Since the early 1980s, service providers and area agencies on aging, that is, the aging network, have developed a number of strengths as they built a community-based long-term-care system in most states. Many area agencies and providers now have the capacity to assess the needs of older persons, identify appropriate services, and administer…

A widespread bias exists among legal, medical, and social service professionals that the appropriate placement for elderly individuals with cognitive impairment (dementia) is a nursing home. Two major reasons for institutionalization are to remove the patient from a potentially harmful situation and to relieve the family of the burden of care.…

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…

A more productive approach to providing appropriate long-term care is to separate physical from psychosocial needs when performing functional assessment and to rearrange them into a matrix. By examining each need separately, and where needs overlap in the matrix, more direct assessment can be performed, and specified interventions can be designed.…

Expressive therapists (in art, music, and dance) possess the techniques necessary for working with older adults who need assistance in making productive use of their leisure time. Therapeutic expressive activities for long-term care residents promote creativity, self-expression, communication, and understanding of oneself. The purpose of the…

Articles in this special issue look at ethical issues in aging in geriatric care, improving care of the dying, the value of autonomy and respect, the role of religion in health-related decisions, protection of nursing facility residents, physician-assisted dying, conflict resolution in nursing homes, and dealing with patients' demands for…

This paper reviews current demographic and programmatic trends with respect to the frail elderly. These trends include the projected growth in population of those 65 and older between now and 2030; the rapidly improving economic status of the older adult population and its effect on views of what the elderly's share of public money should be; the…

Australia's Aged Care Act of 1997 mandates a number of key reforms aimed at ensuring consistency in the quality of care and well-being for all residents of aged care facilities. The law required residential aged care facilities to provide high-quality care within a framework of continuous improvement which requires aged care workers to perform the…