title: Luck and happenstance: how older adults enroll in a program of all-inclusive care for the elderly.
abstract: OBJECTIVE
  This qualitative study explores how older adults enroll in a Program of All-Inclusive Care for the Elderly (PACE).
  
  
  METHODS
  PACE is a community-based long-term care program for nursing home eligible older adults.
  
  
  METHODS
  The study includes interviews with older adults (n = 5), families (n = 4), and staff (n = 10). This study identified common circumstances that led to the recognition of a need for help.
  
  
  RESULTS
  These circumstances included the following: an acute event or crisis, older adult's or caregiver's drive to avoid entry into the nursing home, and the caregivers' recognition that they need relief from their care demands. Once this need was identified, families typically found out about PACE because of happenstance; they happened to talk to someone who knew about the program.
  
  
  CONCLUSIONS
  If PACE is going to be a sustainable alternative to nursing home care efforts, it needs to focus on moving the enrollment process beyond happenstance. Professional case managers are positioned to help older adults and families plan for long-term care by understanding the availability of local community services, developing contacts with local community and long-term care services, and considering what information older adults and their families need, especially during acute care discharges, primary care encounters, and queries for nursing home services.
authors.affiliation: School of Nursing, University of North Carolina at Chapel Hill, NC 27599, USA. asbeeber@email.unc.edu
authors.forename: Anna Song
authors.initials: AS
authors.lastname: Beeber
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003153:Community Health Services / Q000706:statistics & numerical data*; D005260:Female; D015438:Health Behavior; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D008134:Long-Term Care / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D016730:Program Development; D015397:Program Evaluation; D036301:Qualitative Research