For a workplace to be successful, it needs to have a higher morale, thus leading to higher quality of care for residents. For a workplace to be successful in empowerment, it must have developed strong teams, and everyone must work as a team and respect one another. The research for this paper focused on many issues. The most important part of my research came from a study of the nursing assistants at Jennings Hall (JH) in Garfield, Ohio. From the data received, I concluded that the two biggest problems in many nursing homes are lack of respect and lack of team-centered attitude.

Disaster or emergency situations have the potential for serious impact on the safety and security of both residents and staff in a nursing home. Furthermore, federal and state laws require that all nursing facilities be prepared in case of an emergency or disaster. The first part of this document is an introduction and rationale for the development of a nursing home disaster plan. The second part is a procedure manual developed for a nursing home in Oklahoma, outlining emergency actions and recovery procedures for various types of disasters, followed by a list of emergency telephone contacts of key personnel and services both inside and outside the nursing facility.

Although humor is a generally accepted part of everyday life for humans, its existence, importance, and positive influence on older persons are often underestimated. The purposes of this study are to determine whether humor is a normal experience for nursing home residents, enhancing their activities of daily living, and whether it plays a role in contributing to their psychological well-being. The study includes a discussion of research on humor, particularly as it relates to the elderly and the aging process; analysis and comparisons based on interviews with residents on the subject of humor and review of their psychological state as evaluated by the MDS 2.0 nursing facility assessment; individual case studies, and anecdotes illustrating the beneficial contributions humor brings to the lives of nursing home residents.

Widespread concern about the rapid growth of Medicare spending in recent years initiated a legislative response that resulted in the Balanced Budget Act of 1997. The effects of the BBA were far reaching and created shock waves throughout the health care industry. This study presents background information on the history of the Medicare home health benefit, enumerates specific provisions and goals of the BBA of 1997, examines how the BBA has changed the delivery of Medicare home health services, and proposes survival strategies for home health care providers.

The long-term care administrator profession is one that is both new and evolving. The unique historical perspective of this health profession is brief in the number of years it encompasses and crucial in understanding the current issues facing the profession. Administrator experiences provide a point of reference regarding the profession's structural problems. Ethical considerations play a dynamic role in administrators' daily jobs as well as their continued licensure. The significance of the profession's ongoing problems at the state and national level causes the need for alternatives to the current system. A combination of these alternatives must be embraced to assist in the recruitment and retention of long-term care administrators.

Elder abuse first received national attention in 1980, as the subject of a congressional investigation. Now, 20 years later, establishing successful strategies of identification, subsequent intervention, and prevention of abuse is of paramount importance; but progress toward this goal is hindered by lack of consensus as to the definition of elder abuse, and the use of vague, confusing, and sometimes contradictory terms in its discussion. In this paper, both social research and professional approaches and legal approaches to the definition of elder abuse are surveyed, as are definitions formulated for the National Elder Abuse Incidence Study conducted by the National Center on Elder Abuse. The continuing need for a universal or standard definition is emphasized.

The graying of America will have implications for all areas of society, especially the delivery of long-term care services. Many older individuals are aging in place, a phenomenon that is apparent at Dickinson Place, a church-sponsored low-income housing property for the elderly in Dallas, Texas, where the average age of residents has risen from 65 in the early 1970s to 78 in 1999. This change has prompted the board of directors to review the facility's mission, its physical plant, and the services it provides for strategic planning purposes, to ensure that Dickinson Place can continue to meet the needs of its residents both now and in the future.

The effects of teamwork in a long-term care setting were explored, and four key elements of teamwork in the long-term care facility were discovered. These elements--clarity of purpose, clear communication, well-defined decision-making procedures, and participative leadership--are presented in detail. The literature reviewed as well as observations from personal participation in a case study show that employing the teamwork concept in a nursing home environment significantly enhances the quality of life for the residents of such facilities.

Tuberculosis in the nursing home is an ever-growing problem for the health care community. The incidence of tuberculosis in the United States has risen alarmingly since 1982, and high-population environments such as nursing homes are among the places where it is most prevalent. The first part of this document is an introduction to the current concerns faced by nursing home infection control personnel. It includes information about the history, symptoms, and epidemiology of the disease, as well as other topics. The second part is a policy and procedure manual that contains a basic guide to methodical testing for tuberculosis, steps for dealing with active cases of the disease, and suggestions for education of nursing home health care workers.

Assisted living, the fastest growing segment of the senior housing industry, allows individuals to remain as independent as they prefer and still receive necessary services. However, assisted living residences exist primarily to serve those seniors who can pay for the services from their own savings/income. We are facing a critical need for housing options for both the current senior generation and the soon-to-be-retired baby boomers. How will access to assisted living be opened to all types of payors? How will states fund the growth of assisted living? The purpose of this paper is to discuss opportunities for expansion that will make assisted living an affordable option for the low- and moderate-income elderly.

Federal and state regulations require that licensed long-term care facilities have policies for every resident-related topic. Long-term care administrators must plan, implement, and evaluate resident care policies that can be easily personalized to the needs of the specific facility's population. Part 1 of this paper is an overview of resident policies, covering admission, physician services, transfers and discharges, nursing services, restraints, abuse and neglect, pharmaceutical services, dietary services, clinical records, therapeutic recreation services, and social services. Part 2 presents the policies themselves, ready for use by Texas long-term care administrators as part of their facility's administrative policy manual.

North Dakota is faced with the challenge of meeting the needs of its growing population of elderly persons aging with a developmental disability. The challenge of creating new service models presents itself to professionals in the fields of Aging and Developmental Disabilities. Traditionally, the aging person with a developmental disability has been sent to nursing homes or grouped into community programs with younger persons with developmental disability. North Dakota is looking toward the future of caring for this special population through integration with elderly without disabilities.