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The objective of this study was to assess the prevalence of residents who are incapacitated and have no surrogate decision maker, known as the "unbefriended" in Alberta long-term care (LTC) homes. Using cross-sectional online survey methods, data were collected from 123 staff (i.e., directors of care/nursing, administrators) from Alberta LTC homes. Information was collected on survey respondents' demographic characteristics, number of unbefriended residents, and on organizational characteristics. The overall prevalence of unbefriended residents in LTC homes was 4.14% in Alberta (SD = 6.28%, range: 0%-34.6%). Homes with the highest prevalence (nearly 15%) of unbefriended residents had >135 beds and were public not-for-profit and located in large urban centers. Fifty-three percent of unbefriended residents were male. The highest prevalence of unbefriended residents lived in homes located in large urban centers and public not-for-profit operators. Population level and LTC home level prevalence data are needed to assess the scope of unmet needs. Alzheimer Society of Canada Doctoral Fellowship; Tier 1 Canada Research Chair in Knowledge Translation The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by an Alzheimer Society of Canada Doctoral Fellowship to S.A.C. and a Tier 1 Canada Research Chair in Knowledge Translation to C.A.E.

Discusses community services for senior citizens including geriatric care management, adult day care facilities, emergency systems, meal services, home health care, and more.

This publication provides information about basic concepts and approaches used in making decisions on behalf of others or planning for ones own future needs. Read on to understand important concepts about decision making and strategies, including representative payees, powers of attorney, trusts, and guardianship.

This presentation provides an overview of elder financial abuse, including causes and effects.

This publication lists many services available for older adults and where to find further information if necessary.

Throughout history, grandparents and other relatives have raised children, but more are caring for them now than ever before. This publications covers the rewards and challenges, court considerations, and other important resources.

This publication describes some possibilities for living options where older adults may receive assistance: continuing-care retirement communities, assisted housing, nursing homes, ECHO housing, board-and-care homes, congregate housing, and foster care.

This report is an addendum to an earlier report, Elderly & Disabled Waiver Services: Results of a Statewide Client Survey. Since the study’s distribution, further development and analysis of the Client Satisfaction Survey was conducted, with the purpose of creating a short form version to be administered by providers and utilization review analysts of Elderly and Disabled (E & D) Waiver services. Also, a second version of the short survey is presented for use during home visits as a supplement to questions asked of nursing supervisors and utilization review analysts. Virginia Department of Medical Assistance Services

As part of a “Real Choice Systems Change” grant received by the Virginia Department of Medical Assistance Services, the Center for Gerontology at Virginia Tech conducted a statewide survey of clients receiving personal care services under the Medicaid Elderly and Disabled (E & D) Waiver. The goal was to learn about clients’ experiences with personal care, using performance, satisfaction, and outcome measures. Demographic data about clients and aides were also collected. A comparison of the study sample with the larger E & D Waiver population on the available indicators of age, gender, and location showed the sample was representative of the full E & D Waiver population. All planning districts were represented, and the regional distribution reflected that of the larger population. Therefore, findings and observations are likely to be applicable to the full population of E & D Waiver clients in Virginia.

As part of Virginia’s Real Choice Systems Change Grant (July 20, 2001), the Center for Gerontology at Virginia Tech is responsible for Goal 4: “Address gaps in quality assurance and client satisfaction for community-based waiver service programs through the development of performance, outcomes, and satisfaction measures for continuous quality improvement and use.” To meet this goal, the Center has conducted extensive research in client satisfaction with E&D Waiver services (reported elsewhere, e.g., Glass, Roberto, Teaster & Brossoie, 2003a). In addition, the Center reviewed the existing Utilization Review (UR) process, as it is currently the primary means of quality assessment (QA) for the E&D Waiver program in Virginia. Our evaluation, based on the following activities, indicates that mechanisms are now in place to address and monitor the quality of services delivered by provider agencies. Continual development and refinement of the UR process will help ensure clients receive quality services and are satisfied with the assistance they receive.

