Examined incidence and causes of Medicaid spenddown among disabled elderly persons. Found that approximately 10 percent of nursing home discharges experienced asset spenddown, process of converting from private pay to Medicaid, whereas over 50 percent of nursing home patients remained private pay throughout their stays. Becoming Medicaid patient…

Presents some sociohistorical concepts about suicide as framework for considering contemporary attitudes among elderly. Includes verbatim report of group therapy session in long-term care facility in which residents openly discuss their feelings about suicide of fellow resident a day earlier. Illustrates importance of emotional outlet, such as…

Discusses the Swedish experience in which the official old-age care policy has been to substitute home care for institutional care. Found some substitution of the two forms of long-term care which took place from 1965-75, but thereafter the use of long-term care institutions and home care remained stable or contracted. (Author/ABL)

Compared nursing home use of 3,316 residents of continuing care retirement communities (CCRCs) with that of general elderly population. CCRC residents had greater lifetime risk of nursing home entry and repeat entries, while their length of stay per admission was shorter. Findings illustrate nursing home use in insured and managed long-term care…

Describes Wanderer's Lounge, program developed by one nursing home to provide activities to benefit Alzheimer's victims and at the same time provide respite for more alert residents and staff on their units. The program and its benefits are discussed. (Author)

Evaluated special unit for care of patients with Alzheimer's disease or related disorders. Results showed in the unit, in which reduced stimulation was emphasized, patient weight loss was curtailed, patient agitation was diminished, restraint use was reduced, and wandering was no longer a concern. Found family members to be satisfied with care.…

Analyzes women (n=6) whose husbands reside in nursing homes, determining the extent to which these women perceive themselves as married. Some women perceive no existing couplehood with their institutionalized husbands, while others perceive low to high couplehood. Offers implications of such a typology for researchers, clinicians, and…

Explored environmental factors related to suicide in 463 long-term care facilities. Staff turnover, size, auspices, and per diem cost related to suicidal behavior and deaths from suicide. More suicides occurred in larger facilities and facilities with higher staff turnover. Religious or "other" facilities experienced more suicidal deaths than…

Examined effects of social support dimensions on risk institutionalization. Specific aspects of social support (having spouse or adult child caregiver) or having caregiving relationship of at least three years' duration moderated impact of one type of stress on risk of entering nursing home. Networks that included paid provider modestly offset…

A British Columbia survey of 45 intermediate care residents and 45 nurses found significant differences between residents' and staff perceptions of the importance of activities and residents' level of choice. Staff members' erroneous assumptions may result in procedures that restrict residents' choice of activities. (SK)

Twelve women (mean age 90) in a nursing home listened to Golden Age radio programs and answered trivia questions. Reactions to musical programs showed they encouraged reminiscence; trivia stimulated recall of historical and life events. In contrast, comedy programs evoked little response. (SK)

This article recounts the author's counseling relationship with a client who was a nursing home resident. The article describes the client's spiritual experiences and their impact on the client and the counselor. (Author)

A survey of 754 older adults serving as ombudsmen in nursing facilities found that formal education and follow-up training enhanced efficacy. Negative initial training was the most important influence on diminished efficacy. Those with higher efficacy and more positive initial training expressed less worry. (SK)

Interviews with staff in 46 senior residences and nursing homes identified different approaches to the use of reminiscence: formal group and individual sessions; informal, impromptu individual sessions; informal ad hoc sessions; and reminiscence-related activities. The range of staff skills required suggests a need for rethinking the values and…

Hospitalization is a sentinel event that leads to loss of independence for many seniors. This study of long-stay hospitalizations (more than 30 days) in seniors was undertaken to identify risk factors for not going home, to characterize patients with risk factors who did go home and to describe one year outcomes following home discharge. Using…