Biomedical subjects
Publications and source records attributed to L W Kaye.
More and more nursing home ombudsman programs are being implemented as institutions strive to improve the quality of life for the institutionalized elderly and to increase communication between the institution and the community. Abraham and Monk review how different ethnic groups perceive the New York City Nursing Home Patient Ombudsman Program.
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Long term care ombudsman programs are a recently established component within the gerontological services continuum. Public policy in this area is not yet well defined and there is a conspicuous absence of systematic studies assessing the effectiveness of such program efforts. This research reports on the accomplishments of an urban based, volunteer nursing home ombudsman program. Survey findings show moderate levels of goal attainment in the policy and social relations domains and more promising results in the organizational/managerial sphere. The relationship between perceptions of program success and varying ombudsman role behaviors is underscored.
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To what extent do the efforts of relatives, friends, and professional caregivers coalesce or clash in serving the home-bound elderly? This article presents data suggesting that the influence of natural support networks on formal service provision may be negative at times. Results indicate that one set of home care services may be provided more frequently and more effectively by relatives and friends and another set more appropriately by professional home care workers.
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A survey study of home care workers (N = 91) in three federally funded home care programs sheds light on the perceived community care and support service needs of the functionally impaired elderly. Findings also serve to identify those variables which may influence the accuracy and/or legitimacy of needs assessment data, especially when such information is collected from the perspective of the gerontological community worker. Results indicate that professional home care staff are able to more clearly define a finite set of high priority home-delivered services for the elderly. On the other hand, paraprofessional personnel as a group do not agree as easily on a specific set of community support services meriting top priority. Their diffused notion of priority expressed itself in responses regressing to the mean. As a source of targeted needs assessment data, paraprofessional staff may reflect a lesser capacity to selectively set priorities. On the other hand, their responses seemingly reflect a weaker tie to disciplinary biases. The implications of these study data are discussed in terms of the process and methodology of community need assessment for the elderly and the target groups to which program planners will want to seek evaluations of service need in the future.
The research reported here was conducted as part of a larger program evaluation of an urban Medicaid Home and Community Based-Waiver Program (HCBS). Informed by a secondary analysis of data collected on 723 clients, this article describes the association between client demographics and service consumption patterns among program beneficiaries with emphasis on access to care issues. The majority of the clients were female, African American, nearly 80 years of age, receiving approximately $600 of monthly income. Although White clients on average were higher functioning, they were hospitalized more frequently and took more medications than African American or Hispanic clients. Clients who were bedbound, Hispanic, and most dependent in performing activities of daily living received the fewest "number of services." Clients who suffered the most severe intellectual impairment, living with a spouse, and with the highest incomes received the most "units of service." Interestingly, service usage did not always increase as the client became more dependent in Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs), and mobility. The significance of findings is considered in relation to access to care issues.