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.     

Improving Emergency Care for the Elderly

Much has been written on the developing role for social workers in hospital emergency rooms but little has focused specifically on social work interventions with elderly emergency room patients in an urban teaching hospital. A group of fifty patients over sixty-five years of age, referred to social service for assessment and assistance with home care issues, is described. The emergency room social worker's role with these elderly patients is highlighted and three case examples are discussed. It is argued that social work interventions improve the quality of both emergency and ongoing care for this growing and often at risk population.     

Demanding work schedules and mental health in nursing assistants working in nursing homes

Nursing home assistants have physically and emotionally challenging jobs, and they often work demanding schedules in order to provide 24-h care. While the physical effects of demanding work schedules have been studied, little is known about the impact on mental health. This study explored the relationship between demanding scheduling variables and mental health indicators of depression, anxiety and somatization. A cross-section of 473 US female nursing assistants working in nursing homes was surveyed. Work schedule characteristics included shiftwork, hours per day and week, days per week, number of weekends per month, number of double shifts per month, breaks, and number of jobs worked. Working two or more double-shifts per month was associated with increased risk for all mental health indicators, and working 6–7 days per week was associated with depression and somatization. There was a trend for increasing odds of adverse mental health with increased numbers of demanding work schedule factors. The odds of depression was increased four-fold when working 50+ h/week, more than two weekends/month and more than two double shifts/month. Providing work schedules that are less unhealthy may have implications for both worker retention and the quality of care delivered to nursing home residents.     

Adult self-sufficiency and social adjustment in care leavers from children's homes: a long-term assessment

This paper presents a study carried out in Spain that followed up 260 young people, the majority of them adults, who had been in residential care for significant periods. The follow‐up takes place between 1 and 9 years after participants had left residential care, and assesses their level of social and work integration, as well as considering the incidence of problems related to marginalization and social exclusion. Furthermore, it analyses the reasons for the child being taken into care, the socio‐family context, length of stay, changes in placement and other features or incidents in relation to the residential care. The data show that close to 15% have serious problems (drug dependence, delinquency, etc.), 25% receive help from the social services and the rest manage independently to a greater or lesser extent. We discuss the significance of these data, especially the relationship between the final result and the initial and process variables.     

Chain Reaction

Abstract

This paper reports on an exploratory study of nursing home bankruptcy. From state and industry data regarding nearly 1,000 California facilities, it was possible to identify 155 homes in five chains (multi-facility organizations) that were operating in bankruptcy in 2000. When compared with facilities in non-bankrupt chains, while the bankrupt chain facilities had significantly worse financial liquidity, higher administrative costs, and higher payables to related parties, they also had more Medicare residents, fewer Medicaid residents, better solvency, and were located in less competitive county markets and in areas with higher Medicaid reimbursement rates. These findings indicate that, rather than facility characteristics and local market factors, strategic decisions taken at the corporate (chain) level are the major determinants of nursing facility bankruptcy status.     

Continuing Care Retirement Communities:

No abstract available for this article.     

Life Space Over the Life Span

Much of the literature in gerontology has focused on the objective paramters of age, and the narrow causal links between behavior and environment. This has reduced the multi-layered experience of aging to stage-specific taxonomies of a disengagement process which depict behavioral units and overt operational actions, or alternately a developmental-biological paradigm that presents aging as a progressive deterioration of physical and cognitive copmetence. A more wholistic and open perspective of 'topophilia', or i.e., the relations, perceptions, attitudes, values and world view that affectively bond people and place was chosen. An oral history interview method was selected where elderly informants were invited to trace their environmental biographies over their life span. In this way the investigators were able to treat their informants' place memories as experiential data and analyzed the content of their remembrances for significant and recurring themes about space and place. This approach yielded importance insights into fundamental life themes of autonomy, privacy, environmental mastery, and sense of place.     

Chapter 7 Sexual Abuse of Older Women Living in Nursing Homes

Abstract

Aggregated data from APS case files of sexually abused older women between the agesof70 and 89living in nursing homes were collected over a five-year period, yielding a total of 50 substantiated cases. The most common types of sexual abuse involved instances of sexualized kissing and fondling and unwelcome sexual interest in the women's body. All alleged perpetrators were male; they typically were 70 years of age and older and residents in the nursing home. In only three cases was the alleged offender prosecuted in court and only one of these cases was the offender convicted. Implications of these data for future practice and research are discussed.     

The effect of capacity management strategies on employees' well-being: A quantitative investigation into the long-term healthcare industry

The aim of this study is to understand the effects of different capacity management strategies on the well-being of employees in long-term healthcare organizations. Such strategies may produce psychological effects in terms of job satisfaction and well-being among employees, namely frontline employees, thus affecting service quality. We collected 2158 observations from 42 nursing homes in Italy. Our results show that all capacity management strategies addressed in this study can influence the perceived degree of fatigue or of job hazard, and some of them can influence both. Moreover, a better perception of job hazard and fatigue leads to a higher degree of reported well-being from employees, although with the former, it is only through the mediation of job satisfaction. We conclude our paper by discussing theoretical contributions and policy implications.     

Breaking the Walls. The Representation of Domestic Space in Hungarian Panel-Films

The paper investigates how socialist architecture – both as location and visual text – functions as tool of political criticism in the late socialist cinema of Hungary. Through the textual analysis of the living space in the socialist bloc in Péter Bacsó’s A Pianino in Mid-Air (Zongora a levego”ben, 1976), Béla Tarr’s Family Nest (Családi tu”zfészek, 1977) and Prefab People (Panelkapcsolat, 1982), Péter Gothár’s A Priceless Day (Ajándék ez a nap, 1979) and György Szomjas’s Wall Driller (Falfúró, 1985), the study dwells on the elimination of domestic space in the films which, as argued below, corresponds to the families’ disintegration and so to the failure a coherent, socialist society.