This viewpoint examines the complex ethical issues inherent in art therapy practice within a health-care setting for adults with dementia. The author explores and discusses the ways in which aspirational ethical principles outlined by the American Art Therapy Association can provide direction and guidance. The 6 aspirational ethical principles of…

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…

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…

Nonhome-based long-term care sustainable living arrangements for elderly people with Alzheimer's is presented. Characteristics contributing to sustainability are discussed. The ultimate goal in sustainable design for older adult communities is a people-centered model of care in environments that improve their quality of life. Without sustainable…

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…

To discuss the relationship between residents and the management team, we must first review the transition from a medical model to a social model of care that is sweeping across America. Long-term care (LTC) management models were developed for a very autocratic and hierarchical style of management based in the 1960s. Those facilities were built…

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: To identify differences in perspectives that may complicate the process of joint decision making at the end of life, this study determined the agreement of family and staff perspectives about end-of-life experiences in nursing homes and residential care/assisted living communities and whether family and staff roles, involvement in care,…

Purpose: The purpose of this article is to describe the projected use for long-term-care services through 2012. Design and Methods: We constructed a static-component projection model using age, function, and other covariates. We obtained enrollee projections from the Veterans Health Administration (VHA) and combined these with nursing home and…

Purpose: The U.S. Department of Veterans Affairs has adopted two functional assessment systems that guide care planning: one for nursing home residents (the Resident Assessment Instrument [RAI]) and a compatible one for home care clients (RAI-HC). The purpose of this article is to describe the RAI-HC (often referred to as the Minimum Data Set-Home…

Purpose: This article is a critical review of the history, research evidence, and state-of-the-art technology in interdisciplinary care planning and the written plan of care in American nursing homes. Design and Methods: We reviewed educational and empirical literature. Results: Interdisciplinary care planning and the written care plan are…

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…

Describes a research model designed to investigate the shift in the care delivery site from the acute care institution to the home and community. Transitional care may soon become familiar jargon in community health care. (JOW)

The present study compares changes in job satisfaction and career commitment among Alzheimer's care staff participating in a two-phase, state-level training collaborative to improve dementia care. Results reveal an increase in extrinsic job satisfaction and a decrease in career commitment. Findings could be related to the effects of both the…

Purpose: While state policy and market factors are known to have contributed to the increased supply of residential care, little is known about efforts to accommodate demand from lower-income consumers. This study describes participation and expenditure trends for residential care services funded by Medicaid waivers and examines variation across…