scholarly journals Virtual Geriatric Education Preferences of Rural Social Workers

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 328-328
Author(s):  
Joan Ilardo ◽  
Raza Haque ◽  
Angela Zell
Keyword(s):  
Older Adults ◽  
Rural Communities ◽  
Social Workers ◽  
Online Survey ◽  
Transitional Care ◽  
Healthcare Services ◽  
Multiple Chronic Conditions ◽  
Care Plans ◽  
Health Practitioners ◽  
Geriatric Service

Abstract Older adults in rural communities need access to comprehensive healthcare services provided by practitioners equipped with geriatric knowledge and skills. The Geriatric Rural Extension of Expertise through Telegeriatric Service (GREETS) project goal is to use telemedicine and telehealth to expand geriatric service options to underserved Michigan regions. GREETS educational programs train health practitioners to provide geriatric care for vulnerable older adults. To determine gaps in geriatric competencies, the team conducted an online survey of health professionals including behavioral health practitioners. Respondents identified educational topics and preferred virtual delivery methods. Demographic information included respondent’s professional position, practice setting, and county. The respondents were asked to indicate level of educational need using a scale ranging from a low, medium, or high need. Fifty (47%) of 106 total responses were from social workers. We compared the percent of social workers to other practitioners’ responses in our analysis. Four topics emerged for both groups as medium or high educational needs: 1) transitional care when changing residential settings or post-hospitalization; 2) assisting family caregivers cope with caregiving responsibilities; 3) incorporating community-based services into care plans; and 4) and managing frail older adults. Social workers noted higher need than the other respondents for: 1) managing chronic pain; 2) managing care of patients with multiple chronic conditions; 3) having serious illness conversations; 4) diagnosing dementia; and 5) discussing advance care planning. Both social worker and other respondents indicated interactive case-based webinars; published tools, toolkits, tip sheets; and didactic webinars as their top three learning formats.

scholarly journals Social Work Graduates Entering the Field of Gerontology During COVID-19: Exploring Perceived Readiness and Needs

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 390-390
Author(s):  
Susanny Beltran ◽  
Vivian Miller
Keyword(s):  
Older Adults ◽  
Social Work ◽  
Social Workers ◽  
Disaster Preparedness ◽  
Online Survey ◽  
Training Needs ◽  
Cross Sectional ◽  
Term Care ◽  
Scarce Resources ◽  
Gerontological Social Workers

Abstract Gerontological social workers (GSW) are on the frontlines supporting the biopsychosocial needs of older adults in hospitals, communities, and long-term care settings. However, it is unclear whether social workers (SW) are trained to meet the emerging needs of older adults during COVID-19. This study describes training received, perceived readiness, and training needs of GSWs new to the field during 2020. A cross-sectional online survey was conducted with recent graduates from U.S. SW programs. Survey questions explored training received and ongoing needs, perceived self-efficacy (adapted from the Geriatric Social Work Competency Scale), demographics, and confidence in ability to work with populations 55+. A total of 15 recent SW graduates specializing in gerontology completed the survey. Fifty-three percent of the sample held MSWs and over half (53.3%) were licensed social workers or registered interns. Nearly all participants (73.3%) reported taking an introductory aging course, and almost half (46.7%) completed coursework in aging and diversity, aging policy, and end-of-life care/bereavement; 80% completed fieldwork in aging. Participants report moderate skill in assessing issues related to losses or transitions (46.7%), and physical functioning (53.3%), and advanced skill in assessing cognitive functioning (60.0%), and caregiver stress/needs (53.3%). Nearly half of respondents who rated their training as good-excellent indicate being very-extremely confident (42.8%) in their ability to practice with older adults. Training needs among participants include disaster preparedness, telehealth, and coordination of scarce resources. Curriculum development and continuing education are necessary to support emerging gerontological social workers in their practice during COVID-19 and other emergencies.

scholarly journals Understanding transitional care programs for older adults who experience delayed discharge: a scoping review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Katherine S. McGilton ◽  
Shirin Vellani ◽  
Alexandra Krassikova ◽  
Sheryl Robertson ◽  
Constance Irwin ◽  
...  
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Cognitive Impairment ◽  
Scoping Review ◽  
Transitional Care ◽  
Community Dwelling ◽  
Multiple Chronic Conditions ◽  
Care Needs ◽  
Delayed Discharge ◽  
Core Components

