Aged care & services review最新文献

People of all ages hold aging-related attitudes. Even very young children recognize age differences and evidence attitudes that appear to be generation-specific. Since attitudes presumably affect behavior and since long life has recently become the rule rather than the exception, interaction with old persons and personal attitudes toward growing old may well be influenced by one's general aging-related attitudes. The availability, accessibility, adequacy, and acceptability of human services intended for use by old persons are also influenced by the attitudes of younger persons. The aging-related attitudes of decision-makers, services personnel, and tax-payers are particularly important in this regard. Much of the U.S. research literature on aging-related attitudes will be reviewed here. Only the highlights of individual articles will be presented, however. Therefore, this paper might best be regarded as a reference to the literature rather than as a restatement of it.

Much has been written about institutions and care of the elderly. This paper begins with a description of the elderly population and its use of institutional care. A brief history of two types of institutions which provide long-term care to the elderly-mental hospitals and nursing homes-is covered next, along with some of the problems these institutions face in terms of their patients becoming institutionalized and what has happened as a result of pressures to deinstitutionalize the mental hospital population. Ways of assessing quality of care are highlighted in regard to current needs and methods of dealing with these needs. Some of the studies which emphasize outcomes in relation to institutional structure and process are then reviewed. Finally, some conclusions are drawn which summarize major needs and deficiencies in this area of study.

The place of the medical director in the acute care general hospital is discussed. The federal legislation mandating medical directors for nursing homes is summarized, and is criticized for being too closely based on acute care general hospital models. Descriptive writing about the medical director's role are reviewed, and also quantified surveys. It is suggested that an educational and consultative role is most suitable. There is doubt about the ability of the medical director to control and supervise medical staff. His/her ability to control quality of care is also dubious.

The social institutions which comprise the modern British "Welfare State" were largely formed by enactments of the postwar Labour Government. This legislation constitutes a landmark but was part, as well, of the continuing history of social care in the United Kingdom. Many of the institutions created in 1948 were located in existing buildings which could not, in conditions of postwar poverty, be abandoned. Not only were the buildings old; many of the ideas which shaped the policies introduced during this period were ideas with a very long history. In the last thirty years social policy has moved on, but it is intended that this article demonstrate that many of the issues which currently emerge as recurring themes in British professional literature on aging are by no means new ones; rather, they tend to be restatements of problems which have long delayed resolution. Before elaborating on this theme a brief description of the elderly population of the United Kingdom and of the range of institutional services provided for them is given.