Many elderly patients remain in acute care hospitals while they await transfer to Long Term Care (LTC) facilities. Complex problems, common for this special group of patients, place them at risk for delayed discharge. Discharge planning, for these patients, has become an increasingly critical activity for social workers. / This study examined factors that predict the risks for inappropriate hospitalization for 244 patients waiting for LTC in 1999, and it explored the LTC application process to identify barriers to delayed discharges. / It was found that 63% of the hospitalization of these patients was inappropriate. System related factors, such as the timing of the LTC application, were identified as predictors. Timeline investigations revealed areas for improvement in the discharge process and were discussed with a view to social work implementation, for example, the introduction of a high-risk screening protocol.

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Pain is the most prevalent medical problem that elderly persons experience in a long-term care home. Nurses play an essential role in managing their pain. The purpose of this study was to explore nurses’ pain management practices in Ontario long-term care homes facilities. The ultimate aim was to recommend measures for effective pain management in aged people. The setting for this study was a selected long-term care home in Ontario, Canada, a 160-bed nursing home for aged people offering various medical care services. Semi-structured focus group interviews, averaging approximately one hour, were conducted. The population of this study was 45 nurses. The researcher used a purposive sampling method to select a sample of 25 nurses. Open-ended questions were used to explore pain management practices and to find barriers to effective pain management. Qualitative data analysis was used to review the data to identify common issues that recurred, and they were summarised in a narrative form. This study demonstrated the importance of recognising and overcoming barriers to the effective management of pain and reinforcing good practices in long-term care homes. Therefore, improved pain management practices are required to manage pain in a long-term care home effectively. / Health Studies / M.A. (Nursing Sciences)