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R A Lusky

Publications and source records attributed to R A Lusky.

4 recordsLinked to original sources
PubMed1991

Title III services: variation in use within a state.

Using data from Connecticut's management information system for Title III funds, we found, first, that such services are reaching at least one person in every town and thus modestly fulfilling a gateway function; about 9% of Connecticut's elderly use Title III services, with 20% of the oldest old obtaining such services. Nutrition services are reaching the most elderly, both numerically and geographically; among the oldest old (85+), home care service use was most widespread. Indices of use were not statistically related to specific characteristics of the towns' populations (i.e., percentage of elderly, poor, or minority elderly), but small cities and rural towns had the highest use levels. Presence of nutrition sites within the town and service through two of the five area agencies on aging (AAAs) were also correlated with high service use, controlling for the rural-urban continuum. Those two AAAs received the highest per capita amount of Title III funds, based on the state's targeting formulas.

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PubMed1990

Improving hospital ethics committees: testing an educational model.

Overall, the project described in this paper appears to represent a considerable success in the field of postsecondary education, moving from the identification of a population with special educational needs to the implementation of a well-received program in a two year period. The extensive curriculum developed for the project seems to have been appreciated by participants and, in the case of relatively new members, to have improved their readiness to participate in committee work. Even in the case of more experienced HEC members, participation may have had significant, if unmeasureable, benefits. As one experienced HEC member noted, "It was a very stimulating, challenging, exhausting week and one I would recommend to others." These sentiments were echoed by another experienced participant who indicated that, "In the brochure the seminar looked like it might turn out to be the 'same old thing,' but it turned out to be a challenge and a chance to go home and begin again at a 'higher level'." Beyond its immediate benefits to individual participants, the project has led to the completion of 21 participant papers on procedural and bioethical issues, and the founding of a new journal for HEC members in which they will be published (HEC Forum, Pergamon Press, Oxford and New York). For the project faculty, the challenge ahead will be not only to respond to participant concerns, but to adapt the curriculum for presentation "on site" at hospitals across the country. While the move from formal demonstration to full-scale implementation will allow new flexibility, care must be taken to ensure that any changes do not sacrifice the program's clearly documented strengths.(ABSTRACT TRUNCATED AT 400 WORDS)

Bioethical Issues↗
PubMed1986

Anticipating the needs of the U.S. aged in the 21st century: dilemmas in epidemiology, gerontology, and public policy.

Reductions in the prevalence of chronic disease, functional dependence, and associated social problems among aged Americans have been predicted on the basis of improving environmental and social conditions, more effective public health measures, and advances in medical care. Public policy makers have found such predictions attractive since improved health status in old age could significantly offset the increase in health care resources which would otherwise be required to meet the needs of the country's growing number of elderly. This paper reviews the epidemiologic model underlying such predictions. Key assumptions of the model are evaluated by examining the health and social well-being of elderly residing in a socioeconomically advantaged community with an age structure similar to that projected for the United States in the 21st century. Despite their long-standing advantages in education, employment, income, housing, health care, and community services, these elderly experienced age adjusted rates of health and social problems comparable to those found in nationwide samples of elderly. No evidence of a compression of health problems into the final years of life could be found. Considerable diversity in problem constellations suggested a need for sophisticated packages of health and support services. These findings suggest that any significant improvements in the health status of the aged due to general improvements in living conditions or health behavior are unlikely to emerge before the proportion of aged Americans doubles in the first quarter of the 21st century. If this is so, public policy in the U.S. must be directed to expanding and improving health and social services for the elderly in the foreseeable future. Attempts to hold expenditures on the aged constant, or to reduce such expenditures, would seriously compromise the health of the nation's elderly.

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