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Index

Abramovitz, M. 193 accountability of service providers 148,

149 Activities of Daily Living (ADL) scales 200 Adelmann, P. K. 139 advocacy services 48, 11~17, 118, 167,

208, 216 see also carers' advocacy and support

groups age- and sex-specific handicap rates 54,

55 aged care

outcome measures 147-65 policy history, Australia 29-35 responsibility for 5

Aged Care Advisory Committees 35, 44, 119

aged care assessment teams 18,42,43 and targeting 215-16 user rights issues 127-8

aged care programs, outcome evaluation 19

Aged Care Reform Strategy 33, 37-8, 44 and deinstitutionalisation 51-69

aged care services and consumer rights 179-81 and dependency needs 200 Australian regulatory system 20 delivery and funding 6 government expenditure 65-6 planning base changes 34 provision 6 reviews, Australia 33 timeline, Australia 219-25

Aged Consumer Forums 117, 118, 119 aged pension 40,210 aged persons, home care preference

12-13, 15

Aged Persons Homes Act 1954 29 Aged Persons Hostels Act 1972 31 aged population

and health-related quality of life measures 158-60

country comparison 7, 8 home help service use 10, 11-12 projected annual growth rates 9-10 recent annual growth rates 8-9 residential care use 10, 11-12 structural changes, Australia 34 trends, Australia 54-5

ageing as a male problem 24-5 as public issue 4, 5 as social problem 4 see also feminisation of ageing; older

men; older women ageing and disability literatures

implications for reducing dependency 202-4

reducing dependency 199-202 Allen,1. 25, 71, 76, 80, 81, 133, 144,201 Andersen, M. L. 142 Antonucci, T. C. 138, 139 Arber, S. 70, 73, 74, 133, 143, 144 Aronson, J. 78 assessment and targeting 215-16 Australia

aged population 7-10, 34 funding and service arrangements 28 home care policy 12, 13 outcome standards monitoring system

21,22 policy developments 28-47 policy history (1954-1984) 29-35 residential regulatory system 20-1 system reform 33-5

242

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Index 243

Australian Council on the Ageing and Department of Community Services 73, 75, 80

Australian hostels, objectives and outcome standards 105-7

Australian Human Rights Commission 83 Australian Institute of Health and

Welfare 36, 39, 47, 53, 54, 59, 77, 108, 110

Australian nursing homes, objectives and outcome standards 88-91

Australian population, ageing concerns 34

Australian regulatory system 88-92 Ayres, 1. 104

baby boomers 4-5 Baldock, C. V. 76 Baltes, M. M. 146, 197, 198, 200, 203 Baltes, P. B. 146 Barrett, M. 193 barter and exchange 139 Bartlett, W. 148 Baxter,]. 139 Beck, R. W. 76 Beeson, D. 25 Bell, D. 147 Bennett, F. 71 Bergner, M. 157 Beveridge, W. H. 192 Bittman, M. 75 black rights 4 Blieszner, R. 141 Braithwaite,]. 20, 92, 97, 98,100,101,

103, 104, 120, 178 Braithwaite, V. 20,47,71,73,92,101,

102, 202 Brisendon, S. 202 Brody, E. M. 73 Broom, D. H. 180 Brown C. 178 Bryson, L. 193 burden of care 202 Butler, R. N. 135

Calasanti, T. M. 136, 143, 144 capital subsidies 29-30, 32, 36 Care Aggregated Module (CAM) 45, 46 care needs (residents) 106-7 care packages see community aged care

packages carer support strategy 39 carers

and care recipient 201,202,203,214 and caring 146

carers' advocacy and support groups 15-16, 39

carers' kits 39

Carer's pensions 38-9, 79-80 centre-based day care 67, 68 Charter of Residents' Rights and

