Chemical abuse. An intervention program for the elderly.

Although chemical dependency has been identified as a problem in the geriatric population, the literature continues to focus on issues of problem identification; few authors address the issue of providing appropriate services for the chemically dependent elderly. A goal of the Elders Health Program was to design a process of intervention using strategies employed by current chemical dependency treatment facilities, and to interface this process with knowledge and respect for normal aging changes. The intervention involved creating a unified and informed intervention team. The Elders Health Program illustrates that all elders have a network that can be employed or created in an effort to move the client into accepting the need to change. The ultimate goal is to improve the well-being of the client.

Waiting times for nursing-home placement: the impact of patients' choices.

OBJECTIVE: To identify patient characteristics and characteristics of long-term care facilities that significantly affect the waiting time for transfer from hospital to nursing home. DESIGN: Cohort study. PARTICIPANTS: All patients designated to be transferred from four Winnipeg hospitals between June 1, 1988, and May 31, 1989. The patients were followed up until placement, death or May 31, 1990. MAIN OUTCOME MEASURE: Length of time waiting for nursing-home placement and relative rates of placement. RESULTS: The variable found to shorten the waiting time the most was the patient's choice of a for-profit or nonprofit secular facility; other significant variables were male sex, age of 75 to 84 years and occupancy of an acute care bed during the wait. CONCLUSION: The province has three policy options: it can increase the proportion of secular nursing-home beds when new facilities are built; it can require that hospital patients accept an interim nursing-home placement pending transfer to the nursing home of their choice; or it can tie the sponsorship of new facilities to a formula based on the ethnoreligious distribution of the population currently aged 55 to 64 years.