Published online ahead of print March 3, 2014.
February 27-March 2, 2014
During the AMDA Long Term Care Medicine – 2014 meeting, the House of Delegates voted to change the organization’s name to AMDA – The Society for Post-Acute and Long-Term Care Medicine. The House of Delegates also voted to expand full membership to nurse practitioners (NPs) and physician’s assistants (PAs).
AMDA’s name change reflects the increasing prominence of post-acute care in the long-term care continuum, and the longstanding presence of attending physicians and other practitioners in AMDA’s membership in addition to medical directors. NPs and PAs will now be able to participate fully in the life of the organization, to serve on and chair national committees, and to participate in state chapters according to the conditions and requirements that each chapter chooses to establish, including being delegates to the AMDA House of Delegates. Six of AMDA’s national officers will remain physicians; however one of the three House of Delegates representatives on the Board, and one of the three State Presidents Council representatives on the Board may be a nonphysician at any one time.
In an AMDA press release, president Leonard Gelman, MD, CMD, commented, “These changes to AMDA’s bylaws directly relate to what’s happening on the ground in post-acute and long-term care facilities. All medical providers need to be properly trained and supported, including the medical directors, the attending physicians, the nurse practitioners, and the physician’s assistants, in order to provide the highest quality care. AMDA will serve as the professional home for this team as we work together to improve the quality of care for both our post-acute patients and long-term care residents.”
Heart failure is the leading cause of hospitalization and rehospitalization among nursing home residents. Furthermore, there is a broad variation among facilities regarding heart failure care. During an AMDA session titled “Heart Failure Management in Nursing Homes: What Will it Take for Us Not to Fail?” Arif Nazir, MD, CMD, and William Smucker, MD, CMD, discussed barriers to effective heart failure management and provided strategies to optimize care and reduce hospital readmission.
Pseudobulbar affect (PBA), a distressing condition marked by involuntary episodes of crying or laughing, affects nearly 2 million people with a variety of underlying neurologic conditions. These conditions include Alzheimer’s disease and other dementias, stroke, traumatic brain injury, multiple sclerosis, Parkinson’s disease and amyotrophic lateral sclerosis. PBA significantly impacts the lives of patients and care partners, particularly in the long-term care (LTC) setting.
The Centers for Medicare & Medicaid launched an initiative to decrease inappropriate use of antipsychotic medications and improve behavior of nursing home residents with dementia. Implementing function and behavior focused care (FBFC) is one approach long-term care (LTC) facilities may want to consider for this patient population.
Huntington’s disease (HD) is a relatively rare, neurodegenerative, genetic disorder characterized by motor, psychiatric, and cognitive symptoms. Diagnosis of adult-onset HD is usually made upon the start of chorea (abnormal involuntary movements), affecting about 90% of individuals at some stage of the illness. The average age of becoming symptomatic is 30 to 54 years old.
During an educational session, Thomas Lynch, PharmD, and Thomas Grant, MD, discussed updates in current best practices in anticoagulant and antiplatelet therapy and reviewed the “use, misuse, and pitfalls” of the new agents for clinicians in post-acute/LTC setting.