Abstract Background Many hospitalized older adults cannot be discharged because they lack the health and social support to meet their post-acute care needs. Transitional care programs (TCPs) are designed to provide short-term and low-intensity restorative care to these older adults experiencing or at risk for delayed discharge. However, little is known about the contextual factors (i.e., patient, staff and environmental characteristics) that may influence the implementation and outcomes of TCPs. This scoping review aims to answer: 1) What are socio-demographic and/or clinical characteristics of older patients served by TCPs?; 2) What are the core components provided by TCPs?; and 3) What patient, caregiver, and health system outcomes have been investigated and what changes in these outcomes have been reported for TCPs? Methods The six-step scoping review framework and PRISMA-ScR checklist were followed. Studies were included if they presented models of TCPs and evaluated them in community-dwelling older adults (65+) experiencing or at-risk for delayed discharge. The data synthesis was informed by a framework, consistent with Donabedian’s structure-process-outcome model. Results TCP patients were typically older women with multiple chronic conditions and some cognitive impairment, functionally dependent and living alone. The review identified five core components of TCPs: assessment; care planning and monitoring; treatment; discharge planning; and patient, family and staff education. The main outcomes examined were functional status and discharge destination. The results were discussed with a view to inform policy makers, clinicians and administrators designing and evaluating TCPs as a strategy for addressing delayed hospital discharges. Conclusion TCPs can influence outcomes for older adults, including returning home. TCPs should be designed to incorporate interdisciplinary care teams, proactively admit those at risk of delayed discharge, accommodate persons with cognitive impairment and involve care partners. Additional studies are required to investigate the contributions of TCPs within integrated health care systems.

scholarly journals Transition from hospital to home during COVID-19: A case report from an Australian transitional care program

2021 ◽  
Vol 2 (1) ◽  
pp. 1-19
Author(s):  
Claire Gough ◽  
Claire Hutchinson ◽  
Chris Barr ◽  
Anthony Maeder ◽  
Stacey George
Keyword(s):  
Older Adults ◽  
Case Report ◽  
Lived Experience ◽  
Social Isolation ◽  
Transitional Care ◽  
Care Program ◽  
Healthcare Services ◽  
Vulnerable Groups ◽  
Ageing Population ◽  
Transition Care

Aim and Background: With the ongoing COVID-19 global pandemic, consideration for vulnerable groups, including our ageing population has been of great concern. Social isolation has been recommended to protect older adults with chronic diseases and reduce the spread of the virus, as well as to prevent healthcare services becoming overwhelmed. Yet social isolation presents its own health risks. Methods: In this paper, we provide commentary on the lived experience of returning home from hospital during the COVID-19 pandemic. This case report details the experience of an 83-year-old female, who was living and mobilising independently in her own home, prior to hospital admission following a fall and resultant head injury. Results: The participant returned home during the COVID-19 pandemic with a community transition care program which included assistance with cleaning tasks, shopping, and physiotherapy over a 45-day period. Conclusions: COVID-19 has illuminated the issue of social isolation and increased awareness of its negative health effects at a global level. As society eases restrictions and returns to a new ‘normal’, many older adults will remain socially isolated. Ongoing allied health intervention is required to ensure quality of life through the latter years and to support older adults through periods of social distancing. Keywords: transition care; COVID-19, social isolation, community participation    

scholarly journals ACE Model for Older Adults in ED

Geriatrics ◽  
2019 ◽  
Vol 4 (1) ◽  
pp. 24 ◽  
Author(s):  
Martine Sanon ◽  
Ula Hwang ◽  
Gallane Abraham ◽  
Suzanne Goldhirsch ◽  
Lynne Richardson ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
High Risk ◽  
Hospital Admission ◽  
Transitional Care ◽  
Physical Therapist ◽  
Functional Decline ◽  
Interdisciplinary Team ◽  
Care Plans ◽  
Ace Model

The emergency department (ED) is uniquely positioned to improve care for older adults and affect patient outcome trajectories. The Mount Sinai Hospital ED cares for 15,000+ patients >65 years old annually. From 2012 to 2015, emergency care in a dedicated Geriatric Emergency Department (GED) replicated an Acute Care for Elderly (ACE) model, with focused assessments on common geriatric syndromes and daily comprehensive interdisciplinary team (IDT) meetings for high-risk patients. The IDT, comprised of an emergency physician, geriatrician, transitional care nurse (TCN) or geriatric nurse practitioner (NP), ED nurse, social worker (SW), pharmacist (RX), and physical therapist (PT), developed comprehensive care plans for vulnerable older adults at high risk for morbidity, ED revisit, functional decline, or potentially avoidable hospital admission. Patients were identified using the Identification of Seniors at Risk (ISAR) screen, followed by geriatric assessments to assist in the evaluation of elders in the ED. On average, 38 patients per day were evaluated by the IDT with approximately 30% of these patients formally discussed during IDT rounds. Input from the IDT about functional and cognitive, psychosocial, home safety, and pharmacological assessments influenced decisions on hospital admission, care transitions, access to community based resources, and medication management. This paper describes the role of a Geriatric Emergency Medicine interdisciplinary team as an innovative ACE model of care for older adults who present to the ED.

