Considering the Possibilities
Healthcare providers spend a great deal of time considering possibilities, whether to make a diagnosis, determine a treatment plan, identify strategies to enhance patient comfort, as well as for a host of other professional and personal issues, such as how to meet continuing medical education (CME) or continuing education (CE) requirements, how to balance family and work life, whether to make a career change, and the list goes on. This issue of Annals of Long-Term Care: Clinical Care and Aging (ALTC) includes three articles that tackle distinct issues in long-term care that may require healthcare professionals to consider various possibilities.
In “The Effects of Electroconvulsive Therapy on Neurocognitive Function in Elderly Adults,” the authors provide a comprehensive review of the literature regarding the neurocognitive effects of electroconvulsive therapy (ECT) as a treatment for severe major depressive disorder in elderly adults. Although many psychiatrists and other healthcare professionals consider ECT to be a safe and effective procedure, especially now that technical advances in the delivery of this treatment have improved its adverse effects profile, the use of ECT remains controversial. Patients and their families may be reluctant to try it and clinicians may be reluctant to recommend it, especially because of the recent recommendation by the U.S. Food and Drug Administration’s advisory panel to maintain the Class III designation for ECT devices, placing them in the category that has the greatest potential to cause harm. However, ECT may be a viable treatment for some patients, including those with late-life depression, a condition that has been associated with poor quality of life, impaired cognitive abilities, and an increased health burden andmortality risk; thus, when usual treatments fail, clinicians should consider all other options, including ECT.
In “Acute Pancreatitis From Gastrostomy Tube Migration in a Nursing Home Resident,” a rare case of a gastrostomy tube (G-tube) migration resulting in acute pancreatitis in a young nursing home resident is presented. While the authors note that this complication is rare, with a literature review yielding fewer than 10 cases, it is possible that such complications are more common than we may think, as many cases may go unreported. This article demonstrates the importance of both properly securing feeding tubes as well as considering the possibility of tube migration in the differential diagnosis of individuals with G-tubes who present with gastrointestinal symptoms. Whereas the two aforementioned articles provide examples of medical dilemmas requiring consideration of various therapeutic or diagnostic options, there are some cases where healthcare providers should not have to contemplate possibilities, such as whether a patient’s prescription indicates that the medication should be taken QD (once daily) or QID (4 times daily).
In “Medical Terms and Abbreviations Commonly Used in Long-Term Care Settings,” the author outlines and defines terms and abbreviations that are routinely used by individuals working in long-term care and urges everyone working in this setting to avoid using abbreviations that may be misunderstood. Clearly written orders and clinical notes by all team members can prevent miscommunication, ensuring patient safety. This month, we are delighted to announce a new partnership that we have forged with the American Association for Long Term Care Nurses, which we hope will make ALTC an even more valuable resource to long-term care nurses. For more on our partnership with the AALTCN, read our LTC Bulletin Board article.
Be sure to visit our Website at www.managedhealthcareconnect.com/home/altc to vote in this month’s poll, which asks “Is elder abuse a problem in long-term care facilities?,” or send your thoughts on this issue to Christina Loguidice, editorial director, at cloguidice@hmpcommunications.com. Responses may be published in an upcoming issue of ALTC. We hope you enjoy this month’s issue. Thank you for reading!