Responsibilities 47, 115, 116 claim rights 170, 172 Clark, M. 185, 186 Clarke, A. 133 Clarke, M. 22 co-dependency and the Cinderella

complex 197, 198 Coleman, L. 84, 133, 140 collective assertion, nursing home

residents 177-9 Collins, P. H. 142 community aged care packages 38, 43, 69

projections 62-4 community-based care 201

feminist criticism of 78 community-based services

aged persons' use of 76 funding 32, 37 inadequacy of 78 increase in aged persons being cared

for 57 Statement of Rights and

Responsibilities 48, 118 women's needs 83-4

community care reforms, UK 22 community options brokers 38, 127 community options projects 37-8, 69,

119, 127 case studies 160-2

community service providers, and notions of needs 177

community service provision, women disadvantaged 80

community visitors scheme 47, 115, 117 complaints from residents, and rights

174-6, 177 compulsory retirement, and economic

dependency 26 consumer health movement, resource

needs 180-1 consumer rights movement 167, 216 contracting out, home-based care

services 20 coping capacity 202 cost containment, residential care 14, 15 Cox, E. 193 culture of dependency literature 195-6

implications for reducing dependency 196-7

cure versus care, as outcomes 154-7

Danigelis, N. L. 140 David, M. 71,192 Davies, B. 173 Day, P. 20-1,141,148






244 Index

de Beauvoir, S. 25, 133 Dean, H. 195 'decisional' dependency 200, 203 deinstitutionalisation 10-16

and Aged Care Reform Strategy 51-69 Australia 35-40

delivered meals 67, 68, 84 Delivered Meals Subsidy Act 1970 32 demand for aged care 7-10 Demetrakopoulos, S. 137 demographic trends, aged population

7-10, 34 departmental complaint units 116, 118 dependency 184-211

aged persons 53-6, 58 and home-based care 210, 213-14 and interdependency 205-6, 207 and quality of care 171-8 and rights 174-7,216-17 and targeting 41-4 and vulnerability 201, 207 as ideological term 196, 197 as synonym for disability 200-1, 203 attributes 188-9 causes of 188 for what? 187-8 kinds of 186 negative impact on the carer 201 on who or what? 187 policy developments 207 reduction in the elderly 191-204,

213-14 social construction 26-7, 185 taxonomies and typologies 189-91 undesirability of 204-8 what is it? 185-91 see also reducing dependency

dependency-support script 198, 199 developmental psychology, and

dependency 197-8 dignity and privacy see privacy and

dignity (of residents) directors of nursing

and standards 100, 102, 120-1 commitment to residents' rights 120-3,

125, 176 disability

and dependency 188 and disability movement 3, 4 as synonym for dependency 200-1, 203 measures 200-1

disabled aged 19 criticism of feminist work on caring

202 gender and institutionalisation 81,

141-2 women as carers 73

discharge, as outcome indicator 150-1

Dixon, D. 83 domestic responsibilities, in aged care

couple households 74-5 Domiciliary Nursing Care Benefit 38-9,

79,80 domiciliary services 83-4 Donabedian, A. 95, 96, 147, 153, 156 Duckett, S. 43 Duffy, M. 97

Eagar, K. 156, 157 economic dependency 186 Eisenstein, H. 143 Emerson, R. W. 192 emotional dependency 186 empowerment 22-3, 26, 125, 178 enlightenment theory of social welfare

15 equity of access 44-6 Estes, C. L. 133 Europe, home care policies 13 exit, voice and rights in empowerment

22-3 expenditure, aged care services 65-6 exploitation see vulnerability

family members and residents' rights 122 attitude to aged care 15, 16 provision of aged care 38, 75-6, 78,

201,213,214 federal funding, nursing homes 32-3 Feinberg, J. 172 female economic dependency, sexist

assumptions 71 female spouses

as carers 73-4 domestic responsibilities 74-5

feminisation of ageing 24-6, 70-86 feminist movement 3, 4

and older women 25, 70-1, 143 feminist perspective

culture of dependency literature 195 on carers 202, 203 on old age 143-4 on women's dependency 192-4 social provisions for the aged 72-86 see also gender; gender bias; older

women; women financial circumstances

and dependency 188, 200 and targeting 40-1 of women in older age 82-3, 133

Finch, J. 71, 73 Fine, M. 158 Firestone, S. 193 formal services, under-supply, impact on

women 78






Foster, C. 83 founder/donor arrangements 29-30 frail aged 19

independent living 202 maximising independence 26-7, 206 rights 173-7 vulnerability 181,207-10,218

