Background: While existing reviews have identified significant predictors of nursing home admission, this meta-analysis attempted to provide more integrated empirical findings to identify predictors. The present study aimed to generate pooled empirical associations for sociodemographic, functional, cognitive, service use, and informal support indicators that predict nursing home admission among older adults in the U.S.

Adult Day Service (ADS) centers offer a variety of services to meet the needs of older adults and their caregivers. During the last decade, ADS has received increased attention due to shifts in policy toward home and community-based services for an aging population. This article reviews the effectiveness of ADS from 2000 to the present, with particular attention given to caregiver and participant outcomes, health care utilization, and future directions in ADS research. Multiple databases were searched to identify relevant research and 61 articles were selected for review based on inclusion criteria. The results of this review emphasize the need to implement and test more specific interventions targeting the needs of the ADS population.

While it is clear that families remain involved in the lives of loved ones following placement in a nursing home, little research has examined whether visiting and the provision of care has effects on the emotional stress and psychological well-being of family members. Utilizing pre-placement and post-placement data from the Caregiver Stress and Coping Study (n = 185) as well as a theoretical framework to delineate the manifestation of caregiver stress (i.e., the stress process model), the goal of this analysis was to determine whether frequency of visits and provision of personal and instrumental activities of daily living assistance following institutionalization were related to post-placement emotional distress, family conflict, and psychological well-being among family members. Following control of a wide array of pre-placement and post-placement covariates, multiple regression models found that visiting was negatively associated with post-placement role overload; moreover, the provision of instrumental activities of daily living help was negatively related to loss of intimate exchange at post-placement. The results suggest that family involvement following institutionalization may operate differently than when in the community, and add to the literature emphasizing the positive implications of family involvement in residential long-term care.

Using a unique measure of unmet need that taps into several dimensions of informal long-term care, the present study included data from 694 informal caregivers of persons suffering from dementia at different times in the caregiving career (e.g., at home, following institutionalization, following the death of the care recipient). Multivariate regression models found that unmet need for either confidante or formal support had key implications for caregivers' emotional distress in each of the care situations. The findings suggest that conceptual models should incorporate unmet need as a viable predictor of caregiving outcomes and that assessment of unmet need may provide guidance in the development of more refined psychosocial and community-based intervention protocols.

Performing euthanasia services in animal shelters is a necessary function, yet one that can take a heavy toll on shelter staff. The aims of this exploratory study were to understand animal shelter management's perspective on staff reactions to euthanasia, to identify support programs and policies, and to understand the challenges and barriers to offering such services. A convenience sample of 54 shelter managers in the United States was surveyed using structured questionnaires. As expected, euthanasia was a common practice in shelters, averaging 869 dogs and cats annually per shelter. In response to performing euthanasia, sadness (83.3%), crying (68.5%), anger (57.4%), and depression (57.4%) were the most commonly reported staff reactions. Most shelter managers (74.0%) agreed that euthanasia contributed to burnout in staff, yet far fewer (26.0%) felt that euthanasia led to turnover. Shelter managers indicated that support programs were important for staff who perform euthanasia services. The most commonly offered support programs were training and education (offered in 48.1% of shelters), staff rotation (38.9%), informal peer support (38.9%), and breaks after euthanasia (35.1%). The vast majority of managers (74.0%) identified funding as the primary barrier to offering support programs. These findings confirm that performing euthanasia can have serious and problematic ramifications for shelter staff and shelter operations. While support programs are offered, they do not appear to be widespread or universal, primarily due to funding issues.