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We have experienced dysphagia rehabilitation by SpeechLanguage-Hearing Therapists (SLHTs) under nutritional management (nutrition support team, NST) which has been effective for patients' recovery especially in the acute stage. However, available information on the relation among recovery status, rehabilitation by SLHTs, and NST in the acute stage is limited. Hospitals where are not any or are only a few SLHTs, even in some urban areas of Japan still exist. Our aim of this study is to clarify the efficacy of dysphagia rehabilitation under nutritional management in an acute care hospital. The data of 750 patients admitted in a tertiary care hospital provided for this study. They were divided into four groups; SLHT group who were rehabilitated by SLHTs, both SLHT and NST (Abreast) group who were rehabilitated by SLHTs under NST, NST only (NST) group and Nonintervention (NI) group. The patients in SHLT and Abreast groups were older, more demented and with lower scores of FIM on average than the other two groups. 55.4% of SLHT group and 46.7% of Abreast group showed moderate to severe dysarthria. The percentage of tube fed patients was significantly higher in SLHT and Abreast group than others. However their inpatient periods and FIM score improvements did not show significant differences from others. The rate of their secession from tube feeding was significantly higher than others. We concluded that Dysphagia rehabilitation by SLHTs under nutritional management is effective for patients' recovery not only in convalescent stage but also in the acute stage. Medicine, Hebrew Home at Riverdale, Bronx, New York Improving the quality of care to the elderly is a fundamental cornerstone of the practice of geriatric medicine. Reducing the frequency of avoidable hospitalizations is an area of particular focus. Inpatient hospitalizations in the elderly population are often also associated with the development of multiple complications, which, in turn, increase lengths-of-stay. These include hospital-acquired infections, development of new decubiti, physical declines resulting from prolonged immobility, and the untoward effects of acute adjustment reaction from an unfamiliar hospital environment. The development of well-designed interventions in the nursing home can significantly reduce the number of potentially avoidable hospitalizations in this population. "Development of an Outpatient Transfusion Protocol to Reduce Avoidable Hospitalizations" is a quality improvement initiative that was implemented at The Hebrew Home at Riverdale, a skilled nursing facility in Bronx, NY. The objective of this program was to develop a favorable alternative to the hospitalization of postacute and long-term care patients requiring blood transfusion. In our experience, all patients being sent to the hospital for blood transfusion were being admitted as an inpatient, irrespective of the goals of care. This program is being successfully utilized for the patient who is evaluated for anemia at the skilled nursing facility and a clinical decisio...

People with dementia (PWD) are fragile and need aid and care in their daily lives. This scoping review explores the extent to which PWD can be involved in society and their daily lives. Publications were selected according to PRISMA guidelines. We graded the level of participation/involvement in daily life and research using a five-level participation model developed by Shier. A higher grade means a greater ambition to involve PWD in decisions. Of the 11 included studies, three reached level three according to Shier’s model. The studies describe ways of and potentials for participation, capabilities of PWD, caregivers’ opportunities to foster involvement, and cooperation between PWD caregivers and relatives. Caregivers and managers must have the attitude that PWD can be involved in decisions and caregivers need opportunities to actively promote such involvement. Shier’s model can be a tool with which organizations strive to involve PWD.

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This article aims at exploring how community home care of older people is provided and organized at night. In times of welfare decline, organizational changes, and an increasing aged population, questions arise about home care and support for older people. In Sweden, as in many other Western countries, “ageing in place” is a guiding principle in care provision for older people, which put increasing pressure on home care services. Still, nighttime care represents a research gap within health and social care research, nationally and internationally. This telephone interview survey examines 41 operations managers’ perceptions of organization and care provision and how they account for the goals and work of home care at nighttime in a selection of 37 Swedish municipalities. The analysis was inspired by thematic content analysis where three central themes were categorized: organizational context of nighttime care, working conditions, and challenges of nighttime care. Our results reveal that organizational context varied depending on the demography and size of the municipality. The work situation was characterized by constantly unforeseen events to manage. Multiple challenges were identified on societal and political levels, as were limited resources and recruitment problems. In conclusion, our analysis has identified unpredictability as a core feature of nighttime care work. The complexity of the provision of nighttime care was not recognized as important for the municipal organization. To provide high-quality care at night in ordinary housing, there is a need both to focus on organizational aspects and to have sufficient resources and time.