This study addresses the factors influencing decisions to send medicine-surgical (med-surg) patients home or to nursing facilities (NFs). The sample (n = 7,852) was taken from a large, urban, teaching, med-surg unit where discharges were documented and data collected over a two-and-a-half-year period. Using logistical regression, the factors found…

Purpose: Advance directives are important planning and decision-making tools for individuals in nursing homes. Design and Methods: By using the nursing facility Minimum Data Set, we examined the prevalence of advance directives at admission and 12 months post-admission. Results: The prevalence of having any advance directive at admission declined…

Assessed decision-making capability and preferences regarding advance directives of 39 nursing home residents and proxies. Most patients willingly stated preferences; over one-half opted to forego burdensome measures when death appeared imminent. Decisionally capable patients were more likely to forego life-sustaining measures than those of…

Context: Advance directives promote patient autonomy and encourage greater awareness of final care options while reducing physician and family uncertainty regarding patient preferences. Purpose: To investigate differences in decision making authority and the use of advance directives among nursing home residents admitted from urban and rural…

Commissioned scholarly papers and undertook anthropologic observation to examine legal and ethical issues for patients, family, and caregivers during discharge planning. Proposed policy suggestions in which conflicting interests were recognized but in which patients' rights to autonomous decision making in discharge planning were strongly…

Examined attitudes of elderly acute-care hospital patients (N=264) concerning discharge planning. Respondents varied in their reactions to discharge planning and degree to which they exerted final control over decision. Perceived lack of control was associated with posthospital psychological distress for patients with high levels of internal locus…

Kahneman and Tversky's (1979) Prospect theory was tested as a model of preferences for prolonging life under various hypothetical health statuses. A sample of 384 elderly people living in congregate housing (263 healthy, 131 frail) indicated how long (if at all) they would want to live under each of nine hypothetical health conditions (e.g.,…

Surveyed 90 administrative and nonadministrative social workers employed in nursing homes who identified their level of influence in 5 spheres of organizational decision making. There were few differences between the two groups. However, among directors, number of full-time equivalent social workers, type of institution ownership, and length of…

This paper examines the variety of legal rules and processes which have been established to assess and ensure that the quality of care provided in nursing homes satisfies an acceptable level. It begins with a general overview of nursing home law. Areas discussed in this section include: (1) sources of nursing home law; (2) theories of liability;…

Studied discharge plans for 369 African American and white elderly patients and examined posthospital care options pursued by social workers, patients, and families. Discharge planning with African American patients and family members involved less pursuit of nursing home care and more pursuit of formal services in the home than planning with…

This monograph, the fourth in a series of five, provides training information for hospice staff in improving interdisciplinary team functions and humanistic care provisions. Its purpose is to prepare a skilled team of trainers with information about hospices that is relevant to hospice interdisciplinary team training and to document experiences in…