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bureaucratic system: A positive or negative effect on nursing home quality of care?
Title
The bureaucratic system: A positive or negative effect on nursing home quality of care?.
Creator
Lipsman, Lisa A., Florida Atlantic University, Evans, Arthur S.
Abstract/Description
Over the last fifty years quality of care has been a consistent problem in nursing home facilities. The federal government implemented a bureaucratic system as an attempt to improve this standard. This thesis traces the emergence of this system in nursing homes and illustrates its failure to solve the problem. George Ritzer's four-point McDonaldization model of bureaucracy is applied to argue that the bureaucratic system for governing nursing homes has a negative effect on the quality of care...
Show moreOver the last fifty years quality of care has been a consistent problem in nursing home facilities. The federal government implemented a bureaucratic system as an attempt to improve this standard. This thesis traces the emergence of this system in nursing homes and illustrates its failure to solve the problem. George Ritzer's four-point McDonaldization model of bureaucracy is applied to argue that the bureaucratic system for governing nursing homes has a negative effect on the quality of care. Although this hypothesis has proven to be accurate, additional factors were consistently cited as having detrimental effects on resident care. These include issues such as insufficient pay and lack of training/education for CNAs. Moreover, human greed and societal views of the elderly appear to be the true root of the problem.
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Date Issued
2004
PURL
http://purl.flvc.org/fcla/dt/13148
Subject Headings
Long-term care of the sick--Quality control, Nursing home care--Quality control, Outcome assessment (Medical care), Long-term care facilities--Standards
Format
Document (PDF)
How do home and community based services change long-term care?
Title
How do home and community based services change long-term care?.
Creator
Perez, Enrique M., College for Design and Social Inquiry, School of Public Administration
Abstract/Description
The relationship between Public Administration and the people is one that requires legitimacy and compromise in order to solve complex problems. Individuals with intellectual and developmental disabilities (IDD) and their families during the last fifty years have put forth an agenda that calls for the advancement of rights for the disabled and more integration into the larger society. In this arena, government, with post civil rights legislation like the 1990 Americans with Disabilities Act ...
Show moreThe relationship between Public Administration and the people is one that requires legitimacy and compromise in order to solve complex problems. Individuals with intellectual and developmental disabilities (IDD) and their families during the last fifty years have put forth an agenda that calls for the advancement of rights for the disabled and more integration into the larger society. In this arena, government, with post civil rights legislation like the 1990 Americans with Disabilities Act (ADA), plays a huge role in promoting social awareness and bringing down barriers of stigmatization, understanding, and access. This struggle is fought on many fronts. A significant part of the effort focuses on moving the locus of long-term care of the disabled, including the IDD population, from an institutional setting to the least restrictive setting that will foster social ties and integration. Since the early 1980s as part of this effort to deinstitutionalize the disabled, legislation at both the federal and state level has supported and incentivized the creation of Home and Community Based Service (HCBS) programs. HCBS waivers, as they are typically called, are also promoted as a means of containing government expenditures for long-term care. However, the effectiveness of these waivers is poorly understood. The critical questions being - Do HCBS waivers promote and create an environment that increases awareness of the needs of IDD individuals? Do the programs help reduce stigmatization, promote understanding, and increase access to services and activities that foster social interaction? Or, do HCBS waivers create a new "iron cage" where the intellectually or developmentally disabled are once again relegated to existing as second class citizens? In this research, programs are mapped and then evaluated to paint a better picture of how HCBS waivers change long-term care., This research combines qualitative and quantitative approaches to triangulate on these phenoamea as a means to investigate when and how HCBS waiver programs facilitate, promote, or stifle the social integration of those with IDD. How does social integration manifest itself in the quality long-term care of those who often cannot take care of themselves?
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Date Issued
2011
PURL
http://purl.flvc.org/FAU/3318667
Subject Headings
Long-term care of the sick, Medical care, Quality control, Sociology of disabiltiy, Heath care rationing, Outcome assessment (Medical care), Community health services
Format
Document (PDF)