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Jack Isaac Twersky

Associate Professor Emeritus of Medicine
Medicine, Geriatrics
VA Med Ctr Bldg 23, 508 Fulton St, Durham, NC 27705

Selected Publications


Utilization and Cost Effects of the VHA Caring for Older Adults and Caregivers at Home (COACH) Program.

Journal Article Med Care Res Rev · December 2021 Since 2010, the Veterans Health Administration has initiated a home-based Caring for Older Adults and Caregivers at Home (COACH) program to provide clinical support to dementia patients and family caregivers. But its impact on health care utilization and c ... Full text Link to item Cite

Implementing Culture Change in Nursing Homes: An Adaptive Leadership Framework.

Journal Article Gerontologist · August 2015 PURPOSE OF THE STUDY: To describe key adaptive challenges and leadership behaviors to implement culture change for person-directed care. DESIGN AND METHODS: The study design was a qualitative, observational study of nursing home staff perceptions of the im ... Full text Link to item Cite

Preliminary Data from the Caring for Older Adults and Caregivers at Home (COACH) Program: A Care Coordination Program for Home-Based Dementia Care and Caregiver Support in a Veterans Affairs Medical Center.

Journal Article J Am Geriatr Soc · June 2015 Caring for Older Adults and Caregivers at Home (COACH) is an innovative care coordination program of the Durham Veteran's Affairs Medical Center in Durham, North Carolina, that provides home-based dementia care and caregiver support for individuals with de ... Full text Link to item Cite

An advanced course in long term care for geriatric medicine fellows.

Journal Article J Am Med Dir Assoc · July 2013 Long term care deserves focused attention within a geriatric medicine fellowship curriculum to ensure that graduates are prepared not only for clinical care but also for the leadership, administrative, educational, quality improvement, and health policy as ... Full text Link to item Cite

A randomized, controlled study to assess the effect of silk-like textiles and high-absorbency adult incontinence briefs on pressure ulcer prevention.

Journal Article Ostomy Wound Manage · December 2012 Pressure ulcer prevention is an important aspect of nursing home care. A 20-week, unblinded, randomized, controlled trial was conducted to compare the rate of nursing home-acquired pressure ulcers and adverse events between residents managed using: 1) a si ... Link to item Cite

Prioritizing culture change in nursing homes: perspectives of residents, staff, and family members.

Journal Article J Am Geriatr Soc · March 2012 OBJECTIVES: To explore the perspectives and priorities of nursing home residents, family members, and frontline nursing staff concerning a broad range of items representing common targets of culture change initiatives. DESIGN: Qualitative study. SETTING: A ... Full text Link to item Cite

The clinical course of advanced dementia.

Journal Article N Engl J Med · January 28, 2010 Link to item Cite

Underuse of indicated medications among physically frail older US veterans at the time of hospital discharge: results of a cross-sectional analysis of data from the Geriatric Evaluation and Management Drug Study.

Journal Article Am J Geriatr Pharmacother · October 2009 BACKGROUND: Medication underutilization, or the omission of a potentially beneficial medication indicated for disease management, is common among older adults but poorly understood. OBJECTIVES: The aims of this work were to assess the prevalence of medicat ... Full text Link to item Cite

Development and pilot testing of computerized order entry algorithms for geriatric problems in nursing homes.

Journal Article J Am Geriatr Soc · September 2009 OBJECTIVES: To develop order entry algorithms for five common nursing home problems and to test their acceptance, use, and preliminary effect on nine quality indicators and resource utilization. DESIGN: Pre-post, quasi-experimental study. SETTING: Two Depa ... Full text Link to item Cite

Respiratory syncytial virus outbreak in a long-term care facility detected using reverse transcriptase polymerase chain reaction: an argument for real-time detection methods.

Journal Article J Am Geriatr Soc · March 2009 OBJECTIVES: To report an outbreak of respiratory synctyial virus (RSV) in a long-term care facility (LTCF) during ongoing routine respiratory illness surveillance. DESIGN: Rapid antigen testing, viral culture, direct fluorescent antibody (DFA) testing, and ... Full text Link to item Cite

Post-hospital clinic for older patients and their family caregivers

Journal Article Annals of Long-Term Care · May 1, 2008 As a complementary service to our Geriatric Evaluation and Management Clinic, the geriatrics Post-Hospital Clinic (PHC) was recently established for prompt follow-up assessment and care of our geriatric patients and their caregivers after hospital discharg ... Cite

Herpes zoster, cellulitis, and scabies

Chapter · January 1, 2006 Herpes zoster is a neurocutaneous disease caused by the reactivation of varicella-zoster virus (VZV) from a latent infection of dorsal sensory or cranial nerve ganglia. Nearly all elderly adults in the United States are latently infected with VZV and at ri ... Cite

Effects of geriatric evaluation and management on adverse drug reactions and suboptimal prescribing in the frail elderly.

