Search

In 2007, the Health Resources Services Administration introduced new mandates that raised the standards on program evaluation for Geriatric Education Centers. Described in this article are the primary and secondary evaluation efforts undertaken for one program within the Rhode Island Geriatric Education Center (RIGEC), the findings from these efforts, and the modifications to assessment that ensued in response to the increased accountability requirements. The evaluation focused on RIGEC's series of continuing education, day-long workshops for health and social service professionals, the completion of all seven of which leads to a Certificate in Interdisciplinary Practice in Geriatrics. (Contains 5 tables.)

The authors provide an account of their department's minimalist and largely reluctant approach to mandatory assessment in the past decade. A decade earlier, the department had gone all out in an experimental assessment effort supported by the Fund for the Improvement of Post-Secondary Education, an effort the department was neither willing nor able to make once the college's accreditation agency mandated assessment in 2000. The authors describe another "less-than-ideal design" that has nonetheless involved many of the assessment elements described elsewhere (e.g., alumni and student surveys, classroom assignments, external reviewers, research papers) and has nonetheless yielded usable and utilized feedback for both teaching and curriculum construction. (Contains 2 tables and 2 notes.)

The research reported in this paper examined the role of welfare reform in increasing the availability of entry-level workers to meet the rising demand for long-term care employees. Findings from national and statewide evaluations of welfare programs show mixed results in the extent to which beneficiaries could be shifted from welfare caseloads to the ranks of the paraprofessional labor force. Analysis of a welfare-to-work program in Rhode Island demonstrates the potential for recruiting welfare recipients to long-term care employment. It also shows the need for resources, supportive services, case management, and enhanced training to counteract the "work-first" philosophy of welfare reform.

Training of geriatrics clinicians in interdisciplinary teamwork included group dynamics, conflict management, leadership, and team building. Pre/posttest data from eight teams identified challenges in defining teams, stabilizing membership, dealing with health care changes, and coping with stress. Training objectives were revised to include empowering teams for advocacy and group learning. (SK)

Aging 2000 is a Rhode Island organization of community-based networks working to improve geriatric health care through consumer empowerment. Evaluation of workshops on health behavior and the health-care system shows the viability of using older adult volunteers as peer teachers. (SK)

Purpose of program was to improve quality of care delivered to institutionalized elderly and to provide training and assistance on gerontology career ladder to displaced homemakers, AFDC (Aid to Families with Dependent Children) recipients, unemployed immigrants, and other disadvantaged groups. Program successfully produced cadre of committed paraprofessionals but was not suited for those unemployed long term. (Author/BF)

According to a 10-year follow-up of 178 gerontology graduates of Rhode Island College (44 responses), the majority never worked in the field and most had not recently worked in the field. Age, gender, degree, and prior experience were not significant. Most would pursue the certificate program again. (SK)

Discusses the assignment of a research critique assignment to sociology students at Rhode Island College. Explains that students in methodology courses develop research skills by critiquing research articles and writing research proposals. Identifies the structure of the course and its connection with the other parts of the curriculum. Describes project assessment. (SG)

Examined determinants of spending on social security programs, using data from 75 nations representative of core, semiperipheral, and peripheral nations. Industrialization variables had strong effects in models involving all nations, as did multinational corporate penetration in extraction, particularly when region was controlled; such penetration was negatively associated with spending on social security. (Author/NB)

The National Service Framework (NSF) for Older People is a set of standards produced by the Department of Health in England in 2001 to overhaul the health and social service delivery systems over a 10-year period aimed at optimizing the care received by older adults. The NSF arose from broader social and health care reforms that likewise sought the establishment of performance assessment, augmented consumer sovereignty, and greater coherence across health and social services. The United States shares with England similar problems with care for its older adults, strategies for improvement, and obstacles to successful implementation of change. KEYWORDS. England (U.K.), health care, quality of care, social care

This paper provides an overview of English elder abuse policy including guidelines developed for adult protection by their Department of Health in 2000, a report released from the House of Commons Health Committee in 2004 on elder abuse, related policy changes affecting older adults, the mentally incapacitated, and social care regulations, and the launching of public awareness campaigns. In contrast to the U.S., English policy subsumes elder abuse within the larger category of vulnerable adult protection, steers clear of mandatory reporting, emphasizes abuse by formal caregivers rather than domestic violence, relies on a multi-agency approach to investigation and intervention, and supports more remedial, less punitive regulatory oversight, doi:10.1300/J084v18n01_01 KEYWORDS. Elderly abuse, policy, regulation, England

Poland enacted in 1997 legislation that founded a health care system in which health insurance societies contract with providers to deliver health services to the insured population. Through a review of the new statutes, interviews with key informants, analysis of public opinion polls and surveys of insurance administrators and health care workers, we examined the impact of reform on Poland's older citizens. The findings indicate that older adults are likely to be adversely affected by the inadequacies of insurance premiums as a source of finance, the lack of emergent private medical enterprise, and the failure to eradicate private health in its earlier, black market incarnation. KEYWORDS. Poland, health care, health reform, geriatric care, older adults

