Resolving to Optimize Resident Care

Happy New Year! We hope you had a joyous holiday season. As we all know, January is the month of resolutions, the most popular of which is losing weight and getting into shape. While people generally start out strong, leading to packed gyms, refrigerators stocked with more healthy fare, and mailboxes stuffed with fitness magazines, the interest is unfortunately lost in many cases and the resolution is never fully realized. As long-term care (LTC) providers, we witness every day the importance of good health. Whether or not this drives us to achieve our own health goals, it is important for us to resolve to do everything in our power to ensure the health of our residents. In this issue of Annals of Long-Term Care (ALTC), you will find several articles that provide strategies for optimizing the care of residents, including those with dementia, a terminal illness.

Being flu season, January is a good time to examine the issue of vaccination, whether for influenza or other illnesses. In “To the Point: Meeting Vaccination Quality Measures for Older Adults”, Dr. Stefanacci notes that three of the Centers for Medicare & Medicaid Services’ quality measures can be satisfied simply by focusing on vaccines; however, Medicare’s coverage provisions can be confusing, making it difficult to determine patients’ eligibility for various vaccinations. In the article, Dr. Stefanacci reviews the recommended adult immunization schedule and discusses how coverage for preventive vaccines works under various Medicare plans.

It is well known that elders are often deficient in vitamins and minerals, which can increase their risk of developing various health conditions and decrease their ability to heal when they sustain an injury. In “Rational for Zinc Supplementation in Older Adults With Wounds” Dr. Sallit, a clinical advisor to the American Association for Long Term Care Nursing, discusses the prevalence and risk factors for zinc deficiency in older adults, how to assess for zinc status, and the role of zinc in wound healing. She urges clinicians to consider zinc deficiency in residents whose wounds are not healing normally. Because the use of zinc supplements at moderate doses (15-30 mg daily) has few, if any, side effects, Sallit notes that zinc supplementation may be warranted in these patients.

We also feature two articles that examine palliative care as an option for patients with dementia: “Palliative Care Practice for Advanced Dementia: Regulatory Friend or Foe” and “Dementia and Palliative Care”. Even in LTC settings, knowing when to implement palliative care measures can be challenging, and clinicians may be concerned that use of palliative strategies over restorative or curative therapies, even if futile, can compromise regulatory compliance. Collectively, these articles demonstrate how adopting a palliative care approach to manage end-of-life care issues in patients with a terminal illness, such as dementia, can help prevent unnecessary suffering while also supporting the intent of LTC regulations.

We hope you enjoy this issue of ALTC. If you would like to contribute an article to the journal, please view our author guidelines. We are always happy to receive your submissions.

Thank you for reading!