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Long Term Care Ombudsman Complaint data from one state's 261 nursing homes are examined in the study. We assessed differences between male and female groups, including chiefly residents, but also ombudsmen, the residents' relatives or friends, administrators, legal representatives, and others regarding types and rates of complaints as reported in the Administration on Aging (AoA) major categories of: Resident Care, Resident Rights, Administration, Quality of Life, and Complaints Not Against Facility. Proportionately, male residents lodged more complaints than females. Further, males complained more than females about Resident Rights violations and filed more Complaints Not Against Facility. Females lodged significantly more complaints about Care, Quality of Life and Administration. Thus, males were more likely to report technical, impersonal, and legalistic issues, than females, who were more likely to express concerns about personal care and socioemotional-environmental issues. Results yielded further evidence of gender differences in the patterns of resident complaints. Nursing home social workers are highlighted as agents in changing embedded stereotypes about residents and complaints. KEYWORDS. Nursing home complaints, gender, long term care ombudsman program

This purpose of this exploratory study is to describe the education, responsibilities, and knowledge of social service workers in skilled nursing facilities. The study used a stratified random sample for structured telephone interviews of 108 social service workers in Missouri. The data indicate that 16% of respondents have a graduate degree, 46% a bachelor's degree, and the remaining 38% have no college degree. Results show that 11% of facilities with more than 120 beds were out of compliance with OBRA requirements for a 'qualified' social service staff person, while the credentials of 35% of facilities with less than 120 beds exceeded the credential requirements. Social service staff report their responsibilities include facilitating the social and psychological well being of residents, discharge planning, the admission process, and care planning, The findings have implications for policy makers as consideration is given to the mental health needs of nursing home residents and for social work educators preparing students for gerontological practice. KEYWORDS. Nursing homes, social services, social workers, policy, practice, survey research, gerontology

While much of the gerontological literature emphasizes the institutionalization of an older adult as an endpoint of family care, research has emerged illustrating the continued involvement of family members in the lives of residents. The purpose of the present study was to determine how resident setting, family context, resident background, staff background, and resident function influence the provision of family involvement in three long-term care environments: nursing homes, assisted living facilities, and family care homes. Five nursing homes, five assisted living facilities, and 16 family care homes and residents (N = 112) in the state of Kentucky were randomly selected. Results showed that type of facility was less important in accounting for different dimensions of family involvement than family context, family orientation of facilities, or resident need. The findings demonstrate the complex process of family involvement across the long-term care landscape, and have several research and practice implications for the facilitation of family integration in residential long-term care. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address: Website: [C] 2003 by The Haworth Press, Inc. All rights reserved] KEYWORDS. Assisted living, nursing homes, adult foster care, family caregiving, family involvement, long-term care, family orientation, visits, informal care, long-term care continuum

Since the Patient Self-Determination Act became law in 1991, nursing homes routinely address advance directives with all residents. This study investigated the implementation of end-of-life care wishes of residents in one nursing home in Florida. Data were collected from the medical records of residents who died in the facility (n = 75) in one year. Two-thirds of the residents had either completed a living will, or designated a health care decision-maker, and 90.7% of the residents had do-not-resuscitate orders. Findings suggest that in 94% of the cases advance directives were followed, and that professional social work activities contributed to the high rate of compliance. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address: Website: [C] 2003 by The Haworth Press, Inc. All rights reserved.] KEYWORDS. Advance directives, nursing home, autonomous decision-making

Factors influencing the willingness to enter a nursing home were examined among Holocaust survivors (N = 94) and elderly persons who did not experience the Holocaust (N = 74). No differences were found between the groups regarding their willingness to enter a nursing home. Attitudes toward nursing homes were the main factor influencing the decision-making process for both groups. Income was an additional factor for Holocaust survivors, while living situation and education were additional factors for the other group. Holocaust survivors who tried to avoid memories of the Holocaust, were less willing to enter a nursing home, than survivors who made less of an effort to avoid such memories. KEYWORDS. Holocaust survivors, nursing homes, attitudes

Increasing numbers of older adults in our society have created a demand for a range of housing options. This study was conducted to better understand the relationship between the type of housing in which older adults lived and their utilization of formal services. A modified version of the Andersen-Newman model (1973) was used to organize the independent variables with type of housing listed as a separate category for the purposes of regression analysis. People living in senior housing (age segregated) were older, poorer, more functionally impaired, more likely to have Medicaid health insurance, and more likely to use formal in-home services than those seniors living in age integrated housing. In both groups, level of need was the strongest predictor of formal service use. However, even with all the need, enabling, and predisposing variables controlled, housing type made an independent contribution in explaining patterns of service utilization. KEYWORDS. Senior housing, age segregated housing, age integrated housing, formal in-home services, pathways to service utilization

An eight week education-support group given to family members of nursing home residents helped them adapt into the nursing home environment. At the conclusion, and despite deterioration in health status of the residents, family members reported that they enjoyed their visits more than before the intervention started. An especially effective component was when a project staff member worked directly with residents and then helped family members practice those successful visit strategies during support group sessions. With similar programs, nursing homes can reap the benefit of enhanced family involvement. Keywords: Support groups, family caregiving, nursing home quality

This article examines the ways that 11 offspring caregivers talk about the possibility of nursing home admission for their physically disabled parents and explores the relationship between caregiver burden and nursing home placement. Participants were part of a longitudinal population-based study of community- residing older people. Content analysis of extended case narrative from qualitative, semi-structured interviews indicates that caregiver burden is related to feelings about nursing home use but does not necessarily signal a reluctance to continue providing care in the community. Findings are discussed in terms of future efforts to support caregivers and keep elders in the community. Keywords: Informal caregivers, caregiver burden, attitudes about nursing homes, offspring caregivers, disabled elders

Health and mental health providers often work with the aged across shifting fields-the family system, nursing homes and the elderly's inner, imaginal world. To help organize providers' observations and interventions among a variety of psychosocial contexts, effective providers focus on the stress surrounding aspects of conflict resolution. The authors discuss four approaches to conflict resolution, illustrating each with a detailed case study demonstrating how the resolution took into account the elderly's capacity to tolerate stress.

A study of two nursing home units, where one unit houses socially intact residents while the other has residents who are either cognitively or physically impaired or in need of skilled nursing, was conducted. Based on a study of the 'social environment' that prevailed in both units, it was found that the quality of life of the residents largely relied on the level of the social environment of the unit that they belonged to. This suggests that a unit's social environment could affect the resident's conception of self, his interactions with other residents and with the nursing staff.