In this theme issue, 18 articles discuss the motivation for and benefits of working with old and dying people, nursing homes, ethical issues, and the training of home health care workers. Employee recruitment and retention and the economics of health care for the frail elderly are also addressed. (JOW)

Examined type of service, volume, and mix of services provided to 270 poor and frail elders. Predictors of use and volume of service differed depending on type of service. The most prescribed service combinations included nursing, home health, and homemaker; homemaker only; nursing and home health; nursing and homemaker; and nurse only. (RJM)

Issue includes 17 theme articles on long-term care, covering legal issues, federal role, state programs, demonstration programs, family caregivers, home health care, home care workers, culturally appropriate long-term care, financial support, and cognitive impairments. (SK)

A retrospective cohort design is used to estimate the effect of urinary incontinence (UI) on the public costs of home care services to elderly individuals. Multivariate analyses controlling for other individual, household, and supply characteristics demonstrate that those with UI generate significantly greater public costs for home care services.…

A Ford Foundation demonstration project intended to improve the quality of work life and reduce turnover among homemakers/home health aides in the home care industry was evaluated. The project supported three separate work life demonstration at home care agencies in New York City and Syracuse, New York and in San Diego, California. The…

Federal Medicaid long-term care regulations do not require states to offer home and community-based service (HCBS) alternatives; rather, they are offered at the discretion of each state. The two most significant Medicaid HCBS programs are the Medicaid 1915(c) HCBS waiver programs and the Medicaid Title XIX personal care services (PCS) optional…

Describes the outcomes of the Community College-Nursing Home Partnership Project in three areas: faculty development, curriculum innovation, and collaborative relationships. Explains how the project allies associate degree nursing faculty with practitioners to incorporate nursing home care and geriatrics into the curriculum. (JOW)

This report evaluates a self-directed personal service (SDPS) program operated through the larger Enable Program for people with disabilities in Onondaga County, New York. First, it contrasts characteristics of traditional personal assistance services (such as low pay, agency-determined, limited types/levels of support, and program management…

Increasing demands for home health aides to the frail elderly and disabled, coupled with a high rate of turnover among these aides, has led to growing concerns over worker recruitment and retention in the home care industry. This paper therefore describes a model developed to explain job satisfaction and turnover among home health aides. The model…

These two volumes contain research papers and personal reflections developed as culminating projects by adult students involved in workplace literacy classes in nursing homes, hospitals, and home care agencies. The first volume contains 18 papers: "What You Need to Know about Cancer" (Grace Bopst); "What Nursing Assistants Need to Know about Heart…

This document contains the secondary education model curriculum for the secondary education preparation of home health aides in Montana. The document includes: (1) an introduction and a rationale for the program; (2) skills required by programs that meet certification requirements for a long-term care nurse aide (75 hours) and home health aide (an…

Long-term care workers (those who are paid to provide custodial care for long-term patients in nursing homes or at home) must care for a growing number of increasingly disabled or dependent persons. They are working for agencies and institutions under growing pressure to increase productivity. They face new training and competency requirements,…

This "gray paper" asserts that the physical, emotional, and financial needs of unpaid caregivers--usually women--have been largely ignored in our national health care policy regarding care for the severely disabled elderly. It discusses the problem of the caregiving role for wives of severely incapacitated husbands, noting that the present health…

This curriculum guide contains lesson plans and student materials for a workplace literacy program for health care workers in hospitals, nursing homes and home-care agencies. The guide begins with a bibliography that contains the following: 44 books, 15 videotapes, 1 multimedia presentation, 12 health magazines and journals, 41 references, and 26…

Research confirms anecdotal impressions of the following causes of high turnover among both home health and nursing home aides: low wages; inadequate benefits; excessive workloads; poor training, supervision, and working conditions; and job-related stress. Public policy initiatives can dramatically alleviate or exacerbate the crisis among…