Purpose: This article, based on analysis of data from a mixed methods study, builds on a growing body of assisted living (AL) research focusing on the link between residents' social relationships and health. A key aim of this analysis, which uses the social convoy model as a conceptual and methodological framework, was to examine the relative…

Purpose: The purpose of this study was to examine usual long-term care (LTC) practices related to 3 aspects of morning care and determine if there were resident characteristics related to the lack of care. Design and Methods: Participants were 169 long-stay residents in 4 community LTC facilities who required staff assistance with either transfer…

Much has been written about theories of aging in premodern times, but much less is known about theories of residential care. This article describes a handbook prescribing the building, staffing, and running of residences for seniors: "The Gerontocomos," published in Italy in 1489 by Gabrielle Zerbi. The handbook describes in detail the…

Purpose: This study identified how unlicensed staff members decide to administer medications prescribed pro re nata (PRN) to residents of assisted living (AL) settings designated for persons with dementia. Theories of knowledge, including explicit and implicit knowledge, discretion, and judgment, guided the analysis. Design and Methods: Data were…

Purpose: To describe annual care transition patterns across residential and health care settings and assess consistency in care transition patterns across years. Design and Methods: This retrospective cohort study used the Medicare Current Beneficiary Survey (2000-2005). The sample comprised beneficiaries aged 65 years and older (N = 57,684…

Purpose of the Study: Use archived public data from Arizona to explore relationships among selected institutional and resident risk and situation-specific factors and complaints and substantiated allegations of various types of mistreatment in assisted living facilities (ALFs). Design and Methods: An exploratory/descriptive 2-group design was…

Purpose: Although nursing homes (NHs) are criticized for offering poor quality continence care, little is known about the organizational processes that underlie this care. This study investigated the influence of organizational culture on continence care practices in two NHs. Design and Methods: This ethnographic study explored continence care…

Purpose: In this commentary, we examine nursing home quality and indicators that have been used to measure nursing home quality. Design and Methods: A brief review of the history of nursing home quality is presented that provides some context and insight into currently used quality indicators. Donabedian's structure, process, and outcome (SPO)…

Purpose: The purpose of this study was to obtain a profile of individuals with private long-term care (LTC) insurance as they begin using paid LTC services and track their patterns of service use, satisfaction with services and insurance, claims denial rates, and transitions over a 28-month period. Design and Methods: Ten LTC insurance companies…

Purpose: This article investigates how continuing care retirement community (CCRC) residents define transitions between levels of care. Although older adults move to CCRCs to "age in place," moving between levels of care is often stressful. More than half a million older adults live in CCRCs, with numbers continually increasing; yet, no studies…

Purpose: Making choices about everyday activities is a normal event for many adults. However, when an adult moves into an assisted living (AL) community, making choices becomes complicated by perceived needs and community practices. This study examines the relationship between choice and need in the context of practices, using medication…

Purpose: Theories of the policy process recognize that policy proposals are typically generated, debated, redrafted, and accepted for consideration through the gradual accumulation of knowledge within communities of specialists. Thus, to inform long-term care (LTC) reform efforts, we conducted a Web-based survey of 1,147 LTC specialists…

Purpose: To describe a standardized observation protocol to determine if nursing home (NH) staff offer choice to residents during 3 morning activities of daily living (ADL) and compare the observational data with deficiency statements cited by state survey staff. Design and Methods: Morning ADL care was observed in 20 NHs in 5 states by research…

Purpose: Almost half of people age 85 and older who die annually in the United States die as nursing home residents, yet because it is not always clear who is close to death, not all residents who might benefit from end-of-life care receive it. The purpose of this study is to develop a framework for organizing social interactions related to…

Purpose: The purpose of this article was to explore staff-family relationships in assisted living facilities (ALFs) as they are experienced by care staff and perceived by administrators. We identify factors that influence relationships and explore how interactions with residents' families affect care staff's caregiving experiences. Design and…