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The Gerontologist 46:474-482 (2006)
© 2006 The Gerontological Society of America

Who Recommends Long-Term Care Matters

Robert L. Kane, MD1, Boris Bershadsky, PhD2 and Julie Bershadsky, BA1

Correspondence: Address correspondence to Robert L. Kane, MD, School of Public Health, University of Minnesota, D351 Mayo (MMC 197), 420 Delaware Street SE, Minneapolis, MN 55455. E-mail: kanex001{at}

Purpose: Making good consumer decisions requires having good information. This study compared long-term-care recommendations among various types of health professionals. Design and Methods: We gave randomly varied scenarios to a convenience national sample of 211 professionals from varying disciplines and work locations. For each scenario, we asked the professional to recommend the appropriate forms of long-term care. Results: Although the professional respondents used the full spectrum of options offered to them, some professionals tended to favor the sector they worked in. Advanced practice nurses recommended day care and homemaking more and adult foster care less. Gerontologists used skilled nursing-facility placement more actively and rehabilitation, homemaking, and home health care less actively. Geriatricians and primary care physicians both favored rehabilitation and skilled nursing-facility care and were both less enthusiastic about assisted living, homemaking, and informal care, but the geriatricians favored day care more than did the primary care physicians. Registered nurses were highly supportive of assisted living, adult foster care, homemaking, and home health care, and they opposed skilled nursing-facility care. Social workers were less likely than other participants to endorse rehabilitation and adult foster care. Implications: Because consumer preference should be a major factor in making long-term-care decisions, many consumers need information about what options may best fit their situation. In the absence of empirical data on which types of long-term care work best for whom, consumers have to rely on expert judgment—but that judgment varies. Clients should be aware that an expert's background (as defined by discipline and work situation) may affect his or her recommendations. Each discipline appears to have its own set of experiences and beliefs that may influence recommendations.

Key Words: Long-term care • Discharge planning • Placement • Disciplinary bias

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R. L. Kane, K. Boston, and M. Chilvers
Helping People Make Better Long-Term-Care Decisions
Gerontologist, April 1, 2007; 47(2): 244 - 247.
[Abstract] [Full Text] [PDF]

All GSA journals Journals of Gerontology Series A: Biological Sciences and Medical Sciences Journals of Gerontology Series B: Psychological Sciences and Social Sciences
Copyright © 2006 by The Gerontological Society of America.