DOMICILIARY CARE--HOMELIKE CARE OR ACCESS PROBLEM

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This study will compare the residents of domiciliary care homes in terms of demography, health characteristics and care needs in order to address questions of discrimination and/or cultural preference. The long term aim is to assure that frail elderly persons receive care appropriate to their level of need irrespective of ethnic differences. Specifically our aims are: I. To compare African Americans with white residents of domiciliary care facilities in terms of demography, health characteristics, and appropriateness of placement. II. To compare the perceptions of long term care facilities of frail elderly African Americans living in the community to that of a similar group of whites. III. To compare the family sentiment and support of African American residents of domiciliary care facilities with that of white residents. IV. To study the effect of minority status among a) residents, and b) caregivers on the process of care in domiciliary care facilities. The study design calls for an intensive study of both residents and close family members, interviews with staff persons closely involved with the residents' care, chart reviews, and interviews with the administrator of the home. A second aspect of the study involves identifying frail elderly living within the community and interviewing them and their caregiver regarding extent of informal social support, perception and knowledge of nursing and domiciliary care homes, and their preferences for type of care. The total sample size will be 1050.