November 14). Putting the nutrition-focused physical assessment into practice in long-term care settings. Annals of Long-Term Care: Clinical Care and Aging. 21(11): Retrieved January 2, Updated in July 2014 Evidence for the long term cost effectiveness of home care reablement programs This report examines whether elderly Australians can improve their ability to function and reduce their need for ongoing support by participating in a reablement (restorative) programme rather than immediately receiving conventional home care services. Reablement is a holistic, person-centred approach to care that provides timely, flexible and targeted services and focuses on capacity building to enable the individual to live independently. The study found that including a reablement programme when an individual was referred for home care within Australia s reformed aged care system would bring cost savings as well as enable the person to maximise their independence as they age. Lewin, GF., Alfonso, HS. & Alan, JJ. (2013, October). Evidence for the long term cost effectiveness of home care reablement programs. Clinical Interventions in Aging. 8: Retrieved October 7, Search for the full-text article at dovepress.com Venous thromboembolism prophylaxis for chronically immobilized long-term care residents This report reviews the available literature regarding venous thromboembolism (VTE) prophylaxis for patients with chronic immobility in LTC residents. VTE comprises of deep vein thrombosis (DVT) and pulmonary embolism (PE). The report defines immobility, lists VTE risk factors and risks among LTC residents, and highlights prophylaxis recommendations for chronically immobilised patients. It describes the current VTE prophylaxis practices in nursing homes and the practices that can be learnt from hospital settings. Robinson, A.M. (2013, September 13). Venous thromboembolism prophylaxis for chronically immobilized long-term care residents. Annals of Long-Term Care: Clinical Care and Aging. 21(9): Retrieved October 7, Aortic stenosis: What long-term care providers need to know Aortic stenosis (AS) can be congenital or degenerative. The latter results from the calcification of the aortic value over time and is the most common valvular disease in older adults. This report reviews the signs and symptoms of AS; its diagnosis; its clinical Page 6 of 15

7 and economic impact; and management options that include surgical aortic valve replacement and transcatheter aortic valve replacement. AS may result in functional limitations and lead to the need for long-term care. This report provides insights to LTC providers on optimising the care of AS patients. Bernacki, G., & Alexander, K. (2013, September 13). Aortic stenosis: What long-term care providers need to know. Annals of Long-Term Care: Clinical Care and Aging. 21(9): Retrieved October 7, Updated in April 2014 It s somebody else s responsibility Perceptions of general practitioners, heart failure nurses, care home staff, and residents towards health failure diagnosis and management for older people in long-term care: A qualitative interview study This study examines the experiences and expectations of clinicians, care-facility staff and residents in interpreting suspected symptoms of heart failure (HF) and deciding whether and how to intervene. It found that there was a lack of clear lines of responsibility in providing heart failure care in care-facilities. The access to HF diagnosis and treatment was incorrectly moderated with many clinical staff expressing negative assumptions about the acceptability and utility of interventions. There was a lack of opportunity for dialogue about the balance of risks and benefits of intervention between care-facility staff and residents. Physical, social and organisational barriers did not enable residents from being involved in healthcare decisions. The study recommends the provision of onsite HF service as a potential solution. Close, H., Hancock, H., Mason, J., Murphy, J., Fuat, A. Belder, M. Hungin, A.P.S. (2013, July 5). It s somebody else s responsibility Perceptions of general practitioners, heart failure nurses, care home staff, and residents towards health failure diagnosis and management for older people in long-term care: A qualitative interview study. BMC s. 13:69. Retrieved August 22, Nurses role in care home rehabilitation Ireland s population is ageing. Between 2006 and 2011, those aged over 65 increased by 14.4 percent while those aged 85 or older increased by 22 percent. More of them now live in long-term residential care facilities. Since their physical and medical conditions are often complex, they need nursing rehabilitation to improve or maintain their functional status. This study looks at how nurses perceive their role in rehabilitating the elderly in residential care settings. It was ascertained that nurses consider their roles in caring and promoting enablement and independence as important aspects of their duties. However, time constraints, coupled with the limited physical and cognitive ability of the elderly, make it difficult to carry out rehabilitation programmes successfully. It supported further education and training for nurses and the need to create a sense of homeliness by working alongside families to achieve this. O Doherty, E. (2013, July 19). Nurses role in care home rehabilitation. Nursing Times. Retrieved August 22, Search for the full-text article at nursingtimes.net Page 7 of 15

