2015-2016 MSW Fellows in Aging
2015-2016 NJ OOIE Fellow in Aging
Leadership Project: Awareness of and Preparedness for the Diversity of Long-Term Care Residents
Background: The Office of the Ombudsman for the Institutionalized Elderly (OOIE) advocates for the rights of New Jersey residents 60 and over in long-term care, and investigates cases where these rights may have been compromised, including cases of abuse, neglect, and exploitation. One piece of this advocacy is through the volunteer ombudsman program, where civilian volunteers spend four hours each week in an assigned facility interacting with and advocating for residents and helping to resolve complaints before they escalate to major issues.
Project Aims: My project aimed to increase awareness of the diversity of residents in long-term care and their unique needs. The project worked toward this aim in two parts. The first component was to produce a research-informed, written guide that volunteer ombudsmen could use to enhance their understanding of diversity among long-term care residents and issues that might arise for residents from marginalized groups. The second part was to conduct interviews with OOIE staff concerning their attitudes about diversity of residents and training needs.
Outcomes: Both project components were completed. I wrote the research guide, which is now incorporated into volunteer training materials. The research guide contains three sections: an overview of different types of diversity, a sample of issues that might affect residents from diverse and marginalized populations, and a terminology guide for volunteer advocates. I also produced a written report of findings from the interviews and shared them with OOIE employees and presented to the Chief of Staff. Included in the report were areas of strength that the OOIE staff identified concerning resident diversity, as well as recommendations for building from these strengths in the future.
Reflections: This project required me to be self-directed and allowed me to experience both the freedom to explore my own ideas and the structure of a government office. I also was able to approach aging services from an advocacy standpoint, which is what I hope to do in my social work career as well. This has been a valuable experience, and I am grateful to the Aging Fellowship and the OOIE for the opportunities of the last year.
2015-2016 Meadow Lakes Fellow in Aging
Leadership Project: Enhancing End-of-Life Care at Meadow Lakes
Background: Meadow Lakes, a Springpoint Senior Living Community, located in Central New Jersey, is a not-for-profit continuing care retirement community (CCRC). It encompasses independent living, assisted living, skilled nursing, dementia care and subacute rehabilitation units. Founded in 1966, this community was the first of its kind in New Jersey and one of the very first in the country. In 2015, the organization recognized a need to enhance its end-of-life care.
Project Aims: An interdisciplinary Comfort Care Team at Meadow Lakes was created to look at the strengths and weaknesses of current end-of-life practices. I conducted interviews with eight members to understand their experiences and views on end-of-life care at this organization. In addition, direct care workers were interviewed to better understand their educational needs about end-of-life care. Finally, I led efforts to develop the Comfort Cart, which is a customizable tool to enhance support for residents and families at the end of life.
Outcomes: Comfort Care Team members emphasized the importance of having multiple disciplines in close communication to achieve its purpose, as well as the need to further solidify staff roles and team goals. The team identified opportunities to enhance end-of-life care, such as by better educating families on resources for support, having stronger referrals to hospice, better using the POLST form, and enhancing training for staff around end-of-life care. Based on feedback from the Comfort Care Team and members of the direct care work force at Meadow Lakes, I developed several educational tools for in-services, which discuss communication and support at the end of life. I also helped to develop the Comfort Cart by collecting donations of hygiene products and comfort products, such as aromatherapy or music, as well as creating a supportive care guide and securing informational packets for each unique comfort cart pack.
Reflections: This project has allowed me to critically analyze, evaluate and implement policy within an organization to improve quality of care. I learned firsthand the importance of including direct care workers in the implementation of policies. As a social work leader in the field of aging and health, I will expand on this work to both advocate and effect change in other communities.
