Taub Fellowship Alumni

Gerdene Facey

Practicum Learning Site: Avalon Rehabilitation and Care Center
Project Title: “‘Feed the Feeder’ Assistant Program”
Practicum Project: The focus of Gerdene's Taub Fellowship project was to raise awareness about experiences of feeding residents and develop a formal feeding program at the organization. Gerdene partnered with an interdisciplinary team at the organization to develop the program. The target audience for the program was department heads, with the goal of expanding the program to train staff members and families about protocols around feeding. As part of her project, Gerdene conducted research to learn more about the feeding assistance. In terms of project outputs, Gerdene developed a guide that outlines the feeding program.

Amy Keyishian

Practicum Learning Site: Volunteer Guardianship One on One
Project Title: “Creating a Friendlier Volunteer Experience”
Project Description: As part of her project as a Taub Fellow, Amy distributed a survey to the organization’s prior and current volunteer guardians to ask questions about guardian responsibilities, factors that would improve the guardian experience, and advice for future guardians. Guided by the survey responses and a thorough review of the literature, Amy created a standalone resource guide to provide an engaging, less formal addition to the organization’s official handbook. She developed color-coded cards with information on topics such as choosing a long-term care facility and making decisions on behalf of incapacitated people.

Brianna Paden-William 

Practicum Learning Site: Bergen Volunteers Trenton Health Team
Practicum Project Title: “Reframing Aging in Trenton”
Practicum Project Description: The goal of Brianna’s Taub Fellowship project was to provide Trenton Health Team’s community health workers with the reframing aging principles to incorporate into their work supporting Trenton’s aging residents. As part of this project, Brianna administered a pre-training survey to understand how community health workers understood ageism and potential implicit bias that impacts their work. Then, she conducted a training to explain why it is important to reframe aging as well as provide age-inclusive communication tools to incorporate into their work. She also conducted a post-training survey to measure the community health workers’ implicit biases after the training. 

Nimit Kaur, MSW

Practicum Learning Site: Camden County Health and Human Services
Project Description: I developed a resource guide for information assistance and referral staff at the Camden County ADRC, conducted a disabilities needs assessment and communicated the results to county officials. From this work, I was hired to be the disability services coordinator for Camden County ADRC and have an opportunity to create outcomes for some of the needs presented in the community assessments. I also collaborated with and developed a strong relationship with local and statewide service providers and disability professionals in other county ADRC's.

Tyrelle Knight, MSW

Practicum Learning Site: MD Anderson Cancer Center at Cooper
Practicum Project: My Taub Fellowship leadership project was a LGBTQ+ Support Group for Cancer Patients and Caregivers. Before I decided on this leadership project idea, I gave a survey to the social work team about the need for a potential support group for LGBTQ+ patients at the hospital and the analyzed results showed a great need for it. This is when myself and my supervisor decides to implement and co-facilitate a support group. The objective of the support group was to provide a safe space for cancer patients and caregivers to discuss their thoughts and feelings on topics that impact this patient population. It was inclusive and nonjudgmental space for patients as we discussed a plethora of issues such as insurance navigation, mental health, community based resources, relationship changes and so on. It was a short term, six week, once a week group that I co-facilitated for an hour and a half with my practicum supervisor. The turn out of the group was successful as the members of the group completed a patient/caregiver satisfaction survey which helped me to better understand how the members were impacted and it allowed for me to better understand what is needed in the future. My last week I provided the results of the survey and I discussed the group with the social work team. They were very pleased with the group and are looking to come up with more LGBTQ+ related projects in the future.

Anna Eckert-Kramer, MSW

Practicum Learning Site: Greenwhich House
Project Description: I designed a training covering cultural humility (and how it is different than cultural competence), five attributes that are helpful in building cultural humility and how to practice them, and discussion questions for staff to reflect on how this relates to working with both children and parents in families, survivors of intimate partner violence and other forms of domestic violence, and older adults. I also designed a post-training online survey to gather staff feedback about this training.

Annabess Ehrhardt, MSW

Practicum Learning Site: Lenox Hill Neighborhood House 
Practicum Project: To try to better understand the experience of our caregivers, I have created a survey using Qualtrics.  The questions are designed to give caregivers the opportunity to share their honest thoughts about the program and the ways in which our groups may or may not be meeting their needs. The survey was administered via 3 different media. the results did serve as a base for me to create the rest of my project, which ended up being a program evaluation-type project. The program evaluation included the survey, a roundtable discussion with colleagues, focus groups with caregivers, and a small quantitative analysis of Caregiver Program (CGP) data stored in the database that Lenox Hill Neighborhood House (LHNH) uses.

Kathleen (Kayly) Coleman

Practicum Learning Site: Palliative Care Team at Robert Wood Johnson University Hospital – New Brunswick Fellowship
Project Title: “Increasing the Accessibility of Meditation in Acute Care Hospitals” Fellowship
Project Description: After incorporating meditation in her own clinical practice, Kayly observed how little research exists on adapting mediation practices to be more accessible to individuals with varying physical and cognitive needs in a medical setting. Kayly designed a survey to learn how social work staff felt about meditation in terms of familiarity and comfort at the practicum learning site. Many staff reflected how they were interested but lacked training on specific meditative techniques, and identified barriers such as time and high caseloads were also noted in the survey as reasons why maybe staff were unable to consider these effective methods. In response, Kayly compiled meditative scripts for the Palliative Care Team at the hospital that are available to all staff so that these strategies can become more commonplace for providers.

Lori Kitun 

Practicum Learning Site: Portable Assisted Living Services (PALS) at Westwood House, Bright Side Family Fellowship
Project Title: “Staying Connected: A Guide for Using Technology with Clients”
Practicum Project: During Lori’s placement, the PALS program received a donation of three tablets to help support residents impacted by isolation due to the Covid 19 pandemic. Lori noticed early on how some residents were reluctant to explore the tablets, and decided to survey staff about their experiences in offering the tablets to the residents in order to identify potential barriers and strategies to better approach this opportunity with residents. Through this survey, Lori was able to gage staff and residents’ comfort with the tablets, and subsequently developed a guide for staff to use that is infused with social work strategies to better engage clients about using this type technology and its potential benefits including addressing social isolation.

 Taylor Ruszczyk 

Practicum Learning Site: Bergen Volunteers
Practicum Project Title: “Improving Generativity and Strengthening Intergenerational Ties in Bergen County”
Practicum Project Description: At Bergen Volunteers, Taylor worked specifically with the “Chore Homemaker

Education Encouragement Rehabilitation” Program, better known as CHEER. The CHEER Program supports individuals 80+ by connecting them to volunteers for support and connection. The program was significantly impacted by the Covid 19 pandemic, and Taylor’s project focused on creating an informed interview tool and conducting reminiscence interviews in an attempt to restore connection, foster a meaning-making experience for client community members, and identify ways the CHEER Program can make a bigger impact in years to come. 

2019 - 2020 MSW Fellows in Aging

Congratulations to the cohort of MSW Fellows in Aging for the 2019-2020 academic year!

Anne Raulerson Fellowship 

Project: “Implementation of Trauma-Informed Care Assessments, Interventions & Evaluations”
Practicum Learning Site: Parker Health Group

As part of her fellowship project, Anne developed a comprehensive training for the staff at her practicum site, a long-term care facility, on trauma-informed care. The training focused on how to identify trauma in residents and staff, and recommended practical strategies for addressing retraumatizing triggers. The training was used as part of an in-service educational program for the current staff at the facility and will be adopted as part of the facility’s orientation for future staff. Additionally, Anne analyzed the facility’s intake assessment for new residents to explore whether they could be improved upon to improve the staff’s ability to recognize trauma in potential residents and develop revisions.

Elizabeth Wolf

Fellowship Project: “At the Twilight’s Last Gleaming: Promoting Veteran-Centric Care”
Practicum Learning Site: Samaritan Healthcare and Hospice 

As part of her fellowship project, Elizabeth created the framework for a “back to basics” extensive training module, including learning activities, designed to orient the social work staff to the concept of veteran-centric care. Elizabeth took a step further at the practicum site to evaluate the social workers' perceptions of working with armed service veterans as a cultural subgroup. Specifically, Elizabeth evaluated the workers for the presence of moral conflict and/or moral disengagement when working with this population and through the training she developed provided thoughtful learning opportunities to address these and to deliver veteran-centric care.

Iyana Anderson

Fellowship Project: “Senior Center of the Chathams: Transportation Opportunities”
Practicum Learning Site: Senior Center of the Chathams 

As part of her fellowship project, Iyana surveyed the center’s current transportation service and needs of the seniors attending the program in order make it more accessible to different aged seniors and more collaborative, calling upon agencies connected to the center to partner. Iyana developed a comprehensive proposal for an improved transportation program backed by scholarly research that was presented to board members at the site. In her proposal, Iyana highlighted to board members the importance of transportation for older adults, the diversity within the older adult population, funding and grant opportunities, and suggestions for next steps to improve the center’s transportation program.

