Wound Care: What About Larval Therapy?
Myiasis is the medical term for infestation with the larvae of a fly, also known as maggots. The image of maggots in modern society is the exact opposite of health and cleanliness. Indeed, unintended myiasis in a healthcare facility is a frequent precursor of a...
Shakespeare, the Diversity of Aging, and the Need for Geriatrics
The plays of William Shakespeare written in the sixteenth century reflected the culture and opinions of his time. In Shakespeare’s day, life expectancy was in the 30’s, and Shakespeare himself lived to the old age of 52. In contrast to today’s population, very few...
New Pocket Guide to Pressure Ulcers
A new wound guide written specifically for clinicians has just been released. The complete title is "Pocket Guide to Pressure Ulcers: How to Classify, Stage, and Document Pressure Ulcers and Other Common Wounds." Written by me and Elizabeth Ayello RN, PhD,...
Parsley, My Geriatric Dog
My medical specialty is taking care of elderly people, but lately I’ve become attuned to problems taking care of an elderly dog. Parsley, my 18 pound Norfolk Terrier, is now fourteen human years, or 98 dog years old. He’s had his share of medical problems including...
Peripheral Arterial Disease is Underdiagnosed in the Elderly
When ulcers of the lower extremity develop, it is important to find out why. Many ulcers develop over boney prominences which are subjected to pressure, and are therefore labeled as pressure ulcers. However, one common etiology of lower extremity wounds is frequently...
Retooling for an Aging America: The Thud that Should Have Been a Bang
In April 2008 a report entitled Retooling for an Aging America: Building the Health Care Workforce was released. This study was commissioned by the Institute of Medicine (IOM) and put together by the Committee on the Future Health Care Workforce for Older Americans...
Nursing Home Care in Australia
I recently spoke on geriatrics, humanistic medicine, and art at The International Arts and Health Conference in Port Macquarie, Australia. Because I spent so much of my medical career in long-term care, I sought out the opportunity to visit a nursing home to speak...
Ageism, the New York Times, and Geriatric Medicine
After reading an article entitled “The Geezers’ Crusade” by columnist David Brooks in the Op-Ed pages of the New York Times last week I felt compelled to comment on it. The article begins on an encouraging note, pointing out how society’s views of human aging are...
Falls, Aging, and the Bible
Falls are a major problem in geriatric patients. As persons age, falls and their consequences become increasingly more serious. According to the American Geriatrics Society, for those over age 65 and over, 35 to 40% of community dwelling persons fall annually. As...
Skin Surveillance Under Medical Devices is a MUST
Most educational materials on pressure ulcer prevention tell you that the most common areas for pressure ulcers are under boney prominences such as the sacrum, ischium, and heels. However, an area that is frequently under-emphasized in pressure ulcer prevention...
Pressure Ulcer Regulations in the Nursing Home: Introduction to Revised F-Tag 314
Care delivered in nursing homes is highly regulated, particularly for pressure ulcers. Whatever your opinion of government regulation, laws governing nursing homes undoubtedly provide added protection for these vulnerable adults across America. This post will...
How CMS Views Pressure Ulcers in Hospitals
Since October 1, 2008 the Centers for Medicare and Medicaid Services (CMS) classified pressure ulcers as a preventable Hospital-Acquired Condition (HAC) that will no longer be reimbursed by current insurance guidelines. In order to understand how this works, I first...