Spirituality and the Elderly: Survey of Staff and Residents From Long-Term Care Facilities, 1998

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"This study compared staff and resident knowledge, attitudes and practices related to religious expression in long-term care settings. Staff and residents from 13 facilities and organizations providing services to long-term care staff completed a survey related to religion and spirituality in long-term care" (Walker et al. August 1998).

Data File
Cases: 592
Variables: 129
Weight Variable: None
Variables ITEM11 - ITEM43 and AITEM11 - AITEM43 report responses given on items that vary by the module administered (variables ITEM1-10 and AITEM1-10 are the same for all modules). The module items and their variable descriptions by module number are reported at the end of this document.

Variable JOBTITLE reports the qualitative answers to codes found in the data file. The codes follow the module and item descriptions at the end of this document.
Data Collection
Date Collected: March to September 1998
Funded By
National Institute on Aging
Collection Procedures
Self-administered surveys featuring sets of the eight forms of the Knowledge, Attitudes and Practices related to Spirituality and Religion (KAPS-R) were sent to the participating facilities and completed between March and June 1998. All participants were instructed to read the statements and circle either Agree, Disagree, or Don't Know. Average time to complete the survey was 15 minutes.
Sampling Procedures
Staff (N=299) and residents (N=266) from long-term care facilities completed one of eight forms. Facilities included skilled nursing facilities, continuing-care residential communities (CCRCs), retirement apartment complexes and assisted living facilities located in California, Florida, Maryland, Michigan, Oklahoma, Utah and Virginia. Some facilities had affiliations with Protestants, Catholic and Jewish groups, and some were unaffiliated. About half of the participants lived or worked in a facility that had a full-time chaplain.

Coordinators at each site estimated the number of staff and residents available to complete a survey. Each site received a set of surveys with equal numbers of the eight KAPS-R forms along with copies of a letter explaining the project. Approximately half of the surveys were completed.
Principal Investigators
Bonnie L. Walker
Related Publications
Walker, Bonnie L., Ephross, Paul H., Koenig, Harold G., Moberg, David O., Nye, William P., Osgood, Nancy J., & Richardson, James P. Staff and resident knowledge and attitudes toward religion and spirituality in long-term care. Submitted to The Gerontologist February 1999.

Walker, Bonnie L. Religious attitudes, beliefs, and practices of residents in two continuing care residential communities. Under review by the Journal of Applied Gerontology, October 1998.
MODULES
For each of eight topics related to religious expression and spirituality in long-term care, modules were given assessing general program objectives (ITEM01-ITEM10) and 33 separate items assessing one of the eight topics. Responses reported in the data file vary by MODULENU (module number)

Variable Descriptions for variables (ITEM11-ITEM43)in Modules 1-8 are reported below, along with the topic description of the module.

Variables AITEM11-AITEM43 are also variable by module. They are based on the modules' ITEM11-ITEM43, but have been coded as either "correct" or "wrong." "For each of the eight topics, the team developed training objectives and constructed items to assess related knowledge, attitudes and staff practices. Knowledge items were validated by consulting appropriate references; attitudes were considered correct if they reflected religious tolerance; practices were considered correct if they were proactive staff behaviors that would promote opportunities for religious expression and spirituality in long-term care" (Walker et al. 1998).
FOR ALL MODULES:
ITEM1
Staff should help residents so they can participate in the religious activities of their choice.
ITEM2
People with Alzheimer's disease no longer have religious and spiritual needs.
ITEM3
Being religious and being spiritual are the same thing.
ITEM4
There is more to religion and spirituality than going to religious services.
ITEM5
People who participate in religious activities tend to be more satisfied with their lives.
ITEM6
People with religious faith handle problems more easily than nonreligious people.
ITEM7
Staff who are religious or spiritual enjoy their work more than those who are not.
ITEM8
Staff have a responsibility to help the residents to express their religious beliefs.
ITEM9
The staff needs to know the religious and spiritual needs of each resident.
ITEM10
All religious beliefs deserve equal respect.

