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DOI 10.1007/s11294-011-9297-0 Published online: 17 April 2011 © International Atlantic Economic Society 2011 Abstract The United States is in the midst of profound demographic changes. The proportion of the elderly [...]

War, societal and familial upheaval, disease, and natural disasters have resulted in orphaned children throughout time. One societal response to providing care for orphans has been institutionalization or the orphanage. We studied a sample of adults, known as les enfants de Duplessis or Duplessis's children, who were raised in Quebec institutions from birth onward and followed up in late adulthood. Systematic study indicated a high prevalence of adverse outcomes and found high levels of gross psychological trauma and adversity which, moderated by the childhood strengths of the individuals, had adverse effects on adult outcome (Sigal, Perry, Rossignol, & Ouimet, 2003; Perry, Sigal, Boucher, Pard, & Ouimet, 2005a; Perry, Sigal, Boucher, Pard, Ouimet, Norman, & Henry, 2005b). This report describes the experiences of seven individuals in the institutions and their subsequent life history and current functioning. The individual cases reflect a wide range of childhood strengths and experiences of trauma and other adversity in relationship to adult caretakers. While the group overall appears to have had seriously diminished functioning in late adulthood, several individuals had positive outcomes. We hope that by highlighting the potentially adverse effects of institutional rearing on subsequent development into late adulthood, these stories may inform those concerned with the care of orphans.

Drawn from records of a rape crisis center in Israel, this paper examines the institution which had been established and run by femininists as changed by institutional carriers, the professional volunteers and therapeutic professionals who join them.

INTRODUCTION Reality Orientation (hereafter, RO) is a type of therapy frequently used in care of the confused and dementing elderly (Gravell 1988; Jenkinson 1992; Morton and Bleathman 1988). According to [...]

A study was conducted to determine the service quality in US and UK long-term institutional care facilities. A Multiple-Item Scale for Measuring Consumer Perceptions of Service Quality called SERVQUAL was used in the study. Results showed that there is a higher level of service quality reported by UK residents than with US residents. Experts say that US residents have less expectations of institutional service quality, thus resulting in poor or less attractive services.

Introduction Resource use by different types of patients is of increasing interest to health care services all over the world. As demands for health service resources increase, so will the [...]

Introduction With the implementation in all US long-term care facilities of the Resident Assessment Instrument (RAI) [1] and the consecutive introduction of RAI in similar facilities in a number of [...]

South Carolina Community Long-Term Care (CLTC) data were used to identify factors increasing the risk of institutionalization in people with dementia. Clients diagnosed with dementia and observed at least twice between June 1993 and December 1994 (N = 786) were studied. Logistic regression determined that clients with a decline in ADL function who were white, had a nonrelative or child as a caregiver, and were diagnosed with Alzheimer's disease were at increased risk of institutionalization. Identifying CLTC clients at increased risk of institutionalization could be useful in designing additional interventions to prevent institutionalization or in planning the transition to institutional care. Key Words: Nursing home use, Activities of daily living, Cognitive impairment

People with learning difficulties are now surviving into old age and more and more of them are being resettled from long-stay hospitals. The main purpose of this article is to examine some of the key barriers facing, and dilemmas involved in, the provision of community-based services to this newly emerging user group. The findings of some recent field research on older people with learning difficulties who have been resettled into the community are used to illustrate the challenges facing service providers. Particular reference is made to the impact of age discrimination and traditional differences between service specialisms. The article shows that both official definitions of need in old age and the aspirations of the service responses to those needs have been artificially constructed in very narrow terms, especially when compared with the principled approach to service provision for younger people with learning difficulties. In conclusion, therefore, it is argued that the principles underpinning services for people with learning difficulties, such as normalisation, should be applied to older people as well. KEY WORDS - Older people, learning difficulties, community services, deinstitutionalisation, age discrimination, normalisation.

Distinctions between home care and residentially based care are blurring because of two trends: home care providers are offering services, including personal assistance, outside of the private, self-contained family home ot apartment; and a market-driven movement is underway to develop group residential settings where long-term-care (LTC) consumers with substantial disability receive personal care and nursing in their own, fully equipped, apartments where they largely control the schedule. For the customers, such boundary blurring can lead to experiences of greater power and normality in their everyday lives. State regulations will help determine the extent to which new, 'residentially' oriented models of LTC are feasible. Home care providers are challenged to develop flexible and creative paradigms for service that are built on a recognition that older adults with disabilities have the right to choose risks.

The purpose of this article is to examine African American and White disparities in factors associated with institutionalization and differences in the effects of health on the use of this form of long-term care. The research was conceptualized within the context of the double-jeopardy hypothesis. Data for this study were taken from the first and third wave of the Longitudinal Study on Aging (N = 7,440 persons aged 70 and older). Results showed that African Americans were in poorer health than Whites. Help received from relatives for IADL's did not vary by race. However, African Americans received less help from relatives for ADLs than did their White peers. Despite poorer health and less reliance on help from relatives, African Americans were less likely than Whites to be institutionalized. Further research is called for that examines the interconnections between race, discrimination, culture, and the later life experiences and opportunities of the elderly.

Research describing the social world of elderly residents of nursing homes is organised in this paper into three levels of analysis: the institutional level, the relational level and the interactional level. The significance of each level is highlighted, with special attention being given to the interactional level of analysis and the study of language within the nursing home. Data gathered from semi-structured interviews with both elderly residents and nurse aides are presented and interpreted as evidence of interactional problems which may emerge in the resident-staff relationship. Implications and future prospects of incorporating the three levels of analysis into the study of the psychosocial well-being of nursing home residents are considered.

Cognitive development was evaluated in children who had spent at least 8 months in a Romanian orphanage (RO) and two comparison groups of children: a Canadian-Born, nonadopted, never institutionalized comparison [...]