The Continuous Effort to Improve Quality of Life

This issue of Annals of Long-Term Care: Clinical Care and Aging^® (ALTC)   provides examples of different pathways long-term care (LTC) clinicians are taking to ensure the well-being of their patients. Although this issue covers multiple disease states and topics, there is one underlying theme that strings the May issue together—the striving to improve quality of life for older adults.

Music is an important source of pleasure for many older adults. This remains true for adults with Alzheimer’s disease (AD). On page 10, Amy Clements-Cortes, PhD, MTA, MT-BC, FAMI, and Lee Bartel, PhD, review the effects of sound stimulation on AD patients. This nonpharmacological supplemental treatment option provides AD patients with cognitive, communication, emotional, physical, and social benefits. The authors review how music affects emotional responses, the role music plays in the cognitive process, and the importance of rhythmic stimulation of the auditory system. 

The authors suggest ways to integrate music therapy into the lives of patients with AD. Background music and recreational music, such as a concert or a group sing-along, are practical ways to incorporate music. They also examine key considerations when starting a music therapy program including cost, resources, and environmental factors.  

The next article, on page 23, addresses the difficulty of assessing the risk of pressure ulcers in LTC patients. Although the Braden Scale has become the standard route for determining pressure ulcer risk, it may not be the most efficient as the results may change depending on who is administering the test. Ilene Warner-Maron, PhD, RN-BC, CWCN, CALA, NHA, FCPP, reviews studies that demonstrate the validity and limitations of using the Braden Scale during admission of a patient, during routine check-ups, and at end of life. 

Dr. Warner-Maron shares questions all healthcare providers should ask when assessing a patient’s risk for pressure ulcers to ensure an accurate risk assessment score. She also emphasizes the essential need for adequate support and resources to ensure that patients are properly assessed and managed to maximize quality of life.

Many end-stage renal disease (ESRD) patients in skilled nursing facilities receive hemodialysis (HD), the most common form of renal replacement therapy. HD is typically an off-site and time-consuming process, which causes patients to miss rehabilitation and therapeutic activities. Zachary J. Palace, MD, CMD, FACP, and Roxana Bologa, MD, describe an alternative that utilizes peritoneal dialysis (PD) in place of HD on page 28. 

PD offers patients more freedom as it can be done at the skilled nursing facility while the patient is sleeping, avoiding interference with rehabilitation and therapeutic activities. Dr. Palace and Dr. Bologa worked together to develop an in-house PD program at the Hebrew Home at Riverdale in New York City. The researchers stress that if more healthcare providers shared their experiences and initiated collaboration, LTC could be more efficient, and quality of life could improve for LTC patients.  

This issue also features Part 1 of an Ask the Expert, in which epilepsy management is explored. On page 31, Robert T. Wechsler, MD, PhD, FAAN, shares his expertise on treatment approaches  including pharmacological, nonpharmacological, and surgical options. Dr. Wechsler also speaks to current challenges in treating epilepsy in older adults. 

The Anticoagulation Road Map series continues in the May issue, touching on deep venous thrombosis (DVT) prophylaxis. DVT most often occurs in adults over 60 years of age. Anticoagulation therapy is key to preventing DVT prophylaxis. This Road Map reviews the current treatment options for older adults with DVT prophylaxis. 

We hope the articles in this month’s issue of ALTC prove to be a resource and inspiration for continually improving quality of life in LTC patients.