by Tim Gieseke, MD, CMD 

Last November, the long-awaited guidelines for reducing the risk of atherosclerotic events through optimal lipid management were released (see link below).  With the advent of multiple generic statin drugs and with the evidence for their efficacy for reducing events when given in high dose (>50% reduction in LDL) or moderate dose (30-50% LDL reduction), the new guidelines emphasize who should be treated with statins and dividing patients into 4 statin-responsive classes of patients, and then a 5th class of discretionary situations.  With these guidelines, the key issues are identifying atherosclerotic risk and then matching statin intervention with the identified risk.  

In a 2013 article "Boomer Sex With Dementia Foreshadowed in Nursing Home" (Bloomberg News, 7/22/2013), reporter Bryan Gruley addressed the issue of intimacy and sexuality in long term care. Members of AMDA as well as many other professionals were interviewed for this article, which received a great deal of attention and commentary, suggesting significant community interest and need for further investigation.  

As Chair of Education for CALTCM and as a member of AMDA Public Policy Committee, I am amazed at the rapid transitions occurring in health care in our country.  Hospitals are shrinking, becoming more like the ICUs of the past, while nursing home post-acute care is becoming more like acute hospital ward medicine.  For the first time, partnerships and collaborations are developing between hospitals and their downstream providers.