Among the issues confronting America is long-term care for frail, older persons and others with chronic conditions and functional limitations that limit their ability to care for themselves. Improving the Quality of Long-Term Care takes a comprehensive look at the quality of care and quality of life in long-term care, including nursing homes, home health agencies, residential care facilities, family members and a variety of others. This book describes the current state of long-term care, identifying problem areas and offering recommendations for federal and state policymakers. Who uses long-term care? How have the characteristics of this population changed over time? What paths do people follow in long term care? The committee provides the latest information on these and other key questions. This book explores strengths and limitations of available data and research literature especially for settings other than nursing homes, on methods to measure, oversee, and improve the quality of long-term care. The committee makes recommendations on setting and enforcing standards of care, strengthening the caregiving workforce, reimbursement issues, and expanding the knowledge base to guide organizational and individual caregivers in improving the quality of care.

Residential care settings (RCSs), such as assisted living facilities, provide community-based services for older adults and younger people with disabilities who require long-term services and supports. Within RCSs, staffing adequacy is a key factor for ensuring residents’ quality of care. However, because residential care settings are licensed and regulated by the states, staffing requirements vary considerably among states. This paper provides an overview of state regulations related to staffing in residential care, highlighting the variance among state regulations. The primary data source for this analysis was the Compendium of Residential Care and Assisted Living Regulations and Policy, 2015 Edition, funded by the Office of the Assistant Secretary for Planning and Evaluation/US Department of Health and Human Services. Consumers and regulators need to be aware of the state variance in RCS staffing requirements and assess whether a state’s staffing requirements are adequate to meet residents’ needs.

Does a longer life mean a healthier life? The number of adults over 65 in the United States is growing, but many may not be aware that they are at greater risk from foodborne diseases and their nutritional needs change as they age. The IOM's Food Forum held a workshop October 29-30, 2009, to discuss food safety and nutrition concerns for older adults.

This book provides a global comprehensive and systematic state-of-the review of this field that fills the gaps between research, practice, and policy. The book addresses the epidemiology of the issue and the global prevalence of elder abuse in both developed and developing countries, which synthesizes the most up-to-date data about risk factors and protective factors associated with elder abuse and consequences of elder abuse; clinical assessment and management of elder abuse, including screening, detection, management of elder abuse, and the role of decision making capacity and forensic approaches; practice and services that describe adult protective services, legal justice, elder court systems, and guardianship system; elder abuse and culture, which provides more in-depth anthropological and ethnographic experiences; policy issues, which highlights the elder justice movement, GAO reports, elder justice act, older American act and elder justice coordinating council; and future directions, which explores translational research, practice, education/training and policy issues surrounding elder abuse. Elder Abuse: Research, Practice and Policy is a useful resource for aging researchers, social services, general internists, family medicine physicians, social workers, nurses, and legal professionals interested in the issues of elder abuse.

As more people live longer, the need for quality long-term care for the elderly will increase dramatically. This volume examines the current system of nursing home regulations, and proposes an overhaul to better provide for those confined to such facilities. It determines the need for regulations, and concludes that the present regulatory system is inadequate, stating that what is needed is not more regulation, but better regulation. This long-anticipated study provides a wealth of useful background information, in-depth study, and discussion for nursing home administrators, students, and teachers in the health care field; professionals involved in caring for the elderly; and geriatric specialists.

In the early 1990s, the Census Bureau proposed a program of continuous measurement as a possible alternative to the gathering of detailed social, economic, and housing data from a sample of the U.S. population as part of the decennial census. The American Community Survey (ACS) became a reality in 2005, and has included group quarters (GQ)-such places as correctional facilities for adults, student housing, nursing facilities, inpatient hospice facilities, and military barracks-since 2006, primarily to more closely replicate the design and data products of the census long-form sample. The decision to include group quarters in the ACS enables the Census Bureau to provide a comprehensive benchmark of the total U.S. population (not just those living in households). However, the fact that the ACS must rely on a sample of what is a small and very diverse population, combined with limited funding available for survey operations, makes the ACS GQ sampling, data collection, weighting, and estimation procedures more complex and the estimates more susceptible to problems stemming from these limitations. The concerns are magnified in small areas, particularly in terms of detrimental effects on the total population estimates produced for small areas. Small Populations, Large Effects provides an in-depth review of the statistical methodology for measuring the GQ population in the ACS. This report addresses difficulties associated with measuring the GQ population and the rationale for including GQs in the ACS. Considering user needs for ACS data and of operational feasibility and compatibility with the treatment of the household population in the ACS, the report recommends alternatives to the survey design and other methodological features that can make the ACS more useful for users of small-area data.