Describes the development of a statewide strategy to improve resident outcomes in nursing facilities, and presents some evaluative data from this strategy. Results reveal that the partnership has resulted in state agency staff having information from analyses about resident needs. Suggests that other states should consider building partnerships…

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…

Examined whether physical restraints are related to decreased social behavior among nursing home residents. Data collected from 112 nursing home residents suggest that low social performance puts resident at risk of being restrained, but more frequently use of restraint hampers resident's performance of social behavior. (Author/NB)

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…

Short-term longitudinal study assessed single and combined effects of two interventions designed to affect nursing assistants' (n=193) performance by increasing knowledge and motivation. Four sites included skills training only, job redesign only, both interventions, and control. Significant differences were found in knowledge in comparisons…

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)

Used data from 441 new nursing home residents to examine physical restraint use in high and low restraint use homes. Predictors of restraint use during first month and first year were inability to transfer and combination of severe activities of daily living impairment and cognitive impairment. Other predictors: wandering, inability to dress,…

Conceptualizes separation-individuation conflicts in caregivers as behavior under dual control of nonverbal and verbal antecedents and consequences of others and dysfunctional self-rules of caregiver. Describes two types of treatment in context of case study: changing caregiver's problem behaviors by training nursing home staff and teaching…