8 Robot-guided exercise program for the rehabilitation of older nursing home residents For older adults to be physically active, the authors opine that socially interactive robots can be used to encourage and guide the performance of rehabilitation exercises designed for elderly people. This study examines the use of a small humanoid robot to facilitate rehabilitation exercises in three private nursing homes in a county in Finland. The robots were programmed to lead several exercise regimens which the residents could perform while seated. During the exercise sessions, the robot demonstrated the hand and leg motions, while providing pre-recorded instructions for each motion. Feedback received from both nursing home staff and residents were generally positive. Bäck, I., Makela, K., Kallio, J. (2013, June 17). Robot-guided exercise program for the rehabilitation of older nursing home residents. Annals of Long-Term Care: Clinical Care and Aging. 21(6): Retrieved August 22, Updated in January 2014 A preliminary study of aged care facility staff indicates limitations in awareness of the link between depression and physical morbidity It is important to understand the complex inter-relationship between depression and physical illness in order to plan and provide quality health care services for older persons and reduce suffering and early mortality. This study assessed the awareness and knowledge of aged care staff of the link between physical morbidity and depression. Responses to the survey questions demonstrated gaps in knowledge about the relationship between depression and physical health. The need for regular ongoing training to improve knowledge and awareness of this relationship is indicated. Treatment of physical health issues which is essential in reducing the risk for depression in older persons in aged care environments could be optimised by improved staff training.. Atkins, J., Naismith, S.L., Luscombe, G.M., Hickie, I.B. (2013). A preliminary study of aged care facility staff indicates limitations in awareness of the link between depression and physical morbidity. BMC s. Retrieved May 2, Can progressive resistance training twice a week improve mobility, muscle strength, and quality of life in very elderly nursing-home residents with impaired mobility? A pilot study This study determines the effects of progressive resistance training on mobility, muscle strength, and quality of life in nursing-home residents with impaired mobility. It studied 15 nursing home residents aged 77 years and older with impaired mobility in Berlin, Germany. After an eight-week progressive resistance exercise programme conducted twice a week, mobility was assessed using the Elderly Mobility Scale; muscle strength by the eight-repetition maximum ; and quality of life using the Short Form-36 Health Survey. It was found that there was considerable improvement in mobility and muscle strength among the residents after the programme. Krist, L., Dimeo, F. & Keil, T. (2013, April 23). Can progressive resistance training twice a week improve mobility, muscle strength, and quality of life in very elderly nursing-home residents with impaired mobility? A pilot study. (2013, April 23). Clinical Interventions in Aging. Retrieved May 2, Search for the full-text article at dovepress.com Page 8 of 15

9 Small changes have big impact on LTC residents sense of control, autonomy This article addresses two areas of care scheduling and training that can be modified to give more control and autonomy to nursing home residents and help them cope with stressors, reduce depression and anxiety, and increase their satisfaction with care. It encourages increased flexibility with daily schedules where residents can arrange their days to meet their preferences such as time of rehab, dinning and shower. It suggests that staff should be trained in customer service techniques to respond to requests in a pleasant and accommodating manner. Barbera, E. (2013, March 25). Small changes have big impact on LTC residents sense of control, autonomy. Long-term Living Magazine. Retrieved May 2, Search for the full-text article at ltlmagazine.com Updated in September 2013 Does the care dependency of nursing home residents influence their health-related quality of life? - A cross-sectional study This research studied 11 German nursing homes from the period April 2008 to December 2009 to analyse if the care dependency of nursing home residents influenced their health-related quality of life (HRQOL) and