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Commentary on: Miller LG, McKinnell JA, Singh RD et al. Decolonization in Nursing Homes to Prevent Infection and Hospitalization. N Engl J Med. 2023 Nov 9;389(19):1766-1777.
Universal decolonisation of nursing home residents can reduce infection-related hospitalisations and overall hospitalisations. This may translate in the long term into potential reduction in healthcare costs of residents in nursing homes.
Nursing homes have a big role in healthcare delivery in the USA, thanks to the dramatic increase in population of older persons. Social interactions, indwelling devices, comorbidities and long stays predispose these residents to infections, particularly from multidrug-resistant organisms (MDRO), which in turn increase hospital admissions and deaths.
This cluster randomised trial
Commentary on: Yeji Hwang, Miranda V. McPhillips, Liming Huang, G. Adriana Perez and Nancy A. Hodgson, Better caregiver mastery is associated with less anxiety in individuals with cognitive impairment, BMC Nursing. 2023; 22:307.
Implications for practice and research Anxiety is one of the common neuropsychiatric symptoms (NPs) in individuals with cognitive impairment. Considering the fluctuating and variable course of NPs in dementia, studies with longer follow-up periods are required to understand the relationship between caregiver mastery and anxiety in patients with dementia. Dementia, an umbrella condition, encompasses various neurogenerative diseases that can cause behavioural problems, movement problems, autonomic dysfunction, gait and balance problems, as well as cognitive impairment. Hence, it is important to develop caregiver skills with different strategies for each type of dementia.
As the population ages, the prevalence of dementia has increased.
Commentary on: Pomeroy ML, Cudjoe TKM, Cuellar AE, et al. Association of social isolation with hospitalization and nursing home entry among community-dwelling older adults. JAMA Int Med. 2023; 183(9): 955–62. https://doi.org/10.1001/jamainternmed.2023.3064
Social isolation is a significant risk factor for nursing home placement for older adults, and public health interventions to improve social connections are urgently needed. Future research should address interventions across the lifespan and for those more vulnerable to isolation and loneliness, testing practical ways to improve social connectiveness.
The quality of our lives is the quality of our relationships. As we approach a challenging time of the year for loneliness and isolation, what do we know about social isolation and healthcare utilisation in older adults? Almost a quarter of community-dwelling older adults experience social isolation.
Commentary on: Roussel M, Teissandier D, Yordanov Y, et al. Overnight stay in the emergency department and mortality in older patients. JAMA Intern Med. 2023 Dec 1;183(12):1378-1385.
Healthcare leaders should place high importance on organisational solutions to prioritise the admission of older patients from emergency departments (EDs) to wards to reduce risks associated with overnight stays. Further evidence is needed to understand if increased risks to older patients in ED also occur at other times and to establish the most effective interventions to mitigate risks.
Crowding and access block in emergency departments (EDs) are pervasive problems of international concern.
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