Fraser, N. 185, 186, 195-6, 197, 199, 201,205

freedom of choice (of residents) 90, 106, 176-7

Freytag, K. 173 Friedan, B. 3, 134 friendship networks among women 137 Frye, M. 72, 77 funding

aged care services 65-6 and equity 44-6 federal/state responsibilities 32-3 high dependency residents 41, 42, 43 home-based care 37 residential care 12, 36

gay rights 3, 4 Gee, E. 73, 75, 76, 133, 134-5, 136 gender

and disabled aged institutionalisation 141-2

and old age 25, 70-1, 135-6, 143 see also older men; older women;

women gender bias

against women disabled aged carers 80-1

in community service provision 80 geographical equity 44-5 George, L. K. 138 Gerarg, L. E. 133 geriatric assessmen t teams see aged care

assessment teams Gewirth, A. 170 Gibson, D. 27, 38, 39, 59, 63, 69, 84, 85,

92,127,137,139,172,181,198, 200, 201

Gilbert, G. N. 73 Giles Report 46, 87, 114 Gilman, C. P. 72 Ginn,J. 70, 74,133,143,144 Glennerster, H. 14,33 Goodin, R. E. 17,82,172,181,192 Gordon, L. 185,186, 193, 195-6, 197,

199,201,205 Graham, H. 146 Graycar, A. 73, 76, 81 Gregory, R. G. 40, 103 Grey Panthers 4 Griffiths Report 14, 18 Gross, B. M. 148

Index

Grosz, E. 24, 73 Groves, D. 71, 73

245

HACC see Home and Community Care program

Hallady, A. 178 Hardwick, J. 76 Hart, H. L. A. 171, 172 Hatry, H. P. 148 health care (of residents) 90 health status, and outcome measures

155-6 health-related quality oflife 158-60, 163

case studies 160-2 Heinze, R. G. 139 Hendricks, J. 144 Herzog, A. R. 136, 139 Hess, B. B. 133, 144 higher dependency residents 41, 42, 43 Hohfeld, W. N. 170 Home and Community Care program

(HACC) 37, 38, 64, 65 National Service Standards 110, 118 provision level 67, 68 Statement of Rights and

Responsibilities 48, 118 home-based care

and dependency 201, 213-14 and frail aged vulnerability 208-9 assessment 43 Australia 28, 37-8 change of provider effects 180 elderly preference for 12-13, 15 expansion 64-8, 69 expenditure patterns 65-6 funding 32, 37 means testing 41 regulation 110-12 standards 47 user rights 48,118-19,127,177 versus residential care 212-15

home-based respite care 39, 67, 68, 84-5 home-based services

Australia policy 12, 13 criticism, Australia 32 European Union policies 13 increased needs for 79 international usage 10-12 quality appraisal processes 20 social policy shifts 15-16 subsidies 32 supply 67-8 Swedish trend 13-14 under HACC 37, 67 United Kingdom 14

home help 67, 68 home-like environment (of nursing

homes and hostels) 90, 107






246 Index

home nursing 67,68 hostel options project 38 hostel standards 46 hostels 28

1950s 29-30 CAM/SAM funding 45-6 entry payment 40 high dependency residents 42, 43 objectives and outcome standards

105-7 occu pancy levels 180 performance against rights-oriented

standards 124 personal care subsidy 30-1, 36, 38, 40,

42 projections 61-2 provision ratios 36, 37, 61 residency increase 56, 57, 58 resident contributions 40 standards and quality of care 110, III

