Access and issues of equity in remote/rural areas.

This article reports on a workshop in which the major focus was a review of the barriers that prevent access to the array of community-based services available to the rural elderly. The demographics of the elderly were outlined and key components of the service system described. Attention was given to access hospital-based care, the closing of hospitals and the reasons for bypassing rural hospitals for those in large towns or cities. Special emphasis also was given to mental health services and their uneven accessibility. A review of the policy implications closed the workshop.

Health needs and social policy.

This article describes demographic and economic factors that impinge on the health care of elderly women. Policies that control access to and utilization of health and long term care services are discussed. Some of the shortcomings of past policies are noted and current social reform efforts aimed at greater policy equity for elder women are reviewed.

Counseling the isolated elderly.

Increasing interest is manifest in the development of alternative models of counseling for older persons. Irrespective of the particular model used, the counseling of aged persons who have emotional and psychologic problems may require a treatment plan for health, mental health, and social services, to resolve the problems and to assess the functional limitations. Health and mental health centers employing both professional and nonprofessional counselors need to determine the value of adding outreach components to their services, and agencies which already have outreach programs may need to determine their relevance and effectiveness. Effective outreach requires a high level of gerontologic knowledge and clinical skills with aged patients. Agencies and clinics can design and implement mechanisms for supporting the elderly as they make use of multiple sources of service. Mobilization of the family and other informal helping networks in the community, the establishment of better coordination mechanisms within clinic and service programs, and multiple-service integration will improve the efficiency and effectiveness of long-term community care and follow-up programs.

Geriatric day care in theory and practice.

Geriatric day care is currently receiving considerable attention as an alternative to institutionalization for a certain segment of our nation's chronically ill and impaired elderly. There are, however, few clear descriptions of day care and even fewer programmatic guidelines. In an effort to clear up some of the issues, this paper (a) defines geriatric day care and describes various types of geriatric day care centers, (b) discusses the place of day care in the long-term care continuum, and (c) describes the Levindale Adult Day Treatment Center as one model of geriatric day care.