The study drew a random sample of elderly patients newly admitted
to the Visiting Nurse Services in Westchester, a traditional,
not-for-profit certified home health agency serving a 450-squaremile
county north of New York City. Visiting nurse services originated
in the late 1800s and are now found throughout the United
States (11). Like many home health agencies, the collaborating
agency employed social workers but no psychiatric nurses when
these data were collected. Partially in response to its collaboration
in this project, the agency has since opened a division of psychiatric
home health care.