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.

The current mixed methods study utilized an ecological framework to examine public perspectives toward sexual behaviors among long-term care residents with dementia. Analyzing attitudes of the public is an integral component of understanding the entire ecological system that affects the development and overall well-being of a long-term care resident. Attitudes were examined using a multiple segment factorial vignette with a probability sample of 329 respondents from a southern state. Results indicate that attitudes were not statistically affected by sex or the elapsed time since diagnosis, and age, spousal disposition, and degree of intimacy predicted attitudes. A respondent’s education level also predicted attitudes across segments; those who attained higher levels of education were consistently more accepting of sexual behaviors, less likely to expect staff intervention in adulterous relationships, and were supportive of the healthy spouse beginning a new relationship. An ecological perspective provided a framework for guiding and informing future research on the influences of long-term care on sexual development and, in turn, for the development of relevant long-term care policy.

Manitoba’s population is aging. Trends in personal care home (PCH) use have also changed so that residents today have more cognitive impairments including Alzheimer’s disease and related dementias (ADRD). While quality of life (QoL) has emerged as an important PCH research outcome, this literature is relatively sparse for residents with versus without ADRD. This study was conducted to examine the QoL of PCH residents with ADRD, using a recently developed but as of yet untested framework by Kane and colleagues (1999, as cited in Frytak; Kane 2001, 2003). The specific aims of this study were to gather family caregivers’ perspectives on: (a) the meaning of the six domains that constitute Kane et al.’s ADRD-specific PCH-QoL framework; (b) domains they considered to be more important or lacking from this framework; and, (c) general PCH policies, practices, and activities that currently (or could better) facilitate positive QoL experiences for their loved ones.

Background: There is little information on how the quality of oral health services in long-term care (LTC) facilities is conceptualized or assessed. Objectives: This study aims to develop a model for assessing the quality of oral healthcare services in LTC facilities. Methods: This study is divided into four main steps. Firstly, I examined literature for existing concepts relating to program evaluation and quality assessment in healthcare to build a theoretical framework appropriate to dental geriatrics. Secondly, I explored as an ethnographic case study a comprehensive oral healthcare program within a single administrative group of 5 LTC facilities in a large metropolis by interviewing 33 participants, including residents and their families, nursing staff, administrators and dental personnel. I also examined policy documents and made site visits to identify other attributes influencing the quality of the program. Thirdly, I drafted the assessment model combining a theoretical framework with empirical information from the case study. And lastly, I tested the feasibility and usability of the model in another dental geriatric program in northern British Columbia. I applied the assessment model by conducting 15 interviews with participants in the program, made site-visits to the 5 facilities, and reviewed documents on the development and operation of the program. Results: A combination of theory-based evaluation and quality assurance provided six sequential and iterative steps for quality assessment of oral health services in LTC. The empirical information supported the theoretical framework that a program of oral healthcare in a LTC context should be assessed for quality from multiple perspectives; it should be comprehensive; and it should include the three main attributes of quality - capacity, performance, and outcomes. Participants revealed 20 quality indicators along with suggested program objectives which encompass eight quality dimensions such as effectiveness, efficiency, and patient-centered. Conclusion: The model provides a unique system for assessing the quality of dental services in LTC facilities that seems to meet the needs of dental and non-dental personnel in LTC.

Thesis (Ph.D.)--The University of Mississippi, 2007. / Adviser: Larry A. Cox. Includes bibliographical references.

Thesis (Ph. D.)--Virginia Polytechnic Institute and State University, 1993. / Vita. Abstract. Includes bibliographical references (leaves 318-332). Also available via the Internet.

Thesis (Ed.D.)--Teachers College, Columbia University. / Includes tables. Typescript. Sponsor: R. Louise McManus. Dissertation Committee: Dwayne Huebner, Frances R. Kreuter. Type C project. Includes bibliographical references (leaves 84-106).

Mémoire (M.P.M.O.)-- Université du Québec à Chicoutimi, 1992. / Résumé disponible sur Internet. Cette recherche s'inscrit comme exigence partielle de la maîtrise en gestion des petites et moyennes organisations (PMO) de l'UQAC. CaQCU CaQCU Bibliogr.: f. 129-133. Document électronique également accessible en format PDF. CaQCU

Thesis (Ph. D.)--University of Missouri--Columbia, 1999. / Typescript. Vita. Includes bibliographical references (leaves 103-107). Also available on the Internet.

Thesis (M.S.)--University of Wisconsin--Madison, 1984. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 39-44).