This survey can be used to understand CNA workforce issues and challenges and to plan for sustainable solutions to stabilize this workforce. The NNAS can be linked to other existing data sets to examine more comprehensive and complex relationships among CNA, facility, resident, and community characteristics, thereby expanding its usefulness.

No abstract

Among a group of frail older persons living in the community, planning to die in a particular place was common and implemented successfully most of the time. Providing physician care at home may facilitate improved end-of-life care for older persons.

No abstract

This study examines hospice use among adult hospice patients based on the

Study findings indicate that the present system used to document nursing home residents' intake is inadequate and that a more accurate mechanism or an entirely different process for identifying residents at risk for nutritional problems should be developed and implemented.

Estimates of the prevalence of cognitive impairment that are based on nationally representative data are rare, because comprehensively evaluating a national sample by using standard, validated cognitive-impairment assessment methods is difficult and expensive, and because most national surveys are broad based and designed to cover a wide variety of topics. Crude measures of cognitive impairment, such as the presence of confusion or memory loss or limitations caused by senility or dementia, that are included in these multipurpose surveys may be only rough proxies for clinically evaluated cognitive impairment, but they do appear to produce prevalence estimates that are similar to estimates found with the use of more precise case-ascertainment methods. These nationally representative data sets may be used to generate hypotheses related to the prevalence, epidemiology, and health care utilization patterns of people with cognitive impairment that can be tested in studies using more specific case-ascertainment criteria.

Hospice use rates significantly increased for both whites and black patients. Black patients had lower hospice use rates than white patients from 1992 to 1994, but not from 1996 to 2000, which may reflect the diffusion of hospice care to black patients with the rapid growth in hospice programs. Despite differences in patient characteristics, the length of hospice survival was similar among both groups. Future research is needed to assess whether racial disparities exist in quality of hospice care.