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.     

State Variations in Nursing Home Social Worker Qualifications

ABSTRACT

This is the first published account of state administrative code variations in nursing home social worker qualifications. It is important to review state codes because the majority of nursing homes in the U.S. have fewer than 121 beds and therefore are not required by the federal government to employ at least one full-time qualified social worker. States have the option of extending the federal regulations to homes with 120 or fewer beds, or strengthening the federal requirements in other ways. Findings indicate enormous variation in state requirements for qualifications of nursing home social workers, and even when states define a qualified nursing home social worker (not all do), they often exempt facilities from employing one. Seven states were found to be out of federal compliance. Research describing the qualifications of people employed in nursing home social services is called for, as well as research documenting effective psychosocial interventions, especially as they relate to resident quality of life. Ten recommendations for enhancing nursing home social work services are included.     

A New Postnatal Home Care Worker: Challenges for Training,Implementation and Policy

The rise in paid care workers has not, until very recently, included carers specifically trained to provide domiciliary postnatal care. In 2002 a new occupation of domiciliary postnatal carers was introduced in the catchment area of a large metropolitan hospital in Adelaide, South Australia. The carers work with professional midwives to provide home based postnatal support to women discharged early from hospital following childbirth. Carers were trained in a short, six month program, and were recruited from long term unemployed young women from the same geographically disadvantaged catchment area as the hospital. In this paper, findings from the evaluation of the program are described and analysed. These include its implications for the postnatal care workers themselves and for the professionals involved in training and working with them. In addition, the implications for birthing women of a program using young, minimally trained carers are considered. Finally, the more general lessons for the training and ‘insertion’ of paid carers into domiciliary work with professionals are reflected on.     

Managing the Care Home Closure Process: Care Managers' Experiences and Views

This paper reports case study research that set out to identifywhat care managers do during independent care home closures.Little research has focused on the way in which care homes forolder people are closed in England, or what those involved thinkabout the process. This paper reports the activities and viewsof care managers directly involved in helping older people relocatefrom care homes that were closed by their owners. During suchclosures, residents and their families have no choice but tomove, usually to a deadline, and with little control over theprocess. Care managers have a responsibility to help arrangealternative care for those current residents who are publiclyfunded, and to offer information and support to those fundingtheir own care (the ‘self-funded’). Closure relatedactivities could involve considerable staff time. Care managementarrangements, including the organization of teams and provisionof needs assessments, varied across authorities. The care managersdescribed drawing on emotional counselling and inter-personalskills, as well as practitioner knowledge and experience, particularlywhen offering support and advice about finding appropriate newhomes. Tensions between aims, constraints on their actions andviews of good practice are identified.     

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。     

社会建构论：社会问题理论研究的一种新视角

西方建构主义理论对社会问题的研究，提出了一套全新的概念范畴和分析框架，并产生了许多经验研究成果。这种研究在很大程度上异于对社会问题的常识性理解和传统的研究视角。该理论认为社会问题的社会学研究主题不是“有问题的”客观事实或状态，而是这些事实或状态被宣称成为社会问题的活动和过程。经由这些活动和过程，社会问题建构性地存在着。本文通过与传统社会问题理论的比较，着重探讨建构论所进行的社会问题新的理论研究转向及其启发意义。     

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.”     

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.     

English Local Authority Powers, Responsibilities and Guidelines for Managing the Care Home Closure Process

In England, the majority of older people living in care homesare publicly funded and the majority of publicly funded placesare purchased from the independent sector. While the sectoris subject to regulation, there is currently no statutory guidanceaimed specifically at how care home closures are managed. Thisarticle reviews the powers and responsibilities of councilsand the rights of residents during care home closures, beforedescribing the prevalence and content of existing council guidelines.Just over a third of councils in England responded to inquiriesand, of these, two-thirds reported having guidelines. This suggeststhat a considerable proportion of councils have no guidelinesin place. Existing guidelines also varied. Differences includedapproaches to allocating responsibilities and providing help,and assessment to self-funding residents. The large number ofarrangements and activities described suggest that some sortof plan or guidance is warranted to support the task of frontline care managers. At the national level, the variation foundin the guidelines combined with the lack of national guidancespecific to closures suggests that clarification of councils’legal responsibilities and powers during a care home closureis needed. Clarification of the role and responsibilities ofthe national regulatory body would also be useful.     

