About a Third of Nursing Home Social Services Directors Have Earned a Social Work Degree and License.

Nursing home (NH) residents have high psychosocial needs related to illness, disability, and changing life circumstances. The staff member with the most expertise in addressing psychosocial needs is the social worker. However, federal regulations indicate that only NHs with 120+ beds need hire a social services staff member and that a "qualified social worker" need not have a social work degree.

Revising the Lubben Social Network Scale for use in residential long-term care settings.

Purposes: We revised the Lubben Social Network Scale (LSNS) to develop a measure of social support specific to residential long-term care (LTC) settings, the LSNS-LTC with five domains (i.e., family, friends, residents, volunteers, and staff).

Medication therapy management programs: promises and pitfalls.

Background: Medication therapy management (MTM) is one form of a medication benefit program offered by public and private health providers and insurers. Although the term was first coined in 2003, MTM in its earlier forms has been used since the 1990s as a mechanism to improve health metrics for medically complex patients. Its role expanded with the passage of Medicare Part D, as a mandated component to help patients with multiple chronic conditions, high drug costs, and high utilization to improve the effectiveness and safety of their medication treatments.

Validation of the Quality of Dying-Hospice Scale.

Context: Measuring the quality of dying (QOD) experience is important for hospice providers. However, few instruments exist that assess one's QOD; and those that do have not been well validated in hospice.

Objectives: This study tested the properties of the QOD-Hospice Scale (QOD-Hospice) to provide preliminary validation data on internal consistency, inter-rater reliability, convergent validity, and factorability in a hospice setting.

Long-distance caregiving: a systematic review of the literature.

There are an estimated 5-7 million long-distance caregivers (LDCs) in the United States, but little is known about this growing population. This study reviewed the literature on LDCs and examined 16 identified studies. Although studies defined LDCs differently, a composite description of who LDCs are and what they do is presented.

Telling the story: perceptions of hospice in long-term care.

We used qualitative methods (13 homogenous focus groups of residents, bereaved family members, licensed staff, paraprofessional staff, and social workers) to examine the components of a good death in a long-term care (LTC). Hospice involvement as beneficial to end-of-life care emerged as a naturally occurring theme and hospice was deemed as expert in all groups. Participants indicated some barriers to hospice involvement as well as difficulties in collaboration between facility staff and hospice personnel.

Measuring the quality of dying and quality of care when dying in long-term care settings: a qualitative content analysis of available instruments.

Context: Long-term care (LTC) settings have become a significant site for end-of-life care; consequently, instruments that assess the quality of dying and care may be useful in these settings.

Objectives: To evaluate the content of available measurement instruments to assess the quality of dying and care when dying.

Methods: Qualitative content analysis to categorize items as structure of care, process of care, satisfaction with health care (the first three representing quality of care and its evaluation), quality of dying, or patient factors.

Advancing the evidence base for social work in long-term care: the disconnect between practice and research.

This article reviews the research literature relative to social work practice in geriatric long-term care (LTC) settings with the aim of determining the state of the evidence base for practice. Overall, this body of research supports the efficacy of social work services within the context of community-based case management and interdisciplinary models of geriatric intervention; however, there is less evidence of a discipline-specific contribution, particularly in institutional health care settings (e.g.

The end-of-life experience in long-term care: five themes identified from focus groups with residents, family members, and staff.

Purpose: We designed this study to examine the end-of-life (EOL) experience in long-term care (LTC) based on input from key stakeholders.

Design And Methods: The study consisted of 10 homogeneous focus groups drawn from a purposive sample of LTC residents (2 groups; total n = 11), family caregivers (2 groups; total n = 19), paraprofessional staff (3 groups; total n = 20), and licensed/registered staff (3 groups; total n = 15) from five nursing homes and eight residential care/assisted living communities in North Carolina. We analyzed data by using grounded theory techniques to elicit manifest and latent themes.

Emotional and physical health of informal caregivers of residents at the end of life: the role of social support.

