Addressing Older Latinos’ Spiritual Needs in Hospital Settings: Identifying Predictors of Satisfaction

Many older Latinos use spirituality to navigate the challenges associated with hospitalization. Although spiritual assessments are typically recommended in such settings, little, if any, research has sought to identify factors that predict satisfaction with the process of addressing clients’ spiritual needs. Using a national sample of recently hospitalized older Latinos (N = 227), this secondary analysis identified predictors of older Latinos’ satisfaction with how well their spiritual needs were addressed during their hospitalization. Among the eight predictors examined, room quality, nursing staff, and physicians were positively associated with satisfaction, while the discharge process was negatively associated with satisfaction. By understanding the factors that predict satisfaction, practitioners are better positioned to provide culturally relevant and effective services to older Latinos

Multi-level factors related to deficiencies in psychological care in Washington State skilled nursing facilities

Thesis (Ph. D.)--University of Washington, 2007.Persons living in skilled nursing facilities (SNF) have extensive psychosocial needs, yet the services provided to meet those needs appear insufficient. Facility social workers are recognized as the primary providers of psychosocial services in SNFs, but often report barriers interfering with their ability to furnish services to all residents who need them. This study utilizes a three-category quality assessment framework to assess specific factors that either enhance or hinder the provision of effective psychosocial services in Washington State SNFs.A cross-sectional research design was employed merging two sources of data: responses to an investigator-developed questionnaire administered to Social Services Directors (SSDs) in participating SNFs (N= 121) and resident-centered state survey outcomes in psychosocial care-related areas obtained from the Online Survey and Certification Reporting (OSCAR) database. Ordinary least squares regression was utilized to assess the ability of facility structural factors, process factors, and SSD characteristics to predict the frequency of psychosocial services in five diverse service domains: care planning, resource and referral, administration and advocacy, assessment, and intervention. Hierarchical linear regression methods were utilized to assess the ability of structural factors, process factors, and SSD characteristics to predict the scope and severity of survey deficiencies in psychosocial care. Interaction terms were also included in the regression model to determine the potential moderating effect of service delivery on predictive multi-level factors. Results indicate that structural factors, process factors, and SSD characteristics play only a limited role in predicting service frequency, although the size of the SSD's caseload is associated with frequency of care planning and intervention services. Four multi-level factors are associated with positive psychosocial care outcomes: low ownership turnover, more years of SSD experience in SNF social services, stronger SSD identification with the helper role, and paradoxically, lower priority attributed to residents' individualization needs at the facility level. This unexpected finding is possibly explained by a stronger focus on assessment services in lieu of intervention services within facilities that place a high priority on individualization needs. An additional finding is that the frequency of assessment services appears to moderate the impact of both ownership turnover and role identification on outcomes in psychosocial care

Leadership challenges and strategies to dementia care in Chinese faith-based nursing homes: A qualitative study

Aim To address the need and fill a knowledge gap in understanding challenges and coping strategies from the perspectives of nursing home leadership. Background The rapid increase of older adults with dementia in China highlights the need for research on dementia care in long-term care facilities. Methods Semistructured interviews were conducted among 20 facility directors employed by faith-based nursing homes across 12 provinces in China via phone or in-person in their native language. Two researchers fluent in Mandarin Chinese- and English-coded interview transcripts; thematic analysis was conducted to identify patterns. Results Four primary challenges were identified, including recruiting and retaining nursing staff, funding, lacking governmental support and discord with family members. The coping strategies included using external resources, incorporating religious beliefs, teamwork, rewarding performance and improving staff skills and empathy. Conclusions This study contributes to nursing home practice knowledge by disseminating insights of administrators regarding culturally relevant dementia management strategies in China. Implications for nursing management Implications for nursing management are as follows: teamwork and staff encouragement; advocate for a sustainable governmental financial support; staff training and staff-resident ratio regulations and policy; seeking external resources; integrate faith-based means for problem management and service quality improvement

Spirituality and Older Adults: Ethical Guidelines to Enhance Service Provision

Spirituality plays an important role in the lives of many older adults. Consequently, it is not surprising that gerontological social workers frequently engage spirituality in practice settings. The paucity of training gerontological workers have received on this topic, however, is a cause for concern. To help equip workers, three ethical principles are proposed to guide interactions in the area of spirituality. These principles can be summarized as: 1) client autonomy, 2) spiritual competence, and 3) professional competence. The application of these principles in practice settings will enhance the ability of gerontological social workers to interact with older adults’ spirituality in a professional and ethical manner

Psychosocial Assessment of Nursing Home Residents via MDS 3.0: Recommendations for Social Service Training, Staffing, and Roles in Interdisciplinary Care

The Minimum Data Set 3.0 has introduced a higher set of expectations for assessment of residents’ psychosocial needs, including new interviewing requirements, new measures of depression and resident choice, and new discharge screening procedures. Social service staff are primary providers of psychosocial assessment and care in nursing homes; yet, research demonstrates that many do not possess the minimum qualifications, as specified in federal regulations, to effectively provide these services given the clinical complexity of this client population. Likewise, social service caseloads generally exceed manageable levels. This article addresses the need for enhanced training and support of social service and interdisciplinary staff in long term care facilities in light of the new Minimum Data Set 3.0 assessment procedures as well as new survey and certification guidelines emphasizing quality of life. A set of recommendations will be made with regard to training, appropriate role functions within the context of interdisciplinary care, and needs for more realistic staffing ratios