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Based on a cross-disciplinary review of the literature, the concept of family-centered service delivery is traced historically. A new definition is presented that extends the current model by highlighting three core elements--the family as the unit of attention, informed family choice, and a family-strengths perspective. Practice, policy, and research implications, and the challenge they represent to prevailing professional practice, are discussed.

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This study reports on the effectiveness of a community-based senior outreach program in decreasing rehospitalizations and emergency department visits among chronically ill seniors. Participants had been repeatedly hospitalized with chronic illnesses and were subsequently served in an in-home program designed to address their psychosocial and medical needs. Participation in the program was found to be related to lower hospital readmission rates and emergency department usage. Clients also reported decreased financial concerns and depression and anxiety and increased social support. The study adds to the growing body of work supporting community-based programs as effective strategies for decreasing health care usage and improving quality of life for chronically ill seniors.