VARIABLES FOR ITEM11-43 and AITEM11-43
MODULE 1 - Religious Expression in Long-Term Care
This module will help staff and other caregivers understand the role religion plays in later life, especially for older people living in various types of long-term care facilities, including assisted living, adult homes, congregate living, retirement communities, adult day care, or the community at large.

ITEM11
Religion is more important to older people than to younger adults.
ITEM12
Religion is not important to most young people.
ITEM13
Religious services comfort many people with dementia.
ITEM14
Many older people like to say grace before a meal.
ITEM15
Long-term care facilities should provide time for people to say grace before meals.
ITEM16
God created each person with free will.
ITEM17
Staff should not make judgments about another person's spirituality.
ITEM18
All people have the right to practice their religion in their own way.
ITEM19
Religious people make good caregivers.
ITEM20
Religious people deal with personal problems better than non-religious people.
ITEM21
Religious people tend to be healthier than non-religious people.
ITEM22
Religious people usually like to attend worship services regularly.
ITEM23
Prayer can have a positive effect on someone's health.
ITEM24
When I am sick, I want people to pray for me.
ITEM25
I often pray for other people.
ITEM26
Religious people get along better in long-term care than non-religious people.
ITEM27
Most residents would like to attend a religious service once a week.
ITEM28
Long-term care facilities should arrange transportation for residents so they can attend religious events in the community.
ITEM29
Staff needs to know the religious beliefs and interests of the residents.
ITEM30
It would be helpful if the facility residents worshipped together each week.
ITEM31
People who enter long-term care need to find new ways to express their religious faith.
ITEM32
Staff should pray with residents.
ITEM33
Many people appreciate having someone pray with them.
ITEM34
Staff should find volunteers to sing hymns with residents if they ask.
ITEM35
Staff and pastors from community churches should work together with the residents to plan religious activities.
ITEM36
Many residents want their pastors to visit them.
ITEM37
Many of the clergy receive training in pastoral counseling.
ITEM38
A chaplain is an important person in a long-term care facility.
ITEM39
Chaplains help the staff as well as the residents with spiritual problems.
ITEM40
I have witnessed conflict related to religious expression in my facility.
ITEM41
Families and residents often disagree about religious issues.
ITEM42
The facility administration and staff often disagree with each other about religious issues.
ITEM43
Most of the time there is no problem related to religious expression in our facility.

MODULE 2 - The Spiritual Needs of People with Dementia
This module will help staff understand the spiritual and religious needs and capabilities of people with dementia. It will explain how religious and spiritual expression can be beneficial.

ITEM11
In my opinion, people with dementia have the same needs as the other residents.
ITEM12
It is important for staff to understand the spiritual needs of each resident.
ITEM13
Signs of dementia appear suddenly in most people.
ITEM14
Most people with dementia keep their long-term memory in early stages of disease.
ITEM15
It is not easy to know whether a person has dementia.
ITEM16
A religious resident with dementia probably won't want to receive communion.
ITEM17
People with dementia continue to have religious and spiritual needs.
ITEM18
Spirituality is not important to people with dementia.
ITEM19
I think that attending religious services is important for people with dementia.
ITEM20
A Jewish resident with dementia will not care about having kosher meals.
ITEM21
Residents with dementia are not able to pray.
ITEM22
People with Alzheimer's can sometimes remember the words to religious hymns.
ITEM23
People with dementia can often remember the words to prayers.
ITEM24
Putting a crucifix in the room of a Catholic resident with dementia may be comforting.
ITEM25
Some dementia residents respond positively to music that has a spiritual content.
ITEM26
Religious activities can improve the quality of life of people with dementia.
ITEM27
People with dementia do not care about religious activities.
ITEM28
Receiving communion seems comforting to religious people with dementia.
ITEM29
Taking a person with dementia to a religious service often calms down the person.
ITEM30
Participating in religious services helps people with dementia get used to their surroundings.
ITEM31
Staff should help people with dementia attend religious activities in the facility.
ITEM32
Reading scriptures to a resident with dementia can improve communication between staff and the resident.
ITEM33
It is useful for staff to find out the religious preferences of patients with dementia.
ITEM34
Staff can ask residents if they would like them to read scriptures to them.
ITEM35
Working with residents with dementia is a satisfying job.
ITEM36
Having a strong religious faith helps staff who work with residents with dementia.
ITEM37
Staff can help people with dementia find religious programming on TV or radio if they seem to enjoy it.
ITEM38
It is part of the staff's job to take residents with dementia to religious services in the facility.
ITEM39
The spiritual needs of a resident with dementia should be part of the care plan.
ITEM40
I think that staff should pray with religious residents who have dementia.
ITEM41
Staff can communicate with residents with dementia through religious activities.
ITEM42
People with dementia should worship separately because they might disturb the service.
ITEM43
It is helpful for staff to sing religious songs to religious residents with dementia.