Objectives: The objectives of this study were to examine the relationship between selected decedent and caregiver characteristics, facility-related perceptions, and emotional and physical health of 434 informal caregivers (94% family) of recently deceased residents of residential care/assisted living facilities and nursing homes. We also examined potential mediating effects of social support (informal, staff, and spiritual).

Methods: We analyzed data using linear mixed models.

Pain, dyspnea, and the quality of dying in long-term care.

Objectives: To evaluate the relationship between pain, dyspnea, and family perceptions of the quality of dying in long-term care.

Design: After-death interviews.

Setting: Stratified random sample of 111 nursing homes and residential care and assisted living facilities in four states.

An observation of assisted living environments: space use and behavior.

Assisted living facilities have become increasingly popular for older adults needing assistance. They are intended to enable privacy and provide support, but the extent to which they do so, and the degree to which these relate to residents' needs, are unknown. This observational study of 1830 residents in 182 facilities indicates that, during the mid-afternoon, the majority of residents are awake (79%), and one-half (49%) are awake and in public spaces.

Measuring the quality of dying in long-term care.

Objectives: To describe two versions of a new measure, The Quality of Dying in Long-Term Care, for postdeath administration to surrogate respondents (staff and family caregivers) of all decedents (QOD-LTC) and of cognitively intact decedents (QOD-LTC-C) who die in nursing homes (NHs) and residential care or assisted living (RC/AL) facilities.

Design: Using two levels of exploratory factor analysis, 15 candidate items for the QOD-LTC and 36 candidate items for the QOD-LTC-C were tested using multiple criteria to determine factor structure and interpretability of the quality of dying in long-term care (LTC).

Setting: One hundred seventeen RC/AL facilities and 31 NHs in FL, MD, NC, and NJ.

Effect of specialized bathing systems on resident cleanliness and water quality in nursing homes: a randomized controlled trial.

A randomized controlled trial evaluated the impact of different methods of water agitation on clinical and microbiological outcomes in 31 nursing home residents. Four conditions were tested: a) whirlpool tub, jets on, using standard soap products; b) ultrasound tub, ultrasound on, using the standard soap products; c) ultrasound tub, ultrasound on, using specialized soap and skin conditioner; and d) either tub (randomized), water circulation off, using standard soap products (the control condition). Outcomes of interest included skin microbial flora, water microbial flora, skin condition, time spent bathing, and staff satisfaction.

A good death for residents of long-term care: family members speak.

Little research has been done on the topic of end-of-life care in long-term care settings to identify important themes regarding end-of-life care structures, processes, and outcomes. This study utilized data gathered in a stratified, random sample of 437 family members of residents who died in 31 nursing homes (NHs) and 199 residential care/ assisted living facilities. Structural components of care including staffing adequacy, training, and consistency as well as facility environment and size were important factors for family members interviewed.

Hospice attitudes among assisted living and nursing home administrators, and the long-term care hospice attitudes scale.

Objectives: To examine the attitudes of residential care/assisted living (RC/AL) and nursing home (NH) administrators toward hospice and to assess facility and administrator characteristics related to those attitudes.

Design: Two exploratory factor analyses of the Hospice Attitudes Questionnaire using principal factors with a promax (oblique) rotation were conducted. One was in a sample of 390 RC/AL and NH administrators from four states (Florida, Maryland, North Carolina, and New Jersey) and the other included NHs from this and a second sample (n = 244).

Is hospice associated with improved end-of-life care in nursing homes and assisted living facilities?

Objectives: To examine whether hospice enrollment for nursing home (NH) and residential care/assisted living (RC/AL) residents near the end of life is associated with symptoms and symptom management, personal care, spiritual support, and family satisfaction.

Design: Structured, retrospective telephone interviews with family and staff who attended to NH and RC/AL residents in the last month of life.

Setting: A stratified sample of 26 NH and 55 RC/AL facilities in four states.

Characteristics associated with lower activity involvement in long-term care residents with dementia.

This article describes the characteristics associated with activity involvement in 400 residents with dementia in 45 assisted living facilities and nursing homes. Activity involvement was related to family involvement in care and staff encouragement, after adjusting for resident age, gender, race, cognitive and functional status, and comorbidity.