House,]. S. 138 House of Representatives Standing

Committee on Community Affairs 18, 39

household maintenance 74, 84 housekeeping services 84 Hoyes, L. 149 Hunt, A. 80 Hunt, S. M. 157

immunisation programs 153 independence offrail aged 26-7, 206,

215, 218 independent living, for frail aged 202 independent living movement 15,203 indigenous Australians 44 inequity of access 44-6 informal care 38-40, 69, 76

feminist critique 15 lack of for very old people 53 sexual differentiation 80-1 see also home-based care

institutional care, levels of 78-9 institutionalisation

and marriage 75 disabled aged 81,141-2 rates 10, 11-12,76, 141 women 141

Instrumental Activities of Daily Living (IADL) scales 200

interdependency, and dependency 205-6 interest theory of rights 171

jackson,]. S. 139 Jacobs, K. 139 jencks, C. 195 J oint Review of Hostel Care Subsidy

Arrangements 33, 114 joint Review of Nursing Homes and

Hostels 33 Jones,]. 195

Kahn, R. L. 138 Kane, R.A. 21,159,160 Kane, R. L. 21,159,160 Keens, C. 81 Keiher, S. 80 Kendig, H. L. 14,74,75,76 Kewley, T H. 31,199 Keys Committee 103, 105 Kimball, M. 73, 75, 76, 133, 134-5, 136 Kinnear, D. 73 Klein, R. 148 Knapp, M.]. 173 Kohli, M. 139 Korpi, W. 11, 13 Krause, N. 138

labours of love, and women as carers 73-7

Laing, W. 12 Lakey,]. 23 Land, H. 71, 83,192 Lawton, M. P. 202 Le Grand,]. 82, 148 legal system and dependency 188 Leghorn, L. 72 legitimacy and dependency 188-9 length of stay, as outcome indicator

150-1 Lewis,]. 14,33 Lewis, M. 1. 135 Liebig, P. 13 life-cycle stage and dependency 188, 197 Liu, Z. 59 lower dependency residents 41, 42, 43 Lyons, D. 172

Macdonald, B. 25 McIntosh, B. R. 140 McIntosh, M. 71, 82, 192, 193 McLeay Report 30,32,33,45,88, 114 Macri, S. 103 Madden, R. 200 Makkai, T 92 male carers 73 male spouses, domestic responsibilities

74, 75 Malthus, T R. 192 marriage, and institutionalisation 75 Mathur, S. 45, 57, 58, 68 maximally reducible model of

dependency 205 Mead, L. M. 186, 195






Index 247

Means, R. 22, 23 means testing 16,40,41 Meenan, R. F. 157 men

and community-service provision 79, 80,81-2,84

retirement 139 see also older men

Mendelson, M. A. 167 Mendes de Leon, C. F. 138 Mill,]. S. 192 Mills, C. W. 3 Minkler, M. 133 monitoring process (nursing homes) 89,

91-2, 126 Montague, M. 27 Morris,]. 27,146,201,202,207 Moynihan, D. P. 186, 195 Mugford, S. 85, 137 multivariate analysis 144 Murray, C. 195 Myrdal, G. 4

National Carer's Association 39, 119 National Citizens' Coalition for Nursing

Home Reform 173 natural dependencies 189 necessity theory of social welfare 15 Nelson, B.]. 193 Nelson, M. A. 137 Nemschoff, H. L. 76 NHS and Community Care Act 1990

(UK) 22, 23 Nicholas, M. K. 158 non-English-speaking background

persons 44 non-institutional support services 14-16 not-for-profit organisations see voluntary

organisations nursing home beds

bed growth 30, 31, 35-6 capital and recurrent subsidies 30 government controls 35-6 .provision 29 provision ratios 35-6, 37, 60

nursing home care and frail aged vuln'~rability 208-10 and residents' righ s 123, 169-71 government reports 88 high dependency residents 41, 42 projections 60-1 residency decline 56, 57, 58

nursing home options 38 Nursing Home Reform Amendments

(US) 22, 169 Nursing Home Regulation in Action

Project 92-4, 97, 98, 101, 120, 125, 126, 175, 176

nursing home residents and collective assertion 177-9 unnecessary restraint 182-3, 186

nursing homes alternative sources of service provision

209-10 CAM/SAM funding 45-6 discretionary control in access to

service 210 entry eligibility 41-2 entry payment 40-1 funding 32, 42, 45 growth 33 monitoring process 89, 91-2 objectives and outcome standards