MODULE 3 - End-of-Life Issues (Dealing with Death and Dying)
This module helps staff understand end-of-life issues, especially those related to death and dying, the role of spirituality and religious expression, and respond appropriately.

ITEM11
Staff should help residents with end-of-life issues.
ITEM12
Often a staff member is the only person there to help a resident at the end-of-life.
ITEM13
Hearing is the last sense to go when a person is dying.
ITEM14
Staff should recognize behaviors normal for someone in pain.
ITEM15
It is part of the staff's job to offer emotional support to other residents when someone dies at the facility.
ITEM16
It is best if staff doesn't get emotionally involved with a dying resident.
ITEM17
Staff should distance themselves from dying residents.
ITEM18
It is not a good idea to talk with a resident about death and dying.
ITEM19
Staff shouldn't encourage a resident to talk about his feelings about death.
ITEM20
The staff should be willing to talk about death when a resident brings up the topic.
ITEM21
Staff should listen patiently if a dying resident talks about doubts about heaven, fears about death or anger.
ITEM22
Spiritual beliefs are helpful to people who are dying.
ITEM23
Prayer is often comforting to someone close to death.
ITEM24
Staff should tell a resident who is angry about dying that God loves him or her.
ITEM25
You can comfort a dying person by holding his hand.
ITEM26
Staff should encourage all residents who are close to death to fight back.
ITEM27
Staff members must be careful not to "preach" to residents or try to convert them, even if they are dying.
ITEM28
If a resident asks, it is acceptable for a staff member to pray with them.
ITEM29
Staff should arrange for a visit from a clergy if the resident requests it.
ITEM30
It is important for staff to know the religious affiliations of residents in their care.
ITEM31
Hospice is an important resource for staff when residents are dying.
ITEM32
Suicide is an appropriate choice for older people who are very ill.
ITEM33
Many people want to say good-bye to their friends and family when they believe they are dying.
ITEM34
Staff should help people say good-bye to their friends if asked.
ITEM35
It's normal for dying people to see visions of family and friends who have died.
ITEM36
Dying people frequently report seeing visions of family members and friends who have died.
ITEM37
All religions believe in life after death.
ITEM38
It is important to practicing Catholics for a priest to give them the last rites before they die.
ITEM39
Some Protestants will want a clergy to anoint them if they are near death.
ITEM40
Orthodox Jews must be buried with 24 hours of death.
ITEM41
Some religious faiths do not permit cremation.
ITEM42
When a resident asks why God allows them to suffer, staff should call a pastor or rabbi.
ITEM43
Memorial services are healing events for family, staff, and other residents.

MODULE 4 - Bereavement and End-of-life Losses
This module will help long-term care staff better understand and respond to end-of-life losses and resident bereavement.

