Discharges from the hospital to community-based settings are more difficult for older adults when there is lack of communication, resource sharing, and viable partnerships among service providers in these settings. The researchers captured the perspectives of three different groups of participants from hospitals, independent living centers, and Area Agencies on Aging, which has rarely been done in studies on discharge planning. Findings include identification of barriers in the assessment and referral process (e.g., timing of discharge, inattention to client goals, lack of communication and partnerships between hospital discharge planners and community providers), and strategies for overcoming these barriers. Implications are discussed including potential for Medicaid and Medicare cost reductions due to fewer re-hospitalizations.
Ethical decision making is critically important in hospice social work. Through in-depth interviews, researchers explored ethical dilemmas faced by 14 hospice social workers and the processes they used to move toward resolution. The dilemmas were integrated into a framework focused on the sources of ethical conflict: the client system, the agency, and the profession. Processes involved in resolving ethical dilemmas included consulting with other professionals, weighing the pros and cons of options, and bringing about desired outcomes. Findings suggest that hospice teams should be provided with opportunities to meaningfully discuss ethical decision making. Further, the involvement of social workers in administrative leadership is recommended to increase the likelihood that discipline-specific perspectives are incorporated into formal policies and procedures that shape practice in ethically complex situations.
The Reclaiming Joy peer support intervention has potential for reducing depression and increasing quality of life in low-income older adults who have physical health conditions. It is feasible to administer and sustain the intervention through collaborative efforts with minimal program resources and a small amount of technical assistance.
Hoarding interventions with older adults require significant resources from multiple public agencies, yet recidivism occurs frequently. To improve services through better coordination, some communities have formed multiagency hoarding teams (MAHT), which include aging services. MAHTs requested this mixed methods study to understand the progression of cases through the public sector. Quantitative data collected on 52 cases involving adults ages 60+ identified steps in this process. Qualitative data collected from MAHT members were the basis for case studies illustrating the progression of cases through the public sector. Findings have implications for social workers involved in local service coordination, training, and policy.
The decision to move into assisted living (AL) can be viewed as a life-changing process for older adults and their families; and each may possess differing views of this process. This qualitative study examined the AL decision-making process as described by twentytwo older adult and family member dyads. Participants described emotional and logistical components related to the AL moving decision. Further, fifteen of twenty-two dyads expressed conflicting or differing views of the AL moving decision. Our discussion examines the need for future studies to explore the impact of family and older adult disagreements on the older adult's AL adjustment; the necessity for community-based agencies and AL settings to provide social services over the duration of the decisionmaking process; and the importance of employing social workers skilled in family practice in the AL setting.
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