88-101 occupancy levels 180,215 performance against rights-oriented

standards 123 quality of care monitoring 87-8 regulation 20-1, 22, 87-105, 210 regulation concerns 101-5 resident contributions 40 resident independence and gender

81 resourcing of residents' committees

180-1 sanctions for non-compliance 104-5 standards and quality of care 46,

108-10 ,targeting and dependency 41-2 timeliness of visits 103-4 visits without notice 102-3 see also residential care

Nursing Homes and Hostels Review 31, 88, 114

Oakley, A. 193 objectives and outcome standards,

Australian nursing homes 88, 89, 90-1

O'Connell, B. 75,81 Offe, C. 139 old age, and importance of spouses

132-3 older men

comparison with older women's health 135-6

productive work 140 recreational and leisure activities 85

older women 131-46 academic construction inaccuracies

140-2 age as social factor 142 and feminist movement 25-6, 70-1 and public provision 84-5 disadvantaged position 82-3, 132-4,

135






248 Index

financial dependency 83, 133, 135, 139

health and longevity 135-6 in domestic and unofficial economic

sectors 139 meal preparation 84 private sphere activities 138-9 productive work 140 reconstructions 134-8 recreational and leisure activities 85 sex-specific needs 82-6 social provision 82 social/feminist explanation of problems

142-4 views on their disadvantaged position

140-1 Oliver, M. 3, 202 ombudsman programs 21, 116 OPCS Informal Carers Survey 73, 74 outcome measures 19, 20, 147-65,

217-18 case studies 160-2 conceptual difficulties 151 cure versus care 154-7 health-related quality of life 158-63 outcome versus importance 163-4 outcome versus output 164 political difficulties 151-2 problems 150-2 process versus outcome indicators

152-4 quality oflife 157-62 quality or outcomes? 164-5

outcome standards monitoring program 21,22,46-7,88-91

and user rights 117 assumptions 92 evaluation 95-101 impact on quality of care 108-10, III implementation in hostels 105-7 monitoring process 89, 91-2, 126 Nursing Home Regulation in Action

Project 92-4, 97, 98, 101 outcomes or process indicators? 95-8 reliability concerns 100-1 sanctions 104-5 subjectivity of standards 98-100 timeliness of visits 103-4 visits without notice 102-3

paid work, age and gender 143, 145 pain management, and quality of life

measures 158 parasitism 72, 77, 78, 81, 133 Parker, K. 72 Pateman, C. 193 Paterson, H. M. 76

patients' rights see user rights Payne, B. 25 Peace, S. 133, 137 Pearce, D. 205 Pearlin, L. I. 202 Peat, Marwick, Mitchell 77 performance monitoring 148-9 personal care 67 Personal Care Subsidy 30-1, 36, 38,40,

42 personal troubles, and public issues 3-4 phallocentrism 72-3, 81-2, 133 physically active but demented resident,

and rights 175-6 physically disabled and mentally alert

resident, and rights 174-5 Piven, F. F. 193, 195 planning base, aged care services 34 political-activist tradition 4, 23 political and legal dependency 186 population ageing 6

demographic trends 7-10 trends, Australia 54-5

positive dependencies 198, 199 Power, M. 18 powerlessness and lack of control 206-7,

209,216 Preston, G. 75, 81 privacy and dignity (of residents) 89, 90,

98,99, 107, 154 private-for-profit sector 30, 31, 33, 45 privatisation, nursing home services 20 process or outcomes indicators 95-8,

152-4 program evaluation 148-9 provision ratios 35-6, 45, 52, 60 psychological dependency 186 psychological literature, implications for

reducing dependency 197-9 public dependency 192, 194, 203, 213 public provision, impact on women

77-82,83-4 public sector performance measures

147-8 Pynos, J. 13

quality appraisal p ocesses, home care services 20

quality indicators 155 Quality Monitoring System 155 quality of care 181

and dependency 217-18 and qualified staff 156-7 early monitoring 87 federal government reports 88 measures 154-5 regulation 46-7,87-112