Implementing quality assurance (QA) programs in unregulated noninstitutional settings remains a challenge for home and community-based service providers. A sample of 65 Elderly & Disabled (E&D) Waiver providers in Virginia were presented with eight problem scenarios commonly found in home-care services. Each of the respondents was able to identify strategies they would use to recognize and address each problem. Findings suggest providers currently use multiple mechanisms as part of their overall QA program. Discussion focuses on the strengths of using multiple approaches and on increasing provider awareness of complementary QA strategies and reducing the reliance on staff report as a major QA strategy.

Little is known about home and community based services (HCBS) and even less about the quality of those services. As part of a “Real Choice Systems Change” grant received by the Virginia Department of Medical Assistance Services, the Center for Gerontology at Virginia Tech conducted an exploratory survey of clients receiving HCBS under the Medicaid Elderly and Disabled (E & D) Waiver. The goal of the survey was to learn about clients’ experiences with HCBS and to identify the most important dimensions of service provision from their perspectives. An initial focus group with 11 caregivers was first held in Big Stone Gap. Twenty-five telephone interviews were then completed (18 clients and 7 caregivers) in five areas of the Commonwealth. Fifteen were in urban areas (Northern Virginia, Richmond, and Chesapeake) and ten in rural or non-metropolitan areas (New River Valley and Planning Districts 13 and 14).

The Virginia Public Guardian and Conservator Programs were established by law in 1997 in § 2.1-373.10 - § 2.1-373.14 of the Virginia Code. The 10 local programs, chosen through a request for proposal (RFP) process, are administered by the Virginia Department for the Aging. A mandated evaluation of the 10 Virginia Public Guardian and Conservator Programs was conducted over a two-year period, 2001-2002. Data were collected at approximately the same time during the fall of 2001 (Year 1) and 2002 (Year 2). Information was gathered from the programs using a password protected, web-based data collection system designed especially for this project. Five unique survey instruments were developed gather information about the administrative structure and functions of the programs, ward characteristics, the interface between the programs and wards. All of the programs participated in the Year 1 data collection; in Year 2, one of the programs chose to submit data in response to only one (i.e., Agency Profile) of the five evaluation tools (i.e., Agency Profile, Ward Assessment, Ward Care Plan, Administrative Time Log, and Ward Time Log).

Little is known about home and community based services (HCBS) and even less about the quality of those services. As part of a “Real Choice Systems Change” grant received by the Virginia Department of Medical Assistance Services, the Center for Gerontology at Virginia Tech conducted a survey of agencies providing HCBS under the Medicaid Elderly and Disabled (E & D) Waiver. A written survey was sent to 160 providers across the state, based on a sampling plan designed to ensure representation of all planning districts and services mixes. Seventy surveys were returned for a response rate of 44%.

Pamela B. Teaster and Karen A. Roberto Reprinted 2002

Discusses the benefits of calcium-rich foods as we age. Revised Issue 10

Last issue of "As you age" series, summarizing the previous lessons and providing additional information on aging and age-related services. Revised Issue 12

Kathleen M. Stadler and Pamela B. Teaster Reprinted 2001

Kathleen M. Stadler and Pamela B. Teaster Reprinted 2001

Kathleen M. Stadler and Pamela B. Teaster Revised

Kathleen M. Stadler and Pamela B. Teaster

Kathleen M. Stadler and Pamela B. Teaster Revised

A fun challenge to assist you in maintaining or improving your health and wellness as you age.

written by Kathleen M. Stadler, Pamela B. Teaster

The secret to quality of life as we age is to maintain or increase our ability to function independently by eating correctly and exercising. Issue 2

Kathleen M. Stadler and Pamerla B. Teaster Reprinted 2001

Discusses the benefits of vegetables containing vitamin C as we age and lists vegetables containing vitamin C. Issue 6