Journal Article Am J Med · March 15, 2004 PURPOSE: To determine if inpatient or outpatient geriatric evaluation and management, as compared with usual care, reduces adverse drug reactions and suboptimal prescribing in frail elderly patients. METHODS: The study employed a randomized 2 x 2 factorial ... Full text Link to item Cite

Falls in the nursing home

Journal Article Clinics in Family Practice · January 1, 2001 Falls are an important problem in the nursing home. Falls are frequently a sign of a new medical problem or a decline in a chronic condition. They are associated with dementia and confusion, balance and gait abnormalities, psychotropic and cardiac medicati ... Full text Cite

Case report: Disruptive vocalization due to gout in an elderly nursing home resident with dementia

Journal Article Annals of Long-Term Care · August 15, 2000 The authors report a case of an elderly nursing home resident with dementia and disruptive vocalization (DV) precipitated by undiagnosed pain from gouty arthritis, and the successful treatments carried out through multiple approaches. This case demonstrate ... Cite

Management of pneumonia in the nursing home.

Journal Article J Am Geriatr Soc · July 1999 Full text Link to item Cite

Management of pneumonia in the nursing home [3] (multiple letters)

Journal Article Journal of the American Geriatrics Society · 1999 Cite

Utilization and Cost Effects of the VHA Caring for Older Adults and Caregivers at Home (COACH) Program.

Journal Article Med Care Res Rev · December 2021 Since 2010, the Veterans Health Administration has initiated a home-based Caring for Older Adults and Caregivers at Home (COACH) program to provide clinical support to dementia patients and family caregivers. But its impact on health care utilization and c ... Full text Link to item Cite

Implementing Culture Change in Nursing Homes: An Adaptive Leadership Framework.

Journal Article Gerontologist · August 2015 PURPOSE OF THE STUDY: To describe key adaptive challenges and leadership behaviors to implement culture change for person-directed care. DESIGN AND METHODS: The study design was a qualitative, observational study of nursing home staff perceptions of the im ... Full text Link to item Cite

Preliminary Data from the Caring for Older Adults and Caregivers at Home (COACH) Program: A Care Coordination Program for Home-Based Dementia Care and Caregiver Support in a Veterans Affairs Medical Center.

Journal Article J Am Geriatr Soc · June 2015 Caring for Older Adults and Caregivers at Home (COACH) is an innovative care coordination program of the Durham Veteran's Affairs Medical Center in Durham, North Carolina, that provides home-based dementia care and caregiver support for individuals with de ... Full text Link to item Cite

An advanced course in long term care for geriatric medicine fellows.

Journal Article J Am Med Dir Assoc · July 2013 Long term care deserves focused attention within a geriatric medicine fellowship curriculum to ensure that graduates are prepared not only for clinical care but also for the leadership, administrative, educational, quality improvement, and health policy as ... Full text Link to item Cite

A randomized, controlled study to assess the effect of silk-like textiles and high-absorbency adult incontinence briefs on pressure ulcer prevention.

Journal Article Ostomy Wound Manage · December 2012 Pressure ulcer prevention is an important aspect of nursing home care. A 20-week, unblinded, randomized, controlled trial was conducted to compare the rate of nursing home-acquired pressure ulcers and adverse events between residents managed using: 1) a si ... Link to item Cite

Prioritizing culture change in nursing homes: perspectives of residents, staff, and family members.

Journal Article J Am Geriatr Soc · March 2012 OBJECTIVES: To explore the perspectives and priorities of nursing home residents, family members, and frontline nursing staff concerning a broad range of items representing common targets of culture change initiatives. DESIGN: Qualitative study. SETTING: A ... Full text Link to item Cite

The clinical course of advanced dementia.

Journal Article N Engl J Med · January 28, 2010 Link to item Cite

Underuse of indicated medications among physically frail older US veterans at the time of hospital discharge: results of a cross-sectional analysis of data from the Geriatric Evaluation and Management Drug Study.

