Nursing home patients suffering from dementia had a desire for placement in a setting where their special needs could be addressed. This resulted in the creation of special nursing home units designed to meet patient needs. Recent reports have provided evidence that nursing home residents suffering from dementia who receive care on these special…

Purpose: Our objective in this study was to compare Medicare costs of treating older adults with and without dementia in nursing home settings. Design and Methods: An expert panel established the dementia status of a stratified random sample of newly admitted residents in 59 Maryland nursing homes between 1992 and 1995. Medicare expenditures…

Purpose: We sought to determine whether participants in the Program of All-Inclusive Care for the Elderly (PACE) with an informal caregiver have a higher or lower risk of nursing home admission than those without caregivers. Design and Methods: We performed a secondary data analysis of 3,189 participants aged 55 years or older who were enrolled in…

Case studies demonstrate that when chronic sexual conflict constitutes a factor in family homeostasis, nursing home placement of the aged ill is a likely event when either there is a shift in family dynamics due to death or illness of a key member or the aged becomes overtly psychiatrically disabled. (Author)

Presents an overview of topics and concepts appropriate for a secondary course on death and dying including stress, environments within which death occurs, those models explaining the emotional impact of death, treatment of dying patients, and concepts for students. (DC)

Examined possible predictors of physician nursing home practice including residency experiences. A survey of 170 family physicians found physicians with an active nursing home practice were more likely to reside in a small community, have a hospital practice, see more outpatients, and work more hours but not necessarily residency experience of…

Purpose: To promote health and maintain independence, Just for Us provides financially sustainable, in-home, integrated care to medically fragile, low-income seniors and disabled adults living in subsidized housing. Design and Methods: The program provides primary care, care management, and mental health services delivered in patient's homes by a…

Experience gathered to date confirms that capitation of Medicare does not necessarily decrease quality of health care and may in fact encourage an improvement in health care quality. Incentives inherent in capitated reimbursement are threefold. First, practitioners, by not receiving more payment for more service, are discouraged from providing…

A pilot program at the University of California, Davis, that incorporated skilled nursing facility training into the required curriculum of their primary care internal medicine residency is described. The goal was to increase the residents' knowledge in the care of geriatric patients. (MLW)

This article discusses the following questions: What opportunities and challenges for nursing leadership present themselves in institutions that provide care for our expanding aged population? Should nursing administrators take up these challenges? If so, what skills, resources, and attitudes will they need? (Author/CT)

Because of administrative difficulties, therapeutic services provided at a nursing home by Project Adapt, through the St. Louis (Missouri) Regional Community Placement Program, were discontinued. At 2-month intervals, from June through December, 1986, 10 residents from the home where services were discontinued were compared with 10 and 15…

Purpose: Decisions concerning end-of-life care depend on information contained in advance directives that are documented in residents' charts in the nursing home. The availability of that information depends on the quality of the chart and on the location of the information in the chart. No research was found that compared directives by the manner…

This report evaluates the types of data gathered about nursing homes during a survey process by the State of Illinois through its Inspection of Care Review and Quality Incentive Program (QUIP) assessments. The data are compared to other State systems/demonstrations in an effort to choose those indicators which best measure the quality of care in…

As the American population increases, the health problems of older women will be of greater concern to health planners, because it is the elderly woman who most often survives to old age and has greater need of services. Data from the National Health Survey was used to determine characteristics, conditions, management, and outcomes of patients at…

Data on discharge process and caregiver satisfaction were collected from 179 caregivers of hospitalized dementia patients. Findings indicate that social workers are important influences in discharge decisions especially when discharge is to a nursing home. Findings from regression analyses indicate that caregiver satisfaction is dependent on the…