described the HRQOL of nursing home residents at the time of admission. HRQOL was measured with the Nottingham Health Profile (NHP) in the six domains Physical Mobility, Energy, Pain, Social Isolation, Emotional Reaction and Sleep. Care dependency was evaluated using the Care Dependency Scale, age, sex, cognitive status and diseases. The study found that the level of care dependency had no influence on the HRQOL from the nursing home residents perspective except for the sleep domain where high care dependency residents have a lower score compared to moderate and low care dependency residents. In the pain domain, women had a significantly lower HRQOL compared to men. Tabali, M., Ostermann, T., Jeschke, E., Dassen, T. & Heinze, C. (2013, March 11). Does the care dependency of nursing home residents influence their health-related quality of life? A cross-sectional study. Health and Quality of Life Outcomes (41). Retrieved March Search for the full-text article at hqlo.com Factors associated with falls among older adults living in institutions Those prone to falls in nursing homes have multiple diseases. These include urinary incontinence, anti-depressant use, multiple medication use and arrhythmias. This finding was based on a research in Spain involving 733 long-term care residents. They noted that the risk of falls increases from people with no disease or one disease only to those with two or more diseases. Beyond that, the risk plateaus. It was also surmised that some falls prevention programmes were ineffective due to the fact that the factor number of diseases is hard to militate against. However, other primary factors such as urinary incontinence and the use of anti-depressants are easier to control. Damian, J., Pastor-Barriuso, R., Valderrama-Gama, E., & Pedro-Cuesta-J.D. (2013, January 15). Factors associated with falls among older adults living in institutions. BMC s. 13(6). Retrieved March 11, Page 9 of 15

10 The relationship between pain and disruptive behaviors in nursing home residents with dementia Persons with dementia lose the ability to process information and are less likely to express pain in typical ways. This study investigates the effect of pain on disruptive behaviour in nursing home residents with dementia. It examined the following variables: pain, wandering, aggression, agitation, cognitive impairment, activities of daily living impairments and demographic characteristics. It found that residents with more severe pain were more likely to display aggressive and agitated behaviour and less likely to display wandering behaviour. Effective pain management may help reduce aggression and agitation and promote mobility in residents with dementia. Ahn, H. & Horgas, A. (2013, February 11). The relationship between pain and disruptive behaviors in nursing home residents with dementia. BMC s. 13(14). Retrieved March 11, Updated in June 2013 Effectiveness of an exercise programme on postural control in frail older adults This study investigates the effects of an exercise programme with a focus on postural control exercises in frail older adults. Twenty-six older adults from the Falls Unit, University Hospital Mutua Terrassa, Barcelona, Spain, participated in this single-group study. Volunteers postural control was evaluated using the Timed Up and Go Test (TUG) and the Guralink test battery, and their static and dynamic posturography were evaluated. The evaluations included an educational session and two weekly one-hour sessions over eight weeks. The study finds that the programme used was safe and was able to promote some improvement in postural control, especially in the anteposterior direction and in the base support. Alfieri, F.M. [et.al]. (2012, December 18). Effectiveness of an exercise programme on postural control in frail older adults. Clinical Interventions in Ageing. Retrieved January 2, Search for the full-text article at dovepress.com Postural control in elderly women with osteoporosis: Comparison of balance, strengthening and stretching exercises. A randomised controlled trial This study undertook a randomised, controlled trial to compare the efficacy of balance training associated with muscle strengthening or stretching, relative to no intervention, in the postural control of elderly women with osteoporosis. The sample consisted of 50 women aged 65 years or older, with osteoporosis, randomised into one of three groups: strengthening group, stretching group and control group. Results suggest that interventions in both the strengthening and stretching groups are effective in improving postural control when compared to the control group, and the strengthening group was superior to the stretching group in knee extension strength and in directional control. Rodrigues, R. M. (2012, November). Postural control in elderly women with osteoporosis: Comparison of balance, strengthening and stretching exercises. A randomised controlled trial. Clinical. Retrieved January 2, Search for the full text article via National Library Board s digital library - eresources.nlb.gov.sg Register (free) / Login / Browse By A-Z / Select P / ProQuest Central database / Search article using keyword search. Page 10 of 15

