Who recommends long-term care matters

Robert L. Kane, Boris Bershadsky, Julie Bershadsky

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Purpose: Making good consumer decisions requires having good information. This study compared long-term-care recommendations among various types of health professionals. Design and Methods: We gave randomly varied scenarios to a convenience national sample of 211 professionals from varying disciplines and work locations. For each scenario, we asked the professional to recommend the appropriate forms of long-term care. Results: Although the professional respondents used the full spectrum of options offered to them, some professionals tended to favor the sector they worked in. Advanced practice nurses recommended day care and homemaking more and adult foster care less. Gerontologists used skilled nursing-facility placement more actively and rehabilitation, homemaking, and home health care less actively. Geriatricians and primary care physicians both favored rehabilitation and skilled nursing-facility care and were both less enthusiastic about assisted living, homemaking, and informal care, but the geriatricians favored day care more than did the primary care physicians. Registered nurses were highly supportive of assisted living, adult foster care, homemaking, and home health care, and they opposed skilled nursing-facility care. Social workers were less likely than other participants to endorse rehabilitation and adult foster care. Implications: Because consumer preference should be a major factor in making long-term-care decisions, many consumers need information about what options may best fit their situation. In the absence of empirical data on which types of long-term care work best for whom, consumers have to rely on expert judgment-but that judgment varies. Clients should be aware that an expert's background (as defined by discipline and work situation) may affect his or her recommendations. Each discipline appears to have its own set of experiences and beliefs that may influence recommendations.

Original languageEnglish (US)
Pages (from-to)474-482
Number of pages9
Issue number4
StatePublished - Aug 2006

Bibliographical note

Funding Information:
This article was prepared as part of the Evaluation of the National Cash and Counseling Demonstration, which was jointly funded by The Robert Wood Johnson Foundation and the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation (ASPE). The views expressed here are those of the authors and do not necessarily reflect those of the foundation, ASPE, the Cash and Counseling National Program Office, the demonstration states, or the Centers for Medicare & Medicaid Services, whose waivers made the demonstration possible.


  • Discharge planning
  • Disciplinary bias
  • Long-term care
  • Placement


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