Purpose: The aim of this study was to estimate the longitudinal relationship between transitions in the use of long-term care and older adults' depressive symptoms and to investigate whether this relationship could be explained by markers of older adults' underlying health, or other variables including demographics, personality, and partner…

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…

Two challenges facing nursing-home care today are understanding the concept of "quality of life" as it relates to cognitively impaired residents and finding effective ways to ensure that it is achieved. Canadian director Allan King's documentary, "Memory for Max, Claire, Ida and Company," filmed at Baycrest, captures a method…

Purpose: Flexibility is an essential ingredient of person-centered care. We illustrate the potential impact of flexibility by portraying a nursing home that uses flexibility in its approach to residents and staff members. Designs and Methods: The paper describes the management strategies, principles, and environmental features used by the Adards…

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: 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…

Purpose: We compared inpatient days, nursing home days, and total Medicaid claims for five Medicaid-funded home- and community-based services (HCBS) programs for in-home and assisted living services in Florida. Design and Methods: We studied a single cohort of Medicaid enrollees in Florida aged 60 and older, who were enrolled for the first time in…

The education of direct care workers (DCWs) is key to improving job quality and the quality of care in long-term care (LTC). This paper describes the successful integration of a supervisory training program into a continuing education intervention (WIN A STEP UP) for DCWs, identifies the factors that appear to influence the integration of the…

Training of direct care workers (DCWs) varies depending upon the setting in which they work and the state in which they are trained. Evidence points to the importance of adequate training as critical to DCW job satisfaction and reduction in turnover. Several approaches have been taken to enhance the training of DCWs with the objective that as job…

Describes program of short-term rehabilitation care provided to elderly patients through collaboration between hospital and nursing home. Discusses program planning and implementation experiences, patient satisfaction, and rehabilitation outcomes. Notes that program, although successful, was discontinued due to financial and interorganizational…

Purpose: We estimate the independent contribution of crime victimization to nursing home placement in a cohort of older adults who were community dwelling at baseline. Design and Methods: The data come from an observational cohort study of 2,321 community-residing older adults who were members of the New Haven Established Populations for…

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)

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,…

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…