11 The effects of a long-term care walking programme on balance, falls and well-being This study randomly assigned residents of long-term care facilities into one of three intervention groups: Usual Care Group; Interpersonal Interaction Group; and Walking Programme Group. Assessments were completed at baseline, two and four months during intervention, and two and four months post-intervention. The study found that despite the challenges, insights could be garnered regarding benefits of a walking programme as well as practical intervention implications. Improved resident quality of life, psychosocial function, functional abilities and fewer falls all have the potential to lead to favourable financial and healthcare system outcomes over the longer term. Vanina, P.M. [et.al]. (2012, December 18). The effects of a long-term care walking programme on balance, falls and well-being. BMC s. Retrieved January 2, Updated in March 2013 Charles Bonnet Syndrome in a nonagenarian This report presents the case of a 93-year-old woman who started reporting hallucinations shortly after being admitted to a long-term care facility for frailty and generalised weakness after being hospitalised for pneumonia. These hallucinations were disconcerting to her, particularly because she realised that they were not real. It was discovered that the woman was suffering from the Charles Bonnet Syndrome, a condition that causes patients with visual loss to have complex visual hallucinations. Once her poor vision was identified as the source of the hallucinations and she was informed of this, she was no longer as troubled by them and took measures to curtail them. Haider, A. (2012, October 16). Charles Bonnet Syndrome in a nonagenarian. Annals of Long-Term Care: Clinical Care and Aging, 20(10). Retrieved November 6, Free registration required. Meeting oral health challenges in long-term care facilities This study argues that despite advances in oral health care, poor oral health among long-term care residents remains pervasive, as there continue to be numerous barriers to providing care for this population. It looks at a long-term care facility in Kentucky, USA, where a comprehensive oral health staff training programme was designed and implemented to overcome some of the barriers to oral health care. This report describes the pilot programme that yielded positive results and provides a brief review of the serious health issues associated with poor oral care, underscoring the need for other long-term care facilities to work toward implementing similar staff education programmes. Stein, P. [et.al]. (2012, September 17). Meeting oral health challenges in long-term care facilities. Annals of Long-Term Care: Clinical Care and Aging, 20(9). Retrieved November 6, Free registration required. Page 11 of 15

12 Whole-body vibration in addition to strength and balance exercise for falls-related functional mobility of frail older adults: A single-blind randomised controlled trial Falls are a leading cause of morbidity and mortality in older people. This study investigates the effects of whole-body vibration in addition to an exercise programme on functional mobility and related outcomes for frail older fallers. A total of 38 frail older fallers performed the exercise with whole-body vibration (vibration group) and 39 without (exercise group). The programme involved a sixty-minute supervised exercise class three times weekly for eight weeks. The study finds that the addition of whole-body vibration to strength and balance exercise resulted in greater improvements in functional mobility than exercise alone. Pollock, R.D., Finbarr, M., & Newham, D.J. (2012, October). Whole-body vibration in addition to strength and balance exercise for falls-related functional mobility of frail older adults: A single-blind randomised controlled trial. Clinical. Retrieved November 12, Search for the full-text article via National Library Board s digital library - eresources.nlb.gov.sg Updated in December 2012 Borderline personality disorder in residential care facilities This report details case scenarios of late in life borderline personality disorders (BPD) among two long-term care residents. It demonstrates the manifestation of BPD in geriatric persons and explains effective nonpharmacologic intervention strategies in LTC settings to address them. The cases show that the current diagnostic criteria and assessment tools used to diagnose BPD are inadequate as it manifests differently in geriatric patients than in younger patients. More research is also needed on the therapies used in LTC facilities and their success in other settings. Hall, E., Hategan, A. & Bourgeois, JA. (2012, August 6). Borderline personality disorder in residential care facilities. Annals of