The ethical primacy of patient involvement in treatment decision-making requires that more attention be paid to assessment of a patient's competency to make treatment decisions. Makes recommendations to increase sensitivity to this issue with significantly impaired elderly nursing home patients and to improve existing decision-making procedures.…

Evaluates two respite programs which offer families temporary relief from caring for elderly relatives: an institutional program for those needing constant nursing attention, and a residential plan for those requiring housekeeping and companion services. Benefits for clients, family, and community appear to be indisputable. (Author/ABB)

Compared 40 matched pairs of patients discharged from acute care to either nursing homes or to Hawaii's geriatric foster family care program. Foster family patients showed more improvement in well-being and mobility and equal improvement in activities of daily living skills. The cost of foster family care was 61% that of nursing home care.…

Explored attitudes toward the elderly of nursing personnel (N=101) employed in long-term care settings. Also investigated the impact of an experiential education program on the attitudes of nursing personnel providing daily care for the aged. Results tend to contradict several popularly held beliefs. (Author/ABB)

Applied a logistic model to predict elderly patients' risk for discharge to nursing homes following hospitalization. Age was the only consistently strong predictor in the individualized models developed for each of four areas. (Author/JAC)

Debates the effect of relocation on elderly patients in a critique of an earlier study and a rebuttal by the original author. Questions whether patient mortality is related to the stress of moving or a simple function of age, health status, or choice. Additional evidence on relocation effects is needed. (JAC)

Families care for their elderly even when the burden is enormous, suffer guilt when institutionalization becomes necessary, and maintain contact after institutionalization. Policies must be developed to reduce premature institutionalization, help families cope with the process when it becomes necessary, and provide institutional care to those…

To develop alternatives to institutionalization, more emphasis needs to be placed on supports permitting care within the family unit. Presents an example of one family that deinstitutionalized an older confused family member. (Author)

While the family and Catholic church remained important sources of preferred support, increased willingness to utilize institutional long-term care was noted. Favoring proprietary services indicated continued negative attitudes towards public auspices and possible support for a multi-tiered service delivery system for the aged. (Author)

Surveyed 208 Indian Health Service providers and allied personnel to examine extent to which they subscribed to myths about long-term care. With some exception, found long-term care equated with the nursing home, perceived as involving essentially health care professionals; service objectives were assumed to be primarily rehabilitative and…

Studied effects of five 12-month support strategy treatments on family caregivers (N=541) of impaired elderly persons. Found caregivers of elderly persons remaining in community reported lower levels of subjective burden. Found services delayed nursing home placement by adult child caregivers but encouraged placement by spouse caregivers.…

Examined placement of 248 older mentally ill persons into independent settings, community-based programs, or level III or level IV nursing homes. Risk of institutionalization increased as cognitive skills and family support declined. Consistent predictor of placement was prior residence. Number of medical problems and need for nursing or…

Examines the relationship between resident characteristics and time participating in activities. For the 2,672 nursing home residents studied, measures of resource use, cognitive abilities, depression, sense of initiative/involvement, activity repertoire, location preferences, and gender were all found to be significant in explaining the amount of…

Surveyed 90 administrative and nonadministrative social workers employed in nursing homes who identified their level of influence in 5 spheres of organizational decision making. There were few differences between the two groups. However, among directors, number of full-time equivalent social workers, type of institution ownership, and length of…

Investigated the relationship between death fear, attitudes toward the elderly, and personal anxiety about aging in nursing home employees. Nursing professionals (registered nurses or licensed practical nurses) had lower levels of death concern than nursing assistants, and results also indicated that nursing assistants displayed significantly…