by Timothy Gieseke MD, CMD

Our pursuit of sterilizing the urinary tract to prevent serious UTI complications in elderly patients is a concept that no longer stands the test of time.  Multiple studies have shown that asymptomatic bacteriuria is present in 30-50% of older women and that treatment of this condition with antibiotics does not alter the rate of future serious systemic infections.  The traditional argument that a delirious elder has a UTI until proven otherwise typically delays a search for the many other common causes of delirium such as dehydration, new drug, unrecognized pain, etc.  In addition, before a UA is done, you have a huge chance of asymptomatic bacteriuria being misidentified as a symptomatic UTI.  Experts estimate that 25-75% of antibiotics prescribed in nursing homes do not meet clinical guidelines for appropriate prescribing.

On July 13, 2015, the 2015 White House Conference on Aging (WHCOA) took place in Washington D.C. with AMDA President Naushira Pandya, MD, CMD, attending the once-a-decade event. During the conference health care workers, government officials, and advocates discussed various topics from retirement plans to new health care policies including an announcement on a proposal to make major changes to improve the care and safety in long-term care facilities or nursing homes that participate in Medicare and Medicaid programs. Other major goals the administration discussed in tandem with the conference included finding ways to prevent and treat Alzheimer's disease by 2025 and developing a curriculum that health care workers can use to better care for patients with dementia.

Intro by Flora Bessey, PharmD, CGP

You asked and we answered!!!  We have had great success with the ask a question feature of our website. Many of you have reached out asking questions of our editorial staff.  We are happy to say we have kept our promise of trying to answer the question ourselves or referring them to one of our board members or colleagues.  This is one of the great benefits of CALTCM and the Wave...you have a virtual panel of experts at your fingertips.  Take a look at the question/answers as a result of the ASK feature...and keep your questions coming because we love to learn from you as we investigate the answer.

Mary Gessay is a former federal surveyor (Centers for Medicare & Medicaid Services) in nursing homes and hospitals and Captain, retired, US Public Health Service.  Mary combines 11 years of experience with Centers for Medicare & Medicaid Services, quality improvement expertise and coaching to help individuals, care teams and facilities meet performance goals while building strong culture to sustain success.