2011-2012 MSW Fellows in Aging
The Rutgers School of Social Work selected four MSW students as 2011-2012 MSW Fellows in Aging. These students were selected for their strong commitment to social work and aging, as well as their great potential as leaders in this field. The Fellows completed leadership projects in April of 2012 as part of their advanced MSW internship at aging-focused agencies throughout New Jersey.
An Evaluation of Volunteer Service Use and Quality at Haven Hospice
Seth J. Antin, Haven Hospice at JFK Medical Center (Edison, NJ).
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.
Needs Assessment of Senior Housing Complexes in Hunterdon County
Kristen Hatalla at the Division of Senior, Disability, and Veteran Services of Hunterdon County (Flemington, NJ)
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.
Meals on Wheels Cannot End Senior Hunger Alone: The Importance of Collaborations
Monique Roach at the United Way of Essex and West Hudson UWEWH (Newark, NJ)
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 field 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.
Identifying the Needs of Older Caregivers: Implications for Program Development at The Arc of Atlantic County
Gail Ward-Kajander at The Arc of Atlantic County (Egg Harbor Township, NJ)
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.