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 research is twofold. The first purpose is to utilize a new methodology (Bayesian networks) for aggregating various quality indicators to measure the overall quality of care in nursing homes. The second is to provide new insight into the relationships that exist among various measures of quality and how such measures…

To meet the special needs of and provide quality health care to nursing home residents, the health care workforce must be knowledgeable about the aging process. Health professionals are minimally prepared in their academic programs to care for older adults, and few programs have required rotations in geriatrics. Teaching nursing homes (TNHs) have…

Purpose: This research investigates what factors affect the degree to which nursing home performance explains variance in residents' change in status of activities of daily living (ADL) after admission. Design and Methods: The database included all residents admitted in 2002 to a 10% random sample of nursing homes in the United States.…

Nurses (N=30) employed in nursing homes were trained as Geriatric Nurse Practitioners and then implemented their new clinical roles as direct employees of the original facility. Results showed the nurses, their directors, and administrators perceived the nurses as having positive effects on resident outcomes, but described difficulties in…

Discusses the trend toward affiliation of nursing homes with educational programs as clinical teaching institutions for medical, nursing, and allied health students. Reviews potential ethical and legal issues for the nursing home administrator, professional staff member, educator, and student, including informed consent, supervisory…

Surveyed discharge planners at 49 acute care hospitals to ascertain problems they perceived in placing elderly patients. Selected hospital characteristics and placement practices and the ways in which they are associated with hospital back-up (sometimes called administratively necessary days) and delays in placement were analyzed. (Author/JAC)

Projects utilization history of a synthetic cohort of nursing home admissions in 1976 by normalizing length of stay (LOS) specific discharge rates derived from life tables to an estimated 1.1 million persons. Results focus on the LOS distribution, discharge status, and total days of nursing home care used. (Author/JAC)

Studied the effects of monthly psychiatric consultation in a nursing home. Suggested that consultation was primarily useful to staff providing direct care to referred residents. Cited benefits to residents as increased staff awareness and acceptance of emotional problems and increased frequency of therapeutic programs offered at the nursing home.…

Presents Project Adapt, a psychogeriatric rehabilitation service developed to integrate assessment, behavior and medication management, and outcome evaluation to meet needs of mentally ill in nursing homes. Notes that mental health staff perceived significantly more improvement among participating nursing home residents than among those not…

Reports data on admissions, discharges, and changes in health status of eight admission cohorts to nursing homes in a jurisdiction with universally-insured nursing home and home care services. The findings are compared to U.S. studies and disclose differences which may reflect differences in payment mechanisms and admission policies. (Author/JAC)

Describes sub-acute diagnostic and treatment nursing home program for difficult to manage older adults with medical and psychiatric illness. Notes that assessment and discharge can be completed within seven months, and that among sample population studied, almost equal percentages were discharged to state institutions, remained in the study home,…

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)

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)

An 11-year study was undertaken of 1,135 discharged geriatric patients from rehabilitation service in a skilled nursing home. Of the patients aged 62-99, 693 were discharged to independent living. The high rate of return to independent living was made possible through a health team approach including intensive therapy treatment and social work…