The nursing home industry has been saturated for decades with culture change initiatives in an effort to improve resident quality of care. The direct care worker (DCW) is considered a critical position to achieving nursing facility quality improvements. Understanding what leads to job satisfaction for DCWs could result in improved resident care. The relationship DCWs have with their direct supervisor or upper-level manager can impact employee satisfaction. The purpose of this research is to identify factors that are associated with DCWs satisfaction with supervisor and management support. Data was obtained from 307 DCWs who were employed at 11 North Texas nursing homes. It was expected that factors affecting satisfaction with direct supervision and upper-level management would differ. In fact, the study found that the antecedents for employee satisfaction with supervisor support were participative decision-making/empowerment, age, information exchange and feedback. Furthermore, participative decision-making/empowerment, perceived competence, staffing, information exchange and feedback were found to affect direct care workers' satisfaction with manager support. In conclusion, this research provides a starting point towards a more holistic view of employee satisfaction with supervisor support by considering the preceding factors and its subsequent effects.

The aim of this thesis is to identify and to describe barriers to the implementation of person-centered care in specific residential care facility for the elderly. For this purpose, the author firstly conceptualizes the concept of person-centered care. Consequently, she develops the Framework for conducting research. The theoretical portion consists of five chapters. The first chapter focuses on the person- centered care concept introduction, then it describes the relationship between concepts 'individualization of care' and 'person-centered care'. In the conclusion of the first chapter, the Schema of the concept is introduced. The Schema visualizes the structure for chapters two to five. In those chapters, a description of the systems defined in the Schema is provided. Those are: Care Recipients, Direct Care Actors, and Service Providers. The end of the first part brings the topic of a suitable organizational culture. The empirical portion firstly offers the summary of the theoretical background - so follows the Framework for the consequent analysis and data interpretation - then introduces relevant aspects within researched organization, particularly within organization currently implemented a psychobiographical model of care that is the approach to person-centered care. The empirical portion...