Deprescription and the prevention of hospitalization should be priorities, rather than aggressive management, a family physician advised.
VANCOUVER, British Columbia — Conditions like diabetes and dementia are common in patients who are admitted to long-term care facilities, but aggressive management of these conditions in long-term care residents is not recommended, according to a presentation given at theare risky for patients with diabetes who are residents of long-term care facilities, particularly those aged 75 years or older, said Adam Gurau, MD, a family physician in Toronto.
“It is important to keep in mind that our residents in long-term care are at increasing risk for hypoglycemia, and we really should try to reduce and not use dangerous medications or potentially dangerous diabetes management,” said Gurau.that examined the composite risk for emergency department visits, hospitalizations, or death within 30 days of reaching intensive glycemic control with high-risk agents with three or more chronic conditions who had been prescribed at least five medications.
About 62% of seniors living in a residential care home have a diagnosis of Alzheimer’s disease or another dementia, according to the Alzheimer Society of Canada. Evidence suggests that“We want to focus on nonpharmacologic approaches for many of these residents,” said Gurau. “We have to do as much as we can to exhaust all the nonpharmacologic approaches.”Another challenge to tackle in long-term care is the unnecessary transfer of residents to hospital emergency departments, according to Gurau.
Urinary tract infections accounted for 30% of hospital emergency department visits for potentially preventable conditions by older patients who are residents in long-term care, according to 2013-2014 data from the
Diabetes Mellitus Type Ii Type 2 Diabetes Type 2 DM T2DM T2D Long-Term Care LTC - Long-Term Care Alzheimer's Disease Alzheimer Disease Dementia Residency Residents Canada Canadian Hospitals Geriatrics Elder Care Geriatric Medicine Older Adults Seniors Senior Citizens Elderly Hypoglycemia Nonpharmacologic Elderly/Concerns Of Older Adults Elderly Agitation
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