Alzheimer’s Dirty Joke….

Good morning, ProviderNation.

The group formerly known as the American Medical Directors Association (and now known as “AMDA—Dedicated to Long Term Care Medicine”) says it has some thoughts on improving quality. AMDA is teaming up with the ABIM Foundation’s Choosing Wisely campaign and urging docs, patients, and “other health care stakeholders” to rethink tests and “procedures” that AMDA says “may be unnecessary or even cause harm.”

To wit:

  • Keeping feeding tubes out of those suffering from late-stage dementia and instead offering oral assisted feedings;
  • Avoid Sliding Scale Insulin for residents with diabetes in nursing centers;
  • Don’t “obtain a urine culture unless there are clear signs and symptoms that localize to the urinary tract;”
  • Avoid antipsychotic meds “without an assessment for an underlying cause of the behavior;” and
  • Cut down on the use of lipid-lowering meds for patients who have “a limited life expectancy.”

In other news, NPR and the Kaiser Foundation are taking a look at observation stays, the British journal Age and Ageing finds a correlation between stress and falls in elderly men, and some Alzheimer’s researchers wonder if we’re too clean for our own good.

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