scholarly journals Older Adults More Likely to Discuss Advance Care Plans With an Attorney Than With a Physician

2017 ◽  
Vol 3 ◽  
pp. 233372141774197 ◽  
Author(s):  
Mercedes Bern-Klug ◽  
Elizabeth A. Byram
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Decision Maker ◽  
Online Survey ◽  
Medical Decision ◽  
Surrogate Decision Maker ◽  
Future Health ◽  
Care Plans ◽  
Advance Care ◽  
Surrogate Decision

Adults are encouraged to discuss their end-of-life health care preferences so that their wishes will be known and hopefully honored. The purpose of this study was to determine with whom older adults had communicated their future health care wishes and the extent to which respondents themselves were serving as a surrogate decision maker. Results from the cross-sectional online survey with 294 persons aged 50 and older reveal that among the married, over 80% had a discussion with their spouse and among those with an adult child, close to two thirds (64%) had. Over a third had discussed preferences with an attorney and 23% with a physician. Close to half were currently serving as a surrogate decision maker or had been asked to and had signed papers to formalize their role. 18% did not think that they were a surrogate but were not sure. More education is needed to emphasize the importance of advance care planning with a medical professional, especially for patients with advanced chronic illness. More education and research about the role of surrogate medical decision makers is called for.

scholarly journals Aging Through the Time of COVID-19: Healthcare Access for Older Adults Living With Chronic Conditions

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 439-440
Author(s):  
Allie Peckham ◽  
Molly Maxfield ◽  
Keenan Pituch ◽  
M Aaron Guest ◽  
Shalini Sivanandam ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Conditions ◽  
Online Survey ◽  
Healthcare Access ◽  
Preventive Treatment ◽  
Multiple Chronic Conditions ◽  
Multinomial Regression ◽  
The Impact ◽  
Multinomial Regression Analysis ◽  
Poor Management

Abstract Chronic conditions require on-going continuous management and preventive treatment. Over 80% of adults aged 65 and older have multiple chronic conditions. Concerns have arisen about how the COVID-19 pandemic is affecting the management of chronic conditions. Delay, avoidance, and poor management of healthcare during the COVID- 19 pandemic may increase the risk of unnecessary hospitalizations and mortality. This study aims to understand the impact of COVID-19 on healthcare access in a U.S. sample of Americans 50 years of age or older. Participants completed an online survey about healthcare access and other risk factors during the COVID-19 pandemic. Multinomial regression analysis examined the results of two key access points: healthcare provider /doctor (n=468) and medication (n=754). One-half (56%) of those who needed access to a provider were able to be seen. Participants who were older, had multiple chronic conditions, and those with a provider were more likely to have access. However, when individuals with more chronic conditions did not have access, they indicated that this lack of access was due to COVID-19. When not receiving access to medications, unemployed participants attributed the lack of access more often to COVID-19 than other reasons. These findings demonstrate an important lack of access to providers and medication among older adults during the pandemic. In multivariate models, this lack of access was most often due to COVID-19, in addition to traditional factors such as insurance, employment, and medical and behavioral comorbidity. Interventions are needed to lower access barriers to care even further during COVID-19.

scholarly journals Conflicts Experienced by Caregivers of Older Adults With the Health-Care System

2020 ◽  
Vol 7 (6) ◽  
pp. 1130-1135 ◽  
Author(s):  
Alekya Rajanala ◽  
Vanessa Ramirez-Zohfeld ◽  
Rachel O’Conor ◽  
Denise Brown ◽  
Lee A Lindquist
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health System ◽  
Family Caregivers ◽  
Health Care System ◽  
Online Survey ◽  
Transitional Care ◽  
Cross Sectional ◽  
Medical Issues ◽  
Care System

Background: Family caregivers of older adults frequently navigate the health system for their loved ones. As older adults experience more medical issues, the interactions between caregivers and the health system can be fraught with conflicts. Objective: To characterize the conflicts that caregivers of older adults experience with the health-care system. Methods: A cross-sectional national online survey with open-ended questions was conducted among family caregivers ascertaining experiences with the health-care system. Qualitative thematic analysis was completed using constant comparative analysis and review by a third author. Results: Over a 2-month period, 97 caregivers completed the survey. Common themes where caregivers experienced conflicts were Difficulty With Accessing/Communicating With Providers, Delivery of Emergency Care, Disjointed Transitional Care, Unaddressed Clinical Concerns, and Financial. Caregivers reported needing to act as patient advocates in the conflicts with the health-care system. Conclusion: Understanding the conflicts that family caregivers encounter with the health system provides potential targets for future interventions to combat the challenges faced by caregivers of older adults and ultimately improve delivery of geriatric care.

