The National Study of Nursing Home Services Preliminary Results 0/0/006 n=8 (VA and non-va combined) The University of Iowa School of Work Study Director: Mercedes Bern-Klug 5-65 Fax 5-7 Rm 08 North Hall Iowa City IA 54 Mercedes-bern-klug@uiowa.edu
UNDERSTANDING SOCIAL SERVICE INVOLVEMENT in This Nursing Home Facility SECTION A: Admissions Process #-7 To what extent is social services? (If not done by any staff member, please circle ""). Visit potential residents in the hospital or at home to assess for possible admission %. Orient new residents and family members to the 6. Explain to residents/family when and how to apply for Title (Medicaid) 56 4. Explain to residents/families how to find information about a Medicare Part D drug plan 4 5. Coordinate the admissions paperwork 4 6. Engage new residents and/or family in a discussion about whether they have or want advance directives 7 7. Screen all residents for depression upon admission (If yes, please specifiy screening tool: ) 4 SECTION B: Developing an Individualized Plan of Care #8-8. Invite resident and/or family to care plan meetings 77%. Attend quarterly care plan meetings 8 0. Provide written care plan minutes to family or resident. Screen at-risk residents for depression... (Please specify tool, if you use one: ) 5
To what extent is social services? (If not done by any staff member, please circle ""). Screen residents for anxiety... (Please specify tool, if you use one: ) 0%. Screen residents for cognitive impairment... (Please specify tool, if you use one: ) 4 4. Plan interventions for residents who are depressed 65 5. Be part of the team that talks with residents/families about the possibility of hospice enrollment 6 6. Be part of the team that talks with a resident/family regarding stopping treatment (such as dialysis or chemo)... 40 7. Discuss resident's care preferences with the physician 7 8. Review advance directives with a resident and/or family at least quarterly 58. Discuss option of "Do Not Resuscitate" (DNR) with resident or family 6 0. Discuss option of "Do Not Hospitalize" (DNH) with resident or family 4. Document residents' goals for personal growth in the care plan 55. Document residents' goals for participating in the daily life of the nursing home 5. Document residents' goals for remaining connected to the community beyond the nursing home 50
SECTION C: Helping to Improve the & Psychological Well-being of Nursing Home Residents & Families #4- To what extent is social services? (If not done by any staff member, please circle "") 4. Facilitate family support groups (Specify type(s): ) % 5. Provide emotional support to families 74 6. Handle disagreements between roommates 74 7. Facilitate the Resident's Council 8. Respond to resident complaints 6. Respond to family complaints 68 0. Help decide to transfer a resident to a psychiatric /unit for evaluation 56. Provide counseling (psychotherapy) directly with resident for depression and/or mood disorder. Assist with recreational activities. Organize shopping for clothes/supplies for residents 8 8 SECTION D: Planning Discharges #4-8 4. Arrange services in the community for residents who are being transferred from your to live in the community 85% 5. Meet with nursing and others to discuss/decide discharge plans for residents receiving Medicare rehab or sub-acute services... 8 6. Meet with nursing and others to discuss/decide discharge plans for non-medicare residents... 86 7. Identify long-stay residents who could live in the community with services 75 8. Arrange on-site memorial service for deceased residents
SECTION E: Involving the Entire Facility in Meeting Psychosocial Needs #-46 To what extent is social services? (If not done by any staff member, please circle ""). Plan staff interventions for residents who have behavioral symptoms 6% 40. Talk with staff about resident emotional needs 66 4. Talk with staff about family emotional needs 6 4. Deliver staff in-service training on resident rights 6 4. Deliver staff in-service training on how to identify resident physical abuse 46 44. Deliver staff in-service training on how to identify resident emotional abuse 46 45. Deliver staff in-service training on how to identify resident financial abuse/exploitation 4 46. Deliver staff in-service training on how to identify resident sexual abuse 45 SECTION F: General Supportive Services #47-5 47. Prepare and participate in annual state survey.. 88% 48. Recruit and coordinate volunteers 6 4. Arrange transportation for residents to receive health care 7 50. Inform staff about public benefits (food stamps, transportation, housing assistance, etc.) that they may be eligible for 8 5. Coordinate the search for lost possessions of residents 60 5. Help feed residents at mealtime... 5
SECTION G: Training #5-6 How prepared are you to provide one-on-one training to a new social service colleague about: Please circle the number that corresponds to the best answer: Not able to do Could do after - days of preparation time Could do after a couple of hours of preparation Could do without special preparation 5. How to report suspected resident abuse (physical, emotional, financial or sexual) to the state authorities. 7% 54. How to identify residents who would benefit from psychotherapy with a clinical social worker or psychologist 55. How to lead a "crisis management meeting" with resident/family and staff members. 64 4 56. When to request a psychiatric consult with a psychiatrist, psychologist, or psychiatric nurse for a resident 7 57. How to help secure a legal guardian for a resident 58. How to lead a bereavement support group for residents 55 5. How to lead a bereavement support group for staff 0 60. How to identify resident's emotional needs related to health issues 6. How to evaluate the effectiveness of social services provided for residents' emotional issues 64 4