Touch--both touching another and being touched--is a primary form of communication. By old age, both the need and the desire for specific amounts and kinds of touching are well established for the individual. The present study was designed to obtain information about what elderly women in nursing and retirement homes report to be liked and disliked types of touching. Participants who volunteered for this study were 32 ambulatory females 65 years of age or older who were living in nursing or retirement homes. Each participant was shown a set of 20 photos and sketches depicting a staff person touching an elderly woman in various ways, and asked to rate their liking for the particular type of touching on a one to five scale ranging from "like very much" to "dislike very much." The set of photos and sketches included ten comparable scenes with one-half showing a male staff member and the other half showing a female staff member touching an elderly woman. Scenes included: foot massage, helping to stand, back rub, brushing hair, arm around shoulder, holding hand, helping to dress, stroking cheek, helping with toileting, and helping with a shower.

The National Organization for Women use assertion training as a part of its strategy to overcome the oppression of women in our society. Certainly another group of people who suffer from oppression are the elderly. When a person in our society reaches age 65, he or she may suddenly be perceived as of decreased worth and may face forced retirement and quite often may have to adjust to a lifestyle of poverty. If an elderly person's physical health begins to wane, a nursing home may suddenly become the day to day environment he or she must accept. The therapists in the Residential Care Program, which offers mental health services to residents of nursing homes, at Elahan Mental Health Clinic and Center for Family Living in Vancouver, Washington realized that assertion training might be one way to help their elderly clients gain more control over their live and thus implemented an assertion training program. The following is an evaluation of that module which was introduced as part of the Elderly Day Treatment Program in 1977.

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The purpose of this exploratory study was to examine resident, family member and staff perceptions of electronic monitoring and their effect on resident rights. The sample consisted of 53 nursing home residents, 104 staff and 25 family members, in the Dallas Fort Worth metroplex, from a nursing facility in which residents utilize video cameras in their rooms (Nursing Facility 1), two nursing facilities that have video cameras in their common rooms areas (Nursing Facility 2 and 3) and a nursing facility that does not utilize video cameras (Nursing Facility 4). The interview questions and self-administered surveys were in regard to the participant's perceptions of electronic monitoring, perceived risks and benefits of video cameras, awareness of resident rights and consciousness of potential risks to resident rights. Data were analyzed using a mixed methods approach using both ATLAS t.i and SAS. Study findings revealed that residents, family members and staff are aware of the potential benefits of electronic monitoring in nursing facilities. While respondents are hesitant to have electronic monitoring in resident rooms, they are interested in utilizing electronic monitoring in common areas. While residents and staff believe that electronic monitoring compromises resident rights, family members believe resident rights are protected. Different types of staff have different perceptions of electronic monitoring. Those staff members that are more directly involved in resident care are less accepting of electronic monitoring compared to staff that have episodic visits with residents. Among staff members, nursing facilities with prior experience with electronic monitoring are less accepting of electronic monitoring. Further studies are needed to enhance this research.

Typescript (photocopy). / Digitized by Kansas Correctional Industries

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The purpose of this study was to retrospectively identify risk factors of elderly nursing home residents that may predict the hospitalization of recently admitted elderly nursing home residents. Two groups of randomly chosen residents were studied. The non-hospitalized group (n = 100) were admitted to a nursing home and remained in the facility for at least 90 days. The hospitalized group (n = 100) were discharged to a hospital within 30 days of admission to the nursing home. The presence of HCFA irregularities increased the odds for hospitalization of an elderly nursing home resident by 1.67. Regular medication orders on discharge increased the odds of hospitalization by 1.25. This study showed that the use of the 33 HCFA indicators are useful in identifying elderly nursing home residents that may be at an increased risk of hospitalization.

Adults over the age of 65 are at increased risk for influenza and pneumococcal infections; particularly those residing in nursing homes (NHs). Despite the efficacy of influenza and pneumococcal vaccinations, vaccination receipt rates among NH residents remain well below federal recommendations and racial/ethnic disparities exist. Minority NH residents (non-Hispanic Blacks and Hispanics) are less likely to be offered either vaccination and are more likely to refuse them compared to their non-minority counterparts (non-Hispanic Whites). In the past decade, requirements have been implemented to increase vaccination coverage in NHs, but there is little documentation regarding current racial/ethnic disparities in vaccination receipt. Furthermore, activities important to resident care delivery and the prevention of care deficiencies such as infections are primarily dependent on the care provided by certified nursing assistants (CNAs). For these reasons, current research examining racial/ethnic disparities in vaccination receipt in NHs is needed and more attention directed towards CNAs is necessary to improve resident care delivery and outcomes related to infection prevention and control. This dissertation furthers our understanding of racial/ethnic disparities in influenza and pneumococcal vaccination coverage among minority NH residents and the role racial/ethnic diverse CNAs play in infection prevention and control. Chapter One introduces the problem of health disparities in nursing homes (NHs) related to differences in preventative vaccination receipt by racial/ethnic status and the role CNAs play in infection prevention and control. Chapter Two, an integrative literature review on racial/ethnic disparities in NHs, describes racial/ethnic disparities occurring in the NH setting in the context of infection prevention and control and influenza and pneumococcal vaccination receipt along with contributing factors and existing strategies related to policy that have been implemented to address poor care quality. In Chapter Three, facility-level factors related to the CNA’s role and the barriers and facilitators they experience that contribute to infection prevention and control are discussed. In Chapter Four, a systematic review of previous research on racial/ethnic disparities related to influenza and pneumococcal vaccination in NHs, individual, community, and facility-level factors that determine these disparities in influenza and pneumococcal vaccination receipt, along with associated strategies and practices are discussed. In Chapter Five, a national quantitative analysis of vaccination receipt practices (vaccination administered) and reasons for vaccination non-receipt (i.e., not offered versus refused) are presented. The results of this dissertation will inform clinicians and NH administrators as well as future policy and public health interventions and provide evidence needed to improve racial/ethnic minority health and eliminate health disparities.

The elderly population is growing in nursing homes (NHs), with an estimated 3 million seniors to be residing in NH facilities by year 2030. Many of these seniors are potentially at risk for falls or infections. NH residents with Alzheimer’s disease or other forms of dementia are also increasing, and they are vulnerable to the adverse effects of medications. Psychotropics are overused in NHs, with approximately half to two thirds of residents receiving one or more psychotropics. Many negative health outcomes, e.g. falls and infections, have been associated with their use. The usage of psychotropic medications among NH residents has been a concern and topic of scrutiny for nearly three decades. In 1986, the Institute of Medicine published a landmark report that identified the overuse of psychotropic medications in NHs. The following year, the federal government passed the Omnibus Budget Reconciliation Act that included reform legislation to address psychotropic drug overuse. Since then, additional policies and initiatives have endeavored to rectify the problem, and scientists have conducted research regarding psychotropics and negative health outcomes. However, newer research within the last decade and at a national level is lacking. Therefore, this dissertation explores the association of psychotropic medications with falls and infections among NH residents using a national dataset, and this document is organized into five chapters. The first chapter discusses the background, significance, and current challenges surrounding psychotropic medication use in NHs. The second chapter delineates the search of the literature and relevant findings. The third chapter describes the methodology upon which this analytics of this dissertation was conducted. The fourth chapter outlines the results from the analyses. Lastly, the fifth chapter provides a synthesis and discussion of the findings and recommendations for health policy, practice, and future research.