Index 249

quality oflife 89, 154, 181,218 importance of social networks 138 measures 157-60

rationing of services 16-18 recreational and leisure activities 85 recurrent subsidies 30-1, 36 reducing dependency 191-204

ageing and disability literatures 199-202

culture of dependency literature 195-7

nursing home example 208-10 potential directions 204 psychological literature 197-9 social welfare literature 191-4 through move to home-based care

131-4 regulating quality of care 46-7, 87-112

objectives and outcome standards 88-94

ongoing concerns 101-5 standards evaluation 95-101 see also outcome measures; outcome

standards regulation and accountability 18-21, 217 Rein, M. 139, 192 Reinharz, S. 25, 71, 144 Resident Classification Instrument (RCI)

42,43,45-6 hostel care 60, 61-2 nursing home care 58, 59-60

resident perceptions, for outcomes appraisal 98-9

Resident/Proprietor Agreement 116, 125 residential care

and changes in client profiles 57-8 and financial accessibility 40 and residents' rights 116-18 Australia 28, 35-7 change from nursing homes to hostels

56-7 changing provision of 55-6 funding 32, 36 future trends 58-64 gender bias in usage 81 impact of rapid ageing of aged

population 53-4 increased demand for 39-40 international usage 10-12 provision ratios 36-7, 45, 52 rationing effects 39 reduction in 52-8 restructuring 33 supply changes, Australia 35 versus home-based care 212-15 see also nursing homes

residential care facilities, supply and utilisation 180

residential respite care 69 residents, complaints and rights 174-6,

177 residents' committees 23, 47, 124-5, 126,

178 and nursing home management

resourcing 180-1 expectations from 178-9 ineffectuality 125, 178 role in management structure 179

residents' rights movement 183 residents' rights see user rights Residents' Rights in Nursing Homes and

Hostels 102, 115 resource utilisation 17-18 respite care 39, 69 Respite Review 39 retirement 139 Rich, C. 25 Rickwood, D. 200 rights

and correlative duty 171 and independence 21-4 and needs 177 definitions 170-3 for the frail aged 173-7 strategies 181-3 third party as claimant for rights

bearer 172-3 to self-determination 173-4 see also empowerment; user rights

Rivlin, A. M. 147, 148 Roberts, H. 143 Rodeheaver, D. 133 Rodgers, W. L. 136 Ronalds reports 102, 113, 114, 115, 116,

117,167,168-9,173 Rose, H. 192 Rose, R. 71, 139 Rosenman, L. 71, 83, 133, 139 Rossi, A. 137, 138 Rossiter, C. 73 Rowland, D. T 14,38,75,76,79,84 Rudinger, G. 136 rural and remote communities 44 Russell, C. 25, 26, 71, 83, 133, 140, 144,

212

safety (of residents and staff) 91, 97 Sainfort, F. 154, 156 sanctions for non-compliance (nursing

homes) 104-5 Sapiro, V. 20 I Schoonover, C. B. 73 Schreiner, O. 72






250 Index

Schuller, T. 139 Scott, H. 71 Scott, R. 72 Segal, L. 193 self-determination, rights to 173-4 Senate Select Committee on Private

Hospitals and Nursing Homes 33, 88

service provider/service recipient relationship 23-4, 209-10, 214

severe handicap rates, population 65 and over 54, 55

sex, in gerontological research 24-5, 143, 144

sex differences, conceptual models and old age 135-6, 141

sex parasitism 72, 77, 78, 81, 133 sex-specific needs 82-6 sexual attractiveness 132, 133 sexual divisions of labour 74-5 SF-36 (outcome measure) 157, 158 Sharp, T. J. 158 Sherbourne, C. D. 157 shopping and errands 84 Silverberg, S. 197,198 Smith, D. E. 145 Smith, P. 149 Smith, R. 22, 23 social construction of dependency 26-7,

185 social gerontology 24, 25, 70

criticisms 142-5 social independence (of residents) 90,

107 social indicators movement 147-8 Social Justice Strategy (Labor Govt) 33,

44 social networks 85, 136-8, 141 social policy, and sexism 71 social provisions for the aged

feminist view 72-86 women as carers 73-7

social security, cost containment 14, 15 Social Welfare Commission 28 social welfare literature

implications for reducing dependency 194

reducing dependency 191-4 Sommers, T. 25 Sontag, S. 25, 133 special needs groups 44 Spender, H. 192 spouse carers 73-4, 79 spouse carers' pension 80 spouses, role in old age 132-3 Stacey, J. 24, 143