2018-2019 MSW Fellows in Aging

2017 - 2018 MSW Fellows in Aging

Mindy completed her generalist social work practicum placement at Lutheran Crossings Enhanced Living in Moorestown, New Jersey, a continuing care community which offers independent living, assisted living, skilled nursing, dementia care and subacute rehabilitation. There, she performed patient assessments, participated in family care conferences, and created learning materials to support staff education on the topics of resident rights and elder abuse. Mindy’s advanced practicum placement was at Penn Medicine Virtua Cancer Program where she successfully completed her Fellowship project titled LifeCare Social Worker Impact Evaluation.

Jessamyn Tabakin
2017-2018 Atlantic Health Home Care & Hospice, Morristown

Jessamyn completed her first-year internship at The Carol G. Simon Cancer Center in Summit NJ, where she worked with outpatient Oncology patients through clinical interaction, including co-facilitating a mindful meditation group. Her advanced year internship was at Atlantic Home Care and Hospice in Morristown where she was involved with bereavement services and integrative care for inpatient and in-home hospice patients and their caregivers. She successfully completed her fellowship project titled Audio Service In-House Pilot Program Measuring the Level of Distress Before and After Music Interventions.

2015 - 2016 MSW Fellows in Aging

Leadership Projects

Julie Cramer
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.

Alyssa Cullere
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.

Carol Loyd
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.

Alicia O'Connor
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. 

2014-2015 MSW Fellows in Aging

Leadership Projects

Lauren Campasano

Leadership Project: Taking Parker’s Pulse: A S.W.O.T. Analysis of Francis E. Parker Home’s Organizational Culture Education

Background: The Francis E. Parker Memorial Home is a not-for-profit organization that offers a wide array of long term care services including skilled nursing, memory care, assisted living residences, as well as adult day services and health and wellness community services for older adults in Central New Jersey. In 1998 Parker Home became one of four registered Eden Alternative™ homes in the state of New Jersey. Parker Home began a culture change journey at the time to ensure greater involvement and stronger communication among the care team and to continue to strengthen its person-centered environment. In 2014, a Culture Team was created to further develop Parker Home’s cultural identity to make it more portable as the organization continues to grow; enable Eden culture to be more successful; and measure success in culture implementation and change. Parker Home hopes to create a unique identity apart from the Eden Alternative through this process. 

Project Aim: As a contribution to the Culture Team’s Education task force, I completed a qualitative study examining the knowledge and perceptions of organizational culture among employees. Fifteen face-to face interviews were conducted with staff across different departments on two campuses, with particular attention to how the organization can improve its education and training opportunities around organizational culture. 

Outcomes: The end product of this project was a S.W.O.T. (Strengths, Weaknesses, Opportunities and Threats) analysis of Parker’s present culture and educational practices. With this, I identified key points and recommendations for the task force to consider concerning strategies for culture education as Parker continues on the Eden Alternative Path to Mastery, seeks to identify its organizational culture as a unique way of caring for elders, and expands in the future. 

Reflections: This project has allowed me to critically evaluate how to improve an organization’s functioning and to practice communicating research results to health professionals. Organizational culture within long-term care communities significantly contributes to the quality of care provided. As a social work leader in the field of aging, I will take the knowledge I have gained from this project to advocate for both care-providers and those that they care for to promote environments that allow for the best work environments and care. 

Gabriela Nieves-Moskonas

Leadership Project: Enhancing the Engagement of Outreach Volunteers at the AARP NJ State Office

Background: AARP is a national nonprofit organization that champions issues that matter to the 50+ age group, such as healthcare, employment security, and retirement planning. As part of this work, AARP provides older adults the opportunity to contribute as volunteers through community outreach concerning AARP’s position on issues confronting older adults. Volunteers attend events, such as health fairs, senior fairs, and informational conferences. AARP NJ’s Outreach Unit aimed to enhance their volunteer management strategies with an eye toward expanding outreach volunteers in the future. 

Project Aim: As a member of the Outreach Unit, I began to explore ways in which I could combine findings from research on older adult volunteers with quantitative surveys that could be done with both current and former volunteers. Moreover, AARP wanted to expand its penetration into more counties by recruiting more volunteers. To that end, this project aimed to learn what percentage of 121 volunteers from an initial list remained interested in volunteering and how AARP could engage a greater percentage of the volunteers on the list. Mail-back surveys were administered to the 121 volunteers to assess current and future levels of engagement, identify possible barriers to engagement, grow the volunteer list, and identify preferences around training. 

Outcomes: Results from the survey indicated that the number of available outreach volunteers has declined significantly within recent years and that many counties in New Jersey do not currently have any outreach volunteers. Common barriers to participation included health problems and issues concerning transportation, which are expected to become even greater barriers to participation as the volunteer pool advances in age. Guided by national research on volunteerism in later life, I delineated several recommendations that AARP NJ could consider in expanding its outreach volunteer program as well as increase its retention of current volunteers, including the designation of a volunteer manager. 

Reflections:  I was able to learn first-hand the importance of research for addressing issues within any organization. I learned how crucial it is to design a survey instrument to make sure it will measure exactly what you are trying to measure. Overall, this project demonstrated the value of spending resources on research that can create change, affect policy, and ultimately save resources in the future.

Teal Krech Paynter

Leadership Project: Supporting Caregivers at the Carol G. Simon Cancer Center at Morristown Medical Center

Background: The Carol G. Simon Cancer Center (CGSCC) at Morristown Medical Center offers various psychosocial support services to cancer patients and their families during and after treatment. The Social Work Department works with patients and their families in many critical areas, such as: dealing with fear and anxiety related to the cancer diagnosis and treatment; assisting with financial concerns, work-related issues and home care needs; planning for life post-treatment; and bereavement. 

Project Aim: The leadership project sought to bolster a current CGSCC initiative to better understand caregiver needs. Specifically, the goal was to strengthen the Center’s approach by: (a) analyzing data collected through a survey of caregivers at CGSCC; (b) conducting a thorough literature review of cutting-edge, evidence-based interventions used in cancer settings; (c) practicing these interventions with caregivers and developing a personal understanding of their needs; and (d) presenting a report that included four SMART goals (Specific, Measurable, Attainable, Realistic and Timely) for the CGSCC to consider in its future work with caregivers. 

Outcomes: National research supports that caregivers are as overlooked as they are important in cancer care. They provide more than half the care needed by patients, yet they often assume the caregiving role by default with no formal training and little understanding of the knowledge, resources, and skills that their role demands. To provide high-quality to care recipients, caregivers need professionals who understand their value and empower them towards optimal engagement. Although there is no one-size-fits-all model for intervening with caregivers, an analysis of existing research distilled three categories of superior evidence-based interventions: psycho-education, skills training, and therapeutic counseling. 

Reflections: It was an honor and a privilege to work with caregivers in the cancer setting. The fellowship project provided me the opportunity to delve deeper into the practicum learning experience as I considered how caregivers fit into the big picture and asked the question of how to best support them. Now is an opportune time for systematic efforts to support caregivers, as leading health system CEOs are calling for better integration of caregivers to benefit both quality of care and the bottom line. 

Hilary Rives

Leadership Project: Counseling Services at LIFE: Challenges and Opportunities for Improving Participant’s Mental Health

Background: LIFE at Lourdes (LIFE), a Program of All-Inclusive Care for the Elderly (PACE) in Pennsauken Township, is a day program for older adults that provides services such as transportation, medical care, rehabilitation therapy, mental health care, personal care, recreation, meals, and home care. The goal of PACE programs is to allow older adults at high risk for institutionalization to live safely in their own homes for as long as they so choose. Older adults with depression may have decreased functional status, sleep disorders, decreased treatment compliance, higher rate of falls and lower perceived quality of life. Decreasing depression in older adults can therefore have a beneficial impact on their well-being and the cost of treatment within the PACE program. 

Project Goals: The purpose of this project was to identify ways to bolster mental health services, specifically counseling, for LIFE participants experiencing high levels of depressive symptoms. It involved conducting interviews with participants and mental health professionals on staff to determine why participants are, or are not, utilizing counseling services within the social work department. It also used administrative data to identify potential sub-groups of older adults in the program who are more inclined to have depressive symptoms and why, if at all, any particular groups are less inclined to seek or accept mental health services. 

Outcomes: According to the administrative data, there was no particular group of participants more likely to have depression. Interviews with social workers indicated that the high amount of case management (in part, due to the especially low socioeconomic status of the participants), the lack of a scheduling system, and the participants’ busy schedules at the day program made it difficult to provide adequate counseling services. Participant surveys indicated they did not always remember counseling services were available. Recommendations were summarized and presented to the LIFE administration and management team. 

Reflections: At LIFE, social workers wanted to be able to provide more effective mental health care, and participants wanted to receive mental health care. As demonstrated by their positive response to my final presentation and willingness to address the suggested recommendations, it was clear that the administration was receptive to improving mental health, but they had not been aware of the need for improved services and what could be done to make them possible. Overall I have learned how to properly evaluate mental health care needs through research and effective interviewing skills. As a leader in social work, I can carry forward the importance of effective communication among participants, staff, and administration to ensure that the best possible services are being provided. 

