Nursing homes in Illinois Quality Incentive Program receive separate bonus payment per Medicaid day for achieving each of six quality standards. Of 809 participating homes (1985-88), over 90 percent of eligible facilities chose to participate annually. Success in achieving bonus payments in multiple standards increased over time, with 27 percent…

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)

Baccalaureate-prepared registered nurses (RNs) in hospitals appear to have more differentiated roles than nurses in nursing homes or ambulatory care. If employers believe that it is more cost-effective to shift responsibilities from physicians to RNs, demand for nurses with bachelor's degrees will increase. (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…

Purpose: This article describes the progress of our study to examine the advantages and costs of using self-managed nurse aide teams in nursing homes, steps that are being taken to implement such teams, and management strategies being used to manage the teams. Design and Methods: A quasi-experimental design is underway where certified nurse aide…

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…

Purpose: Longitudinal research in dementia has acknowledged the importance of transitions during the course of family caregiving. However, long-term adaptation to institutionalization has received little attention. This study attempts to describe caregivers' adaptation (changes in stress, well-being, and psychosocial resources) to placement up to…

Purpose: Using a conceptual framework from the field of care work and the theory of boundary work, we explore the use of family metaphors by nurse's aides to describe their affective care for nursing home residents. We focus on how nurse's aides can express affective care in spite of experiencing racial abuse. Methods: Using the technique of…

Purpose: This study identifies the relative importance of reasons for institutionalization endorsed by caregivers of patients with dementia; examines the relationship between caregivers' reasons for institutionalization and indicators of caregiver and patient physical and emotional functioning measured in the prior year; and compares, on these…

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…

Purpose: This study reviews staffing standards from the 50 states and the District of Columbia to determine if these standards are related to nursing home staffing levels. Design and Methods: Rules and regulations for states' nursing home staffing standards were obtained for the 50 states and the District of Columbia. Nurse staffing data were…

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…

The decision to move a family member with dementia to a nursing home is a difficult experience for caregivers. Complex psychosocial factors are involved and knowledge of predictive factors alone is insufficient. Using grounded theory, this study explores the decision-making process with regards to institutionalization, from the perspective of…