The Affordable Care Act of 2010 builds on earlier efforts to expand home and community-based alternatives to institutional long-term care. Identifying people living in the community who have unmet ...

Hospital readmissions can negatively impact cost and patient outcomes. Predictors of 30-day readmissions have been primarily identified using medical claims data. Reported here are results of a patient survey developed as part of regular hospital quality assurance activities. Two-thirds of patients reported good discharge experiences but were still readmitted. One-third of patients discharged had a post-discharge doctor appointment scheduled; half were readmitted before that scheduled appointment. Results suggest post-discharge experiences could be improved, especially the timing of follow up doctor appointments. Identified weaknesses in the survey process highlight need for engagement of survey methodologists in efforts to understand patient experiences.

Objective.: The consequences of obesity among older adults are significant, yet few obesity interventions target this group. Unfamiliarity with weight loss intervention effectiveness and concerns that weight loss negatively affects older adults may be inhibiting targeting this group. This paper reviews the evidence on intentional weight loss and effective weight loss interventions for obese older adults to help dispel concerns and guide health promotion practice. Data Source.: PubMed articles. Study Inclusion and Exclusion Criteria.: Randomized controlled trials examining behavioral and pharmaceutical weight loss strategies with 1-year follow-up targeting obese (body mass index ≥30) older adults (mean age ≥60 years), and studies with quasi-experimental designs examining surgical weight loss strategies targeting older adults were examined. Data Extraction.: Abstracts were reviewed for study objective relevancy, with relevant articles extracted and reviewed. Data Synthesis.: Data were inserted into an analysis matrix. Results.: Evidence indicates behavioral strategies are effective in producing significant (all p < .05) weight loss without significant risk to obese older adults, but effectiveness evidence for surgical and pharmaceutical strategies for obese older adults is lacking, primarily because this group has not been targeted in trials or analyses did not isolate this group. Conclusion.: These findings support the promotion of intentional weight loss among obese older adults and provide guidance to health promotion practitioners on effective weight loss interventions to use with this group.

Obesity rates are high among all age groups, including older adults. Obesity negatively affects health and functional ability, increasing the risk for nursing home (NH) admission. The current study examines trends over 11 years in moderate to severe obesity rates among NH residents. A generalized least squares regression model for panel data was used to test the effect of time (years) on the rates. A significant increase in rates and significant variation in rates were observed. Little research has focused on the issue of obesity in NHs. High and increasing rates and variation in rates raise questions on demand and access to NH care for obese older adults. Additional research is needed to consider factors other than time that may affect NHs’ ability to admit moderate to severely obese individuals. Understanding these trends will help NHs prepare for future demand, ensure equal access, quality care, and financing of services. [Res Gerontol Nurs. 2015; 8(4):173–178.]