Nursing Assistants (NAs) are the largest workforce in nursing homes, but often lack adequate preparation for their role. The Living Classroom (LC) is an integrated learning approach, whereby a NA program is delivered in a nursing home (NH) in collaboration with a community college. This paper describes the implementation and evaluation of the LC.…

Purpose: Special Focus Facilities (SFFs) are nursing facilities designated by the Centers for Medicare & Medicaid Services to be of chronic poor quality. Relatively few nursing facilities are included in this initiative. The purpose of this research was to examine whether nursing facilities included in the 2007 SFF initiative subsequently…

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)…

An intergenerational initiative was developed and implemented to enhance gerontology in the first course of the practice sequence. Seventeen students met with older adults (ages 82-98) in the classroom and at an assisted living facility. The evaluation of this older adult infusion project was conducted through two questionnaires and by the review…

The purpose of this study was to evaluate learning by older adults living in nursing homes through observational learning based on Bandura's (1977) social learning theory. This quantitative study investigated if older adults could learn through observation. The nursing homes in the study were located in the midwestern United States. The…

This qualitative study focused on the learning experiences of individuals, age 80 and older, in care facilities in a Midwestern state. Even with the well documented growth of the over age 85 demographic, there are few studies about learning that included this demographic or considered the wants and needs of this group. Using a phenomenological…

Community-based frail older adults, burdened with complex medical and social needs, are at great risk for preventable rapid rehospitalizations. Although federal and state regulations are in place to address the care transitions between the hospital and nursing home, no such guidelines exist for the much larger population of community-dwelling…

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: We compared the rates of specialized care for residents with Alzheimer's disease or dementia in special care units (SCUs) and other nursing home (NH) units and examined the associations of SCU residence with process of care and resident outcomes. Design and Methods: Data came from the 2004 National Nursing Home Survey. The indicators of…

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: Nursing home pay-for-performance (P4P) programs are intended to maximize the value obtained from public and private expenditures by measuring and rewarding better nursing home performance. We surveyed the 6 states with operational P4P systems in 2007. We describe key features of six Medicaid nursing home P4P systems and make…

This article describes a graduate course in clinical geropsychology that combines classroom, practicum, and field-visit components. The course provides clinical and applied developmental students with an overview of the major research and clinical topics of the field, as well as firsthand exposure to the setting of the nursing home, its residents,…

Purpose: Weak empirical evidence exists showing that nursing home staffing levels influence quality of care. We propose that weak findings have resulted in many prior analyses because research models have underspecified the labor composition needed to influence care processes that, in turn, influence quality of care. In this analysis, we specified…

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…

Purpose: Given concerns about end-of-life care for many nursing home (NH) residents, this study sought to understand factors influencing hospice referral or nonreferral as well as timing of referral. Design and Methods: We conducted semistructured interviews with personnel from seven participating NHs and two hospices. We interviewed NH directors…