Publications by authors named "Lois J Cutler"
In the half century since enactment of the 1965 Great Society programs, accomplishments were gradually made to improve access to and quality of long-term services and supports (LTSS), including: mitigation of financial and care abuses in nursing facilities (NFs); substantial rebalancing of LTSS towards consumer-preferred home-and-community-based services (HCBS); increasing flexible consumer-centered HCBS including payment to family caregivers; and more assisted-living and housing options for seniors with heavy care needs. A unified planning and advocacy agenda across age and disability type and greater consumer transparency fueled progress. Nonetheless, LTSS is a broken system; persistent problems interfere with substantial and necessary change.
View Article and Find Full Text PDFPurpose: This article aims to review research measures and findings related to physical environments of assisted living (AL) according to multiple conceptual perspectives--ecological, cultural, and Maslovian hierarchy.
Design And Methods: A literature and research review was undertaken with two foci: performance measures for physical environments, and environmental research findings themselves.
Results: The research review identified a variety of environmental studies with a broad scope of topics, including post-occupancy design multimethod approaches, homeyness, evolution of AL, services, quality of life as an outcome, aging in place, regulatory influences, and environmental design principles.
A longitudinal quasi-experimental study with two comparison groups was conducted to test the effects of a Green House (GH) nursing home program on residents' family members. The GHs are individual residences, each serving 10 elders, where certified nursing assistant (CNA)-level resident assistants form primary relationships with residents and family, family is encouraged to visits, and professionals adapted their roles to support the model. GH family were somewhat less involved in providing assistance to their residents although family contact did not differ among the settings at any time period.
View Article and Find Full Text PDFObjectives: To determine the effects of a small-house nursing home model, THE GREEN HOUSE (GH), on residents' reported outcomes and quality of care.
Design: Two-year longitudinal quasi-experimental study comparing GH residents with residents at two comparison sites using data collected at baseline and three follow-up intervals.
Setting: Four 10-person GHs, the sponsoring nursing home for those GHs, and a traditional nursing home with the same owner.
Purpose: We present the concept of the Green House, articulated by William Thomas as a radically changed, "deinstitutionalized" nursing home well before its first implementation, and we describe and discuss implications from the first Green Houses in Tupelo, Mississippi.
Design And Methods: Green Houses are small, self-contained houses for 10 or fewer elders, each with private rooms and full bathrooms and sharing family-style communal space, including hearth, dining area, and full kitchen. Line staff at the level of certified nursing assistants, called Shahbazim, are "universal workers," who cook meals, do laundry, provide personal care, assist with habilitation, and promote the elders' quality of life.
Purpose: We developed and tested theoretically derived procedures to observe physical environments experienced by nursing home residents at three nested levels: their rooms, the nursing unit, and the overall facility. Illustrating with selected descriptive results, in this article we discuss the development of the approach.
Design And Methods: On the basis of published literature, existing instruments, and expert opinion about environmental elements that might affect quality of life, we developed separate observational checklists for the room and bath environment, unit environment, and facility environment.
Background: Quality of life (QOL) is a goal for nursing home residents, but measures are needed to tap this phenomenon.
Methods: In-person QOL interviews were attempted for 1988 residents, stratified by cognitive functioning, from 40 nursing homes in five states. Likert-type response options were used with reversion to dichotomous responses when necessary; z-score transformations were used to combine the formats.