October 11, 2023
In the latest edition of JAMDA On-The-Go, Host Karl Steinberg, MD, HMCD, CMD, and his guests focused on three articles that detail programs, concepts, and research that can empower residents and staff and improve outcomes and quality of life.
First up was Monique Martin-Parent, MN, BN, RN, GNC, talking about her article, Promoting Resident Autonomy to Maintain Quality of Life. She said, “During the pandemic, I saw the impact quarantines and restrictions had on resident well-being.” She noted that she also saw it firsthand with her own father, who was isolated for several months. When she finally was able to see him, she was “shocked” about the effect it had on him. This inspired her to explore the issue of restrictions and autonomy further.
In her article, she said that “the rights of continuing care residents were stripped away when they were not given the opportunity to make informed decisions regarding their care and day-to-day life. Governments and health-care organizations denied them the dignity to experience the positive outcomes that result from risk-taking based on their personal values and preferences.”
Ms. Martin-Parent noted that “this wasn’t a typical research study, and some people may find the topic controversial.” She explained that she has received feedback from facilities and others highlighting the challenges they faced in balancing patient safety and autonomy during the pandemic. Clearly, she said, this issue requires more research on the ethical implications of creating and maintaining this balance in a healthy, constructive way.
In the meantime, Ms. Martin-Parent stressed the importance of transparency and communication. For instance, she said, “In Canada, we are seeing some individuals who view restrictions and precautions as necessary, while some are against these. We need to work on better messaging and support for those who lack trust in the system.”
Next, Marie-Lee Yous, PhD, discussed her article, Feasibility and Effects of Namaste Care for Persons with Advanced Dementia in Canadian Long-Term Care Homes. In the study, caregiving staff delivered Namaste care to residents with the support of volunteers. This included activities involving efforts such as aromatherapy, music, and snacks/beverages. Dr. Yous and her team found that Namaste care showed promising evidence of impact, even though all targets weren’t met. For instance, she said, “Namaste care addresses social isolation and quality of life.”
One challenge, Dr. Yous noted, is the staff time necessary to provide this care. However, in the study, they saw results with twice weekly interventions in a group format. It also is possible to involve family members, she said.
Finally, JAMDA Co-Editor-in-Chief Paul Katz, MD, CMD, discussed Acute Antipsychotic Use and Presence of Dysphagia Among Older Veterans with Heart Failure. This study, Dr. Katz indicated, demonstrates that introducing any antipsychotic during a hospital stay may be associated with dysphagia. Specifically, the study showed that antipsychotic medication exposure was associated with increased dysphagia coding and MDS assessment. “We all know swallowing function is critical to hydration, nutrition, and medical management of heart failure, so avoiding dysphagia is important to preventing complications,” he said.