ITEM11
Staff members do not need to understand the spiritual needs of the residents.
ITEM12
Most staff do not need special training to help people who are grieving.
ITEM13
Most people enter long-term care because of a major, recent loss.
ITEM14
Moving to a nursing home results in a loss of privacy and personal freedom.
ITEM15
Moving is an extremely stressful event for people at any age.
ITEM16
Nearly everyone is depressed when they first move into long-term care.
ITEM17
I think that strong religious faith helps people deal with their losses.
ITEM18
Religious activities play a major role in the lives of the majority of older people.
ITEM19
Leaving a familiar church or synagogue is difficult for religious people when they move to a long-term care facility.
ITEM20
People in long-term care continue to experience new losses.
ITEM21
Religious people handle difficult situations better than non-religious people.
ITEM22
Prayer can help residents overcome their problems.
ITEM23
It is pleasant to be around religious people.
ITEM24
Having religious symbols in the room is comforting to religious people.
ITEM25
Staff need to help residents create a space that is entirely theirs and reflects their personalities.
ITEM26
Staff should encourage residents to show their family photos and talk about family members.
ITEM27
Staff should encourage residents to talk about their own religious beliefs.
ITEM28
It is a waste of time to develop a relationship with people who have a short time to live.
ITEM29
It is helpful for residents to discuss feelings about their lives with staff.
ITEM30
Talking about the past often helps people deal with the present.
ITEM31
Grieving after a loss is normal.
ITEM32
Religious people do not need to grieve.
ITEM33
Brief periods of depression are normal when people experience losses.
ITEM34
Staff should call a trained professional to treat a person with severe depression.
ITEM35
Chaplains are trained to help people deal with sadness and loss.
ITEM36
Grieving for an important loss often requires one or two years.
ITEM37
Thinking about suicide is a common response to a major loss.
ITEM38
Listening to music is spiritually uplifting to many people.
ITEM39
I often turn on the TV when I come into a room.
ITEM40
Staff should encourage a depressed person to become involved in religious activities.
ITEM41
Staff can encourage residents to pray for them.
ITEM42
Older people can remain useful and loving to others through spiritual activities and religious expression.
ITEM43
Residents should be allowed to make their own choices whenever possible.

MODULE 5 - Knowledge of Faiths and Their Expression
This module expands staff knowledge of the differences in expression of religious faith and spirituality among the major religious faiths with the goal of increasing tolerance towards diversity.

ITEM11
People of all religious beliefs live in long-term care.
ITEM12
People can learn a lot by talking about their religious beliefs with each other.
ITEM13
Long-term care residents have very different ideas about religion.
ITEM14
Religion is very important to the majority of people in long-term care.
ITEM15
Some people are spiritual even though they aren't religious.
ITEM16
All long-term care facilities should allow residents to worship God the way they choose or not to worship at all.
ITEM17
Long-term care facilities should be sure that all residents can practice the religious faith of their choice.
ITEM18
All religions believe that people have free will.
ITEM19
Each person has free will to decide what to believe about God.
ITEM20
God gave each person the choice of whether to believe in him or not.
ITEM21
God loves all people the same.
ITEM22
In my opinion, all religions worship the same God.
ITEM23
Facilities should help Christians celebrate the birth of Christ.
ITEM24
Some Christian services do not include hymn singing.
ITEM25
Facilities should provide a Sabbath service for Jewish residents.
ITEM26
The Bible is the only book that was divinely inspired.
ITEM27
The Torah is the holy book of the Jews.
ITEM28
Facilities should have a chapel without religious symbols if they have members of many faiths.
ITEM29
Hindus believe in daily meditation.
ITEM30
Moslems stop each day at the same time to pray no matter where they are.
ITEM31
Staff should call a priest to administer last rites for Catholic residents who are dying.
ITEM32
Hindus believe in reincarnation.
ITEM33
Some Christians believe that any use of alcohol is a sin.
ITEM34
Most Seventh Day Adventists do not eat meat.
ITEM35
Facilities should not serve pork to Moslems and Orthodox Jews.
ITEM36
Christian Scientists generally will not accept medical treatment.
ITEM37
Facilities should not serve caffeine beverages to people whose religions prohibit using them.
ITEM38
Unitarians do not believe that Jesus Christ was the son of God.
ITEM39
I believe that people can be healed through prayer.
ITEM40
Some religious people like to attend religious services, others don't.
ITEM41
Some religious faiths don't permit cremation.
ITEM42
Staff should arrange for someone to come to the facility to serve communion to Christians at least once a month.
ITEM43
Staff should allow time for residents to pray before meals.

