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Rheumatic Disease in the Nursing Home Patient

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Geriatric Rheumatology
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Abstract

Currently 20,000 nursing homes provide care for nearly two million persons in USA. Today, 69% of people turning 65 years will need some form of long-term care. By 2020, 12 million Americans will need long-term health care for short-term rehabilitation, short-term hospice care, or longer term custodial care. These are typically the ­oldest and sickest geriatric patients and the most vulnerable to geriatric syndromes including polypharmacy, falls, cognitive impairment, and frailty (failure to thrive). Pain and functional impairment related to rheumatic disease are quite common in this population. Assessment of these patients is complicated by cognitive impairment and comorbidities. Pharmacologic management can be challenging, making non-pharmacologic approaches imperative. Interdisciplinary collaboration adds to the therapeutic options and improves function and comfort.

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References

  1. AAHSA. Aging services: the facts. http://www2.aahsa.org/aging_services/default.asp (2008). Accessed 2 Feb 2008.

  2. Guccione AA, Meenan RF, Anderson JJ. Arthritis in nursing home residents. A validation of its prevalence and examination of its impact on institutionalization and functional status. Arthritis Rheum. 1989;32(12):1546–53.

    Article  PubMed  CAS  Google Scholar 

  3. Abell JE, Hootman JM, Helmic CG. Prevalence and impact of arthritis among nursing home residents. Ann Rheum Dis. 2004;63(5):591–4.

    Article  PubMed  CAS  Google Scholar 

  4. NIH. NIH consensus development conference statement: geriatric assessment methods for clinical decision making. J Am Geriatr Soc. 1998;36:342–7.

    Google Scholar 

  5. Dunlap DD, Semanik P, Song J, et al. Risk factors for functional decline in older adults with arthritis. Arthritis Rheum. 2005;52(4):1274–8.

    Article  Google Scholar 

  6. Mathias S, Nayak USL, Isaacs B. Balance in elderly patient, the “get up and go” test. Arch Phys Med Rehabil. 1986;67:387–9.

    PubMed  CAS  Google Scholar 

  7. Tinetti ME. Performance oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986;34:119–26.

    PubMed  CAS  Google Scholar 

  8. McCarberg BH. Rheumatic diseases in the elderly: dealing with rheumatic pain in extended care facilities. Rheum Dis Clin N Am. 2007;33(1):87–108. http://www.mdconsult.com/das/article/body/86217310–2/jorg=journal&source=&sp=1780. Retrieved 22 Jan 2008.

  9. Felson DT, Naimark A, Anderson J, et al. The prevalence of knee osteoarthritis in the elderly: the Framingham osteoarthritis study. Arthritis Rheum. 1987;30:914–8.

    Article  PubMed  CAS  Google Scholar 

  10. Schwab E. Managing arthritis in elderly patients. Arthr Pract. 2005;1(4):14—23. http://www.arthritispractitioner.com/article/4817. Retrieved 21 Apr 2008.

  11. Hadjistavropoulos T, Herr K, Turk D, et al. An interdisciplinary expert consensus statement on assessment of pain in older persons. Clin J Pain. 2007;33:S1–43.

    Google Scholar 

  12. Magaziner J, German P, Zimmerman SI, et al. The prevalence of dementia in a statewide sample of new nursing home admissions aged 65 and older. Gerontologist. 2000;40:663–72.

    Article  PubMed  CAS  Google Scholar 

  13. Black BS, Finucane T, Baker A, et al. Health problems and correlates of pain in nursing home patients with advanced dementia. Alzheimer Dis Assoc Disord. 2006;20(4):283–90.

    Article  PubMed  Google Scholar 

  14. Hurley AC, Volicer L. Evaluation of pain in cognitively impaired individuals (comment). J Am Geriatr Soc. 2001;49(10):1398.

    Article  Google Scholar 

  15. Herr K, Sprah KF, Garand L, et al. Evaluation of the Iowa pain thermometer and other selected pain intensity scales in younger and older adult cohorts using controlled clinical pain: a preliminary study. Pain Med. 2007;8(7):585–600.

    Article  PubMed  Google Scholar 

  16. American geriatrics society clinical practice guidelines: the ­management of chronic pain in older persons. Geriatrics. 1998;53(Suppl 3):S6–7.

    Google Scholar 

  17. American Pain Society. Practice guideline for the management of pain in osteoarthritis, rheumatoid arthritis, and juvenile chronic arthritis (2002). http://www.ampainsoc.org/pub/arthritis.htm. Retrieved 27 Apr 2008.

  18. Rochon P. Drug prescribing for older adults (2008). http://www.utdol.com/online/content/topic.do?topicKey=geri_med/6960&view=print. Retrieved 4 Feb 2008.

  19. Silverstein FE, Faich G, Goldstein JL, et al. Gastrointestinal toxicity with celecoxib vs. nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis: the CLASS study. A randomized controlled trial. Celecoxib Long-term Arthritis Safety Study. JAMA. 2000;284:1247–55.

    Article  PubMed  CAS  Google Scholar 

  20. Cramer GW, Galer BS, Mendelson MA, et al. A drug use evaluation of selected opioid and nonopioid analgesics in the nursing facility setting. J Am Geriatr Soc. 2000;48:398–404.

    PubMed  CAS  Google Scholar 

  21. Fick DM, Cooper JW, Wade WE, et al. Updating the Beers criteria for potentially inappropriate medication use in older adults: results of a US consensus panel of experts. Arch Intern Med. 2003;163(22):2716–24.

    Article  PubMed  Google Scholar 

  22. Minor MA, Sanford MK. The role of physical therapy and physical modalities in pain management. Rheum Dis Clin N Am. 1999;25(1):233–48.

    Article  CAS  Google Scholar 

  23. Gloth M, Matesi M. Physical therapy and exercise in pain management. Clin Geriatr Med. 2001;17(3):525–35.

    Article  PubMed  CAS  Google Scholar 

  24. Fiatarone MA, O’Neil E, Doyle N, et al. Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med. 1994;330(25):1769–75.

    Article  PubMed  CAS  Google Scholar 

  25. NCCAM. Energy medicine: an overview. http://nccam.nih.gov. Retrieved 13 Apr 2008.

  26. Gregory S, Verdouw J. Therapeutic touch: its application for residents in aged care. Aust Nurs J. 2005;12(7):23–5.

    PubMed  Google Scholar 

  27. Therapies Natural Treatments Home Remedies. Alternative therapies – natural treatments – home remedies. http://arthritis.about.com/od/alternativetreatments/Alternative. Retrieved 21 Apr 2008.

  28. NCCAM. Research report: rheumatoid arthritis and complementary and alternative medicine. http://nccam.nih.gov/health/RA/. Retrieved 21 Apr 2008.

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Correspondence to Joanne Sandberg-Cook .

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Sandberg-Cook, J. (2011). Rheumatic Disease in the Nursing Home Patient. In: Nakasato, Y., Yung, R. (eds) Geriatric Rheumatology. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-5792-4_8

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  • DOI: https://doi.org/10.1007/978-1-4419-5792-4_8

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  • Online ISBN: 978-1-4419-5792-4

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