The Influence of Religious and Personal Values on Nursing Home Residents’ Attitudes Toward Life-Sustaining Treatments A cross-sectional survey design was used to interview 133 Jewish, Catholic and Protestant residents from 13 nursing homes to examine the influence of religious and personal values on attitudes toward life-sustaining treatments. Subjects on average were 83 years old, Caucasian and female, with more than half having Advance Directives (ADs). Jewish subjects, as well as those who relied on God, were better educated and more anxious about death, had significantly more positive attitudes toward life-sustaining treatments at the end-of-life. On the other hand, those who had implemented ADs desired fewer life-sustaining treatments. Finding demonstrate that understanding individual desires for life-sustaining treatments is complex. Practitioners who provide education on end-of-life decisions need to discuss a myriad of issues including individual religious and personal values and other characteristics in an effort to understand and respect treatment choices. Read more
A model intervention for elder abuse and dementia This article describes a 2-year collaborative project in Cleveland, OH, that improved the reporting and management of potential and suspected elder abuse situations involving persons with dementia. Educational curricula for cross-training, screening tools, and referral protocols were developed and tested for staff and volunteers in adult protective services and dementia care. A handbook for caregivers of persons with dementia was produced that enables caregivers to self-identify elder abuse risk and seek appropriate interventions to prevent abuse. Project organization, implementation, and evaluation are discussed along with strategies for replication in other communities. Read more
Prevalence and Problems in the Use of Satisfaction Surveys Results from Research on Ohio Nursing Homes The purpose of this chapter is to investigate the extent to which consumer satisfaction surveys are being conducted in skilled nursing facilities in the state of Ohio, the nature of the survey process and outcomes, and reported problems with satisfaction surveys. To date, research has not examined these issues, hence there is a lack of empirical information to gauge the prevalence and effectiveness of the consumer satisfaction survey process and outcomes from the perspective of facility staff. This study helps to fill the gap in the research literature by providing information on satisfaction surveys, based on interviews with management staff from a random sample of nursing homes throughout the state that are certified by the Ohio Department of Health as licensed providers. Read more
Ethical Issues in Conducting Customer Satisfaction Surveys in Long-Term Care Institutions Ethics is a field of study that deals with concepts and principles about what is right and wrong. Several researchers have discussed the main ethical issues in long-term care facilities (Elander, Drechsler, & Persson, 1993; Moody, 1983), such as 1) conflict of interests and divided professional loyalties, 2) paternalism versus autonomy, 3) confidentiality versus beneficence, and 4) the allocation of limited resources versus getting maximum benefits. The planning and implementation of customer satisfaction surveys in nursing homes is accompanied by similar as well as unique ethical issues. This chapter takes these four principles and examines them in light of the planning and implementation of customer satisfaction surveys in nursing homes. First, issues surrounding each ethical dilemma, including making decisions as to what the ethical controversy or problem actually is, are presented. Second, several suggestions and alternatives to solve the dilemmas are suggested. Read more
An Overview of the Process of Conducting Consumer Satisfaction Surveys in Nursing Facilities This chapter deals with the process of conducting consumer satisfaction surveys in nursing facilities. It is primarily focused on providing a “do-it-yourself” approach, and deals with issues such as how important staff commitment is before undertaking such an enormous task; whom the consumer is in the nursing home; methods for surveying consumers; tips for developing an instrument in-house; pretesting and piloting instruments; establishing reliability and validity; what tasks are involved in the actual implementation of the survey; how to analyze the data; and how to present the findings. It concludes with a case example of a nursing facility that designed and conducted its own survey. Since the tasks involved in developing an in-house survey are numerous, and require expertise and skill in survey methodology, this chapter is only meant as an overview of the process of conducting consumer satisfaction surveys in long-term care (LTC). Toward that end, the references may be used to obtain more detailed information on the tasks involved. Read more
The Buffering Effect of a Computer Support Network on Caregiver Strain ComputerLink was a computer support network for family caregivers of people with Alzheimer's disease. In a 12-month experiment, 102 caregivers were randomly assigned to an experimental group that had access to ComputerLink or to a control group that did not. This investigation examined whether caregivers in the experimental group had greater reductions in four types of care-related strain by the end of the 1-year study. ComputerLink reduced certain types of strain if caregivers also had larger informal support networks, were spouses, or did not live alone with their care receivers. More frequent use of the communication function was related to significantly reduced strain for caregivers who were initially more stressed and for non-spouse caregivers. Greater use of the information function was related to significantly lower strain among caregivers who lived alone with care receivers. Overall, ComputerLink appeared to be an effective tool for reducing strain for some caregivers. Read more
Family Caregivers and In-Home Respite Options The Consumer-Directed Verses Agency-Based Experience This study examined the preferences for and characteristics of consumer-directed (i.e., direct pay) and professionally-managed (i.e., agency-based) respite for family caregivers of adults with cognitive impairments. The sample of 168 caregivers was drawn from the in-home respite caseload of California’s Caregiver Resource Centers. Respondents in both groups reported the same ‘‘most important’’ reasons for preferring their respective mode of respite: wanting to be sure their loved one was safe, and having good, reliable and trustworthy help. The data revealed a clear preference for consumer direction in respite care in the home. Practice implications are addressed for improving the delivery of in-home respite care. Read more
Attitudinal Influences on the Elderly’s Use of Assistance This research examines the use of informal and formal assistance with personal and instrumental activities of daily living and the amount received by a randomly selected sample of urban older persons. A modified version of the Andersen behavioral model is used to organize explanatory factors that include the elderly's attitudes toward service use and filial expectations. Findings underscore the important influence of attitudes on assistance use in contrast to self-designated race, which had no influence either independently or in interaction with attitudinal variables. Elderly persons more likely to receive assistance were women of older age with lower incomes, who expressed more concerns about using services and were more physically disabled. Those receiving larger amounts of help had fewer concerns about using formal services and lived with their primary caregivers. Read more
