Purpose: We compared inpatient days, nursing home days, and total Medicaid claims for five Medicaid-funded home- and community-based services (HCBS) programs for in-home and assisted living services in Florida. Design and Methods: We studied a single cohort of Medicaid enrollees in Florida aged 60 and older, who were enrolled for the first time in…

The education of direct care workers (DCWs) is key to improving job quality and the quality of care in long-term care (LTC). This paper describes the successful integration of a supervisory training program into a continuing education intervention (WIN A STEP UP) for DCWs, identifies the factors that appear to influence the integration of the…

Training of direct care workers (DCWs) varies depending upon the setting in which they work and the state in which they are trained. Evidence points to the importance of adequate training as critical to DCW job satisfaction and reduction in turnover. Several approaches have been taken to enhance the training of DCWs with the objective that as job…

We assessed effectiveness of four education programs in providing nursing assistants with ability to produce a therapeutic milieu supportive of intact residents' activities of daily living, positive self-esteem and mood: (1) a combination of Orem's Systems of Nursing Care and Skinner's Applied Behavioral Analysis, (2) Applied Behavioral Analysis,…

This study examined the experience and planned activities regarding nursing home admissions of persons with Acquired Immune Deficiency Syndrome (AIDS). Surveys were sent to 235 nursing home administrators in Illinois to obtain information on the facility, staff needs and experiences in service provision to persons with human immunodeficiency virus…

In order to test the effectiveness of the use of pets with the elderly in a nursing home setting, three concurrent studies were conducted. The 29 residents participating in the experiment were selected by nursing home personnel as meeting the criteria of being depressed and withdrawn, and receiving no regular (weekly) visitors. Study I compared…

As part of the adult education program of Mountain View-Los Altos (California) High School District, elderly patients at skilled nursing care facilities take classes in poetry. The poetry classes are therapeutic in nature, satisfying a real need for these very ill elderly people to express their frustrations, hopes, fears, and joys. All of the…

Three studies were undertaken to examine topics of care planning, personnel management, and quality assurance in long-term care facilities. The first study examined the formulation and implementation processes of care planning for nursing home residents. The exemplary homes' care planning included the existence of strong care planning leadership,…

This article examines leadership from the perspective of administrators of homes for the aging. The article points out that most educational institutions have become enamored of linear thinking, quantification, and scientism. On the other hand, intuition, feelings and sesitivity -- the essence of human relations training -- have tended to become…

Provides further insight into the relationship between facility ownership and facility performance in nursing homes. Found proprietary nursing homes to have lower costs than not-for-profit and government homes. Measures of quality, however, may be inadequate to assess the psychosocial quality aspects of environments. (Author/ABB)

Examined difficulty of obtaining valid informed consent from participants in research with older persons. Of 470 nursing home residents asked to participate in nonrisk study, 406 agreed. High consent rate was attributed to perception of research significance, presentation format, and absence of risk or pain. (Author/NB)

Interviewed 28 relatives of nursing home residents about their involvement in care of elderly relatives and perceptions of care provided by nursing home staff. Relatives attributed responsibility for most tasks to nursing home staff; held themselves responsible for some tasks, such as monitoring and evaluating quality of care, and teaching staff…

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…

Administrative staff (N=49) of not-for-profit nursing homes identified 103 autonomy-enhancing programs for mentally impaired. Programs were encompassed within six categories: special resident programming, structural and environmental adaptations, staff training, family programming, staff deployment, and ethics initiatives. (Author/NB)

Statistical and legal analysis of California nursing home admission agreements indicated that agreements limited autonomy of nursing home residents in important ways, including constraints on resident's right to make health care decisions and other basic personal choices, entitlement to due process or grievance procedures, and right to informed…