Social Service Staffing in US Nursing Homes

Using data from the 2003 national Online Survey Certification and Reporting System, this study examines how the structure of social service staffing in nursing homes is affected by organizational and contextual factors. The results suggest that, although federal regulations impose minimal obligation, requiring only facilities with more than 120 beds to employ qualified social service providers, nearly 12 percent of these facilities failed to meet this staffing requirement in 2003. Results further suggest that the skill mix of social service providers in nursing homes is influenced by market competition, market demand, facility ownership, aggregate resident acuity, and the proportion of facility residents funded by Medicare

Facility Service Environments, Staffing, and Psychosocial Care in Nursing Homes

Using 2003 Online Survey Certification and Reporting (OSCAR) data for Medicare and Medicaid certified facilities (N=14, 184) and multinomial logistic regression this study investigated if (1) psychosocial care quality was better in facilities where State requirements for qualified social services staffing exceeded Federal minimum regulations and (2) facility service environments are associated with psychosocial care quality. For-profit status and higher percentage of Medicaid residents are associated with lower quality. Staffing, market demand, and market competition are associated with better quality. Psychosocial care quality is more associated with payer status and market forces and less with regulatory requirements

Integrating Globalization into the Social Work Curriculum

The reality that social work is a global profession is explored. Authors encourage a broadening of social work education, moving beyond the traditional conception of internationalized to a globalized social work curriculum. Practical teaching strategies for a globalized perspective are presented with selected key concepts specifically applied to social policy, community practice, human behavior in the social environment, and sustainable development. Discussion includes macro-scale ethical considerations in a neoliberal economic system

Psychological Well-Being And Social Support Among Elders Employed As Lay Helpers

Impacts on lay helpers of participation in part-time work supporting rural elders with severe mental illness were explored in a group of 17 older adults employed in a demonstration project. Self-rated well-being and social support were assessed over 1 year. Ratings of autonomy and positive relations with others varied over 1 year. Perceptions of the amount of social support provided showed a trend toward improvement at 1 year. Results are considered in the context of role theory and illustrated with an ethnographic case study of the service environment. The lay helper role is a form of productive engagement through paid caregiving, with potential to supplement rural mental health service systems while supporting elders\u27 needs for meaningful civic engagement

A Lay Helper Intervention For Rural Elders With Severe Mental Illness

Carolina Companions established a lay helping relationship between an older adult with severe mental illness and a similar age peer without a mental health diagnosis who was paid to provide companionship and support. In adapting the Rhinelander, Wisconsin model of community supportive care this demonstration project involved elders as providers and recipients of care. Impacts of the intervention on self-rated quality of life among 10 participating consumers matched with 10 comparison older consumers receiving standard community treatment were evaluated. Consumers had numerous chronic physical conditions, reported generally low levels of psychiatric distress, adhered to psychiatric treatment, and increased daily activities and social contacts. Challenges associated with evaluating a small demonstration project for rural elders with mental illness are explored. © 2006 by The Haworth Press, Inc. All rights reserved

Public Policy And The Future Of Social Work In Long-Term Home Health Care

The widespread adoption of conducted energy devices (CEDs) across American police departments over the last decade has been mired in public controversy. It is generally accepted, from a police perspective, that CEDs are safer for officers who can use the weapon at a greater distance, avoiding much of the harm associated with close physical struggles with citizens. Research has generally supported the notion that aggregate levels of officer injuries are reduced following the implementation of CEDs. Unfortunately, multivariate examinations that, in varying degrees, have attempted to compare CED applications to other forms of force (while controlling for rival causal factors) have yet to produce the same consistent results as the pre- and post-CED adoption studies. The current research adds to recent multivariate inquiries by using data collected as part of a national multiagency use of force project to assess the independent effect of CEDs on officer injuries. Based on a series of multivariate models, our results generally find evidence of increased benefits (i.e., lower probability of officer injury) of CEDs when used by themselves. By contrast, in some instances when CEDs were used in combination with other forms of force, there was an increased probability of officer injury. The implications of these findings for police researchers and practitioners are considered. © The Author(s) 2012

Crisis Intervention Responses To Children Victimized By Terrorism: Children Are Not Little Adults

This article presents a brief overview of the effects that the threat of terrorism can have on children. To address this fear from a clinical perspective Roberts\u27 (1991, 2005) Seven-Stage Model of crisis intervention is utilized as one very practical method to tackle the growing fears of the American public. Suggestions are provided for parents to assist the child in dealing with terrorism incidents. Too often the notion that adult treatment strategies can be applied to children can obstruct the effectiveness of treatment efforts directed toward children and young adolescents. Application of Roberts\u27 model is stressed as an educational strategy used to help these young individuals cope when faced with the continual threat of a new and different type of war. Recommendations for therapeutic content are made within the current time-limited practice setting. © The Author 2006. Published by Oxford University Press. All rights reserved

Gerontological Social Workers\u27 Perceived Efficacy For Influencing Client Outcomes

Using a sample of practitioners (n = 269) from the 2004 National Study of Licensed Social Workers, this article employs a quality assurance structure-process-outcome model to examine factors at the practitioner, workplace, and service delivery levels that influence the perceived efficacy of licensed gerontological social workers to affect client outcomes in the context of a highly challenging health care environment. A regression model accounted for 33.9% of the variance (adjusted R2 =.291) in perceived efficacy with 3 aspects of service delivery satisfaction having significant effects: ability to address complex/chronic care, to influence the design of services, and to help clients navigate the system. © 2012 Copyright Taylor and Francis Group, LLC

Commitment Of Licensed Social Workers To Aging Practice

This study sought to identify client,professional,and employment characteristics that enhance licensed social workers\u27 commitment to aging practice. A series of binary logistic regressions were performed using data from 181 licensed, full-time social workers who reported aging as their primary specialty area as part of the 2004 NASW\u27s national study of licensed social workers. Several variables were identified as being significant predictors of commitment to aging, including clients\u27 source of insurance, practitioners\u27 years of experience in social work and gerontology, perceived adequacy of training, number of social work colleagues in the work environment, perceived appropriateness of delegated tasks, and annual income. This study illuminates critical areas of need to promote professional commitment to aging practice. Promotion of training and competency-based education and the need for sufficient job challenge and appropriate assignment of roles (that is, those that are consistent with practitioners\u27 skills and abilities) will encourage commitment to working in the field of gerontology

Post-Hospitalization Experiences Of Older Adults Diagnosed With Diabetes: “It Was Daunting!”

Multimorbidity combined with geriatric syndromes in older adults with diabetes exacerbate their risks for poor post-discharge outcomes. The purpose of this study was to examine self-described hospital-to-home transition challenges encountered by older adults with a diagnosis of diabetes within the first 30 days following discharge. The qualitative responses for this paper emerged from a larger mixed methods study (n = 96) in which participants provided free responses specifying transition challenges during follow-up telephone interviews on the 7th day (n = 67) and 30th day (n = 55) post-discharge. Using inductive content analysis techniques four major themes emerged: a) “The daily stuff is difficult”; b) engineering care at home is complex; c) “life is very difficult”; and d) managing complex health problems is difficult. Findings suggest existing system-level metrics such as readmission rates fail to capture the complex and dynamic interplay of personal, family and social factors which complicate hospital-to-home transitions of older adults with pre-existing diabetes