Ellen Olson

Sequential outbreak of influenza A and B in a nursing home : Efficacy of vaccine and amantadine

OBJECTIVE: To describe the sequential occurrence of influenza A and B in a nursing home, and to determine the efficacy of influenza vaccine and/or amantadine treatment with respect to incidence and sequelae.

Early Experiences of an Ethics Consult Team

I ncreasingly, long-term care institutions are following in the footsteps of their acute care counterparts and forming ethics committees to address the growing number of ethical issues that they face on a daily basis.l! While most parties agree that some mechanism is needed for the resolution of ethical dilemmas in long-term care, some concern has been expressed regarding the use of ethics committees for this purpose. For example, Glasser et aV in their national survey of ethics committees in nursing homes, found a number of attitude barriers toward the formation of such committees in long-term care settings. Among these are the bureaucratic nature of ethics committees, their distance from the clinical situation, and their tendency to diffuse responsibility. Described here is an alternative method of case consultation for ethical dilemmas that addresses some of these issues: the ethics consult team at the Jewish Home and Hospital for Aged in New York City.

MENTAL STATUS GUIDE: FROMAJE for Use With Frail Elders

1. There is no single pathognomonic sign, symptom, or clinical or laboratory test for making the diagnosis of dementia. A key element of the examination must be the inclusion of a mental status evaluation. 2. The FROMAJE--an acronym for Function, Reasoning, Orientation, Memory, Arithmetic, Judgment, and Emotion--Mental Status Guide (FMSG) has the advantage of a clear relationship between the acronym and the characteristics being measured. 3. The FMSG is meant to serve as a guide for the primary care clinician, who may have little experience in formal mental status testing. It is a convenient cognitive screening instrument to detect dementia in the elderly.