The CaseA 78-year-old woman with congestive heart failure was admitted to a skilled nursing facility following a 3-day acute care hospital stay for the condition. She had been hospitalized for heart failure three times in the previous 9 months. Each time, she was discharged directly home from the hospital.

Three days after nursing facility admission, she... »

The Case

An 87-year-old woman with Alzheimer’s disease, visual impairment, and hearing loss hit a facility caregiver while the person was attempting to change the patient’s clothing during her morning routine. Nursing staff responded by administering 1 milligram of injectable lorazepam, as the patient would not take the medication orally.

Subsequently,... »

The Case

A 74-year-old woman with moderately severe Alzheimer’s disease was admitted to a skilled nursing facility for long-term care. She had been cared for at home by her husband for 4 years until he was hospitalized for a heart attack and upon going home was suddenly unable to continue that role despite his intention to do so.

Over subsequent months,... »

Case One

An 82-year-old physician is admitted to a skilled nursing facility following a 30-day hospitalization for trauma resulting from a fall from a ladder outside his home. Hospitalization was complicated by deep venous thrombosis, catheter-associated urinary tract infection, nosocomial pneumonia with respiratory failure requiring mechanical... »

The Case

An 87-year-old, female nursing facility resident was awakened in the morning by a nursing assistant who informed her it was time to get dressed. With mild dementia, a history of stroke, left-side weakness, osteoarthritis, and urinary incontinence, the resident required assistance with all activities of daily living.

The nursing assistant had... »

The Case

An 86-year-old woman with Alzheimer’s disease was involuntar­ily discharged from a nursing home for wandering, agitation, and fight­ing. These undesirable behaviors persisted despite medication man­agement by a consulting psychia­trist throughout her 6-month stay. She received escalating doses of quetiapine (475 mg/24 hours) and ven­lafaxine (225... »

Case

A 74-year-old man was admitted to a skilled nursing facility at 5:15 p.m. on a Friday afternoon, coming from a 17-day hospitalization for chest pain.

This was the third time in 3 months he had come to the skilled nursing facility from the hospital, so staff knew he had diabetes, chronic heart and lung disease, corticosteroid-dependent asthma,... »