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D James W. Conroy, Ph.D. CONSUMER DIRECTED PERSONAL CARE: AN INQUIRY INTO PROGRAMMING FOR ELDERLY COGNITIVELY IMPAIRED INTRODUCTION There is a quiet revolution underway in long term care for the chronically ill and chronically disabled. It is nothing less than a major shift in how the ancient doctrine of parens patriae is played out for children, people with mental illness, people with mental retardationpeople with physical disabilities and the elderly disabled. The force and direction of this.

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