Case Management in the Law Office

Abstract

This study examines the assumption that including Black-Americans with larger samples of White-Americans produce an accurate picture of the predictors of nursing home use by Black-Americans. Using the Longitudinal Study of Aging (1984-1990), Cox proportional hazard models are estimated for Black-Americans and White-Americans. This study finds that in fact the models for Black-Americans are not the same as for White-Americans. For Black-Americans, living below the poverty line, problems of functional status, age, and not having the potential for care for a few weeks from relatives (in or out of the home) are predictive of a higher risk of nursing home use while, for White-Americans, age, lower versus higher income, being female versus male, poor evaluation of self health care, poor functional status, lower levels of community activity, and living alone compared to living with a spouse or children were predictive of a higher risk of nursing home admission. The implications for policy and case management practice are discussed regarding these findings.     

社区互助养老与村办敬老院可持续运营——以福建省晋江市萧下村敬老院为例*

社区互助养老是指在社区组织动员下，社区居民本着志愿互助原则以无偿或低偿形式提供场所、资金与劳务，以支持社区养老事业的发展。本文以晋江市萧下村敬老院为个案，介绍社区互助养老机制在村办敬老院的实践情况，有效降低运营成本，实现村办敬老院可持续发展。萧下村敬老院由村老年协会管理，老年协会与宗祠管委会重合，社区资源动员能力强。     

Examining Direct Service Worker Turnover in Three Long-Term Care Industries in Ohio

This is the first study to examine direct service worker turnover and its predictors across three provider types: nursing homes, home health agencies, and providers of services for the developmentally disabled. Stratified random sampling procedures were used to select provider types across five geographic regions in Ohio. Data were collected from administrative staff. Findings indicated that annual direct service worker turnover did not significantly vary by provider type (mean = 33%). Predictors of turnover related to job burnout, negative social support, and region. Policymakers can promote practices to lower direct service worker turnover such as addressing burnout and increasing support.     

中国农村老年人养老院居住意愿的影响因素研究

利用西安交通大学人口研究所2006年在安徽省巢湖地区进行的"安徽省老年人生活福利状况"抽样调查数据,采用Logistic多元回归模型,分析老年人社会经济状况、健康状况、孝道观念和代际支持因素对老年人入住养老院意愿的影响。居家养老符合大部分农村老年人的愿望,但也有相当一部分老年人对机构养老抱有期待。传统的孝道观念对于农村老年人选择养老院养老起到了阻碍作用。慢性病所带来的医疗需求是老年人愿意入住养老院的动机之一。老年人在居家养老中更重视感情上的"孝",而子女给予的实际的"养"并不能降低老年人入住养老院的意愿。     

Effects of Impact-Absorbing Flooring in Residential Care from the Perspectives of Enrolled Nurses

Falls are a daily occurrence in nursing homes and few interventions for reducing fall-related injuries have proven to be effective. Impact absorbing flooring (IAF) in residential care has shown promising results in reducing fall-injuries and in the process of developing and implementing IAF all aspects are valuable to explore. Therefore, the aim of this qualitative study is to describe the enrolled nurses (ENs) experiences of IAF. We carried out focus group interviews with ENs and used content analysis to process the data. The ENs experienced both negative and positive aspects with the IAF. Importantly, the ENs perceived the IAF as effective in preventing fall-injuries. They also appreciated the improvements in acoustics. Negative aspects were that the flooring initially was challenging to walk on and that it made it harder to maneuver heavy equipment. A significant and transferable finding in this study was the importance of the ENs' perceived difficulty in preventing fall-injuries amongst elderly people living in nursing homes. This seemed to be a driving force to accept the intervention. Although IAF affects the working conditions in a nursing home, ENs are willing to accept these issues given the perceived effectiveness of the intervention.     

Materializing architecture for social care: Brick walls and compromises in design for later life

This article reports on an ethnography of architectural projects for later life social care in the UK. Informed by recent debates in material studies and “materialities of care” we offer an analysis of a care home project that is sensitive to architectural materials that are not normally associated with care and well-being. Although the care home design project we focus on in this article was never built, we found that design discussions relating to a curved brick wall and bricks more generally were significant to its architectural “making”. The curved wall and the bricks were used by the architects to encode quality and values of care into their design. This was explicit in the design narrative that was core to a successful tender submitted by a consortium comprising architects, developers, contractors, and a care provider to a local authority who commissioned the care home. However, as the project developed, initial consensus for the design features fractured. Using a materialized analysis, we document the tussles generated by the curved wall and the bricks and argue that mundane building materials can be important to, and yet marginalized within, the relations inherent to an “architectural care assemblage.” During the design process we saw how decisions about materials are contentious and they act as a catalyst of negotiations that compromise “materialities of care.”     

论毕飞宇小说中“异乡人”形象

“异乡人”是毕飞宇小说中一以贯之的人物形象,它体现作者的小说创作由先锋到写实的转变。     

流动与家庭--农民外出就业与家庭关系研究综述

农民外出就业,对农民的家庭以及家庭关系的变迁产生巨大的影响.大多数家庭夫妻关系稳定,但有些男性则因经济收入和职业地位变化而产生家庭危机.流动农民的孩子,特别是父母双方均外出的孩子的学习成绩一般不理想甚至很差.留在农村的老人经济上的供养提高了,但抚养孩子、沉重的家务以及田间劳工往往使老人疲惫不堪.     

A federal survey deficiency citation is needed for resident-to-resident aggression in U.S. nursing homes

Resident-to-resident aggression (RRA) in nursing homes is a prevalent and concerning public health problem. A rapid growth in the number of research studies has led to advancements in understanding and awareness of these incidents. However, no state survey deficiency citation (F-Tag) currently exists to capture RRA in a structured way in the Centers for Medicare & Medicaid Services’ (CMS) nursing homes F-Tags Coding System. This omission represents a major barrier to State Survey Agencies, CMS, consumers, and care advocacy organizations’ efforts to keep vulnerable and frail residents safe and free from psychological harm. The commentary makes the case for development and implementation of a new RRA-specific F-Tag by identifying 20 problem areas and the ways in which this F-Tag could address them. The new F-Tags Coding System (part of the new Federal Nursing Home regulations) represents a rare and time-sensitive opportunity to bridge this major gap in practice, research, and policy.     

Exploring personhood in dining experiences of residents with dementia in long-term care facilities

Despite the shift toward using person-centered approaches in dementia care, the relevance and applicability of the concept “personhood” remains unclear in everyday practice and activities, such as mealtime experience for residents with dementia. Based on a qualitative study, this paper presents emergent themes at mealtimes that support or undermine personhood of twenty residents with dementia in two long-term care facilities. Methods of data collection included conversational interviews with residents with dementia, participant observations, focus groups with staff and examination of available documents. Data analysis identified eight themes: (1) outpacing/relaxed pace, (2) withholding/holding, (3) stimulation, (4) disrespect/respect, (5) invalidation/validation, (6) distancing/connecting, (7) disempowerment/empowerment, and (8) ignoring/inclusion. These findings raised questions about current practice and identified areas for improvement. Although staff approaches seemed to have the greatest impact on residents' experiences, the physical environment and organizational milieu were also responsible for hindering and facilitating staff to provide the best possible care and interaction.