The Teaching Nursing Home of the Albert Einstein College of Medicine and Montefiore Medical Center and their associated facilities the Beth Abraham Hospital, Morningside House Nursing Home, and Hebrew Home for the Aged at Riverdale, represents a reorganization of resources relating to research on geriatric health problems into a structure which crosses institutional, departmental and disciplinary lines. A number of well-known faculty, institutions, and programs involving a wide range of types of care and levels of service, are included. The objective is to bring the research and teaching characteristics of the University hospital to the long term care facility, while simultaneously bringing geriatrics into the mainstream of medical and professional school activities. The TNH will consist of an identified group of approximately 500 elderly subjects, either residing in one of three long term care facilities, patients/clients of affiliated Assessment Units in acute care settings, or Home Care clients, each of whom will be enrolled in specific research protocols. Research protocols are submitted regarding the following problems: dementia, falls, nosocomial infections, osteoarthritis, and urinary incontinence. The plan for development includes the establishment of a core structure as a resource for TNH research (and teaching) activities. This core structure will include a Data Management and Statistics Unit which will service all TNH research projects. The projects rely on the Nurse-Research-Facilitator as the research case manager of the subjects and the """"""""traveling core"""""""" of the TNH. A Standard Assessment is proposed for all subjects, and is based on experience with an ongoing longitudinal aging study. An attempt is made to achieve an economy of subjects in that subjects may participate in more than one protocol and also in the availability of comparative data from the ongoing Bronx Aging Study at no cost to the TNH. Autopsy consents will be sought actively, and clinicopathological verificiation will be obtained whenever possible. The TNH will provide the impetus for a number of investigations into common problems of the elderly in nursing homes and outside which have potentially significant clinical implications for decreasing human suffering and ultimately perhaps for preventing or forestalling institutionalization.
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