“Would You Do That in Your Home?” Making Nursing Homes Home-like in Culture Change Implementation

Qualitative interviews with nursing home administrators reveal innovative and cost-conscious ways to physically modify facilities that help institute culture change practices. Telephone interviews were conducted following a national survey of nursing home nursing directors and administrators. In this cross-sectional snapshot of administrator experiences, motivations for making facilities more home-like and less institutional and creative responses to challenges are described. State and corporate support and regulator encouragement are noted that help their reform efforts. Administrators note that small steps to create a more home-like environment can result in a positive impact that minimizes disruption to existing care processes. They describe how they respond to challenges, such as the physical plant and high costs, and note how comparative shopping, cost-conscious physical improvements, and continuous involvement of staff and residents contribute to successful efforts. Their examples illustrate novel ways to humanize long-term care facilities that other nursing homes can emulate.     

Latin American Households in Comparative Perspective

Comparative family sociology has had little to say about the Latin American family or household despite it links to a European colonial culture mixed with a distinct set of indigenous and historical circumstances. In this paper tentative judgements are put forward about the similarities and differences between the Western and Latin American household by examining four of its dimensions: the household's relative complexity, the separate residence of conjugal units, the incidence of households headed by women, and the incidence of household members being unrelated to the head. Data come from the World Fertility Survey household files gathered during the middle 1970s in six countries: Mexico, Costa Rica, Panama, the Dominican Republic, Colombia and Peru. We find that household complexity in the six countries is intermediate between that of the West and East. Many of the households are extended laterally instead of vertically, because conjugal couples tend to reside in separate households, but often live with unmarried relatives as well. In addition, a high level of marital instability results in a significant proportion of households headed by women, many of them containing members of the extended family. Finally, whereas the circulation of young unmarried people of both sexes was common in rural areas in the West, being an unrelated individual in another's household is most common in urban areas among females between 15 and 19 years old.     

“A Cruel Medium for a Woman”

The developing Melbourne television service featured a number of female personalities who successfully transcended the circumscribed boundaries of their on-camera roles to become household names. Personalities like Corinne Kerby, Panda Lisner, and Toni Lamond were pivotal to the affective connection that many viewers forged with live, locally produced shows. Yet, these women have all but disappeared from the official histories of Australian television, as well as from the shared recollections of the past that form the “public archive” of Australian television. This article not only seeks to recuperate these early performances, but to examine the public discourses that circulated around these personalities, their TV personas, and their private lives.     

Military Veterans Sharing First‐Person Stories of War and Homecoming: A Pathway to Social Engagement,Personal Healing,and Public Understanding of Veterans' Issues

What power, meaning and value may exist within a soldier's first‐person war story? Former Marine captain Tyler Boudreau, quoted below, suggests that constructing a personal narrative of the traumas of war and homecoming, then “asking questions” of the story, can provide a veteran with a “chart.” If this is so, can that chart help one along the road to healing from those traumas, especially when that story is shared with others? Could there be dangerous turns or pitfalls on the journey? How can a public sharing of narratives of wartime experiences help audiences to better respond to those veterans and families who must cope with a difficult transition from the battlefield to home? What guidelines can be used effectively to train and prepare storytellers for their role? In this collaborative article, strengthened by the clinical wisdom of various consulting clinicians, we examine these questions through the lenses of two programs that provide veterans opportunities to share their war stories publicly. They include the Veterans Education Project (VEP) and the “100 Faces of War Experience” project (100 Faces).     

Family Influence on Caregiver Resistance,Efficacy, and Use of Services in Family Elder Care

This research investigated how resistance to use of services attributed to family members and primary caregiver self-efficacy and resistance influenced actual use of services. Data were analyzed from questionnaires completed by 224 persons engaged in informal elder care in the community. Tests of 6 hypotheses revealed that family influence on caregivers had a consistent, important influence on behavior and views of caregivers. Family resistance to use of formal services framed caregivers' feelings, preferences, and decisions ranging from their own perceived self-efficacy to actual obtainment of help outside the family. Professionals must include family members in their dialogue with primary caregivers about their plans for elder care. Suggestions for interventions to better understand family and caregiver resistance are discussed.     

Managing in the Trenches of Consumer Care: The Challenges of Understanding and Initiating the Advance Care Planning Process

To better understand how community-based long-term care providers define advance care planning and their role in the process, we conducted 8 focus groups with 62 care managers (social workers and registered nurses) providing care for Ohio's Medicaid waiver program. Care managers shared that most consumers had little understanding of advance care planning. The care managers defined it broadly, including legal documentation, social aspects, medical considerations, ongoing communication, and consumer education. Care managers saw their roles as information providers, healthcare team members, and educators/coaches. Better education, resources, and coordination are needed to ensure that consumer preferences are realized.     

Trauma and Stress Among Older Adults in the Criminal Justice System: A Review of the Literature with Implications for Social Work

The purpose of this article was to review the empirical literature that investigated trauma and stress among older adults in the criminal justice system. Nineteen journal articles published between 1988 and 2010 were identified and extracted via research databases and included mixed age samples of adjudicated older and younger adults (n = 11) or older adult only samples (n = 8). Findings revealed past and current trauma and stress, consequences and/or correlates, and internal and external coping resources among aging offenders. The implications and future directions for gerontological social work, research, and policy with older adults in the criminal justice system are advanced.     

Patient-Centered Approach to Building Problem Solving Skills Among Older Primary Care Patients: Problems Identified and Resolved

This article describes problems identified by older primary care patients enrolled in Problem Solving Therapy (PST), and explores factors associated with successful problem resolution. PST patients received 1 to 8, 45-min sessions with a social worker. Patients identified problems in their lives and directed the focus of subsequent sessions as consistent with the steps of PST. The 107 patients identified 568 problems, 59% of which were resolved. Most commonly identified problems included health related issues such as need for exercise or weight loss activities, medical care and medical equipment needs, home and garden maintenance, and gathering information on their medical condition. Problems identified by patients were 2.2 times more likely to be solved than those identified by a health care professional. Using PST in primary care may facilitate patients in addressing key health and wellness issues.