Purpose: Relationships are examined between age and out-of-pocket costs for different health goods and services among the older population. Design and Methods: Age patterns in health service use and out-of-pocket costs are examined by use of the 1990 Elderly Health Supplement to the Panel Study of Income Dynamics (N = 1,031, age 66+). Multivariate…

Purpose: The purpose of this article is to explore how medical care is delivered to older people in assisted living (AL) settings and to suggest ways for improving it. Design and Methods: We present a review of the limited research available on health care for older AL residents and on building testable models of better ways to organize primary…

Context: Advance directives promote patient autonomy and encourage greater awareness of final care options while reducing physician and family uncertainty regarding patient preferences. Purpose: To investigate differences in decision making authority and the use of advance directives among nursing home residents admitted from urban and rural…

We assessed effectiveness of four education programs in providing nursing assistants with ability to produce a therapeutic milieu supportive of intact residents' activities of daily living, positive self-esteem and mood: (1) a combination of Orem's Systems of Nursing Care and Skinner's Applied Behavioral Analysis, (2) Applied Behavioral Analysis,…

Short-term longitudinal study assessed single and combined effects of two interventions designed to affect nursing assistants' (n=193) performance by increasing knowledge and motivation. Four sites included skills training only, job redesign only, both interventions, and control. Significant differences were found in knowledge in comparisons…

Nursing homes in Illinois Quality Incentive Program receive separate bonus payment per Medicaid day for achieving each of six quality standards. Of 809 participating homes (1985-88), over 90 percent of eligible facilities chose to participate annually. Success in achieving bonus payments in multiple standards increased over time, with 27 percent…

This study examined the effectiveness of a new skills training program designed to increase nurse aides' knowledge of behavior management. The training program, designed as five 90-minute group learning modules, was implemented in two Western Pennsylvania nursing homes over a 5-month period. Topics covered within the training program included…

Restorative care attempts to break the cycle of dependency and functional decline in nursing homes by addressing individual resident needs. The Restorative Care Education and Training (RCET) Program consists of a five-week workshop and resource manual for both supervisory and direct care staff. This paper describes the RCET approach and presents…

For all the baby boomers who've embraced and adopted healthier lifestyles, including proper diet and exercise, there may be an even more compelling reason. If you get sick or become hospitalized, you may not have the critically needed services of a well-trained nurse. It's been widely reported that there is a nursing shortage in the United States,…

In the current study, nursing home staff were taught to administer functional analyses to determine the variables maintaining aggression by an elder with dementia. The results indicated that aggression was evoked during bathroom routines and that escape maintained aggression. Staff then reduced aggression to near-zero levels with noncontingent…

This paper explains how commonality analysis (CA) can be conducted using a specific Statistical Analysis System (SAS) procedure and some simple computations. CA is used in educational and social science research to partition the variance of a dependent variable into its constituent predicted parts. CA determines the proportion of explained…

The article relates the nursing home component of a nationwide study of public mental retardation/developmental disabilities spending to requirements of Public Law 100-203. Approximately 51,000 individuals with developmental disabilities resided in nursing homes in 1989 of which 40 percent may need to be relocated under P.L. 100-203. (Author/DB)

Purpose: We identify environmental and organizational predictors that best discriminate between formal continuous quality improvement (CQI) adopters and nonadopters in nursing homes (NHs) and create a diagnostic profile for facility administrators and policy makers to promote CQI. Design and Methods: We performed a cross-sectional survey of…

This article reviews the current and changing status of residential supports for persons with intellectual and developmental disabilities (ID/DD). It examines four major trends in those supports: (1) Decreasing use of larger institutions and increasing use of community housing; (2) Decreasing size among community settings; (3) Increasing numbers…

The aims of this study were to examine effects of on-the-job feedback after conventional analog staff training and to corroborate earlier findings of competent performance maintained without feedback from others. The study took place in a nursing home with four staff participants and a resident with problem behaviors. A multiple baseline design…