MODULE 6 - Creating a Spiritual Environment
This module helps staff understand the need for a spiritually enhanced environment and what they can do to create and maintain it.

ITEM11
The place where you live has a lot to do with your quality of life.
ITEM12
Staff have a responsibility to create a pleasant environment for the residents.
ITEM13
Staff should care for the residents' spirits as well as their bodies.
ITEM14
It is possible to have a good quality of life while living in a nursing home.
ITEM15
Everyone enjoys beauty in their environment.
ITEM16
The temperature in the room should be comfortable for the resident, not the staff.
ITEM17
Staff should pick up any trash they see in the facility.
ITEM18
A clean room is the most important thing to almost everyone.
ITEM19
Smoking is forbidden in most long-term care facilities.
ITEM20
Many people are allergic to perfume and deodorants.
ITEM21
When possible, staff should put a chair beside the window so the resident can look out.
ITEM22
Residents of long-term care should be allowed to have pets.
ITEM23
Staff should put bird feeders outside residents' windows and maintain them.
ITEM24
Residents often find arranging flowers to be a spiritually fulfilling activity.
ITEM25
Staff should help residents take care of their plants, if help is needed.
ITEM26
Residents need to communicate with nature whenever possible.
ITEM27
Everyone needs a quiet place to go.
ITEM28
Spiritual people must have opportunities for meditation.
ITEM29
All facilities should have a place where residents and staff can pray.
ITEM30
Staff should help residents find a quiet place when they ask.
ITEM31
Loneliness causes more pain to residents than physical illness.
ITEM32
Staff should greet residents by name when they pass them in the hall.
ITEM33
Staff should smile at residents as often as possible.
ITEM34
Most residents in my facility enjoy interaction with children.
ITEM35
Staff should ask residents before turning on the TV.
ITEM36
For many residents, the staff are the most important people in their lives.
ITEM37
Staff should talk softly (or not at all) if a resident is sleeping.
ITEM38
Listening to soft, pleasant music adds to a resident's quality of life.
ITEM39
Many residents enjoy singing religious music.
ITEM40
A good facility offers the residents freedom of choice whenever possible.
ITEM41
Residents should be allowed to choose their roommates.
ITEM42
Residents should be encouraged to be independent as long as possible.
ITEM43
People who feel as though they are in control are not as likely to be depressed as people who feel out of control.

MODULE 7 - The Need for Continuity in LTC
Continuity is an important need for people moving to LTC. This module helps staff see the need for continuity and ways they can help this happen.