2013-2014 MSW Fellows in Aging

Megan Brozena-Creech
New Jersey Housing Mortgage Finance Agency (2013-2014)

An Assessment of the Services for Independent Living (SIL) Program

Background: The New Jersey Housing and Mortgage Finance Agency’s  (NJHMFA) Services for Independent Living (SIL) program provides or expands upon supportive services—such as case management and linkages to transportation, health screening, education, training, and assistance with housekeeping and shopping—for older adults living in subsidized senior housing developments. A guiding principle of the SIL program is that the promotion of independent living, as opposed to institutionalization, is not only cost effective, it also maintains self-respect and dignity in seniors as they become frail and/or weak. The SIL program requires social service coordinators to be hired by each housing development to be eligible for participation. The onsite SIL coordinator works with the NJHMFA staff to develop programs that can meet the needs of the residents living in that particular development. 

Project Goals: The purpose of the project was to (a) provide the administration at NJHMFA and social service coordinators with findings and feedback from interviews with SIL coordinators across the state; (b) highlight areas of strengths and areas for improvement in the SIL program; and (c) describe the importance of social services in a non-social service host setting. 

Outcomes: Over the period of six months, I conducted face-to-face or telephone interviews with 34 SIL coordinators across northern, central and southern NJ. The interview notes were analyzed and categorized into key themes, which were put into a final report and a PowerPoint presentation for both NJHMFA administration and the SIL coordinators at their regional meetings. SIL Coordinators identified many strengths of the program, including an overall understanding and value of social services in senior housing developments and enjoyment of the knowledge shared through trainings and conferences. They also identified several areas of improvement, such as internal concerns within housing developments, differential backgrounds of SIL coordinators, and concerns regarding the locations of trainings. Key recommendations from the stuy included expanding social services and SIL staff oversight within NJHMFA, developing training for all housing development staff, and standardizing the format of reports   required for SIL and other programs. 

Reflections: It has been a very fulfilling experience at NJHMFA through the Aging Fellowship Program. I was provided with great leadership and supervision, which has helped me to grow and expand my knowledge and experience both at the macro level of social work and in aging. Most of all, this fellowship has provided me with an opportunity to conduct social work research and provide an assessment of a program that has affected the lives of so many seniors throughout New Jersey. 

Katelyn Ciarelli
Francis E. Parker Memorial Home (2013-2014)

Measuring Quality of Social Services at Parker Memorial Home

Background: Francis E. Parker Memorial Home offers a wide variety of services, including skilled nursing, assisted living, memory care, adult day services, and health and wellness community services in Central New Jersey. Social Services are offered as part of all of these services and provide support in many critical areas. These areas include adjustment, loss, mood, behavioral issues, cognitive issues, and family concerns. Although other consumer satisfaction surveys are administered with consumers, the social services department at Parker currently lacks a tool to ensure quality services are being provided to residents; currently, there is no mechanism for the department to receive feedback regarding their services. 

Project aim: This leadership project aimed to strengthen the social work department by gathering and analyzing departmental performance measures from residents and families. An initial survey was created in the fall of 2013 and focused on evaluating recent changes within the department. The survey—to be administered by the organization in the near future—inquired about the responsiveness, helpfulness, satisfaction, and availability of social workers in the unit. The second piece of this leadership project aimed at creating a quantitative tool to assess the department’s overall effectiveness. The metric will be distributed to residents and families in skilled nursing. The survey was designed to gather feedback on the availability, responsiveness, approachability, helpfulness, supportiveness, and general satisfaction with social services. 

Findings: The second instrument was piloted with 10 residents. All residents reported that they were satisfied or mostly satisfied. All residents responded that they would seek out social services in the future. When asked to give an overall rating, seven out of the ten participants rated the services excellent, while the remaining three rated the services good. The most common comment in regards to the survey was that they were pleased to have an outlet to express gratitude for the help they have received. The other variables that were expressed in high regards were helpfulness and availability of the staff. For future use, the survey will be distributed to cognitively able residents and family members within both of Parker’s skilled nursing locations. 

Reflection on my leadership development process: This project has given me the opportunity to learn how metrics are created and what it takes to ensure quality services are being provided in agencies. At first, I was unsure as to how many residents and families would be interested in filling out another survey, but I was met with enthusiasm and a very positive response. Residents and families at Parker largely seek an outlet to express their gratitude and/or concerns with the social services department, and this survey allowed them to do so. The overwhelmingly positive responses contribute to the social work department’s morale as well, as it reinforces their role, offers valuable feedback, and expresses deep gratitude. In the future, Parker Memorial Home can offer this survey annually as a way to ensure quality services continue being achieved.  

Amanda Lazzarotti
Saint Peter’s University Hospital/Central Jersey Internal Medicine Associates, PA (2013-2014)

Broadening the Continuum of Care through Social Work in Primary Care

Background: Older adults may experience many transitions throughout the course of their lifetime, such as changes in personal care needs, social relationships and health. These changes can lead to repeated emergency department visits or hospitalizations, which can be stressful for individuals, families and the healthcare system. To address these challenges, Saint Peter’s University Hospital is a healthcare system seeking new ways to provide a holistic approach to care that is person-centered and emphasizes the physical, mental, and social aspects of the person. One of these innovations involves piloting social work in a primary care office, Central Jersey Internal Medicine Associates, PA. 

Project Aims: This project addressed psychosocial issues experienced by patients, families and caregivers in an outpatient medical setting. Goals of the project included improving care transitions, reducing unnecessary hospitalizations or emergency room visits due to psychosocial risk factors, and improving accessibility to community resources such as behavioral health and support services. My role included performing psychosocial assessments, interventions, and planning tailored to specific needs of the patient. Through this project, social work became a valuable component of interdisciplinary team collaboration at the clinic. I also had the opportunity to share my experiences as a panelist for Behavioral Health Awareness and Career Pathways Day at Brookdale Community College, in addition to submitting articles about social work in primary care to the publication of the New Jersey Foundation for Aging and the Rutgers School of Social Work Alumni Newsletter.

Findings: The opportunity to network with various healthcare professionals about innovations in primary care and the role of social workers was invaluable. Conversations surrounding social work in primary care were full of interest and excitement. These discussions raised awareness surrounding the need for person-centered care and how the social work profession can have an impact. Through my experiences, networking with healthcare consumers across disciplines about the importance of social work in primary care resulted in meaningful discussion and advocacy. By participating in outreach, such as becoming a panelist or submitting articles for publications, healthcare professionals and the public can learn about the value and the role of social work in a nontraditional setting, for example, a primary care office. 

Reflections: The development and implementation of this integrative project encouraged me to examine extending the social work role beyond the acute care setting and addressing psychosocial issues in a primary care office. Moreover, I recognized how networking and outreach advocates for the value of social workers across the healthcare continuum and highlights career opportunities in the evolving realm of healthcare. The knowledge gained from this project as well as the skills I developed in effective communication, leadership, and interdisciplinary collaboration will be applied throughout my professional social work career. 

Stephanie Olsen
Jewish Family Service of North Jersey (2013-2014)

Intergenerational Programming: Ascertaining Benefits and Feasibility at a Community Social Service Agency

Background: Jewish Family Service of North Jersey (JFSNJ) is a community social service agency that serves clients in parts of Passaic, Bergen, and Morris counties in New Jersey. The agency provides an array of services for youth and senior clients, but there is little programming overlap with these two populations. Many of JFSNJ’s senior clients are homebound and have diminished ability to engage in socialization activities. The goal of intergenerational programming is to provide programs and activities specifically designed to facilitate interaction between older and younger generations. Research has found that such programs have the potential to increase intellectual growth, self-worth, and acceptance in both youth and seniors. 

Project Aims: The overarching goal of this project was to determine the potential for initiating and sustaining intergenerational programming at JFSNJ. This was carried out through the following activities: (a) A literature review was conducted that provided a framework for the research at the agency; (b) The JFSNJ social work staff was administered surveys to elicit their feedback about possible intergenerational programming ideas; (c) The JFSNJ Executive Director was interviewed to discuss the staff’s ideas as well as the guidelines for conducting interviews with the agency’s senior clients; (d) Appropriate senior clients were identified and interviewed to determine their socialization patterns and needs, and (e) A search was conducted for possible funding sources that might support intergenerational programming at JFSNJ. 

Outcome/Findings: Existing literature cites the increased need for intergenerational contact since there is a dearth of these relationships occurring naturally within families or communities. The literature review also elucidated the plethora of favorable outcomes that generally occur as a result of intergenerational connection. For instance, intergenerational programming facilitates the exchange of wisdom and values between participants as well as promotes successful aging in seniors.  

Staff survey results were compiled and two main ideas were highlighted. The first was the potential for young adults to act as volunteers with older adult clients. The second was to coordinate socialization between young children and senior clients. The ideas generated from the staff surveys were discussed and feasibility issues were addressed with the executive director. It was determined that homebound senior clients should be the focus of the interviews, as they are a client group that is at especially high risk for social isolation and loneliness.

