Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.

Care of the elderly in a home like setting vs an instutional nursing home.

Does your question include a comparison of different health care approaches? (If no, your topic will still be considered.)

yes

If yes, explain the specific technologies, devices, drugs, or interventions you would like to see compared:

1. Would like to see relationships/bonds of CNA's and residences in both situations.
2. Would like to see what both the caregiver and the cared for think of having the same care giver 5 out of 7 days.
3. Is there a positive or negative aspect of those relationships as viewed by both the care giver and the cared for?

What patients or group(s) of patients does your question apply to? (Please include specific details such as age range, gender, coexisting diagnoses, and indications for therapy.)

Those who reside in both a residential home and a nursing home.

Are there subgroups of patients that your question might apply to? (For example, an ethnic group, stage or severity of a disease.)

1. The subgroups could apply to dementia patients or groups that would be deemed to need assisted living.

Describe the health-related benefits you are interested in. (For example, improvements in patient symptoms or problems from treatment or diagnosis.)

I am interested in the elderly feeling connected to their care givers, feel honored and enjoy what ever time they have left by doing activities they enjoy.

Describe any health-related risks, side effects, or harms that you are concerned about.

The emotional ties at the end of life for the care givers to the people cared for will need to be addressed before end of life happens. The activities need to be selected on what the cared for want to do, what is safe to do and what is enjoyable for them.

Appropriateness for EHC Program

Does your question include a health care drug, intervention, device, or technology available (or likely to be available) in the U.S.?

yes

Which priority area(s) and population(s) does this topic apply to? (check all that apply)

EHC Priority Conditions (updated in 2008)

• Arthritis and nontraumatic joint disorders
• Cancer
• Cardiovascular disease, including stroke and hypertension
• Dementia, including Alzheimer's disease
• Depression and other mental health disorders
• Diabetes mellitus
• Functional limitations and disability
• Infectious diseases, including HIV/AIDS
• Obesity
• Peptic ulcer disease and dyspepsia
• Pulmonary disease/asthma

AHRQ Priority Populations

• Low income groups
• Minority groups
• Women
• Elderly
• Individuals with special health care needs, including individuals with disabilities or who need chronic care or end-of-life health care

Federal Health Care Program

• Medicare

Importance

Describe why this topic is important.

This topic is important because the population is aging and the baby boomers are not interested in being institutionalized or given depersonalized care.

What specifically motivated you to ask this question? (For example, you are developing a clinical guideline, working with a policy with large uncertainty about the appropriate approach, costly intervention, new research you have read, items in the media you may have seen, a clinical practice dilemma you know of, etc.)

My mother has Alzheimer's and has been in 2 very different facilities. The philosophy of these facilities are very different and are carried out differently.

Does your question represent uncertainty for clinicians and/or policy-makers? (For example, variations in clinical care, controversy in what constitutes appropriate clinical care, or a policy decision.)

yes

If yes, please explain:

If we only have one option for care of the elderly there is no choice in where they can go.

Potential Impact

How will an answer to your research question be used or help inform decisions for you or your group?

What is the best way to care for the elderly. How do the elderly want to be cared for and who gains from excellent care or sub optimal care?

Describe the timeframe in which an answer to your question is needed.

Depending if we can get the monies for a residential home will dictate our time frame. Possibly we could use an already established residential home and a nursing home.

Describe any health disparities, inequities, or impact on vulnerable populations your question applies to.

How many beds will be private pay and how many can be for the indigent? This newer way of living for the elderly can changed people’s lives, influenced clinical practice, improved policies, and affected patient outcomes

Nominator Information

Other Information About You: (optional)

Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)

What is the best way to care for the elderly. How do the elderly want to be cared for and who gains from excellent care or sub optimal care?

Are you making a suggestion as an individual or on behalf of an organization?

Individual

Please tell us how you heard about the Effective Health Care Program