ITEM11
People continue to grow and change throughout their lives.
ITEM12
Most older adults are capable of adapting to changes in their environment.
ITEM13
The religious beliefs of older adults can change just like those of younger adults.
ITEM14
Older people living in long-term care facilities continue to use their life experiences to make choices.
ITEM15
People who do not learn from their experiences do not adapt well to new experiences when they are old.
ITEM16
Many older people would rather attend religious activities at the facility where they live than to attend services in the community.
ITEM17
Older people pray, meditate and read scriptures more than they did when they were younger.
ITEM18
Older people tend to be more spiritual than younger people.
ITEM19
Staff should ask residents for advice when appropriate.
ITEM20
Moving into long-term care is a major life change for most residents.
ITEM21
People who were unhappy when they were young are usually unhappy when they are old.
ITEM22
Life in a nursing home offers the residents opportunities for growth and change.
ITEM23
Each resident values his sexual identity (being a man or a woman) as much as they ever did.
ITEM24
Residents often miss attending religious services at their former house of [worship,] church or synagogue.
ITEM25
A person's physical appearance is not a good measure of what that person is really like.
ITEM26
I think that a person can be in poor health and still be happy.
ITEM27
People who have been religious all their lives find religious activities important in old age.
ITEM28
Residents may want to attend religious services to meet friends and sing songs and familiar hymns.
ITEM29
After a religious service, residents may like to have refreshments and talk to their friends.
ITEM30
Staff need to ask residents about their religious beliefs.
ITEM31
Helping people express their religious beliefs should be a part of the care plan.
ITEM32
Most older people want to continue their religious activities when they move to a long-term care facility.
ITEM33
Staff has a responsibility to provide opportunities for people to attend religious services.
ITEM34
Staff can help residents cope with changes in their lives by listening sympathetically to their concerns.
ITEM35
Our lives have meaning that continues after we die.
ITEM36
Staff should reassure residents that their lives have meaning.
ITEM37
The value of a person does not depend on his past.
ITEM38
Staff should tell the residents that they are important.
ITEM39
Staff should help residents find opportunities to do things for others.
ITEM40
I enjoy sharing personal experiences with other people.
ITEM41
Spiritually alert residents can serve others through their attitudes, words and prayers.
ITEM42
Staff work is easier when residents participate in their own care.
ITEM43
Long-term care administrators should consider the spiritual needs of both staff and residents.

MODULE 8 - Resident Rights Issues
This module discusses resident rights issues, such as freedom of religion (to be religious or not to be), freedom to be proactive in their faith in the manner that they choose (including the right to attend services of the denomination of their choice), obligations and limitations of the facility to provide transportation to religious opportunities and problems related to pragmatic limitations.

