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 2011 Seniors Housing & Care Journal Abstracts
Abstract To properly establish the value of a specialized health care facility such as seniors housing, an analyst must understand the underlying elements that create value in the business entity. It may be difficult to separate the market value of the land and the building from the total value of the business, but such division of realty and nonrealty components of value is often required. Estimating the value of any complex property, where the income and expenses are driven by both the real estate and business, one must rely on a recognized methodology supported with market data to properly account for the components of land and buildings, along with tangible and intangible personal property. This article builds on growing market knowledge and provides a quantitative analysis to support reasonable allocations of the real estate component of various seniors housing facilities. Back to Seniors Housing & Care Journal Information
Abstract The nursing home culture change movement continues to gain support from government, industry, and consumer groups. Many believe it holds promise for improving both the quality of care and the quality of life for people residing in long-term care settings. One of the challenges currently facing the movement is insufficient guidance regarding the specifics of both implementing and sustaining culture change. This article presents findings from a study of THE GREEN HOUSE® model, focusing specifically on the development of empowered direct care staff. Although the study was conducted exclusively in Green House homes, the findings have implications for any long-term care organization interested in empowering staff.
Abstract The theory of environmental press is overwhelmingly used in aging scholarship to understand how older adults "fit" some residential environments better than others. This fit is based on how well older adults function physically and cognitively in their environments, as well as the supportive structure of the place. This article utilizes the framework of environmental press to initiate a critique of this theory in a sample of 30 urban, African American, low-income older adults in Detroit. Results from in-depth interviews and observational fieldwork indicate that older individuals who occupy oppressed social locations do not consider their aged bodies in determining an appropriate environmental fit but rather, they turn to long-held identities based on unequal class, race, and gender, as well as age, to determine appropriate housing. The author uses these findings to advance a gerontological imagination that is more inclusive to the experiences of a range of individuals.
Abstract This article discusses the idea that many boards in the continuing care retirement community (CCRC) campus health care segment, especially the non-profit, are comprised of people who are unfamiliar with the industry. They usually have inadequate orientations to both the campus and the industry, don't receive robust financial or market information on a routine basis, and do not receive a rigorous analytical study to help address strategic issues. Yet, they are responsible for being financial stewards of the campus and ensuring that appropriate decisions are made to enable the campus' future financial sustainability. This article makes recommendations regarding where and how routine information to boards can be improved and how boards can make more informed and useful strategic decisions.
Abstract Historically, the assisted living (AL) industry has promoted a social, non-medical model of care. Rising health acuity of residents within AL, however, has brought about the need for providing increased health care services. This article examines the key staff role related to health care provision and oversight in AL, described as the health care supervisor. It briefly describes individuals in this role (N = 90) and presents their perspectives regarding their roles and responsibilities as the health care point person within this non-medical environment. Qualitative analyses identified four themes as integral to this position: administrative functions, supervision of care staff, provision of clinical and direct care, and clinical care coordination and communication. The article concludes with recommendations for AL organizations and practice of the emerging health care supervisor role in AL.
Abstract Poor oral and nutritional health are major contributing factors to disease and death in older adults and are known to increase the risk threefold for conditions such as cardiovascular and respiratory disease. A cross-sectional convenience sample of 1,100 older adults living in the rural Midwestern U.S. was surveyed. Trained interviewers administered a battery of questionnaires regarding housing, demographics, health, and nutrition. Data were analyzed using a variety of techniques, including structural equation modeling, factor analysis, and descriptive statistics. The results indicated that the more restrictive the housing, the better the nutritional and oral health of the respondent. This indicates that older persons living in rural areas may not be able to adequately care for their mouths and provide nutritious, balanced food intake for themselves when they live in their own homes without caretakers. This has implications for health screenings of older adults by providers working in rural communities.
Abstract Existing research establishes that THE GREEN HOUSE® model of licensed nursing home care provides significant and sustained satisfaction and clinical improvements when compared to traditional nursing homes. Questions remain about the model's initial and long-term financial viability due to its significant transformation of traditional nursing home practices in caregiver staffing, administrative and organizational structure, and environmental design. Several recent studies, each limited in scope but with mutually reinforcing findings, provide growing evidence that The Green House model's operations are comparable in cost to traditional nursing home operations as well as nursing homes implementing other culture change practices. Capital costs for Green House homes are found to be equivalent to or less than similar culture change models but higher than traditionally designed nursing homes offering fewer square feet and amenities. Revenue enhancements are likely from the care and environmental upgrades found in The Green House model. These research results, coupled with anecdotal experience, indicate that Green House homes offer a strong option for organizations to explore as they seek to address current and future challenges in their nursing home operations and markets.
Abstract This article explores the outcomes from a pilot program of a culture change-focused learning circle curriculum conducted in a long-term care setting. The effectiveness of the learning circle intervention was measured by pre- and post-test. Data collected illustrates that the learning circles were an effective tool to educate staff about culture change concepts and practice. The learning circles also enhanced team cohesiveness and acknowledged diversity of participants. The authors explore how learning circles are a natural fit for organizations involved in the culture change movement, provide suggestions for replication in other long-term care communities, and identify other uses of the learning circle.
Abstract This study examined why individuals choose to move into a continuing care retirement community (CCRC), their expressed satisfaction with their relocation decision, and views on the advantages and disadvantages of CCRCs over time. Residents (N = 300) reported that their primary reasons for moving into a CCRC were avoidance of home upkeep (48%) and anticipated future needs (25.7%). The majority (97.1%) reported that they were glad they had made the decision to move. The advantages of living in a CCRC revealed two main themes: (1) easier lifestyle, including fewer worries, especially related to home upkeep; and (2) more time for socialization and activities. The main theme that emerged as a disadvantage was apartment-style living, including space constraints and facility regulations. Developers and operators of seniors housing can apply these results to better meet the needs and expectations of their customers.
Abstract
Abstract Telephone-activated personal emergency response services (PERS) were developed
30 years ago so persons experiencing adverse events could summon assistance.
Little evidence exists, however, associating PERS use with improved outcomes.
With growing PERS use within continuing care retirement communities, it is important to tie usage to residents' needs. The authors present data from research at Baylor College of Medicine comparing event rates, well-being scores, and sense of security between cohorts of older persons with and without PERS. Results from retrospective studies in the U.S. and Canada comparing hospitalization experience with PERS use guided an IRB-approved, randomized controlled trial of PERS use with one year of telephone follow-up. Outcome variables included frequency of health care use, functional levels measured by SF-36 scores, and self-reported sense of security. Retrospective data revealed reduced hospitalization rates among PERS users. Prospective findings revealed slight increases in emergency department use and significant increases in sensed security and SF-36 vitality and mental health component scores. PERS is most useful when relieving a sense of insecurity, and making improvements in mental well-being are indicated. Expanding PERS use among a burgeoning older population should be tailored to changes in physical and psychosocial indicators that warrant environmental prescriptions for such services, especially in long-term care settings.
Abstract Studies reveal that baby boomers intend to age in place for as long as they can before moving into senior living communities (SLC). A relatively new program for older adults, "Without Walls," has evolved over the past 10 years; examples include senior centers, educational programs offered over the phone, and the "village" movement, all of which aim to serve and engage older adults where they naturally live and gather. Mather Edgewater is an example of one Without Walls model, which offers older adults programs that enhance educational, social, emotional, vocational, and physical well-being-the six dimensions of wellness. |