Qualities of institutional care that affect outcome

Much has been written about institutions and care of the elderly. This paper begins with a description of the elderly population and its use of institutional care. A brief history of two types of institutions which provide long-term care to the elderly-mental hospitals and nursing homes-is covered next, along with some of the problems these institutions face in terms of their patients becoming institutionalized and what has happened as a result of pressures to deinstitutionalize the mental hospital population. Ways of assessing quality of care are highlighted in regard to current needs and methods of dealing with these needs. Some of the studies which emphasize outcomes in relation to institutional structure and process are then reviewed. Finally, some conclusions are drawn which summarize major needs and deficiencies in this area of study.