Interviews with the agency’s homebound senior population proved congruent with the findings of the literature review in that most people experienced a lack of intergenerational connection. Many respondents also expressed an interest in forging relationships with younger people as a way of staying connected and feeling younger. Oftentimes, the client’s own health problems precluded them from leaving the house and having face-to-face contact with others. Most clients stated that they would prefer to leave their home more often than they currently do. Overall, clients interviewed saw positive aspects of increased socialization opportunities.

Using the Foundation Center website, five potential funding sources were identified. All of these donors expressed an explicit interest in serving the older adult population and/or intergenerational groups.

Reflections on my leadership development process:  Engaging in a multi-faceted research project made me see how all the pieces need to come together in order to form a cohesive whole. Along the way, I learned much about interpersonal communication and the importance of having a well-informed knowledge base via the input of all involved parties. Taking charge of the planning and implementing of this project increased my self-confidence and bolstered my leadership skills. Additionally, conducting face-to-face interviews with older adults increased my understanding of this population and made me more keenly aware of their attitudes and needs. I feel a real sense of accomplishment in seeing my year-long project come to fruition. Being given the opportunity to participate in this fellowship program was a true gift. The knowledge I gained from this experience will be carried with me into my future career as a social worker.

Julia Sameth
Jewish Family & Children’s Service of Greater Mercer County (2013-2014)

Advance Directives and End-of-Life Planning: Creating a Checklist Tool for Care Managers

Background: The Jewish Family & Children’s Service of Greater Mercer County (JFCS) is a non-profit organization serving over 3,000 community members of all backgrounds. The agency’s official mission is to “strengthen individuals and families by empowering people to care for themselves and others.” A major focus of the agency is supporting seniors who wish to age in place. Care managers—including master’s level gerontologists and MSW clinical interns—work to connect over 250 older adults to services as well as to provide programming and support, information and referral, and advocacy and education.

Project aims: This project sought to enhance care managers’ focus on early advance care planning for older adults. Early advance care planning refers to the use of documents including the Do Not Resuscitate Order (DNR), Living Will, Health Care Proxy, Medical Power of Attorney, FIVE WISHES Document, and Physician’s Orders for Life Sustaining Treatment (POLST). Research indicates that older adults with lower levels of income and education are less likely to have such documents in place. To better understand the needs for advance care planning at JCFS, I conducted a survey of seniors from the two distinct client groups that JFCS serves (Secure@Home--S@H and United Aging and Disability Partnership-UADP) to determine the level of clients’ preparedness and areas of educational needs in end-of-life planning. S@H clients typically have higher levels of education and economic resources in comparison to UADP clients. Results were used as a guide to construct a checklist tool for care managers to use in facilitating discussion and education around advance care planning with clients and their families. 

Findings: Responses were more easily obtained from the S@H group, with 89 completed web-based surveys (versus 15 UADP telephone-based surveys). In the S@H group, almost 97% had completed financial wills with the preponderance (90%) having some kind of advance directive in place, usually a living will. About 15% had a POLST in place. Comments included concern about the documents not being readily available in an emergency and the documents being incomplete or out of date.

Interestingly, although over 80% of respondents reported having had conversations with their significant others and family around their care in the event of long-term or terminal illness, only about half of respondents had communicated to loved ones their wishes on where they would want to spend their last days. Those who had not had conversations with loved ones reported that the subject matter was “too fraught” or that they were not sure what they wanted. 

Respondents overwhelmingly (81%) indicated that they would be interested in knowing more about at-home care in the event of long-term or terminal illness-. Nearly 90% of respondents reported that their doctors had not discussed the issue of advance directives, nor had they, on the whole (70%), discussed hospice or palliative care as an option in the event of terminal illness. Seventy percent of respondents indicated they have some type of long-term care insurance in place. Responses to open-ended questions revealed a prevalent theme regarding the desire to die at home.

These results further underscore the need to create a simple tool to help clients clearly articulate their end-of-life preferences and to furnish their loved ones with a central document that they can use as an easy mechanism for reference and as an aid to locating essential documents during times of crisis.  Given that the literature reveals traditional advance directives have limited efficacy in the event of emergencies, and they often cannot be easily located, education on alternative documents designed to address these limitations, such as the POLST, will be an important addition to care managers’ discussions in end-of-life and serious illness planning. It is therefore essential that clients understand the differences between the available documents and employ as many as are applicable to their situations with a mind toward appropriate updating.

Reflections on my leadership development process: Embarking on this research has afforded me a deep learning experience. It was particularly challenging to approach the topic of death and dying with the UADP population—one whose clientele is often in crisis. Often other, more pressing matters presented or clients were already overwhelmed with such serious issues that it was not the right time to conduct surveys. It became clear that the UADP group is in need of particular attention to this topic at initial assessment and at regular intervals when clients are not in crisis and that the checklist tool could act as a good catalyst to begin this sensitive but imperative discussion. 

2012 - 2013 MSW Fellows in Aging

Shaina Goldberg
Jewish Family Service of Greater MetroWest Older Adult Department

"The Clinician’s Ability to Address Issues of Sexuality with Older Adults"

Background: Jewish Family Service of Greater MetroWest’s Older Adult Department in Florham Park, New Jersey serves as a resource for a wide range of services for seniors. Part of Jewish Family Service’s mission is to provide innovative social services to individuals at all stages of life. Currently, there is a lack of training available for clinicians regarding older adults and sexuality. Clinical assessments from agencies often disregard the relevance of an older adult’s sexuality. Also, older adults have limited access to information about the transmission of Sexually Transmitted Infections (STIs). There is an increase in STI’s among people who are above the age of 50 (CDC, 2008). Additionally, the lack of services for lesbian, gay, and transgender seniors is clear in the negative financial and social impact that being an older homosexual senior has (Morrow & Messinger, 2006). As a social worker, the clinician has an ethical responsibility to address issues of oppressed and vulnerable populations. Therefore, addressing issues of sexuality with seniors is a necessary part of a comprehensive assessment. 

Project Aims: The aim of this project is to open dialogue between clinicians regarding older adults and sexuality as well as to educate clinicians about the need to develop a level of comfort in discussing older adult client’s sexuality. To address this goal, I examined peer-reviewed research on this topic, as well as through informational interviews with clinicians. Through this research I developed a seminar to encourage open discussion and a dissemination of factual and relevant information regarding seniors and sexuality. This seminar was presented to 8 members of the older adult department at Jewish Family Service. A post-seminar survey was conducted to measure the impact of the seminar, including assessing clinicians’ interest in furthering their understanding of the dynamics of older adult’s sexuality as well as suggestions for improvement.

Outcome: Clinicians reported through the post-seminar survey that the presentation was informative and they felt encouraged to address issues of sexuality with senior clients. Additionally, as an outgrowth of my presentation to the older adult staff, the agency is working on bringing more educational programs on topics related to sexuality to the entire faculty of Jewish Family Service of Greater MetroWest. The most significant outcome of my project is the addition of a question about a person’s sexuality to the agency’s psychosocial intake document for all new clients. The addition of these questions regarding client’s sexuality is a huge step towards allowing conversations regarding sexuality emerge as a normal component of the therapeutic process. 

Reflection: The development and implementation of this project encouraged me to look deeper into an issue that many people are uncomfortable speaking about.  I was thrilled with the outcome of the presentation, the attendees’ responses to my project were positive, and it sparked a great deal of conversation and change within the agency. My plans for the future of my project include presenting the seminar at other agencies serving the older adult population as well as providing other members of the clinical staff at Jewish Family Service with a meta-analysis of my findings on older adults and sexuality in clinical practice. Recognizing the positive changes that took place after my presentation, it is evident that providing this seminar to other social service agencies serving older adults may encourage agency change and increased comfort in speaking with seniors about sexuality.

References:
Centers for Disease Control and Prevention (2012). Persons Aged 50 and Older.  Division of HIV/AIDS Prevention: National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, 21. Retrieved from http://www.cdc.gov/nchhstp/.
Morrow, D. F., & Messinger, L. (2006). Sexual orientation and gender expression in social work practice: Working with gay, lesbian, bisexual, & transgender people.  New York: Columbia Univ. Press.

Louis Hoffman
New Jersey Travel Independence Program (NJTIP)

"Addressing the Needs of Older Adults Transportation Transitions in Essex/Union Counties in NJ"

Background: Many older adults drive past their ability to do so safely as a result of physical and cognitive changes associated with aging. Traffic accidents are a leading cause of fatalities for older adults. Many would stop driving, but they are unaware of the alternatives. Services do exist to help older adults maintain mobility and independence even when they are no longer able to drive. In order to address the need for more clear and concise information about available services and how to use them, the New Jersey Travel Independence Program (NJTIP) provides travel instruction services throughout New Jersey. Currently, NJTIP provides travel instruction services that teach people about many of these transportation options with on the road instruction to seniors and others who apply for Access Link ADA paratransit through funding allocated by NJ TRANSIT ADA Unit. 

Project aims: This project aims to improve the reach and effectiveness of NJTIP’s programs to address the transportation needs of older adults in New Jersey by, 1) Conduct informational interviews with relevant organizations within Essex and Union Counties, statewide and national organizations as well as other stakeholders (e.g., older adults), about transportation services and service gaps for older adults, 2) Review the scholarly literature for models that support older adults’ before, during and after driving cessation, and 3) Identify long term funding sources and communities with appropriate services and interest in supporting a senior mobility program. 
 

