RESUMEN
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.
Asunto(s)
Cuidados Paliativos al Final de la Vida/ética , Grupo de Atención al Paciente/organización & administración , Relaciones Profesional-Familia/ética , Relaciones Profesional-Paciente/ética , Servicio Social/ética , Toma de Decisiones/ética , Humanos , Comunicación Interdisciplinaria , Entrevistas como Asunto , Grupo de Atención al Paciente/normas , Prioridad del Paciente , Investigación Cualitativa , Revelación de la Verdad/éticaRESUMEN
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.
Asunto(s)
Servicios de Salud Comunitaria/organización & administración , Servicios de Salud para Ancianos/organización & administración , Vida Independiente/normas , Alta del Paciente/normas , Derivación y Consulta/normas , Servicio Social/métodos , Anciano , Actitud del Personal de Salud , Servicios de Salud Comunitaria/normas , Servicios de Salud para Ancianos/normas , Hospitales , Humanos , Relaciones Interinstitucionales , Entrevistas como Asunto , Investigación Cualitativa , Servicio Social/normasRESUMEN
This qualitative study examined multidisciplinary team members' perspectives of their involvement in older adult hoarding cases. Fifteen informants, as representatives of four hoarding teams, described cases in which teams did or did not work well together. Specifically, informants described their (a) team characteristics, (b) awareness of hoarding as a mental health illness, (c) barriers to providing mental health services for older adults who hoard, and (d) components of successful teamwork within the team and with the older adult as hoarder. Implications include research to better guide interventions, team training to develop common perspectives, and policy development that supports mental health representation on teams and in-home mental health treatment.
Asunto(s)
Acaparamiento/terapia , Trastornos Mentales/diagnóstico , Trastornos Mentales/terapia , Servicios de Salud Mental/organización & administración , Grupo de Atención al Paciente/organización & administración , Factores de Edad , Anciano , Anciano de 80 o más Años , Envejecimiento/fisiología , Envejecimiento/psicología , Actitud del Personal de Salud , Femenino , Servicios de Salud para Ancianos/organización & administración , Acaparamiento/diagnóstico , Acaparamiento/epidemiología , Humanos , Comunicación Interdisciplinaria , Masculino , Trastornos Mentales/epidemiología , Evaluación de Necesidades , Investigación Cualitativa , Medición de Riesgo , Factores SexualesRESUMEN
Older adults, as active members of the Veterans of Foreign Wars (VFW), describe multiple benefits of participation in the organization to their overall well-being. This qualitative study examined the perspectives of 20 active participants of a VFW Post and its Ladies Auxiliary. Findings indicate that, for the study participants, the VFW serves as a primary source of cross-generational influence, emotional support, and meaningful activity and provides a safe and secure environment for members. This article provides valuable information that social work researchers and practitioners can use to help increase older adults' civic engagement and address service gaps.
Asunto(s)
Relaciones Interpersonales , Apoyo Social , Veteranos/psicología , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Relaciones Intergeneracionales , Masculino , Persona de Mediana Edad , Satisfacción Personal , Investigación Cualitativa , Servicio Social , Factores Socioeconómicos , Estados UnidosRESUMEN
This qualitative study reports on thirteen assisted living (AL) administrators' perspectives of the role and the importance of the AL social worker in addressing the unmet needs of older adults as they move and transition into AL. Participant interviews were analyzed using the constant comparative method. Administrators described 5 AL social work roles: (a) decision-making and adjustment coordinator; (b) resident advocate; (c) mental health assessor and counselor; (d) family social worker; and (e) care planner. Implications include directly examining AL social workers' views, analyzing costs and benefits of employing AL social workers, and developing social work practicum sites within AL.
