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Tytuł:
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Recommendations for Medical and Mental Health Care in Assisted Living Based on an Expert Delphi Consensus Panel: A Consensus Statement.
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Autorzy:
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Zimmerman S; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill.; School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill.; Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill.
Sloane PD; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill.; Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill.
Wretman CJ; Wretman Research, LLC, Hillsborough.
Cao K; School of Medicine, University of Illinois Chicago, Chicago.
Silbersack J; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill.
Carder P; Portland State University, Portland, Oregon.
Thomas KS; Brown University, Providence, Rhode Island.
Allen J; Allen Flores Consulting Group, Searcy, Arkansas.
Butrum K; Silverado, Irvine, California.
Chicotel T; California Advocates for Nursing Home Reform, Berkeley.
Giorgio P; Evergreen Estates, Clarkston, Washington.
Hernandez M; Hearth & Truss, Wilsonville, Oregon.
Kales H; Department of Psychiatry, University of Michigan, Ann Arbor.
Katz P; Department of Geriatrics, College of Medicine, Florida State University, Tallahassee.
Klinger JH; Brookdale Senior Living, Brentwood, Tennessee.
Kunze M; American Assisted Living Nurses Association, Belmar, New Jersey.
Laxton C; Society for Post-Acute and Long-Term Care Medicine, Columbia, Maryland.
McNealley V; Washington Health Care Association, Tumwater.
Meeks S; Department of Psychological & Brain Sciences, University of Louisville, Louisville, Kentucky.
O'Neil K; ALG Senior, Hickory, North Carolina.
Pace D; Alzheimer's Association, Chicago, Illinois.
Resnick B; University of Maryland School of Nursing, Baltimore.
Schwartz L; Workforce & Quality Innovations, LLC, Bear Creek, North Carolina.
Seitz D; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
Smetanka L; National Consumer Voice for Quality Long-Term Care, Washington, DC.
Van Haitsma K; College of Nursing, The Pennsylvania State University, University Park.
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Źródło:
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JAMA network open [JAMA Netw Open] 2022 Sep 01; Vol. 5 (9), pp. e2233872. Date of Electronic Publication: 2022 Sep 01.
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Typ publikacji:
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Journal Article; Research Support, N.I.H., Extramural
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Język:
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English
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Imprint Name(s):
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Original Publication: Chicago, IL : American Medical Association, [2018]-
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MeSH Terms:
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Consensus*
Dementia*/therapy
Aged ; Delphi Technique ; Humans ; United States
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References:
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Grant Information:
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R01 AG050602 United States AG NIA NIH HHS; T35 AG038047 United States AG NIA NIH HHS
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Entry Date(s):
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Date Created: 20220929 Date Completed: 20221003 Latest Revision: 20230718
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Update Code:
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20240105
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PubMed Central ID:
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PMC10350914
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DOI:
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10.1001/jamanetworkopen.2022.33872
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PMID:
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36173637
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Importance: Assisted living (AL) is the largest provider of residential long-term care in the US, and the morbidity of AL residents has been rising. However, AL is not a health care setting, and concern has been growing about residents' medical and mental health needs. No guidance exists to inform this care.
Objective: To identify consensus recommendations for medical and mental health care in AL and determine whether they are pragmatic.
Evidence Review: A Delphi consensus statement study was conducted in 2021; as a separate effort, the extent to which the recommendations are reflected in practice was examined in data obtained from 2016 to 2021 (prepandemic). In the separate effort, data were from a 7-state study (Arkansas, Louisiana, New Jersey, New York, Oklahoma, Pennsylvania, Texas). The 19 Delphi panelists constituted nationally recognized experts in medical, nursing, and mental health needs of and care for older adults; dementia care; and AL and long-term care management, advocacy, regulation, and education. One invitee was unavailable and nominated an alternate. The primary outcome was identification of recommended practices based on consensus ratings of importance. Panelists rated 183 items regarding importance to care quality and feasibility.
Findings: Consensus identified 43 recommendations in the areas of staff and staff training, nursing and related services, resident assessment and care planning, policies and practices, and medical and mental health clinicians and care. To determine the pragmatism of the recommendations, their prevalence was examined in the 7-state study and found that most were in practice. The items reflected the tenets of AL, the role of AL in providing dementia care, the need for pragmatism due to the diversity of AL, and workforce needs.
Conclusions and Relevance: In this consensus statement, 43 recommendations important to medical and mental health care in AL were delineated that are highly pragmatic as a guide for practice and policy.
Comment in: JAMA Netw Open. 2022 Sep 1;5(9):e2233877. (PMID: 36173635)