scholarly journals Feasibility and preliminary effects of an integrated hospital-to-home transitional care intervention for older adults with stroke and multimorbidity: A study protocol

2019 ◽  
Vol 9 ◽  
pp. 2235042X1982824 ◽  
Author(s):  
Maureen Markle-Reid ◽  
Ruta Valaitis ◽  
Amy Bartholomew ◽  
Kathryn Fisher ◽  
Rebecca Fleck ◽  
...  
Keyword(s):  
Older Adults ◽  
Transitional Care ◽  
Pragmatic Trial ◽  
Community Dwelling ◽  
Multiple Chronic Conditions ◽  
Rehabilitation Centre ◽  
Major Life ◽  
Web Based ◽  
Care Intervention ◽  
Hospital To Home

Background: Stroke is a major life-altering event and the leading cause of death and disability in Canada. Most older adults who have suffered a stroke will return home and require ongoing rehabilitation in the community. Transitioning from hospital to home is reportedly very stressful and challenging, particularly if stroke survivors have multiple chronic conditions. New interventions are needed to improve the quality of transitions from hospital to home for this vulnerable population. Objectives: The primary objective of this study is to examine the feasibility of implementing a new 6-month transitional care intervention supported by a web-based app. The secondary objective is to explore its preliminary effects. Design: A single arm, pre/post, pragmatic feasibility study of 20–40 participants in Ontario, Canada. Participants will be community-dwelling older adults (≥55 years) with a confirmed stroke diagnosis, ≥2 co-morbid conditions, and referred to a hospital-based outpatient stroke rehabilitation centre. The 6-month transitional care intervention will be delivered by an interprofessional (IP) team and involve care coordination/system navigation, self-management education and support, home visits, telephone contacts, IP team meetings and a web-based app. Primary evaluation of the intervention will be based on feasibility outcomes (e.g. acceptability, fidelity). Preliminary intervention effects will be based on 6-month changes in health outcomes, patient experience, provider experience and cost. Conclusions: Information on the feasibility and preliminary effects of this newly-developed intervention will be used to optimize the design and methods for a future pragmatic trial to test the effectiveness and implementation of the intervention in other contexts and settings.

scholarly journals Uncovering Pet Issues: A Survey of Professionals Working With Older Adults and Care Partners

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 217-217
Author(s):  
Jessica Bibbo ◽  
Justin Johnson ◽  
Jennifer Drost ◽  
Margaret Sanders
Keyword(s):  
Older Adults ◽  
Social Services ◽  
Online Survey ◽  
Healthy Aging ◽  
Pet Ownership ◽  
Care Recipients ◽  
Pet Owners ◽  
Care Partners ◽  
Geriatric Service ◽  
Financial Aspect

Abstract Pets can play an important role in older adults’ health behaviors and decisions. However, the degree to which these issues are encountered or addressed by professionals working with this population remains unknown. An interdisciplinary (e.g., healthcare, social services) sample of professionals (N=72, 93.05% female, Mage=48.82, SDage=12.57) completed an online survey focused on the pet ownership issues they have encountered while working with older adults, persons with dementia, and care partners. The professionals (n=66) estimated 42.86% of their clients had been pet owners, and 45.58% regularly asked their clients about pets. Issues raised to the professionals varied by type of client. Older adults most often brought up exercising the pet, routine veterinary care, and the financial aspect of ownership (all 37.50%). Persons with dementia most often discussed accessing pet care items (12.50%), exercising the pet (9.72%), and basic pet care (8.33%). Care partners brought up basic pet care (33.33%), planning for the pet due to their care recipients’ housing transition (26.38%), and exercising the pet (25.00%). Professionals reported talking to clients about planning for the pet due to housing transition, concerns about falling, and concerns about the pet’s behavior (all 31.94%). The professionals (n=69) were very favorable toward pet ownership in general (M=4.43, SD=0.78) (1=extremely unfavorable, 5=extremely favorable), less favorable about older adult pet ownership (M=4.15, SD=0.72, p=.002), and even less favorable about persons with dementia owning pets (M=3.51, SD=0.93, p<.001). The results provide evidence that pet ownership issues are likely encountered in geriatric service settings and may shape healthy aging.

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