As part of a study of 198 residents with low vision in 28 nursing homes, 91 participated in a low vision rehabilitation intervention. Among the rehabilitation participants, 78% received simple environmental modifications, such as lighting; 75% received low vision instruction; 73% benefited from staff training; and 69% received simple nonoptical…

Purpose: We used data from a large sample of nursing homes to examine the association between staff turnover and quality. Design and Methods: The staff turnover measures came from primary data collected from 2,840 nursing homes in 2004 (representing a 71% response rate). Data collection included measures for nurse aides, licensed practical nurses,…

This article describes a pay-for-performance system developed for Minnesota nursing homes. In effect, nursing homes can retain a greater proportion of the difference between their costs and the average costs on the basis of their quality scores. The quality score is a derived and weighted composite measure currently composed of five elements:…

Purpose: To estimate the impact of nursing home work practices, specifically compensation and working conditions, on job satisfaction of nursing assistants employed in nursing homes. Design and Methods: Data are from the 2004 National Nursing Assistant Survey, responses by the nursing assistants' employers to the 2004 National Nursing Home Survey,…

Purpose: Nursing supervision of the routine daily care (e.g., grooming, feeding, and toileting) that is delegated to unlicensed assistive personnel (UAP) is critical to nursing home service delivery. The conditions under which the supervisory role is organized and operationalized at the work-unit level, taking into account workloads, registered…

An opportunity exists for those working with older adults in nursing homes to significantly encourage independence in the older adult using a creative approach. The use of folklore is suggested as a means for assisting the older adult toward a reconnection with the individuation process.

Purpose: This article aims to review research measures and findings related to physical environments of assisted living (AL) according to multiple conceptual perspectives--ecological, cultural, and Maslovian hierarchy. Design and Methods: A literature and research review was undertaken with two foci: performance measures for physical environments,…

Residents (N = 32) of 3 skilled nursing homes participated in a study designed to document the nature of the stressors they experienced and the coping mechanisms they used. Medical issues were the most common stressors. The most common coping responses were prayer, reading, watching television, listening to music, and talking to friends and…

This article explores facilitators and barriers to the impact and sustainability of a learning initiative to increase capacity of long-term care (LTC) homes to manage the mental health needs of older persons, through development of in-house Psychogeriatric Resource Persons (PRPs). Twenty interviews were conducted with LTC staff. Management…

Purpose: We examined the relationship between the quality indicator for decline in activities of daily living (ADL) and the use of the Minimum Data Set (MDS) for determining Medicaid skilled nursing facility reimbursement. Design and Methods: We conducted a cross-sectional analysis using the 2004 National MDS Facility Quality Indicator reports as…

Purpose: This research investigates what factors affect the degree to which nursing home performance explains variance in residents' change in status of activities of daily living (ADL) after admission. Design and Methods: The database included all residents admitted in 2002 to a 10% random sample of nursing homes in the United States.…

As the population ages, mobility limitations are associated with increased mortality and negative health-related states both in the general population and among people with intellectual disabilities. The influence of mobility limitations upon the lives and lifestyles of people with intellectual disabilities remains poorly understood. Specifically,…

Purpose: We examine whether the Nursing Home Reform Act (NHRA) improved nursing home staffing and quality. Design and Methods: Data from 5,092 nursing homes were linked across the 1987 Medicare/Medicaid Automated Certification System and the 1993 Online Survey, Certification and Reporting system. A dummy-year model was used to examine the effects…

These authors argue that estimates of the net economic cost of suicide should go beyond accounting for direct medical costs and indirect costs from loss of earnings by those who commit suicide. There are potential savings from (a) not having to treat the depressive and other psychiatric disorders of those who kill themselves; (b) avoidance of…

Purpose: Residential care/assisted living facilities have become an alternative to nursing homes for many individuals, yet little information exists about staffing in these settings and the effect of staffing. This study analyzed the intensity and skill mix of nursing staff using data from a four-state study, and their relationship to outcomes.…