2015-2016 Francis E. Parker Fellow in Aging
Leadership Project: The Cultural Construction of Death and Dying at Parker: Analysis and Ideas for Policy Change
Background: The Francis E. Parker Home is a nonprofit organization in central New Jersey providing older adults with a continuum of care services, including adult day programs, assisted living, and skilled nursing. Parker subscribes to the philosophy of Eden Alternative®, a holistic, person-directed approach that seeks to be in harmony with nature, nourishing both mind and spirit. Aligned with this ethos, Parker has appointed a Culture Team to analyze its policies relative to bereavement care and make recommendations for change. Providing mechanisms to enfranchise grief as it impacts the community can lead to positive outcomes, such as allowing elders to fulfill generativity needs, and fostering personal and professional growth among staff.
Project Aims: To support the Culture Team’s future work, I obtained qualitative feedback from the community through a focus group with residents, in addition to nine one-on-one interviews with staff from different departments and residents across two sites. In addition, I completed a comprehensive review of contemporary, peer-reviewed literature on grief and bereavement theories and communal loss in long-term care settings. I also developed a survey of best practices, which was sent to five organizations in Parker’s peer collaboration network.
Outcomes: The final deliverable for this project was a presentation to the Culture Team highlighting common themes, key quotes, and salient points. The presentation concluded with recommendations for policy change and training opportunities around organizational policies and practices to enfranchise grief and offer bereavement support to staff and residents. I also organized the raw data from the interviews and focus group (including blinded transcripts) as well as full-text articles, an annotated bibliography, and survey questionnaire, into a binder. The team can now use this information to consider recommendations in terms of feasibility, alignment with Parker’s culture, and potential impact in the community.
Reflections: Elders often express a desire to reflect on death and afterlife as a crucial existential need, and, yet, avoidance of the topic of death is socially reinforced. The development of policies and programs to support older adults’ psychosocial and spiritual needs as they contemplate and approach the end of life is a key task for social workers serving this population. Spirituality in social work practice is a growing area—one that particularly interests me as a dual-degree student who also holds a Master’s of Divinity—and no topic could be more important in this concentration area. I feel fortunate to have completed my fellowship in a year when Parker was exploring this subject; it is one that I hope will continue to be a focus as I work with elders in future pursuits.
2015-2016 S-COPE MSW Fellow in Aging
Leadership Project: Evaluating the Effectiveness of S-COPE Services
Background: The New Jersey Statewide Clinical Outreach Program for the Elderly (S-COPE) is a grant-funded program through the State’s Division of Mental Health and Addiction Services (DMHAS) and operated by Trinitas Regional Medical Center. S-COPE provides clinical outreach to older adults residing at nursing facilities experiencing mental health and/or behavioral issues and advocates for the appropriate use of crisis services to divert unnecessary emergency room presentations. S-COPE aims to equip facility staff—through assessment, consultation, on-site coaching and training—to more effectively manage behavioral issues in long-term care facilities.
Project Aims: S-COPE became operational in 2012 and since has collected anecdotal evidence regarding the significance of its services. The purpose of this leadership project was to conduct a more formal program evaluation to evaluate existing measurement processes, other potential metrics and the perspectives of facility staff on the value and effectiveness of S-COPE services. First, it involved examining diversion data collected by S-COPE, as well as analyzing S-COPE case records and statistics from the primary Psychiatric Emergency Screening Services (PESS) in Ocean County. Second, I conducted interviews with representatives from four long-term care facilities that regularly use S-COPE services to examine the staff’s perspectives on what they find of value in the program.
Outcomes: In the final report, I presented findings from the diversion analysis and interviews through a S.W.O.T. analysis (Strengths, Weakness, Opportunities and Threats). As an example, interviews indicated S-COPE’s training services and coaching as key strengths and indicated the promise of providing training in conjunction with the PESS to clarify the policies and procedures for the facilities. Another opportunity that this analysis identified is conducting more targeted trainings with facility administrators and directors of nursing, who oversee the policies and procedures for sending residents out.
Reflections: I was able to critically examine potential metrics of S-COPE services and explore whether the goal of S-COPE to reduce the number of unnecessary emergency room presentations of older adults residing at nursing facilities who are experiencing mental health and/or behavioral issues is supported by the services it provides. I learned how to perform an evaluation, analyze collected data, and communicate effectively the results. Going forward, I will take with me the importance of continuous program evaluation and providing evidence to stakeholders about program effectiveness.