After his admission to the nursing facility, it is discovered that Mr. C ("Jimmy") had been incarcerated for a number of assaults, has a history of substance abuse, and is a registered sex-offender. He is 74 years old, exhibits signs of moderate dementia, and is limited to a wheelchair following a stroke. He is impulsive and prone to angry... »

I am amazed at how many times, before I first meet a patient, I am warned by a member of my staff that the new patient is as nice as could be, but "watch out for the family." I guess I shouldn’t be surprised that we often encounter "difficult" families, as even seemingly perfect ones can behave or think differently when under stress or... »

Research on the aging brain consistently highlights the importance of education to life expectancy and quality. Research indicates that Alzheimer's disease and other dementias occur less often and later in people who have more education.

As a recreation therapist, social worker, and adult-education instructor, I have always been interested in the effects... »

Humor—telling or hearing jokes, reading a comic, or watching a funny movie or the antics of children—has long had the popular reputation of being good for your health. Norman Cousin's book “Anatomy of an Illness as Perceived by the Patient: Reflections on Healing and Regeneration” (New York: Norton, 1979) on how humor helped him decrease his pain and... »

The care of nursing facility residents over the past decade has become increasingly challenging. Paralleling the complexity that we see in our patients is the increased documentation requirements to satisfy the insurers that pay us for our services. Our documentation must stand up to the test, or we risk being denied reimbursement or facing fraud... »

It started with the usual blasé feeling and the body aches. This was followed within the hour by diminished energy and slowing of my ability to think and reason—and an overwhelming desire to nap. I knew I had been exposed to a patient with pandemic A(H1N1) infection, and it was clear to me that I had contracted “swine” flu.I... »

No one can dispute the growing acceptance of assisted living as an option for long-term care residents. Is it time for physicians to become more attentive to the needs of AL residents? Sheryl Zimmerman, PhD, and her colleagues have evidence that it is. Dr. Zimmerman, a researcher at the University of North Carolina at Chapel Hill, noted that the dependence... »