title: Who recommends long-term care matters.
abstract: OBJECTIVE
  Making good consumer decisions requires having good information. This study compared long-term-care recommendations among various types of health professionals.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: School of Public Health, University of Minnesota, D351 Mayo (MMC 197), 420 Delaware Street SE, Minneapolis, MN 55455, USA. kanex001@umn.edu
authors.forename: Robert L
authors.initials: RL
authors.lastname: Kane
authors.forename: Boris
authors.initials: B
authors.lastname: Bershadsky
authors.forename: Julie
authors.initials: J
authors.lastname: Bershadsky
mesh_terms: D006282:Health Personnel / Q000523:psychology*; D006707:Homes for the Aged; D006801:Humans; D008134:Long-Term Care / Q000523:psychology*; D009735:Nursing Homes; D010343:Patient Admission; D012017:Referral and Consultation; D014481:United States