Purpose: The Gentle Persuasive Approaches (GPA) curriculum was developed as an adjunct to other educational initiatives that were part of Ontario, Canada's Alzheimer Strategy. GPA emphasizes that an individual's unique personal history has a direct application to the interpretation of and response to their behavior. It incorporates strategies into…

Examined differences among nursing homes in rates at which they transfer patients to hospitals. Data from nursing staff and charts on 286 most recent transfers from 10 nursing homes revealed that, from relatively equivalent patient populations, high-rate facilities transferred more chronically ill, physically frail patients and patients with…

Conducted interviews with 54 home care clients (over half of whom were age 60+) and their home health aides and personal care attendants. Interviews revealed home care relationships tended to be both formal and informal, in that job responsibilities tend to be diffusely defined and home care workers often became involved in the…

Purpose: The purpose of this article is to explore how medical care is delivered to older people in assisted living (AL) settings and to suggest ways for improving it. Design and Methods: We present a review of the limited research available on health care for older AL residents and on building testable models of better ways to organize primary…

Examined agreements between physicians and patients on major goals and topics discussed during outpatient medical visit. Found concordance to be significantly greater for younger patients and their physicians than for older patients and their physicians on major goals and major medical topics discussed during primary care interview. (Author/NB)

Content analysis of problems caregiving daughters and daughters-in-law (n=51) elected to work on during counseling yielded seven categories: improving coping skills; meeting elder's needs; responding to family issues; concern over caregiver-recipient relationship; eliciting support; feelings of inadequacy and guilt; and planning for elder's…

Notes that day care programs created to serve physically frail elders are hesitant to accept growing number of clients with severe cognitive impairment. Suggests ways to modify existing programs to accommodate clients with dementia. Discusses adapting screening and intake procedures, the first few visits, behavior management, programming, and…

Examines the assumed negative effects of nursing personnel turnover rates and nursing home and aggregate resident characteristics on resident discharge and death rates. Although the effects of nursing home and aggregate resident characteristics were expected, the unanticipated influence of nursing personnel turnover rates suggest that turnover…

Examined nationally representative sample of 60 adult day care centers to describe state of adult day care. Results indicated that day care centers could be categorized into 3 models of care, each serving distinctive subpopulation. Tested model appropriateness with analysis of variance of differences in participant characteristics. Contrasted…

Describes the intervention approaches, clients groups, and impacts on use of Medicaid and Medicare reimbursed services for five demonstrations included in the national evaluation of community-based long-term care. Only one project produced significant reductions in nursing home use. Unlike other projects, it identified potential clients through…

Using a newly developed coding method, the Geriatric Interaction Analysis system, the interactions of doctors with a matched sample of older and younger patients were audiotaped and scored. Patients and doctors raised fewer psychosocial issues in interviews with older patients than with younger patients. Doctors also responded less well to these…

Compares differences between elderly who use formal home care services and those who do not. Data revealed users as less healthy and less active and as receiving more assistance from both formal and informal sources. Suggests that formal and informal services complement rather than substitute for one another. (NRB)

Describes targeting policies of four Social Health Maintenance Organization sites which deliver integrated, prepaid, acute, and chronic care to Medicare beneficiaries. Analyzes complexities of operationalizing targeting systems in four different settings. Notes that selection criteria for targeting expanded benefits and their implementation affect…

Found clientele of two comprehensive sociomedical home care programs to be similar to clientele of a traditional medical nursing program. The comprehensive programs did not have clientele with more problems and less adequate social supports. To serve their target clientele, these programs need more homemaker and personal services. (Author/ABB)

Presented 192 clinical psychologists with clinical vignettes in which client ages varied. Respondents rated older depressed and older agoraphobic clients as significantly less ideal than younger clients with identical symptoms and histories. Older depressed and manic clients also were given significantly poorer prognoses than younger clients.…