The research assessed the impact of a major innovation in the Long-Term Care Ombudsman Program that occurred in Rhode Island in 1997-the introduction of a volunteer component in which community members were trained and certified as advocates for residents in long-term care. Based on reports to the state ombudsman office, the findings indicated that the placement of volunteer ombudsman was associated with the generation of more complaints and more serious complaints about the facilities in which they were placed, some of which could not be resolved despite the greater intensity of interventions applied in these cases. Dat derived from nursing home inspections revealed a negative and significant correlation between the length of time a volunteer had been at a facility and the number of deficiencies. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address: Website: KEYWORDS. Ombudsman, volunteer, long-term care, nursing home, quality of care

In 1990, Great Britain enacted the National Health Service and Community Care Act to reduce unnecessary institutionalization, improve coordination of community-based long-term care, and stimulate private service provision. An overview of four major principles of the legislation is provided: the elevation of the assessor/care manager role, the emphasis on inter-agency collaboration across the health and social care divide, privatization of service, and support of carers (caregivers). Preliminary findings related to their implementation indicate incremental rather than sweeping change. The elements of the new policy that borrow from American models of community care - and may be difficult to transplant - are highlighted. Key Words: Community care, Long-term care, Institutionalization, Nursing homes, Great Britain

The research assessed the impact of a major innovation in the Long-Term Care Ombudsman Program that occurred in Rhode Island in 1997–the introduction of a volunteer component in which community members were trained and certified as advocates for residents in long-term care. Based on reports to the state ombudsman office, the findings indicated that the placement of volunteer ombudsman was associated with the generation of more complaints and more serious complaints about the facilities in which they were placed, some of which could not be resolved despite the greater intensity of interventions applied in these cases. Dat derived from nursing home inspections revealed a negative and significant correlation between the length of time a volunteer had been at a facility and the number of deficiencies. [ABSTRACT FROM AUTHOR]

Grass roots advocacy programs increase the capability of ombudsman programs in nursing homes. The advocacy programs provide supplemental manpower to the ombudsman program, and assist them in tackling political resistance and bureaucratic rigidity. These groups support the ombudsman indirectly via their scrutiny, criticism and presence. The ombudsman office needs to be independent of the government and collaborate with citizens groups to provide actual consumer representation.

An analysis of the gerontological training program for nursing assistants organized by the New England Gerontology Academy shows that the program has produced many paraprofessionals sincere to the job and that it is suitable for people undergoing a transition in their lives. The program however failed to provide employment to many recipients of public support and was not considered suitable for people who had been permanently separated from the labor market. The program attempted to provide quality care for institutionalized older adults and opportunities of training for disadvantaged groups.

Describes Alzheimer Support/Tender Loving Caregivers Project which represents the efforts of a mental health center to collaborate with an interfaith coalition to recruit and train church-based volunteers to provide respite care for frail elderly and their families. Describes educational component as overshadowing service. (Author/ABL)

Aged inmates comprise a growing segment of the incarcerated population world-wide, yet very little research has been devoted to examining the intergenerational experiences of this cohort and the research that has been conducted has been inconsistent in its findings of victimization and negative social relationships. In an attempt to help fill this gap, this study examined the intergenerational elements of the lives of older (male) inmates and investigated their social supports and the degree of age segregation characterizing their carceral experience. Qualitative data revealed ruptured connections among inmates and their children and apprehensive relationships with younger fellow inmates or the correctional staff. Nevertheless, the findings counter the contention that the intergenerational environment is detrimental to aged inmates and that age-segregated carceral units would be beneficial to them. [ABSTRACT FROM AUTHOR]

There is a well-described need to increase the competence of the primary care workforce in the principles of geriatrics and palliative care, and as value-based payment models proliferate, there is increased incentive for the acquisition of these skills. Through a Geriatric Workforce Enhancement Program grant, we developed an adaptable curriculum around commonly encountered topics in palliative care and geriatrics that can be delivered to multidisciplinary clinicians in primary care settings. All participants in this training were part of an Accountable Care Organization (ACO) and were motivated to improve to care for complex older adults. A needs assessment was performed on each practice or group of learners and the curriculum was adapted accordingly. With the use of patient education and screening tools with strong validity evidence, the participants were trained in the principals of geriatrics and palliative care with a focus on advance care planning and assessing for frailty and functional decline. Comparison of pre- and post-test scores demonstrated increased confidence and knowledge in goals of care and basic geriatric assessment. Participants described feeling more able to address needs, have conversations around goals of care, and more able to recognize patients who would benefit from collaboration with geriatrics and palliative care. [ABSTRACT FROM AUTHOR]

The aim of this article is to describe the impact of an educational initiative intended to increase adoption of a delirium protocol (the Confusion Assessment Method [CAM]) in the acute care wards of two hospitals. The project embodied the Plan-Do-Study-Act model for improvement of health care delivery, characterized by feedback loops from ongoing evaluation. Continuing education workshops on delirium and focused training on CAM implementation were assessed through pre-/post-test measures. To determine the effectiveness of training, administration of CAM at admission and discharge was tracked for the months preceding training, immediately after training, and during a sixmonth sustainability period in experimental units. Educational programming was well received by staff and increased the use of delirium screening at both hospital sites posttraining, but with declines occurring in the sustainability period at one of the two hospitals. Modifications to the electronic medical record system overcame some obstacles to implementation at the hospital with lower compliance. [ABSTRACT FROM AUTHOR]