Multilevel Factors Related to Psychosocial Care Outcomes in Washington State Skilled Nursing Facilities

As the primary providers of psychosocial services in skilled nursing facilities, social services professionals report barriers interfering with their ability to meet residents' needs. This study utilizes a 3-category quality assessment framework and a cross-sectional survey design to assess factors impacting the provision of effective psychosocial services in Washington State facilities. Hierarchical linear regression results indicate that the 3-factor model explains 26.4% of the variance in psychosocial outcomes; 4 variables exert the most influence: ownership turnover, practitioner experience, practitioner role identity, and the importance of individualizing care. Findings have implications for developing necessary supports for quality psychosocial care delivery.     

Nursing Home Social Services Directors and Elder Abuse Staff Training

In a nationally representative study of 1,071 nursing home social services directors 80% of social services departments provided resident rights training and 60–70% were involved in abuse training. Departments headed by recent grads and in chain nursing homes or in the northeast were more likely to be involved in training. Seventy-two percent of social services directors were able to provide one-on-one training about reporting suspected abuse; education and licensure were related to ability to train.     

Social Work Student Interest in Nursing Home Employment: A North American Study

Nursing homes (NHs) are a primary setting for gerontological social work; yet, little is known about social workers' career interest relative to this setting. This article reports the findings of an online survey of social work students (177 US and 91 Canadian) that sought to identify personal characteristics and beliefs that influence NH employment intentions. Students who were enrolled in bachelors programs, lacked previous practice experience, and had already had a NH field placement or wanted this experience were more likely to express employment intent. The implications of these findings for social work education and research are discussed.     

Understanding the Impact of Early-Life Trauma in Nursing Home Residents

Reactions to early life trauma can reemerge or be exacerbated in later life as coping resources and abilities are compromised by age-related changes and declines in health. For newly admitted nursing home residents, this can impact their receptiveness to assistance with care and elicit challenging reactions to environmental and situational triggers. Unfortunately, current assessment tools fail to account for reactions to early-life trauma. In this article, we review existing literature on early-life trauma and aging and introduce a hypothetical case to illustrate the importance of identifying nursing home residents with past trauma experiences.     

构建社会工作视角下的居家养老服务模式

居家养老模式正在全国全面展开,但其服务专业化水平低,多数从业人员未掌握为老年人服务的价值伦理和专业方法,制约了居家养老模式的全面推进,影响了老年人的生活质量。引入专业社会工作,能够提升居家养老服务的专业化水平,提高居家养老服务的质量,促进居家养老模式的不断完善,解决我国人口老龄化难题。秉持并践行社会工作价值伦理,掌握并运用社会工作专业方法,能够提升居家养老服务的专业化水平。     

Social Worker as Client: My Education as a Family Member in a Nursing Home

A social worker's professional experience in providing a service does not necessarily ease her own personal stress when she is the recipient of that same service. The author is a nursing home social worker whose own mother was a resident in the facility where she works. Her first-hand experience with the "system" and with her emotions brought new enlightenment to the practice of her profession.     

Nursing Home Social Services Directors Who Report Thriving at Work

Nationally representative data from a sample (n?=?928) of full-time nursing home social services directors were used to investigate whether knowing characteristics of the social environment at work can help to explain which directors report job thriving. Two-thirds of directors reported they were thriving in their jobs. Multiple regression results show that thriving is increased by job autonomy, being treated like an important part of the team, having enough time to identify and meet resident psychosocial needs, not having to do things that others could do, and being clear what the social services role is. Findings suggest that addressing these aspects of the social environment and social services role will likely contribute to increasing a sense of thriving at work among social services staff members.     

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.”     

Risk Factors and Intervention Programs for Depression in Nursing Home Residents: Nursing Home Staff Interview Findings

The in-depth qualitative interviews with 25 nursing home staff members were done to examine (a) their perceptions and experiences of risk factors for residents' depression, (b) current depression intervention programs, and (c) specific needs for staff training. The interviewees identified the residents' sense of loss and grief and feelings of isolation and loneliness as the causes of their depression and in-house activities and contract mental health services as current services aimed at reducing depression. They also pointed out the following barriers to providing effective depression interventions: too much dependence on antidepressant medication, low Medicaid reimbursement rate, staff shortage, residents' attitudes, and nursing home culture. The types of training that the staff members desired were: skills to monitor nonverbal signs and changes and to systematically screen different types of depression; education about antidepressants and their effects, side effects, and interaction effects with other medication; and systematic training in different types of psychosocial and behavioral interventions for late-life depression in residents with various levels of physical disabilities and cognitive impairments.     

Psychosocial Care in Nursing Homes in the Era of the MDS 3.0: Perspectives of the Experts

Meeting psychosocial needs of nursing home residents is increasingly regarded as a critical component of care, and the nationally-mandated nursing home care screening instrument— the Minimum Data Set (MDS) 3.0—was modified and implemented in 2010 to promote better assessment of psychosocial needs and health. Recognizing the importance of psychosocial well-being among nursing home residents, and the promise of MDS 3.0 for improving psychosocial care, this article reports recommendations derived from a conference of stakeholders representing diverse disciplines and organizations regarding next steps following MDS 3.0 screening. Results relate to seven areas of psychosocial care and address cross-cutting recommendations to improve psychosocial care.     

Compassion Fatigue and the Adult Protective Services Social Worker

Compassion fatigue is a relatively new term that describes the symptoms that are experienced by social workers and other helping professionals who work with clients experiencing trauma. This article defines the concept of compassion fatigue and relates compassion fatigue to Adult Protective Services (APS) social workers. It is proposed that APS social workers may be susceptible to the deleterious effects of compassion fatigue due to the nature of their work and environment. Suggestions for avoidance of compassion fatigue are also discussed, including self-care strategies and the need for continuing education regarding this phenomenon.     

