Background: Aspiration pneumonia (AP) is a subset of pneumonia caused by the aspiration of food and fluids to the lungs and is highly prevalent in the older population. Oropharyngeal dysphagia (OD) is one of the risk factors for AP and it is also associated with malnutrition, dehydration and poor functional outcomes. As pneumonia is the second…

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…

A major demonstration and evaluation project was undertaken to study the consequences of using incentive payments to change admission, discharge, and outcome patterns for Medicaid patients in nursing homes. Thirty-six proprietary, Medicaid-certified, skilled nursing homes in San Diego County with a combined Medicaid inpatient census of…

With improvements in medical technology and an increase in life expectancy, there also has been a substantial increase in the number of individuals with chronic diseases. The chronically ill elderly, who absorb an ever-growing proportion of our public and private resources, are of particular concern. This study analyzes findings from a major…

Assesses the stability of nursing home residents' preferences for medical treatments. Nondemented, nondepressed residents (N=37) were surveyed serially over a six-month period. Subjects preferred more treatment for their current health concerns than for all hypothetical conditions. All preference changes were toward less intervention. Most…

Evaluated Connecticut's Medicaid Home and Community-Based Care program which allowed elderly persons to remain in community with home and community-based services instead of entering nursing homes. Results did not reveal if the program was cost effective. Recommends rigorous preadmission screening of nursing home applicants to increase likelihood…

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…

Interviewed 198 nursing home residents and 34 primary nurse caregivers regarding perceptions and preferences of resident participation in health care decisions. Approximately 40 percent of residents reported being told nothing about their medical conditions; another 40 percent reported being told everything. Concordance between residents' and…

Savings in hospital reimbursements through use of extended-care facilities to shorten hospital stays for Medicare patients have more than outweighed the costs of the extended-care facilities. (MF)

Surveyed 35 nursing home staff members and found that nurses generally are not knowledgeable about psychiatric symptoms and do not seek out psychiatric intervention for their patients. Suggests that the organizational character of health care delivery in nursing homes makes adequate nursing response to mental illnesses impossible. (JAC)

Purpose: This study examines whether the relationship between making familial wealth transfers and becoming a Medicaid recipient sheds light on the current debate about Medicaid estate planning, whereby some elders transfer their assets to their families to qualify for Medicaid. Design and Methods: Using the Health and Retirement Study, we tracked…

This report from the Select Committee on Aging examines financial, medical, and social issues surrounding terminally ill patients with special emphasis on the elderly terminally ill. The first section discusses topics related to the medical treatment of the terminally ill. Two basic issues are important: the right to have medical treatment and the…

The increasing age of the American population and the current emphasis on cost containment in health care make the 1980s an ideal time for building bridges to span the health care needs of elderly persons in acute care and long-term care. While hospitals often discharge patients to nursing homes as an intermediate step between hospitalization and…

The Nursing Home Research Study is concerned with the quantitative measurement of nursing service in nursing homes. The purpose of the project was to provide data needed to establish a basis for proposing minimal staffing patterns for nursing homes. In an adaptation of the methodology used in a study conducted by the Milwaukee, Wisconsin Health…

Purpose: The purpose of this study is to expand knowledge regarding end-of-life care received in nursing homes through the use of narrative interviews with family members close to the decedents. Design and Methods: We conducted follow-up qualitative interviews with 54 respondents who had participated in an earlier national survey of 1,578…