Long-Term Care Survey Alert

Published on Fri Apr 13, 2007 PDF

Check out AMDA's new decision-making guidelines.

Facilities will now have an easier time deciding on preventive care options for their elderly residents.

The American Medical Directors Association has released a new clinical practice guideline: Health Maintenance in the Long-Term Care Setting. The guideline "focuses on primary prevention ... to the extent that it is feasible and beneficial in the frail, elderly long-term care population," says Jackie Vance, RN, director of clinical affairs for AMDA.

It's an excellent tool for dealing with a frail population in terms of deciding what to do about screening, says certified medical director Matthew Wayne, MD, who helped review the practice guidelines.

Preventive medicine has four major components, says Vance:

• Vaccinations to prevent some infectious diseases.

• Screening to detect conditions such as high blood pressure, diabetes, and cancer. • Medication (e.g., cholesterol-lowering drugs to prevent atherosclerosis, aspirin to prevent heart attacks or strokes, antihypertensive drugs to reduce blood pressure and prevent strokes).

• Counseling aimed at helping people make healthy lifestyle choices and to understand the health choices they face and the realistic clinical courses available to them.

Nursing facilities might expect to reap these outcomes by implementing the guideline:

1.  Reduce the number of patients who receive inappropriate procedures and care, Vance tells Eli.
2.  Promote "patient-centered goals" that meet the patient's needs and wishes, says Vance.
3 . Residents' families or advocates will also have more "appropriate expectations" about the resident's care goals, adds Vance.