Findings: Conversations with professionals and older adults’ service recipients within New Jersey and from around the country highlighted the need for a full spectrum of transportation services for the older adult population and to find additional avenues for disseminating this information to older adults. These discussions illuminated multiple types of transportation services, which range in their levels of flexibility, support, accessibility and cost. These conversations highlighted the need for assistance in understanding information about the services and which services are most appropriate for each individual. This is necessary in many communities however the transportation services in New Jersey are especially confusing because of the many layers of services provided by municipalities, counties, NJ TRANSIT, the Port Authority as well as private carriers. To make this more confusing branding is often unclear as many vehicles are owned or were previously owned by NJ TRANSIT and still bear remnants of their branding yet local agencies, counties or private carrier may be the service provider. This is one reason why it is so important to have concise and complete resource guides to share information with seniors and the professionals that serve them.

Scholarly literature confirms the needs that became evident in conversations between the travel trainers and older adults. The findings suggest that older adults are more successful at transitioning away from driving without losing mobility when they have a peer and professional network of support. The NJTIP program strives to build this network of support and make information and services more accessible for all stakeholders. This effort has most recently been exemplified in the NJTIP/Greater MetroWest “On The Go” model, which brings community partners and concentrations of older adults living in the community together. Intervention strategies include peer training, professional “Connect to Transit” training, environmental barrier analysis, group familiarization and transportation forums. Through the process of this aging fellowship the model was analyzed. Scholarly literature and interviews with a host of multidisciplinary professionals from agencies providing aging services and transportation around the country have been consulted. One effort used in many programs across the country which contributes to the sustainability of the model is enhanced by training provided to professionals and seniors to help others understand services as well as by the guides to public transportation customized for each community served.

In 2013 “On The Go” will be implemented using this revised model in West Orange, NJ with the Jewish Community Housing Corporation and the Jewish Federation of Greater MetroWest NJ. NJTIP sought long term funding streams through this leadership project and has identified potential funding opportunities; some of these funding possibilities include Community Transportation Association of America, or another NJ Foundation for Aging grant.  Longer term funding for this project may come from “MAP 21” Federal Transit Administration funds as well as New Jersey Department of Transportation or local/county funding sources.  

Reflections on my leadership development process: This aging fellowship project provided an opportunity for reflection and planning outside of the normal funding.  Literature and technical assistance from outside agencies was also utilized to improve the model. Using principles of strategic planning reasonable aims for NJTIP were analyzed. Principles of program planning were used to demonstrate a timeline and plan of how the project will be implemented. Principles of financial management were also used to create budgets for different programmatic and funding possibilities. Professionals on the national level and individuals in senior housing provided many perspectives that have affected changes at micro, mezzo and macro levels. This has been a defining experience for me as a Nonprofit and Public Management student and for NJTIP. The products of this fellowship will have a lasting impact on the partnering agencies and the safety and mobility of older adults across the state of New Jersey.

Rajini Kurian,
Francis E. Parker Memorial Home

"Hand to Hand: A Resident Peer Mentoring Program"

Background:  Transitioning to new living environments is often a difficult process; however, it is especially challenging for seniors who leave their families and communities behind to live in assisted living facilities. Transitions such as these can lead to feelings of loneliness and helplessness, and may result in mental health issues such as depression (Eden Alternative, 2009).   The Francis E. Parker Memorial Home provides long term care to older adults in its assisted living and skilled care nursing communities. Our ENDEAR program (Eradicating depression by Noticing when changes may be Developing in our residents through Education and Engagement, Assessment, Referral) aims to prevent these potential issues and promote engagement. Engaging new residents is important for preventing loneliness, which accounts for a large part of why seniors suffer from depression. My project “Hand to Hand: A Resident Peer Mentoring Program” was developed for the assisted living community: Parker at Stonegate.

Project aims: The proposed program “Hand to Hand: A Resident Peer Mentoring Program” engages new residents through mentoring with the aim of preventing loneliness, and hopefully in the long term, preventing depression. Through a mentoring partnership, new residents will receive help acclimating to their new home, experience socialization, and be able to provide their loved ones who are worried about adjustment, peace of mind. To develop this program I, 1) conducted interviews with a variety of professionals working in long term care settings, 2) conducted a literature review of scholarly publications relevant to this topic, 3) developed a mentoring curriculum that could then be implemented, 4) started to lay the framework to implement this project. 

Findings: To research models for creating a mentoring program of this kind, I contacted several professionals working in long term care settings. This resulted in the realization that this was not being done or had been unsuccessful at one point in time. In designing an approach specific to this setting, I interviewed various staff members and residents of Parker at Stonegate. This helped to produce a program that would be of interest not only to a prospective mentor but also to the mentee. Four veteran residents were recruited to become mentors in this role. Mentors are required to attend a training session prior to their first meeting with their mentee. The training for mentors provides an overview of the program, including guidelines for mentors, exploring and valuing diversity, relationship building, effective communication, responsible mentoring, and closure. A mentor will be assigned interested new residents. Each mentor and mentee will meet once every two weeks for the first four-months from when the new resident moves to Parker. At the end of the mentoring partnership, both the mentors and mentees will be asked to fill out an evaluation form. Specifically, the mentees will be given an opportunity to identify their interest in becoming a mentor for future new residents. While the program has not yet been implemented, critical parts to the process have been completed: recruiting mentors, establishing operational standards and other operations materials, and producing detailed training documents to educate the mentors on their role and expectations.  

Reflections on my leadership development process: This project has given me a new appreciation for the complexity associated with developing a new program. Throughout this process I developed the ability to look at the bigger picture while still attending to the details. I learned how to work independently while simultaneously assessing when to consult with others. I have also realized how valuable the input of colleagues and supervisors is to the development process, and continue to be grateful to the ENDEAR program committee throughout the process of developing the Hand to Hand program. Moreover, the work put into the development of the program was commended and recognized as high quality; I have been asked to return to Parker to present the program to the Senior Executive Leadership team. The plan for the future is to have a program that can be used as a best practice for other assisted living communities.   

Erin Mickelwaite
Princeton Hospice

"Integrating Therapeutic Touch with End-of-Life Care"

Background:  Princeton Hospice consists of an interdisciplinary team including a medical director, nurses, social workers, and a chaplain who work together to provide comfort care for patients who have a terminal illness. Members of the care team continuously assess and track patients through the dying process and work together to provide comprehensive care.  One important aspect of end-of-life care is that of therapeutic touch. Older people, and those who have significant illnesses, are among the least frequently touched portion of the population (Meek, 1993), especially those residing in long-term care facilities (Nelson, 2009). However, therapeutic touch has been demonstrated to improve well-being for individuals receiving end-of-life care (Ziembroski et. al., 2003, Kutner et. al., 2008).  Although Princeton Hospice does offer some therapeutic touch services such as Reiki therapy, the majority of the care team do not receive explicit training about therapeutic touch. In this project, I focused on increasing the frequency with which Princeton Hospice patients received therapeutic touch through educating staff and volunteers.  My own expertise as a practicing, licensed massage therapist in New Jersey afforded me a unique opportunity to fuse my working knowledge of therapeutic touch with hospice social work.  

Project aims: To accomplish this goal, I conducted a literature review to examine evidence-based practices that utilize therapeutic touch with the intention of integrating these into the care model used by Princeton Hospice. Second, I sought to facilitate greater awareness about the benefits of therapeutic touch for hospice staff, volunteers and nursing home staff to increase their comfort level and willingness to use appropriate touch with patients. I utilized experiential in-services to disseminate this knowledge and provide further instruction on therapeutic touch. Third, I aimed to evaluate the efficacy of this training. Finally, I sought to create an information packet that will remain available at the Princeton Hospice offices.

Findings: Altogether, I conducted four in-services. These were attended by a cohort of twelve hospice volunteers, five members of the hospice interdisciplinary team, ten nursing students who were completing a rotation in hospice as well as four members of the activities department and six certified nurse’s aids (CNA’s) at a local nursing home served by Princeton Hospice. Those who attended commented that the information greatly increased their comfort level with providing appropriate and therapeutic touch to patients and some remarked that they planned to incorporate the techniques they learned into daily patient care. Several of the more experienced volunteers had been using some form of therapeutic touch for patients and were eager to learn more. The nursing students reflected that although touching patients in a therapeutic manner was not something they had encountered in their curriculum, they felt it was quite important. Participants reflected that because they often make task-oriented physical contact with residents, learning several therapeutic techniques would enhance their ability to provide care. The CNA’s noted that they felt there was not enough free time for them to incorporate many of the techniques into their daily care routines for patients due to a high patient-to-CNA ratio. 

Reflection on my leadership development process: The project was an excellent way for me to challenge myself to become more comfortable presenting information formally in a small group setting by selecting in-services as my primary means of disseminating information. The project has allowed me to develop stronger communication skills and to experiment with various pedagogical techniques that will support my career in social work going forward.  As a licensed massage therapist and a social worker, I will have the opportunity to present this information to local nursing homes and other agencies that work with patients who receive end-of-life care. 

