Ruth M. Tappen

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A substantial proportion of hospitalizations of nursing home (NH) residents may be avoidable. Medicare payment reforms, such as bundled payments for episodes of care and value-based purchasing, will change incentives that favor hospitalization but could result in care quality problems if NHs lack the resources and training to identify and manage acute(More)
The effective use of nursing staff time is a major determinant of the quality of care in long-term care facilities. The purpose of this work sampling study was to identify those activities that consumed the largest amount of staff time on a locked unit housing: 60 chronically ill and demented patients. A heavy work load, large proportion of direct care, and(More)
UNLABELLED The purpose of this study was to compare the effects of 16 weeks of a comprehensive exercise routine to supervised walking and social conversation on depression in nursing home residents with Alzheimer's disease (AD). METHOD This study was a three-group, repeated-measures design with random assignment to treatment group. Forty-five nursing home(More)
OBJECTIVES To describe nursing home (NH) staff perceptions of avoidability of hospital transfers of NH residents. DESIGN Mixed methods qualitative and quantitative analysis of 1,347 quality improvement (QI) review tools completed by staff at 26 NHs and transcripts of conference calls. SETTING Twenty-six NHs in three states participating in the(More)
The purpose oF this study was to examine the eFFects oF 3 behavioral interventions on aFFect and mood in nursing home residents with Alzheimer's disease. In a pre-post design, 90 residents with Alzheimer's disease were randomized to 3 groups: supervised walking, comprehensive exercise (walking plus strength training, balance, and Flexibility exercises), and(More)
BACKGROUND Investigation of the effects of exercise on frail, institutionalized individuals with dementia has been impeded by concerns about the reliability of physical performance measures when used in this population. METHODS The physical performance of 33 institutionalized subjects with Alzheimer's disease was measured during both the morning and(More)
It has been well documented that education influences the individual's performance on category fluency tasks but it is still unclear how this effect may differ across the different types of category tasks (i.e., animals, fruits, vegetables and clothing). This study aims (1) to analyze the effect of the level of education on four different types of category(More)
The purpose of this experimental study was to compare the effects of skill training, a traditional stimulation approach, and regular care (control group) on the ability to perform the basic activities of daily living of nursing home residents with dementia. Sixty-three subjects were randomly selected and randomly assigned to the three groups. Ability to(More)
The effectiveness of conversation in improving verbal communication of nursing home residents with Alzheimer's disease was compared to exercise and a combination of both interventions. Fifty-five participants were randomly assigned to treatment group and raters were blinded. Treatment was given three times weekly for 30 minutes, for 16 weeks. Although all(More)
The Mini-Mental State Examination (MMSE) [Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). Mini-Mental State: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189-198] has frequently been challenged for its bias against individuals with lower levels of education and the use of(More)