Asunto(s)
Instituciones de Vida Asistida/organización & administración , Geriatría , Necesidades y Demandas de Servicios de Salud/tendencias , Servicios de Salud para Ancianos/tendencias , Servicio Social , Anciano , Manejo de Caso , Consejo , Toma de Decisiones , Humanos , Cuidados a Largo Plazo , Salud Mental , Proyectos Piloto , Rol Profesional , Investigación Cualitativa , ConfianzaRESUMEN
Multidisciplinary teams, representing professionals from diverse disciplines, are often involved in addressing difficult ethical dilemmas as they work with older adults who hoard (e.g., resolving conflicts between the older adult's freedom to engage in hoarding behaviors versus individual or public safety). The purpose of this article is threefold: (a) to explore the current use of hoarding task force or team interventions to address ethical dilemmas that occur within hoarding cases; (b) to propose an ethical decision making framework for use by teams and others; and (c) to discuss practice implications for hoarding teams in implementing this ethical decision making framework.
Asunto(s)
Ética , Trastornos Mentales/psicología , Trastornos Mentales/terapia , Grupo de Atención al Paciente/ética , Anciano , Terapia Cognitivo-Conductual/métodos , Humanos , Servicio SocialRESUMEN
The adult day services (ADS) industry continues to grow and develop in providing care to larger numbers of older adults and their caregivers. Despite the growth in the number of programs and the changes in the way services are delivered, a systematic examination of the development of the ADS industry from a policy perspective has not been published since the mid-1990s. This article provides an analysis of the development of the ADS industry using the resource dependence model within a values-based context to determine whether public reimbursement opportunities are congruent with the needs of older adults and caregivers. Potential directions for the future development of the industry are presented through analysis of the collaborations of adult day providers with the providers of other services for older adults and the effort by public and private funders to connect quality outcomes and resources.
Asunto(s)
Financiación Gubernamental/organización & administración , Servicios de Salud para Ancianos/organización & administración , Política Pública , Asignación de Recursos/organización & administración , Anciano , Financiación Gubernamental/economía , Servicios de Salud para Ancianos/economía , Humanos , Relaciones Interinstitucionales , Persona de Mediana Edad , Asignación de Recursos/economíaRESUMEN
Older women who misuse substances represent a growing population within the United States. Yet, helping professionals lack guidance in addressing ethical issues that arise in working with these older women. The purpose of this article is to (a) examine what we know about older women who misuse substances, (b) address professional ethical dilemmas and other ethical issues that emerge in treating and delivering services to older women, (c) identify barriers for treatment, and (d) propose practice recommendations. Specifically, the authors examine the overarching professional ethical dilemma or tension between client autonomy and professional beneficence that emerges in treating and delivering services to older women. Implications are delineated for professional education, gender-and age-sensitive substance misuse services, and research and policy efforts.
Asunto(s)
Ética Profesional , Práctica Profesional/ética , Trastornos Relacionados con Sustancias/terapia , Salud de la Mujer , Factores de Edad , Anciano , Anciano de 80 o más Años , Beneficencia , Atención a la Salud/ética , Atención a la Salud/métodos , Femenino , Política de Salud , Humanos , Incidencia , Paternalismo , Defensa del Paciente , Autonomía Personal , Prevalencia , Relaciones Profesional-Paciente/ética , Factores Sexuales , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/psicología , Estados Unidos/epidemiologíaRESUMEN
This qualitative study examined ethical dilemmas faced by female caregivers of frail elders as well as the dominant role of caregivers' spirituality in addressing these dilemmas. Dilemmas are difficult decisions that involve conflicting values, e.g., freedom versus safety. In-depth interviews were conducted with thirteen ethnically diverse caregivers recruited from a home health agency and its parent hospital. Purposive sampling was used to obtain variation among research participants. Focus group interviews of home health staff, key informant caregivers, and interviewees provided guidance for the research design, reflection on findings and development of implications. In order to deal with ethical dilemmas, all caregivers used spirituality as (1) a philosophy of life, e.g., "This is what you do when you're family," (2) an aid to decision-making, e.g., through the use of prayer; and/or, (3) a way to transcend dilemmas, e.g., "no choice is hard." Implications include the importance of caregiver-driven assessment, professional self-reflection, and sustained formal services for caregivers.