Julie Stewart
Vitas Hospice

"Enhancing Hospice’s Therapeutic Child Bereavement Services"

Background: Vitas Hospice provides end-of-life care to terminally ill patients, working with both the patient and their families to ensure comfort and preserve dignity.  Because coping with death and dying can be an extremely complex and difficult task, especially for children, bereavement services for family members are an integral part of hospice care. Vitas Hospice provides psychosocial and bereavement services not only to the patient, but to the patient’s loved ones, including their children and grandchildren, while on service and for thirteen months following death. This project will provide a guide for grieving parents on how to address the difficult subject of death with their children.

Project Aims: The purpose of this project was to identify best practices in children’s bereavement that will enhance their bereavement care plans to ensure high quality end-of-life care to patients and their families. My first aim was to research best practice strategies regarding children’s grief process, particularly regarding the death of a grandparent. My second aim was to gather input from multiple sources, such as Vitas’ interdisciplinary team (including nurses, medical doctors, social workers, chaplains, health aides), from local and national hospice agencies, and from research on the child bereavement process, interventions, the grandparent-grandchild relationship, and cultural considerations surrounding death and dying. The third aim was to develop a resource packet that families can use when working with their child through the death of   a grandparent. In the long term, another goal of this project is to acknowledge and preserve the patient and the family’s dignity and values. 

Findings: Key findings from this project are that bereavement is family-focused and needs to be tailored to families’ values and cultural background.  Parents play a key role in child bereavement and parents need to be prepared both educationally and emotionally on how to address the issue of ‘death’ with their child(ren). Social workers can aid in preparing parents for these discussions. Parents need use honest, sensitive, and engaging communication.  Research shows that parents who are not “open, sensitive, and responsive” risk leaving their children “ill-prepared through immaturity and inexperience,” which frames how children will cope with later life stressors (Kirk and McManus, 2002, p. 470). Age-appropriate grief support is crucial. Because parents are the key player in the bereavement support, remind them that it is important to understand their own grief and the importance of their own self-care.

Grandparents are often scared holders of familial heritage, culture, and values.  Their stories and memories have the potential to leave a lasting legacy only adult children and grandchildren if bereavement is addressed properly to keep the memories of their loved one alive.  Social workers should encourage ‘verbal discussions’ of the lost loved one, which allows for a reflection of memories, engagement of affect, and disclosure of thoughts and feelings, which is both ‘therapeutic’ and can ‘help decrease grief symptomatology’ (Tonkins and Lambert, 1996). To ensure sustainability, I put together “bereavement packets” for the Vitas team that incorporates already available, yet underutilized, literature on the child bereavement process and activities for parents to do with their children.  I included summaries of my research to support each key point in the bereavement packet.   

Reflections on my leadership development process: This project enhanced my leadership skills in a variety of ways. It prompted me to interview people of several disciplinary backgrounds and translate their advice for a broader audience.  In this sense, I strengthened my collaboration and communication skills.  Furthermore, I strengthened my research skills, both formally (through evidence-based research) and informally (through team member communication and feedback). The project required me to gather information from a larger context (scholarly articles, other hospice agencies, team members) and incorporate that into the local, organizational context.  Lastly, this project taught me the importance of persistence both in my personal and profession endeavors. Personally, I have a passion for intergenerational work, which is currently under-acknowledged and under-researched. This project required me to conduct my own personal research to supplement the minimal research currently surrounding this issue. Professionally, I learned to advocate for my belief of the importance of an issue using personal and professional research and presenting the issue in a way that illustrates its relevance and pressing nature to a population who does not fully understand its importance. The knowledge gained from this project about children’s grief experiences, as well as the skills I developed in effective communication, leadership, research, and interdisciplinary collaboration will follow me throughout my professional career.  

References:
Kirk, K., & McManus, M. (2002). Containing families' grief: therapeutic group work in a hospice setting. International Journal Of Palliative Nursing, 8(10), 470-480.
Metel, M., & Barnes, J. (2011). Peer-group support for bereaved children: A qualitative interview study. Child & Adolescent Mental Health, 16(4), 201-207. doi:10.1111/j.1475-3588.2011.00601.x 
Tonkins, S., & Lambert, M. J. (1996). A treatment outcome study of bereavement groups for children. Child & Adolescent Social Work Journal, 13(1), 3-21.

2011-2012 MSW Fellows in Aging

Seth J. Antin
Haven Hospice at JFK Medical Center (Edison, NJ)
Contact: sethantin@optonline.net

An Evaluation of Volunteer Service Use and Quality at Haven Hospice

Background: Haven Hospice, based at JFK Medical Center in Edison, NJ, is a complete resource for patients with advanced, life-threatening illness. Hospice care is focused on comfort and palliative care rather than treatment. Among the hospice care team are physicians, registered nurses, social workers, and trained volunteers. Under the direction of a Volunteer Coordinator, Haven’s volunteers provide support and practical assistance to patients and their families. All aspects of hospice services receive continuous feedback from patient satisfaction surveys completed by families of expired patients. The feedback consists of both quantitative and qualitative data, allowing Haven to measure its patient satisfaction scores over time and against other hospice providers. Questions involving volunteer services are often left unanswered.

Project aims: First, I intended to address the lack of feedback regarding volunteer services through telephone surveys with surveys regarding their satisfaction with volunteer services (e.g., whether volunteers were utilized, which type of services they received, satisfaction with volunteer services, etc.). Second, I intended to help boost patient satisfaction survey completion rates through provision of verbal encouragement to family members to complete surveys. Third, as part of my clinical social work internship, I intended to provide an additional "layer" of bereavement calls to families. One-hundred-fifty-six families of 216 patients admitted to Haven between January 1, 2012 and March 28, 2012 were contacted by telephone. Of those contacted, I gathered information from 119 families.

Findings: Haven Hospice maintains a volunteer roster of over 100 active volunteers. However, less than 15 % of responding families reported volunteer utilization. The most commonly utilized volunteer service was companionship. Average length of stay for nearly 66% of patients admitted during the project was under nine days. Despite short lengths of stay on program, 58 of the 119 family units I spoke with (49%) reported being highly satisfied with Haven Hospice services.

Plans for future/Evidence of success:  This project was included as an official Quality Assurance Performance Improvement (QAPI) Project in January 2012. In April 2012, my project findings, along with my recommendations, were presented to the QAPI Committee, consisting of department heads and Haven team members. Additionally, I submitted the Excel database, progress notes for the telephone calls I made, and all supportive documentation in April 2012.

Reflection on my leadership development process:   This project provided me with an opportunity to practice skills that I might not have had the opportunity to use otherwise in a traditional clinical social work internship. First, I was afforded the opportunity to participate in QAPI meetings with department heads. I was able to expand my perspective on the work that I was doing at Haven as an intern, acquiring a greater understanding of the macro environment and context in which my agency exists and some of the challenges that it faces as a hospice provider in an increasingly-patient satisfaction survey result-driven environment. Second, creating and maintaining a database sharpened my Excel skills while the statistical analytical portion of my project clarified my strengths and weaknesses. Finally, presenting my report and its findings provided me with a forum to practice my public speaking and communication skills.

Kristen Hatalla
Division of Senior, Disability, and Veteran Services of Hunterdon County (Flemington, NJ)
Contact: kbrittanyh3@gmail.com 

Needs Assessment of Senior Housing Complexes in Hunterdon County

Background: The Division of Senior, Disability, and Veteran Services of Hunterdon County is responsible for developing and coordinating various programs and services, which enable Hunterdon County residents 60 years of age and over to remain independently in their own homes as long as possible and to maintain their dignity. As part of this mission, the Division runs a senior center centrally located in Hunterdon County. Division staff has observed that older adults from three senior housing residences rarely utilize the different services that are offered by the Division, and this is a concern because it is their goal to serve the entire community.

Project aims: I conducted a needs assessment of older adults in senior housing residences through surveys and focus groups. I aimed to gather information from the senior residents to identify if there are any additional needs that are not currently being met. Results were summarized in a brief report, which was presented to the Advisory Council, housing complexes, division supervisor, and community members who potentially can use this information to develop additional programs that meet the various needs that were presented.

Findings: There was a very positive response rate from the three senior housing complexes as 41 surveys were completed, and 32 individuals attended the focus groups. There were four major themes that emerged from the surveys and focus groups. One theme was a need for additional services in existing programs, such as having more exercise programs offered at satellite locations. Another theme was the need for additional programs that currently are not offered at all. For example, there is not an inexpensive place where seniors can utilize a swimming pool to allow for exercise. There was also positive feedback about programs that are currently in place where no additional needs were mentioned. These programs included the farmer’s market voucher program, Meals on Wheels, and the Personal Assistance Service Program. The last major theme addressed the built environment. This included speed limit signs and accessible and affordable housing in Hunterdon County.

