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April 12, 1995

Routine Laboratory Tests in Impaired Nursing Home Residents

Author Affiliations

University of Maryland Baltimore

JAMA. 1995;273(14):1092. doi:10.1001/jama.1995.03520380028029

To the Editor.  —The study of laboratory testing in nursing home residents by Drs Kim and Berlowitz1 confirms previous studies2,3 and recommendations4 that routine laboratory testing in nursing home residents is unlikely to benefit these patients. Now that the value of routine laboratory tests in nursing home residents has been debunked, however, I am afraid that casual readers of the article may miss the importance of other types of assessment for elderly nursing home residents.Physicians who care for nursing home residents should think about the goals of care and plan laboratory testing and other types of assessment accordingly.4,5 On admission to a long-term care facility, every patient should receive a geriatric assessment that includes assessment of advance directives, functional assessment, and mental status testing in addition to the usual history and physical examination. Moreover, at the time of admission, appropriate nursing home residents should have a

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