Long-Term Care: Clinical Care and Aging, 20(8), Retrieved September 7, Free registration required. There s a monster under my bed : Hearing aids and dementia in long-term care settings This report details the challenges faced by nursing homes in managing patients with dual disabilities of cognition and sensory impairments. It explains this through a case study of a blind and severely hearing-impaired elderly woman with Alzheimer s disease who became agitated, confused and reported being assaulted. Investigations revealed that her hearing aid was not functioning properly. Once this issue was addressed, there were no further episodes of agitation and confusion. It highlights the point that sensory deprivation could lead to agitation in patients with dementia. The barriers to appropriate care for LTC residents with hearing aids were also addressed. Haque, R., Abdelrehman, N. & Alavi, Z. (2012, August 16). 'There's a monster under my bed': Hearing aids and dementia in long-term care settings. Annals of Long-Term Care: Clinical Care and Aging, 20(8), Retrieved September 7, Free registration required. Page 12 of 15

13 Undetected sight loss in care homes: An evidence review This report provides a comprehensive review of the current approach to eye care in care homes in the United Kingdom. It examines the key issues and barriers to good eye health, and proposes solutions for relevant parties and within policy frameworks for sight testing in care homes. Key recommendations include: Incorporating eye health indicators into the assessment criteria for care homes; encouraging care home providers to add eye health and sight loss testing to their key performance indicators; and training care home staff and managers in issues of sight loss and eye health. Watson, J. and Bamford, S.-M. (2012, July 9). Undetected sight loss in care homes: an evidence review. International Longevity Centre UK. Retrieved September 7, Search for the full-text article at ilcuk.org.uk Updated in October 2012 Effects of circuit training as alternative to usual physiotherapy after stroke: Randomised controlled trial This study analyses the effect of task-oriented circuit training compared with usual physiotherapy in terms of self-reported walking competency for patients with stroke discharged from a rehabilitation centre to their own home. It undertook a randomised controlled trial with follow-up to 24 weeks. The setting was a multicentre trial in nine outpatient rehabilitation centres in the Netherlands and the participants were patients with stroke who were able to walk a minimum of 10 minutes without physical assistance and were discharged from inpatient rehabilitation to an outpatient rehabilitation clinic. The study found that taskoriented circuit training could safely replace usual physiotherapy for patients with stroke who were discharged from inpatient rehabilitation to the community and need further training in gait and gait-related activities as outpatients. Port, I.G.L., Wevers, L.E.G., Lindeman, E., & Kwakkel, G. (2012, May 10). Effects of circuit training as alternative to usual physiotherapy after stroke: Randomised controlled trial. BMJ. Retrieved June 25, Search for the full-text article at bmj.com Enhancing physical activity in older adults receiving hospital based rehabilitation: A phase II feasibility study Low activity levels and poor mobility outcomes are found in older adults receiving inpatient rehabilitation. Increased physical activity may improve their mobility. This study evaluates the feasibility of a randomised controlled trial (RCT) of enhanced physical activity in older adults receiving rehabilitation. To determine the most appropriate measure of mobility, three measures were trialled: the Timed Up and Go; the Elderly Mobility Scale; and the de Morton Mobility Index. The study showed that the de Morton Mobility Index was most feasible. In addition the study found that a larger multi-centre RCT to establish whether this intervention is cost effective and improves mobility was warranted. Said, C. M., Morris, M.E., Woodward, M., Churilov, L., & Bernhardt, J. (2012, June 8). Enhancing physical activity in older adults receiving hospital based rehabilitation: A phase II feasibility study. BMC s. Retrieved June 25, Page 13 of 15