Staden, F. 81 Standard Aggregated Module (SAM)

45,46 standards see outcome standards

monitoring program Standards Monitoring Review Panel

104 state/territory governments, funding

role 32 Statement of Rights and Responsibilities

48, 118 States Grants Acts 32 Stewart, J. 22 Stone, R. 133 Streib, G. F. 76 subsidies 29-32 Sundstrom, G. II superannuation, and women 83 Sweden, home-based care trend 13-14

targeting and assessment 215-16 and dependency 41-4 and financial circumstances 40-1 of services 16-18

Taylor-Gooby, P. 195 temporality 179-80, 189 third party as claimant for rights bearer

172-3 Thomae, H. 136 Thompson, C. 158 Thorne, B. 24, 143 Thornton, P. 167 timeliness of visits (nursing homes)

103-4 Tinker, A. 12 Titmuss, R. M. 192 Townsend, P. 26, 27, 198, 199, 212 Tozer, R. 167 transport 84 Tulloch, P. 192

unemployment and dependency 188 Ungerson, C. 71, 73, 201 United Kingdom

home-based care 14 nursing home regulation 20-1 user rights 22-3

United States ombudsman programs 21 regulatory philosophy 91-2, 96 residents' rights 22, 167, 177

unnecessary dependency 198 unofficial economic activities 139 unpaid activities 140 user empowerment 22-3






Index 251

user rights 20, 21-4, 26, 47-8, 113-28, 166-83,216-17

and aged care assessment teams 128 and dependency 174-7, 216-17 as policy agenda item 167-70 Charter of Residents' Rights and

Responsibilities 47, 115, 116, 169 client frailty and lack of knowledge

127 community groups concerns 114 consequences assessment 119-25 definitions 170-3 departmental complaint units

116, 118 directors of nursing commitment to

121-3, 125 evaluation and explanation 125-8 for frail aged 173-7 home-based care 48,118-19, 127, 177 hostels 123-4 models, appropriateness 181-3 nursing homes 123, 169-71 Resident/Proprietor Agreement 116 Ronalds' report recommendations

115, 168 specific nature of 168-9 strategy implementation 115-19 see also residents' committees; rights

variety of experience (of residen ts) 91, 107

very old people, residential care needs 53-8

very old population, growth rates 8, 9-10

visits without notice (nursing homes) 102-3

voluntary organisations, funding arrangements 29-30, 31

voluntary sector homes 33, 45 deficit financing 31 growth controls 31

vulnerability and dependency 201,207 frail aged 181,207-10,218 nursing home care example 208-10

Waldron, J. 170 Walker,A. 11,12,15,17,18,23,26,185,

186,198,199 Ware, J. E. 157 Waring, M. 77, 139 Warren, L. 11,12,15,17,18,23 Watson, S. 84, 133, 140 'welfare mothers' 196 welfare state, and women's dependency

192-3, 196 Whittington, F. 25 widowhood

adaption to 137, 138 and institutionalisation 141

Wiles, D. 83 Wilson, E. 71, 192 Wilson, W. J. 186, 195 Wistow, G. 14,33 Woerness, K. 73, 76, 133,201 women

access to labour market 82 and public provision 78-82 and superannuation 83 care of the aged 71-2, 73-7, 79-80,

201 community-based service needs 80,

83-4 institutionalisation rates 141 longevity 134-6, 138, 146 paid and unpaid labour 76-7 personal coping capacities 137, 138 reliance on informal care 79 social networks 136-8 see also older women

women's dependency 192-4, 196 Woolf, V. 73 Working Party on the Protection of Frail

Older People in the Community 113, 118

Wright, F. 75

Young, M. 139

Zajicek, A. M. 136, 143 Zimmerman, D. R. 154, 155, 156 Zinn, D. K. 193






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