Motivation and Commissioning: Perceived and Expressed Motivations of Care Home Providers

Commissioning of social care for older people has seen major changes since the early 1990s. Considerable responsibility now rests with local authority staff, whose views of care home providers’ motivations, their perceived strengths and weaknesses as service providers, will have a bearing on commissioning decisions. We examine commissioners’ views of provider motivations in eight English local authorities and compare their perceived motivations with providers’ expressed motives. Data were collected through semi‐structured face‐to‐face interviews with commissioners and care home providers. Providers are generally perceived by commissioners as highly altruistic, but also relatively financially motivated individuals. Further analysis revealed significantly different views towards profit‐maximizing, which commissioners perceive as very important, while providers consider it to be of little motivational value. Private sector providers are described by commissioners as significantly more motivated by personal income. Associations are found between commissioners’ perceptions of motivations and the nature of their relationships with providers. Perceptions of providers’ motivations appear important within the commissioning framework.     

公民社会视角下社会工作的社会责任建构

综观中国当代社会工作的实践,社会责任始终是社会工作的重要议题,但在相关理论研究上,大多只谈到社会工作的哲学、使命、价值观等这些源于西方的意识形态方面,少有直接提及社会责任问题。本文认为,社会责任不仅是社会工作本土化的重要特征,也是公民社会的重要特征,因此,社会工作背景下的社会责任需要积极建构。因此,从公民社会的视角出发,以在海南开展的戒毒社会工作等社会实践为例,在理论基础、现实需求和实现途径这三个方面对建构本土化社会工作的社会责任问题进行了探讨。     

Home Modifications among Community-Dwelling Older Adults: A Closer Look at Race and Ethnicity

ABSTRACT

This study investigated racial and ethnic differences in home modification use. Data from the 2011 National Health and Aging Trends Study were used (n=6,764). Compared with non-Hispanic Whites, Hispanics were less likely to have a grab bar (odds ratio (OR) = 0.6), bath seat (OR = 0.8), or raised toilet (OR = 0.6). Non-Hispanic Blacks were less likely to have a grab bar (OR = 0.7) or bath seat (OR = 0.7) than non-Hispanic Whites, but more likely to have a raised toilet (OR = 1.3). English proficiency largely explained ethnic differences, while health status partially accounted for racial disparities.     

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。     

A Good Death for Residents of Long-Term Care

Abstract

Little research has been done on the topic of end-of-life care in long-term care settings to identify important themes regarding end-of-life care structures, processes, and outcomes. This study utilized data gathered in a stratified, random sample of 437 family members of residents who died in 31 nursing homes (NHs) and 199 residential care/assisted living facilities. Structural components of care including staffing adequacy, training, and consistence as well as facility environment and size were important factors for family members interviewed. “Being there” and manner of care delivery (e.g., staff attitudes/empathy) were major elements in the process of care. These factors were mentioned more than direct care, Hospice, or resident preferences. Family members identified themes of [dying at] home and being comfortable and clean as important outcomes of care. These identified structural components, processes, and outcomes have implications for the role of social workers in these settings despite that social work support is notably absent in these findings.     

Part of the Problem or Part of the Solution? The Role of Care Homes in Tackling Delayed Hospital Discharges

As part of current UK policies to reduce the number of delayedhospital discharges, a number of commentators have identifiedan alleged crisis in the care home market as one of key contributingfactors. With local authorities under pressure to cut costs,it is argued, the number of care homes is reducing, and delaysin hospital can often result. Behind this diagnosis is a seriesof assumptions about the role and nature of care home provision,the appropriateness of this form of service for many older people,and the need for more care homes to reduce the number of hospitaldelays. In order to explore and critique these assumptions,this paper reviews the role of care homes in tackling delayeddischarges, and argues the need for fewer and different carehome placements rather than more of this type of provision.     

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.     

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.     

新生代农民工社会工作支持研究

作为"80后"的新生代农民工相对于传统农民工在经济、社会和心理层面对社会工作支持有新的利益诉求。社会工作可以从制度、社区、企业、家庭等层面针对该群体从不同角度提供最直接、最基本的社会服务,帮助他们融入城市。