ITEM11
Most people living in long-term care are able to attend the church or synagogue of their choice.
ITEM12
Residents in nursing homes should have the same rights and responsibilities as people living in the community.
ITEM13
Residents of long-term care facilities have all of their rights as citizens.
ITEM14
People living in long-term care facilities have the right to vote.
ITEM15
In the U.S., Christianity is the official religion.
ITEM16
Each person is free to decide what to believe about God.
ITEM17
People living in long-term care have the right to go to the church or synagogue of their choice.
ITEM18
The U.S. Constitution guarantees freedom of religion.
ITEM19
The Bible guarantees freedom of religion.
ITEM20
Residents in long-term care have the legal right to demand transportation to the church or synagogue of their choice.
ITEM21
People with dementia should be allowed to attend religious services.
ITEM22
If a person is judged to be incompetent, someone must be appointed to act on that person's behalf.
ITEM23
Staff should take dementia patients to religious services even if they seem to object.
ITEM24
It is morally wrong to deny someone the opportunity to attend religious services.
ITEM25
It is wrong to see that someone has violated a resident's rights and not try to restore them.
ITEM26
Staff should not make non-believers attend religious activities.
ITEM27
I think people have the right to die if that is their choice.
ITEM28
Christian Scientists do not believe in medical treatment.
ITEM29
Residents have the right to make decisions about their religious expression.
ITEM30
It is good for residents to attend religious services.
ITEM31
Staff should always ask permission before turning on a TV or radio.
ITEM32
In a long-term care facility, the residents make the rules for their rooms.
ITEM33
Staff and visitors should knock before entering a resident's room even if the door is open.
ITEM34
The resident can make rules about staff behavior in his room.
ITEM35
Staff should respect a person's choice not to eat certain foods.
ITEM36
Staff should tell the resident if they disagree with the resident's religious beliefs.
ITEM37
It is okay for a staff to try to convert a non-believer to their religious faith.
ITEM38
Everyone has a right to their own religious beliefs.
ITEM39
When residents talk about their own religious beliefs, they violate the rights of the staff.
ITEM40
Facilities should find transportation so that residents can attend the church or synagogue of their choice.
ITEM41
Staff should make sure that all residents know about any religious activity or event at the facility.
ITEM42
Staff should welcome volunteers to help residents with religious needs.
ITEM43
Staff should contact the resident's church or synagogue if that person is no longer able to attend services.
Codes for JOBTITLE
4 Academic
5 Accountant
6 Acting Administrator
8 Activity Aide
9 Activity Assistant
10 Activity Coordinator
11 Activity Director
12 Activity Fitness
13 Addiction
14 Administrative Assistant
18 Administrator
19 Admissions Assistant
20 Advertising
21 Aide
22 Analyst
23 Army Budget
24 Art Historian
25 Assistant
26 Assistant Coordinator
27 Assistant Director
28 Attorney
29 Bank Clerk
30 Beautician
31 Biostatistician
32 Bookkeeper
33 Builder
34 Busboy
35 Business
36 Business Development
37 Cabdriver
38 Cabinetmaker
39 Cancer Biologist
40 Caregiver
41 Caretaker
42 Cartographer
43 Case Manager
44 CENA/CLA
45 CEO
46 Certified Nurse
47 Charge Nurse
48 Charge/Medicine
49 Chemical Engineer
50 Chemist
51 Civil Engineer
53 Clergy
54 Clerical
55 Clerk
56 Clinical
57 CMA
58 CNA
61 Communication
62 Community Living
63 Community Skills
64 Computer Science
65 Construction Engineer
66 Consultant
67 Cook
69 Coordinator
70 Cosmetologist
71 CPA
72 CST
73 Dietary Aide
74 Dietetic Tech
75 Dietitian
76 Dining Service
77 Direct Care Supervisor
78 Direct Care Worker
79 Director
80 Domestic
81 DON
82 DRA
83 Earth Science
84 Economist
85 Editorial
86 Educational
87 Engineer
88 Environment
89 Espionage
90 Executive Director
92 Farmer
93 Financial
94 Floor Aide
95 Floor Assistant
96 Floral Arranger
97 Florist
99 Food Service
100 Foreign Service
101 Geriatric Nurse
102 GNA
103 Government
105 Homemaker
106 Hotel Manager
107 House Supervisor
108 House Tech
109 Housekeeper
110 Housewife
113 Human Resources
114 IBM Operator
115 Indexer
116 Instructor
117 IRS
118 Journalist
119 Labor
120 Laundry
121 Lawyer
122 Librarian
123 Line Server
124 LPN
125 LPN Charge Nurse
126 LPN Rehab
127 LPN Student
128 LPN/Administration
129 Medication
130 Maintenance
131 Manager
132 Marketing
133 Mathematics
134 Medical
135 Medicine
136 Medicine Aide
137 Meteorologist
138 Military
139 Mill Work
140 Minister
141 Meeting Planner
143 Music Education
144 Naval Architect
145 Navy, Aerospace
146 Nurse
147 Nurse Manager
148 Nurse Supervisor
149 Nursing Assistant
150 Nutritionist
151 Office Coordinator
152 Office Manager
153 Optical Engineer
154 Occupational Therapy
155 Other
156 Owner/Administrator
157 Packing House
158 Pastor
159 Payroll
162 Personal Assistant
163 Pharmacy Assistant
164 Physical Therapy
165 Physician
166 Piano Teacher
167 Postal Clerk
169 Professor
170 Program Manager
171 Project Manager
173 Psychologist
174 Public Relations
175 Purchasing
176 Psychiatrist
177 RCA and MAT
178 Real Estate
179 Receptionist
180 Research
181 Resident Service
182 Residential
183 Restaurant Owner
184 RN
185 RNC
186 Seamstress
187 Secretary
188 Senior Activities
189 Social Activities
190 Social Worker
191 Staff Development
192 Statistician
193 Stenographer
194 Student
195 Supervisor
196 Supply
197 Switchboard
198 Teacher
199 Telephone
200 Theologian
201 Trainee
202 Training Coordinator
203 Unemployed
204 Unit Manager
205 Van Driver
206 Volunteer
207 Waitress
210 Other