14 Effects of comprehensive geriatric assessment and targeted intervention on mobility in persons aged 75 years and over: A randomised controlled trial The effect of a comprehensive geriatric assessment and individually tailored intervention on mobility in older people is assessed in this study. It also explores the effectiveness of geriatric interventions among a subgroup of persons with musculoskeletal pain. Seven hundred and eighty-one Finnish persons aged years were assigned to an intervention or control group of a three-year geriatric development project. The result found that the comprehensive geriatric assessment and individually tailored multifactorial intervention had a positive effect on mobility, underlining their importance in health promotion and disability prevention in older people. Lihavainen, K., Sipila, S., Rantanen, T., & Kauppinen, M. (2012, April). Effects of comprehensive geriatric assessment and targeted intervention on mobility in persons aged 75 years and over: A randomised controlled trial. Clinical. Retrieved June 25, Search for the full text article via National Library Board s digital library - eresources.nlb.gov.sg Register (free) / Login / Browse By A-Z / Select P / ProQuest Central database / Search article using keyword search. Updated in August 2012 Community Care Dietitian Project: Nutritional care improves client outcomes and reduces hospital admissions This article highlights the Community Care Dietitian Project that was carried out in Okanagan (Penticton, Kelowna and Vernon), Canada. This project was implemented as it was observed that a high number of patients discharged from hospital were malnourished and could not support a nutrition plan at home. It aimed to support the nutritional requirements of people pre and post surgery to reduce acute hospital stays and promote the health of the elderly population. The use of the Mini Nutritional Assessment to map the patients current nutritional status and close work with community partners and home care providers saw a sharp reduction in hospital admissions from 32 percent to three percent when the project was implemented. Canadian Home Care Association. (2010). Community Care Dietitian Project: Nutritional care improves client outcomes and reduces hospital admissions. High Impact Practices. Retrieved April 7, Search for the full text article at cdnhomecare.ca Comparison of people with ABI living in two accommodation settings: Shared supported accommodation and residential aged care This study compares the care provided to people with severe acquired brain injury (ABI) in shared supported accommodation services (SSA) and residential aged care (RAC) in Victoria, Australia. It lists the characteristics of SSA, its support needs and the level of community inclusion of ABI individuals. This is then compared with RAC s characteristics, support needs, social contact, community integration and leisure participation. The findings revealed that the person s experience with regards to community participation was significantly impacted based on the kind of accommodation they were enrolled in. SSA enabled the individuals to participate in more community-based leisure activities and visit friends more often compared to the RAC setup. Winkler, D., Farnworth, L., Sloan, S., Brown, T. & Callaway, L. (2010, December). Comparison of people with ABI living in two Page 14 of 15

15 accommodation settings: Shared supported accommodation and residential aged care. Brain Impairment, 11(3): Retrieved April 7, 2011.Search for the full text article at atypon-link.com How can we improve targeting of frail elderly patients to a geriatric day-hospital rehabilitation programme? This paper provides a retrospective cohort analysis over a period of five years of patients admitted to the Day Hospital (GDH) programmes in Montreal, Canada. It aims to identify potential predictors of rehabilitation outcome for the elderly patients. The patients were measured using various measurement tools such as Barthel Index, Older American Resources and Services, Folstein Mini Mental Status Exam, Timed Up & Go, Grip Strength, and European Quality of Life 5 Dimensions. The findings revealed that the GDH rehabilitation programme was effective when it came to improving the patient s physical performance. Pereira, S., Chiu, W., Turner, A., Chevalier, S., Joseph, L., Huang, A.R. & Morais, J. A. (2010). How can we improve targeting of frail elderly patients to a geriatric day-hospital rehabilitation programme? BMC s. Retrieved April 7, Search for the full text article at biomedcentral.com Parkinson s safety net This article reflects the growing importance of physiotherapy in helping Parkinson s patients in the Netherlands and the various physiotherapy initiatives that are developed in the country. In 2002 the Parkinson s Center Nijmegn was set up and a select group of physiotherapists, speech therapists and occupational therapists were trained in Parkinson care. ParkinsonNet enabled the therapists to see many more Parkinson patients, learn from them and fine tune their skills. It also created a network of professionals who could consult with each other. Fysio Online was started by Zorggroep Almere. It provides patients with information on physiotherapy via their website. The first physiotherapy treatment guidelines for cervical dystonia are currently being drawn up by physiotherapists and clinicians at the Amsterdam and Nijmegen Academic Medical Centers. Tony Sheldon. (2011, March 16). Parkinson s safety net. Chartered Society of Physiotherapy. Retrieved April 7, Search for the full text article at csp.org.uk Page 15 of 15

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