Home-Based Palliative Care Study

Abstract

Purpose: To examine differences in site of death and costs of services by primary diagnosis for patients receiving home-based palliative care as compared to usual care at the end of life verity of illness, service use, and site of death.

Design and Methods: A nonequivalent group design was employed with 298 terminally ill patients diagnosed with cancer, CHF, or COPD enrolled. The treatment group received an interdisciplinary home-based palliative care program and the comparison group received usual Kaiser Permanente services. Data collected included patient demographics, se-

Results: Among all diseases, patients enrolled in palliative care were more likely to die at home. Enrollment in palliative care was significant associated with cost reductions for patients with cancer, COPD, and CHF. No significant difference was found between diagnostic groups in terms of magnitude of cost savings.

Implications: Provision of interdisciplinary home-based palliative care at end of life can effectively increase the likelihood of dying at home for patients with CHF, COPD, and cancer while realizing significant COSt savings.     

Developing and Testing a Satisfaction Survey for Nursing Home Residents

Abstract

Input from consumers has become an important part of quality improvement in long-term care and for consumer decision-making. This paper documents the development of the Ohio Nursing Home Resident Satisfaction Survey (ONHRSS) through a partnership of state government, research, and industry experts. The instrument was tested and refined through two waves of data—a pretest phase and later with statewide data. Exploratory and confirmatory analyses with statewide data identified eight primary factors along with an underlying, secondary Global Satisfaction factor. Reliability of the domains ranged from .69 to .95. Recommendations for further refinement and testing of the instrument are discussed along with policy and practice implications.     

Reunifying Families Affected by Maternal Substance Abuse: Consumer and Service Provider Perspectives on the Obstacles and the Need for Change

ABSTRACT

This paper presents the findings of a qualitative study which examined the views of chemically dependent mothers, child welfare service providers and substance abuse service providers regarding the obstacles to family reunification and recommendations for change. Implications for practice, policy and research are discussed, with special reference to the mandates of the Adoption and Safe Families Act.     

Hospice and Latinos

Abstract

Research on hospice use by Latinos, although increasing since the late 1990s, remains sparse. This article presents a review of the recent available literature on this topic within the past 15 years. The main aspects discussed are access to hospice care and various factors that researchers suggest affect Latino utilization of hospice care. These factors include beliefs about health care, death and end-of-life care, lack of insurance, lower referral rates by health care professionals and the hospice caregiver requirement. Overall, Latinos underutilize hospice but the reasons remain unclear. No evidence exists to indicate that Latinos are dissatisfied with services once they receive them. Also, no evidence exists to indicate they want services but cannot obtain them. Implications for social work practice and research are discussed.     

‘We’re Civil Servants’: The Status of Trauma-Informed Care in the Community

ABSTRACT

Trauma-informed care (TIC) in social service organizations means that the organizations operate with the understanding that everyone involved has possibly experienced trauma in their lifetime. This qualitative study examined local service organizations’ usage of the 5 main principles of TIC: safety, trustworthiness, collaboration, empowerment, and choice (as developed by Fallot & Harris, 2006). Ten focus groups (n = 69) and 6 individual interviews (n = 6) with employees from administration through management were interviewed such that almost all facets of each agency were represented. The participants were asked about their agencies’ policies and practices for utilizing the 5 principles of TIC. The results suggest that the vast majority of organizations in this study implemented many of the principles of TIC with clients, though they had not labeled their practices as “trauma-informed.” However, although clients were receiving TIC, some of the principles were neglected as they pertain to staff, such as choice and empowerment. The findings of this study suggest that agencies are unaware of the relevance of TIC as it relates to staff. It is recommended that future research examine whether the use of TIC in agencies prevents “burnout,” high turnover rates, and vicarious traumatization of staff.     

Beyond talking – children's participation in Norwegian care and protection cases

The attempt to give children an effective voice in social work processes which can have substantial impact on their lives takes different forms in countries with varying professional cultures and legal frameworks. This paper reports on a study of children's participation in decision-making in care and protection services in Norway, which was carried out in conjunction with a project to support social work teams in enabling children to participate, using materials borrowed from England and Wales. The results showed that (a) taking an active part in decision-making did not correlate perfectly with (b) having an influence on the outcome. Cases were therefore classified as ‘participation’ or ‘non-participation’ using a combination of both the above criteria. Statistical analysis of the factors influencing children's participation enabled the proposition of a model which appeared to explain much of the variance. The results point to the inadequacy of equating social work conversation with children with effective participation in decision-making.     

Linking Elderly to Holistic Care Services through Integrated Communication Technology: The Personal Emergency Link Service Rendered by the Senior Citizen Home Safety Association in Hong Kong

Through a Personal Emergency Link system, the Senior Citizen Home Safety Association has rendered 24-hour care to more than 111,000 service users in Hong Kong who are mostly vulnerable seniors and chronic invalids living alone or living with their elderly spouses/caregivers only. This article will describe how the Personal Emergency Link system is used to link seniors living in the community. Measures taken to prevent failure of the system will be described. With the use of different technology applications, many human touches and warm caregiving are rendered to the elderly and needy.     

The Role of the Social Worker in Long-Term Care

Abstract

Making use of a formulation by Rosalie Kane of the ingredients necessary to “a good life” for residents of homes for the aged and other long term care facilities, the role of the social worker in insuring the presence of these ingredients is discussed. Included is an analysis of the responsibilities and tasks of the social worker which must be carried and fulfilled in order that social workers make appropriate contributions to “the good life.”