Reflections on my leadership development process: This project has been a terrific learning experience. I was unsure how many residents would attend the focus groups and fill out the additional surveys. The positive response and valuable input was significant and provided great insight at how important it is to understand the residents’ needs. I have grown in understanding the complexity of conducting a needs assessment and the importance of it. This project has shown me that completing surveys does not allow you to gather as much depth of information as focus groups due to the participants not being able to express their needs in detail. In gathering this information, I have found areas where improvements may need to be made in what services that are provided, but see the challenges that lay ahead in implementing services that address the various needs. A foreseeable challenge in implementing these services would be the fiscal support that is needed in creating these programs - a barrier that needs to be addressed.

Monique Roach
United Way of Essex and West Hudson UWEWH (Newark, NJ)
Contact: moniquenroach@aol.com

Meals on Wheels Cannot End Senior Hunger Alone: The Importance of Collaborations

Background: Meals on Wheels is a community-based senior nutrition program that is located in all 50 U.S. states that works toward addressing food insecurity among seniors. Meals on Wheels provide meals to vulnerable seniors who have limited mobility or homebound as well at congregate sites. Barriers to accessing Meals on Wheels benefits in Essex County include: continuous decrease in funding for senior nutritious programs, extremely low income requirements, affordability of meals, and long waiting lists for seniors to access services. These barriers cause seniors to contemplate whether to satisfy their nutritional needs or other immediate needs such as rent or medication.

Project Aims: The purpose of this project was to gather information to help the United Way of Essex and West Hudson (UWEWH) consider actions to address current challenges facing Meals on Wheels. This allows UWEWH to recognize how food insecurity directly correlates to senior health. Collecting information through reviewing research, public data and conducting interviews with key informants gives a clearer picture of obstacles encountered by older adults and Meals on Wheels. The project not only raises awareness, but it also prompts UWEWH to place senior health on their health initiative agenda.

Findings:  According to research from literature, public records, and interviews with key informants, this project found the following: (a) public funding for Meals on Wheels has been steadily reduced over the past 20 years; (b) New Jersey ranked the 35th state where seniors are at risk for food insecurity; (c) food insecurity is associated with negative health outcomes and an increase in preventable diseases;  and (d) nutritionally adequate foods are not available, accessible and affordable for seniors. These findings suggest the importance of the UWEWH’s further involvement with Meals on Wheels and senior hunger. In the report, I recommend that the UWEWH partner with Meals on Wheels, the faith-based community along with various senior-health focused agencies to further their cause in health. Their collaborative partnerships will allow them to maximize various forms of support while assisting seniors in maintaining optimal health.

Reflections on my leadership development process: This project has been a great learning experience for me because it allowed me to strengthen my research skills, build relationships and engage in networking. It also helped me to understand how I need to approach obstacles when encountered and be flexible. For example, some providers were unwilling to share information and on most occasions informed me that they were not responsible for reports and directed me to the next individual. This required me to enlist the support of my practicum learning supervisor as well as other community players. In addition, I learned that relationship building is a crucial factor that can influence a project. Fortunately, the UWEWH was very supportive and saw the value it could have on the community. 

Gail Ward-Kajander
The Arc of Atlantic County (Egg Harbor Township, NJ)
Contact: kajandergail@comcast.net

Identifying the Needs of Older Caregivers:  Implications for Program Development at The Arc of Atlantic County

Background: Trends affecting family supports for adults with developmental disabilities (DD) have been radically changing over the past 50 years in the United States. With the advent of de-institutionalization, and the expectation for community inclusion, coupled with better medical treatment and increased longevity for persons with DD, the task of caregiving can last for decades. Increased caregiving responsibilities have impacted every aspect of family life, including the ability to work, increased care burden and increased health risks to the caregiver as they age. The change in longevity for persons with DD has impacted how the care for these individuals is being managed.   Project aims: The purpose of this project was to research current trends found in the literature reflecting the needs of the older caregiver of children with DD, compare the research with the results of a focus group of older caregivers of the consumers from the Arc of Atlantic County, and make recommendations for program development at The Arc of Atlantic County.

Findings: The literature suggests that older caregivers have unique needs due to long-term caregiving and the complexities of caring for an adult child with DD, as well as caring for the needs of their family and themselves as they age. These needs were also identified by the focus group that convened at The Arc. The group provided feedback on their particular concerns, including feelings of isolation and inability to provide socialization for their child and for themselves due to their increasing caregiving responsibilities. Additionally, the group related frustration at dealing with the current local, state and federal system, which provides barriers to obtain the necessary help they require as they adapt to the increasing medical needs of their child. The group identified weariness over time at having to deal with these barriers including, caseworkers coming and going and having to manage several agencies providing different types of care with multiple criteria and long waiting lists for services. Because of these barriers, the families found it easier to not depend on outside help. The group also identified the difficulty at receiving appropriate and timely information related to the management of their current caregiving responsibilities, as well as how to plan for their loved ones future needs when they are no able. The Arc of Atlantic County will use this information while developing a program for the older caregivers which will provide a supportive, informative environment, that will meet their needs, and advocate for these caregivers.

Reflections on my leadership development: The development of a program that was non-existent, prior to this point in time, has provided challenges and rewards for me. The challenges included improving the way I communicate the vision for the program to The Arc management. My strategic planning course helped me to communicate the program vision by focusing on programmatic tasks and timeframes so I could be more specific about the program details. Working on this project helped to merge the theoretical aspects of program development to the actual implementation of the coursework in the "real world." The rewards of helping to develop this program came with the knowledge that this program will provide a supportive environment that will help to meet the needs of this unique population and also advocate for these caregivers. Using this program, The Arc of Atlantic County has the opportunity to provide a template for beginning older caregiver programs at other Arc agencies throughout New Jersey.

2010-2011 MSW Fellows in Aging

Four MSW students were part of the 2010-2011 cohort of MSW Fellows in Aging: Lauren Cleary, Amy Florence, Jennifer Smejkal, and Myrna Gomez (from left to right, pictured above). (PICTURE TO WHICH TEXT IS INDICATING IS NOT THERE.)

In partnership with the Rutgers School of Social Work and their practicum learning agencies, the Fellows implemented leadership projects at their respective agencies. Congratulations to the Fellows on their success!

Lauren Cleary
Philadelphia Corporation for Aging (Philadelphia, PA)

"An Evaluation of the Family Caregiver Support Program: Caregiver Satisfaction Survey"

Background: Historically, the Family Caregiver Support Program (FCSP) has conducted annual caregiver satisfaction surveys. In the past few years, however, this standard of evaluation has fallen out of practice. As a program that is federally funded, FCSP is mandated to report on how its dollars are being spent and in what capacity to ensure continued funding. While evaluating the program in these terms is important, it does not consider the consumers' point of view on program adequacy.

Project aims: In an effort to re-incorporate consumer involvement in the program evaluation process, this project aims to create and implement a consumer satisfaction survey instrument in conjunction with the Director of FCSP. Distribution of the instrument via USPS mail in November 2010 yielded a near 50 percent response rate (out of approximately 950 potential respondents) as of February 2011. Following this success, I am in the process of coding, analyzing, and evaluating the quantitative and qualitative responses to the survey. My goal is to determine which areas of the program consumers are most satisfied and dissatisfied with, and to generate ideas for improvement in areas that consumers perceive as lacking. Once areas of satisfaction, dissatisfaction, and needs are established, FCSP will be equipped to begin to prioritize changes to the program that will most benefit the needs of our consumers.

Findings: A total of 951 surveys were distributed to the caregivers of FCSP. Returned surveys (n = 377) yielded a response rate of approximately 41%. Considering that the survey was distributed only once and the agency did not utilize follow-up reminder phone calls or mailings, this response rate is very high.

The major findings of the survey were:

• Overall, the goals of the program are being met, as 87% of respondents report reduced stress or burden as a result of being involved with the program.
• Burden is most reduced by reimbursement for respite and contact with FCSP care managers.
• Personal care is the service most often reimbursed with FCSP funds, with 70% of caregivers reporting this is how they use their reimbursement funds.
• 100% of caregivers report that FCSP helps them to be a better caregiver.
• 72% of respondents say training sessions would make the program better, and of those respondents, 52% said they would attend training on stress management.
• Most respondents report that more money toward respite and supplies would increase their satisfaction with the program.

Conclusions: Having completed the implementation and analysis of this survey, I identified several limitations and recommendations for future survey implementation. A major limitation of coding and analyzing this data was due to apparent respondent confusion on certain questions, which may be a result of too much variety in the types of questions asked. For example, some questions asked for a "yes", "no", or "sometimes" answer; some asked respondents to select only one answer from several choices; and still others had respondents selecting "all that apply". So many different types of questions led to confusion among respondents who selected more than one answer on questions where they were only supposed to make one selection. Furthermore, this made analyzing the data difficult because the researcher was not able to extrapolate exactly how the caregiver intended to respond. One recommendation for next year's survey would be to change the format of the questions to include only one or two "types" of responses or to group questions with like responses together. I believe this will reduce respondent confusion and increase validity.

Another concern is that the Russian translation of the survey does not reflect the English version closely enough. It asks only who the caregiver is and not the care recipient. Also, the order of some of the possible responses did not coincide with the English version, which made coding the data difficult. Lastly, one question asked if caregivers would attend meetings and/or conferences, but it is unclear exactly what "meetings and/or conferences" means. Would these meetings/conferences be different than a support group or training session?  If so, it would be helpful to clarify or remove that choice from next year's survey.

