Search results for ‘Author:"mcauley william j."’ Sort:
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Recent trends in advance directives at nursing home admission and one year after admission
- Authors:
- McAULEY William J., et al
- Journal article citation:
- Gerontologist, 46(3), June 2006, pp.377-381.
- Publisher:
- Oxford University Press
By using the nursing facility Minimum Data Set, this American study examined the prevalence of advance directives at nursing home admission and 12 months post-admission. The prevalence of having any advance directive at admission declined slightly from 2000 to 2004, whereas the prevalence of having any advanced directive at 12 months after admission increased slightly during the same period. Compared with admissions, residents at 12 months post-admission were more likely to have their decisions made by family members and to have advance directives of any type. The results suggest that greater use of advance directives in nursing homes may depend on additional information and support from nursing facility personnel and the health and social services professionals who are in contact with individuals moving toward nursing home admission, as well as those who remain in facilities over time.
The influence of rural location on utilization of formal home care: the role of Medicaid
- Authors:
- McAULEY William J., et al
- Journal article citation:
- Gerontologist, 44(5), October 2004, pp.655-664.
- Publisher:
- Oxford University Press
This research examines the impact of rural–urban residence on formal home-care utilization among older people and determines whether and how Medicaid coverage influences the association between rural–urban location and risk of formal home-care use. The authors combined data from the 1998 consolidated file of the Medical Expenditure Panel Survey Household Component with data from the Area Resource File to generate the analytical data set. They established two measures of formal home-care utilization: home care reimbursed through any source, and Medicare-reimbursed home health care. Our measures of rural–urban residence included metropolitan counties, nonmetropolitan counties having towns of at least 10,000 people, and nonmetropolitan counties with no towns of 10,000 people. The authors used logistic regression analyses to examine main effects and interaction effects of Medicaid coverage and residence on the two types of formal home care under controls for person-level characteristics and state fixed effects. The unadjusted logistic analyses demonstrate that older people who reside in the most rural counties (nonmetropolitan counties having no town of 10,000) are significantly more likely than metropolitan residents to use any formal home care and Medicare home health care. The fully adjusted logistic analysis results point to an interplay between residential status and Medicaid coverage with regard to formal home-care use. In comparison with metropolitan residents covered by Medicaid, the adjusted relative risk of any formal home-care use is significantly higher for Medicaid enrollees residing in nonmetropolitan counties having no town of 10,000 people. Use of Medicare home health care is significantly greater for residents of the most rural counties, irrespective of their Medicaid coverage, as well as Medicaid-covered residents of nonmetropolitan counties having a town of at least 10,000 people. In nonmetropolitan areas, Medicaid may be an important mechanism for linking older individuals with formal home care, especially Medicare home health care, and with the services that generate formal home care. Formal home care, including Medicare home health care, may substitute for less available forms of care in the most rural of nonmetropolitan areas. Therefore, policies that limit access to formal home care could lead to increased service-related vulnerabilities among older rural residents.
A conceptual model for the mobility patterns of nursing home admissions
- Authors:
- McAULEY William J., USITA Paula M.
- Journal article citation:
- Gerontologist, 38(6), December 1998, pp.726-734.
- Publisher:
- Oxford University Press
This article draws from the literature in long term care, demography and geography to develop an initial conceptual framework to explain variations in the patterns of nursing home moves in the USA. The conceptual framework is bolstered by preliminary data from state censuses of nursing homes that asked about the origins of current nursing home residents. The data suggest that a relatively high proportion of nursing home residents move to a different county in the process of moving to a nursing home. The research and applied implications of the framework are discussed.