Journal Article Am J Geriatr Pharmacother · October 2009 BACKGROUND: Medication underutilization, or the omission of a potentially beneficial medication indicated for disease management, is common among older adults but poorly understood. OBJECTIVES: The aims of this work were to assess the prevalence of medicat ... Full text Link to item Cite

Development and pilot testing of computerized order entry algorithms for geriatric problems in nursing homes.

Journal Article J Am Geriatr Soc · September 2009 OBJECTIVES: To develop order entry algorithms for five common nursing home problems and to test their acceptance, use, and preliminary effect on nine quality indicators and resource utilization. DESIGN: Pre-post, quasi-experimental study. SETTING: Two Depa ... Full text Link to item Cite

Respiratory syncytial virus outbreak in a long-term care facility detected using reverse transcriptase polymerase chain reaction: an argument for real-time detection methods.

Journal Article J Am Geriatr Soc · March 2009 OBJECTIVES: To report an outbreak of respiratory synctyial virus (RSV) in a long-term care facility (LTCF) during ongoing routine respiratory illness surveillance. DESIGN: Rapid antigen testing, viral culture, direct fluorescent antibody (DFA) testing, and ... Full text Link to item Cite

Post-hospital clinic for older patients and their family caregivers

Journal Article Annals of Long-Term Care · May 1, 2008 As a complementary service to our Geriatric Evaluation and Management Clinic, the geriatrics Post-Hospital Clinic (PHC) was recently established for prompt follow-up assessment and care of our geriatric patients and their caregivers after hospital discharg ... Cite

Herpes zoster, cellulitis, and scabies

Chapter · January 1, 2006 Herpes zoster is a neurocutaneous disease caused by the reactivation of varicella-zoster virus (VZV) from a latent infection of dorsal sensory or cranial nerve ganglia. Nearly all elderly adults in the United States are latently infected with VZV and at ri ... Cite

Effects of geriatric evaluation and management on adverse drug reactions and suboptimal prescribing in the frail elderly.

Journal Article Am J Med · March 15, 2004 PURPOSE: To determine if inpatient or outpatient geriatric evaluation and management, as compared with usual care, reduces adverse drug reactions and suboptimal prescribing in frail elderly patients. METHODS: The study employed a randomized 2 x 2 factorial ... Full text Link to item Cite

Falls in the nursing home

Journal Article Clinics in Family Practice · January 1, 2001 Falls are an important problem in the nursing home. Falls are frequently a sign of a new medical problem or a decline in a chronic condition. They are associated with dementia and confusion, balance and gait abnormalities, psychotropic and cardiac medicati ... Full text Cite

Case report: Disruptive vocalization due to gout in an elderly nursing home resident with dementia

Journal Article Annals of Long-Term Care · August 15, 2000 The authors report a case of an elderly nursing home resident with dementia and disruptive vocalization (DV) precipitated by undiagnosed pain from gouty arthritis, and the successful treatments carried out through multiple approaches. This case demonstrate ... Cite

Management of pneumonia in the nursing home.

Journal Article J Am Geriatr Soc · July 1999 Full text Link to item Cite

Management of pneumonia in the nursing home [3] (multiple letters)

Journal Article Journal of the American Geriatrics Society · 1999 Cite

Abnormalities of carbohydrate and lipid metabolism in Dahl rats.

Journal Article Hypertension · November 1991 Plasma glucose, insulin, and triglyceride concentration, blood pressure, and insulin action on isolated adipocytes were determined in weight-matched Sprague-Dawley, Dahl salt-resistant, and Dahl salt-sensitive rats. Blood pressure and plasma glucose concen ... Full text Link to item Cite

Age-associated differences in beta adrenergic-stimulated lipolysis in adipocytes from Sprague-Dawley and Fischer 344 rats.

Journal Article J Gerontol · July 1991 We compared the ability of adipocytes isolated from the epididymal fat pads of Sprague-Dawley and Fischer 344 rats of different ages and weights to release glycerol in response to beta-adrenergic stimulation. Twelve-month-old Sprague-Dawley rats weighed ap ... Full text Link to item Cite

Hypertriglyceridemia in Dahl rats: Effect of sodium intake and gender

Journal Article Hormone and Metabolic Research · 1991 Cite