Personally and professionally, I feel that having been involved in this project and playing a role in revamping FCSP's satisfaction survey process proved to be successful both for myself and for the agency. It is my hope that by following the recommendations above and using the codebook that I provided to the program director, that the survey will continue to be distributed and analyzed annually so that FCSP can make evidence-based decisions about how the program is operating. Leading this project allowed me to further develop skills learned in research courses while allowing me also to work collaboratively with members of other disciplines in the agency. Both skill sets are sure to be of use to me in the future, and this project gave me an opportunity to really hone them while also producing something of concrete usefulness to the agency.

Amy Florence
Karen Ann Quinlan Hospice (Newton, NJ)

"Inclement Weather Project"

Background:  Severe weather poses a risk for many people; however, seniors who are in a vulnerable state of health are even more at risk. Every winter news reports tell of the unnecessary deaths of older adults who are unprepared for power outages and severe winter storms. Older adults and other individuals at the end-of-life are especially vulnerable.

Project aims:  My project is an enhancement of a project previously designed to bring awareness to the essential items that are needed for people enrolled in hospice care to survive a severe winter storm. "Blizzard Packs" are kits that are distributed to the hospice patients living in private homes. The Blizzard Pack contains ten representative objects that serve as a prompt to gather necessary items, such as a one gallon bottle of water and a three-day supply of non-perishable foods. Also included is a laminated list of alternative items on one side with emergency contact information on the other side. Additionally, it instructs patients who depend on oxygen how to contact their electric company to be placed on a priority list. My contribution to this project was to organize it so that it would be more efficient and to evaluate the effectiveness of the project. With the help of my leadership, the agency distributed packs to 145 households this past winter.

Evaluation: A focus group was held with the social workers and nurses who delivered "Blizzard Packs" to the hospice patients in March, and a report was given at the April team meeting. The consensus was that it was a successful project and worth the time and effort. Comments included: "It is nice to give the patient something other than paperwork and instructions. They are so pleased to get the bag of goodies."  Another comment was: "The caregiver was happy to receive the contact numbers. She felt better knowing who to contact in case they needed help."  Since this focus group was held in early March, it was asked if we could make up a second set of "Blizzard Packs" for patients who just came into the program. Due to the overwhelming positive response by the hospice staff, ten more "Blizzard Packs" were made for each of the three counties. 

The focus group also discussed some changes that might be considered for next year. Those changes include using a reusable water bottle instead of a bottle with water in it. The reason for this was some of the staff members took the "Blizzard Packs" home with them in the evening for delivery the next morning. Since the water might freeze overnight, they could not leave them in the car. Using empty reusable plastic bottles would also help reduce the transportation weight. It was also recommended that we use plastic bottles with the agency logo imprinted on them. 

Reflections on my leadership development process:  This project has shown me the importance of documenting the steps of a project so that it can be sustainable year after year. A large percentage of time was spent recreating the project. Through proper documentation this project will be able to be continued by following the steps and the timeline that was developed and placed in a computer database. This will make the work more efficient, thus improving the chance that it will be continued in the future, even if there are staffing changes. The focus group evaluations confirmed that staff members feel this is a good project to continue and provided feedback to improve the project in the future.

Jennifer Smejkal
Cedar Crest Continuing Care Retirement Community (Monroe, NJ)

"Client Satisfaction Program Evaluation: Intermissions"

Background: Cedar Crest Continuing Care Retirement Community is located in Monroe, NJ, and offers independent living,  assisted living, nursing care, rehabilitation, Alzheimer's care, and respite care. The Intermissions program is a socialization program for Cedar Crest residents with cognitive difficulties. Intermissions is available five days a week, 11 a.m. to 3 p.m., and participants attend a minimum of two days per week. It offers activities designed to sustain participants' highest level of functioning possible and enhance their cognitive abilities. It also gives participants an opportunity to engage with others in recreational activities that relate to their prior life roles, such as cooking and gardening. Intermissions participants take field trips, go to lunch together, and attend activities on campus as a group. An additional benefit of the Intermissions program is that it provides respite to the caregivers. For spouses who live with a cognitively impaired person, the constant care can be stressful and tiring. For family members who do not live with the person, there is still the constant worry over the safety and functioning of their loved one. Intermissions offers a solution to both these issues.

Project aims: An evaluation of Intermissions had never been conducted prior to this project. A client satisfaction survey was distributed to spouses of current and former Intermissions participants. Based on the responses, I aim to improve Intermissions to better meet the needs of the participants and their spouses. 

Findings: The survey responses were extremely positive. However, two respondents commented that they wish they were able to learn about their spouses' participation during the day. Due to cognitive difficulties, Intermissions participants may not remember their day, and therefore the spouses are unable to hear about it. In some cases, an individual may be actively participating and socializing all day, only to tell his or her spouse that they did nothing during the program. To meet this need, I created a "report card" that Intermissions employees will fill out at the end of the day. This card will give an indication of the individual's level of participation, socialization, eating, toileting, and physical or behavioral issues. This card will ensure that each spouse receives an individual report for the day. Also, I delivered the client satisfaction survey instrument to the Director of the Intermission program so that it can be used on an annual basis to ensure that the Intermissions program continues to meet its goals and best serve its clients. This sustainability will allow my project to continually benefit the agency, even after my practicum placement is over, and help Intermissions to strengthen and grow.

Reflections on my leadership development process: This project has been a great learning experience for me because I did not know what to expect when the survey began. There was no way of knowing how people would respond to the survey, which required me to be flexible in my plans. The overwhelmingly positive response was great news for Intermissions and validated the program's success in achieving its objectives. However, this project demonstrated that there is always room for improvement and growth, as I found useful suggestions from the respondents, even with the high level of satisfaction. The addition of "report cards" to the program will strengthen it and help it to better meet the participants' needs. Additionally, I found that there is a lack of literature concerning the use of these "report cards" in dementia day programs. I found this gap in research to be interesting, as it shows a potential untapped area of investigation. Listening to what caregivers want from a dementia socialization program is an important component of ensuring that the program meets the needs of its participants. By conducting an evaluation and hearing the concerns of participants, Intermissions was able to strengthen its program and provide even better services.

Myrna M. Gomez
The Daughters of Miriam Center (Clifton, NJ)

"What are your clients saying about you? A client satisfaction survey"

Background: The Daughters of Miriam Center for the Aged/The Gallen Institute, located in Clifton, NJ, is a long-term and sub-acute care facility providing broad-based services. On its 13-acre campus are skilled nursing facility, a sub-acute care wing, a dementia/Alzheimer's care pavilion, a rehabilitation program, a medical adult day care center with a dementia day care program, a sheltered workshop, hospice care, and a respite care program as well as senior apartments with supportive programs. Since nursing homes are regulated by several regulatory agencies, such as the Joint Commission, one of the requirements is to obtain and document clients' input into the development of services that meet their needs.

Project aims: To meet this requirement, the project consisted of a client satisfaction survey to determine older adult consumers' and their family members' level of satisfaction with the services provided by the center. Each section of the survey tool addressed a different type of service at the center, including admissions, room accommodations, meals, physician and nursing services, religious services, social services, transportation and a special section specific to family member/caregivers. A total of 440 surveys were distributed to residents and family members of long-term and sub-acute residents and adult day care clients. A total of 172 surveys were returned for an approximate return rate of 38%. All participants were asked to rate 50 variables on a scale of 1 through 5 with 1 = strongly disagree and 5 = strongly agree. Assistance was provided by social workers for those elders who had difficulty in reading the survey in English and/or wished to be interviewed in English or Spanish as part of the process. 

Findings: Generally speaking, 91.9% of seniors and family members were highly satisfied with the services provided and would recommend the facility to others. Other than the identification of key departmental staff as being highly courteous, the top three variables identified by all respondents as the organization's strengths were a feeling of the center being safe and secure, cleanliness of the room and facility, and respect for privacy. Additionally, since research has identified a strong correlation between client's level of satisfaction and food, it was not surprising that the survey also identified food preferences, variety of choices and flavorfullness/tastiness as an area for improvement. 

Plans for future/Evidence of success: As part of the future planning process, a presentation will be given to management and the center's Board of Directors outlining the qualitative results of the survey. The presentation will also include a qualitative analysis of the comments for each section as reported by the respondents, and comparisons will be made as to the identification of the sections that most highly correlate with overall satisfaction. Management may then form teams to further drill down the data and recommend action plans. A second survey is scheduled for 2012 in order to determine the level of improvement based on level of client satisfaction.

Reflection on my leadership development process: This project enhanced my leadership skills in a number of ways. First, in assessing the appropriate variables to measure and determining the most effective survey methodology to use, I exercised critical thinking skills. Second, because of the size of the project, I was granted the use of additional social work students, and, as such, I needed to utilize effective communication and teamwork skills. Lastly, after analyzing the data, I needed to prepare a succinct presentation to individuals in positions of organizational change. My efforts did not go unnoticed. The organization offered me a full-time position of employment, and I accepted:  A successful outcome to a successful practicum placement and project!