The Effects of Housing Costs on Nursing Home Diversion

Abstract

This article examines the effect of the housing market on nursing home diversion and/or transition. Prior evaluations of federally funded diversion/transition efforts indicate that lack of housing may be a significant impediment to diversion policy efforts. We test this charge by examining the transition rates in all 351 municipalities in Massachusetts, using a data set of over 15,000 individuals seeking to remain or transition home between 2010 and 2014 through Massachusetts' Options Counseling program and their relation to key indicators of housing quality and affordability, including housing burden, crowding, and incomplete kitchen and plumbing facilities. We also control for demographic indicators identified in previous findings, which are age, level of frailty, and whether seniors live alone. We do not find a significant relationship between housing affordability or quality and successful nursing home diversion. This fact suggests that consumers are not as sensitive to housing costs and conditions as previously expected. Future research should continue to investigate the economic and social conditions behind this fact in the context of home value appreciation, incidence of home ownership, and the ability of seniors to offset nursing home costs through accumulated home equity.     

Expanding the Role of Long-Term Care Social Workers: Assessment and Intervention Related to Urinary Incontinence

Urinary incontinence (UI) is a common and stigmatizing problem faced by long-term care (LTC) residents. It is typically addressed by medical professionals, with social work rarely involved. The purpose of this article is to illustrate how social workers can address the psychosocial implications of UI while working with residents and their family members as part of an interdisciplinary team. Using a case example and the NASW objectives for LTC, recommendations on how the role of the LTC social workers can be expanded to better address both the needs of residents, families, and the larger LTC system are provided.     

Civic Engagement for Nursing Home Residents: A Call for Social Work Action

Civic engagement has been found to be associated with a number of emotional and physical benefits for older adults. For those residing in nursing homes, however, opportunities for civic engagement are limited. Societal barriers such as ageism and practical issues such as transportation can limit their access to activities that promote civic engagement. In this article, we review past research on civic engagement for older adults and explore the challenges and barriers faced by nursing home residents. We conclude with a call for social work professionals to develop, implement, and evaluate interventions that increase civic engagement opportunities for this undervalued group.     

初探养老福利机构社工岗位的配置

目前我国社会工作尚处于探索和发展阶段。本文通过对在养老福利机构加强社会工作人才队伍建设的必要性和可行性的论述,提出了在养老福利机构中社工岗位设置的原则以及岗位配置的设想。     

A Multilevel Analysis of Aggressive Behaviors Among Nursing Home Residents

Individual and organizational characteristics associated with aggressive behavior among nursing home residents were examined among a sample of 5,494 residents from 23 facilities using the Minimum Data Set 2.0 and the Organizational Social Context scale. On admission, some individual level variables (age, sex, depression, activities of daily life [ADL] impairments, and cognitive impairments) and no organizational level variables were associated with aggressive behaviors. Over time, aggressive behaviors were linked with some individual characteristics (age, sex, and ADL impairments) and several organizational level variables (stressful climates, less rigid cultures, more resistant cultures, geographic location, facility size and staffing patterns). Findings suggest multi-faceted change strategies are needed.     

Advance Care Planning with Residents in Nursing Homes in Singapore

With an aging population, the government is allocating more resources in the care of the elderly. Hospitalization may not be a natural desire of the sick nursing-home resident. Advance care planning is explored as a strategy to promote the right site of care, defined here as the most appropriate place that patients can receive treatment by medically competent teams at the lowest possible cost (Khaw, 2007). Advance care planning, when practiced with residents in nursing homes, comes with unique challenges, which this paper will illustrate. This paper also presents the multiple roles of a social worker in advance care planning and concludes with factors that contributed to effective advance care planning facilitation.     

The Role of the Nursing Home Social Worker in Terminal Care

This study examines the role of the nursing home social worker in terminal care. Questionnaires were distributed to 60 social workers in 14 nursing homes in the greater Milwaukee area. The hypothesis was that the presence of policies/procedures governing terminal care would be related to a decreased amount of stress for social workers. This correlation was not supported by the survey results. Although 71% of respondents indicated no policies were available to them, only 32.6% of social workers reported that terminal care was a source of stress. In fact, 59% reported that the social worker's role in terminal care had not been discussed in the social services department of their facility. Comparative lack of stress for social workers may be related to the lack of perception that social workers play a significant role in the terminal care of residents.     

Social Worker Assessed Vulnerable Income Management

Despite the small size of the sub program, Social Worker Assessed Vulnerable Welfare Payment Recipients Income Management is often cited as a preferred approach to this type of initiative, being tightly targeted at a group of people with identified high needs, and demonstrated poor outcomes. Although the program was considered in the two recent major evaluations of income management, specific findings relating to it have tended to be overshadowed by the more general finding of an absence of positive outcomes, and indeed potentially negative effects, from compulsory income management. While the size of the sub program has made evaluation difficult, the two major evaluations of income management have nevertheless made specific findings which suggest that the program has had some positive outcomes for a highly marginal participant group. These findings, along with aspects of the operation of the program, including the role played by social workers, and a proposal to abolish the program, are discussed.     

The Family Group Within the Nursing Home:

An ongoing monthly family group was implemented in an intermediate care facility in hopes of improving communication between staff and families of long term care residents. Other objectives of the group were to provide families with information about policies and procedures, education about the aging process, and to facilitate an informal support group network where families could share problems and concerns. The feedback and evaluation process indicated that sharing feelings of anger, quiet, frustration and other emotions helped the families deal with the responsibilities of institutionalizing a relative and helped to facilitate better communication between staff and family members.