The long-term care administrator profession is one that is both new and evolving. The unique historical perspective of this health profession is brief in the number of years it encompasses and crucial in understanding the current issues facing the profession. Administrator experiences provide a point of reference regarding the profession's structural problems. Ethical considerations play a dynamic role in administrators' daily jobs as well as their continued licensure. The significance of the profession's ongoing problems at the state and national level causes the need for alternatives to the current system. A combination of these alternatives must be embraced to assist in the recruitment and retention of long-term care administrators.
Elder abuse first received national attention in 1980, as the subject of a congressional investigation. Now, 20 years later, establishing successful strategies of identification, subsequent intervention, and prevention of abuse is of paramount importance; but progress toward this goal is hindered by lack of consensus as to the definition of elder abuse, and the use of vague, confusing, and sometimes contradictory terms in its discussion. In this paper, both social research and professional approaches and legal approaches to the definition of elder abuse are surveyed, as are definitions formulated for the National Elder Abuse Incidence Study conducted by the National Center on Elder Abuse. The continuing need for a universal or standard definition is emphasized.
This dissertation examined the impact of Medicare Plan D on medication compliance in Medicare beneficiaries at University of Texas Health Center at Tyler, TX. Data were collected before and after the implementation of Plan D. The impacts of various types of benefits, such as private insurance, employer insurance and pharmacy assistance programs were evaluated in terms of impact on drug compliance. Medication compliance was found to increase in those respondents without Plan D. Plan D was found to be a predictor of those who spent less on basics in order to buy medications. Although compliance increased in general, these increases could not be attributed to the acquisition of a Plan D policy.
Loneliness is a significant problem for older adults and can lead to negative health and social outcomes. Having a companion pet is beginning to be recognized as a way loneliness can be reduced for older persons. The purpose of this descriptive study was to determine the effect of pets on the level of loneliness in persons 60 years old or older who live alone and independently in a large metropolitan community in the North Central Texas area. Using a non-random snowball sample of older individuals (N = 252), who met the study criteria, each subject was administered the researcher-developed demographic data survey instrument containing the following variables: (a) pets - having a pet/wanting a pet, (b) age, (c) gender, (d) marital status, (e) living alone, (f) losses within the last six months, (g) interactions with family members, (h) interactions with others outside of the family, (i) highest educational level achieved, (j) employment or volunteer involvement in the community, (k) religious participation, and (l) self perceived health status. The UCLA Loneliness Scale Version 3 was used to obtain the loneliness scores. Prediction of loneliness and relationship with the independent variables was tested using frequency, correlation, analysis of variance (ANOVA), and multivariate analysis using ordinary least-squares (OLS) regression analysis. The findings from this study showed that those older adults living alone who did not have a pet but would like to have a companion pet had higher levels of loneliness (p<0.05). Other findings suggested that older adults' loneliness was less if they had moderate religious participation and interactions with others (p< 0.05). Future studies are needed to examine the effects that pets have on feelings of loneliness and the ability of older individuals to cope effectively with those feelings.
Federal and state regulations require that licensed long-term care facilities have policies for every resident-related topic. Long-term care administrators must plan, implement, and evaluate resident care policies that can be easily personalized to the needs of the specific facility's population. Part 1 of this paper is an overview of resident policies, covering admission, physician services, transfers and discharges, nursing services, restraints, abuse and neglect, pharmaceutical services, dietary services, clinical records, therapeutic recreation services, and social services. Part 2 presents the policies themselves, ready for use by Texas long-term care administrators as part of their facility's administrative policy manual.
The graying of America will have implications for all areas of society, especially the delivery of long-term care services. Many older individuals are aging in place, a phenomenon that is apparent at Dickinson Place, a church-sponsored low-income housing property for the elderly in Dallas, Texas, where the average age of residents has risen from 65 in the early 1970s to 78 in 1999. This change has prompted the board of directors to review the facility's mission, its physical plant, and the services it provides for strategic planning purposes, to ensure that Dickinson Place can continue to meet the needs of its residents both now and in the future.
The purpose of this study is two-fold: (1) to examine the correlation between frequency of sexual activity and general happiness among older Americans and (2) to examine the correlation between frequency of sexual activity and marital happiness among older married Americans. This study employed quantitative data drawn from the 2004-2008 General Social Surveys. Two samples were used. The first sample included all respondents 65 years of age and older with valid responses for the dependent, independent, and control variables. The second sample was a subset of the first and included only the married respondents. Both bivariate cross-tabulations and binary logistic regression analyses were conducted. As expected, the data support a positive association between sexual activity and general happiness in both the total elder sample and the married elder sample (p < 0.05). Also, as expected, the data support a positive association between frequency of sexual activity and marital happiness in the married elder sample (p < 0.05). Even with the introduction of control variables, frequency of sexual activity was found to be a significant predictor of both general and marital happiness (p < 0.05). This study suggests that sexual activity does indeed contribute the happiness and well-being of older Americans.
The effects of teamwork in a long-term care setting were explored, and four key elements of teamwork in the long-term care facility were discovered. These elements--clarity of purpose, clear communication, well-defined decision-making procedures, and participative leadership--are presented in detail. The literature reviewed as well as observations from personal participation in a case study show that employing the teamwork concept in a nursing home environment significantly enhances the quality of life for the residents of such facilities.
Tuberculosis in the nursing home is an ever-growing problem for the health care community. The incidence of tuberculosis in the United States has risen alarmingly since 1982, and high-population environments such as nursing homes are among the places where it is most prevalent. The first part of this document is an introduction to the current concerns faced by nursing home infection control personnel. It includes information about the history, symptoms, and epidemiology of the disease, as well as other topics. The second part is a policy and procedure manual that contains a basic guide to methodical testing for tuberculosis, steps for dealing with active cases of the disease, and suggestions for education of nursing home health care workers.
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