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Health and psychosocial needs of older adults who are experiencing homelessness following hospital discharge
- Authors:
- CANHAM Sarah L, et al
- Journal article citation:
- Gerontologist, 60(4), 2020, pp.715-724.
- Publisher:
- Oxford University Press
Introduction: Though hospitals are a common location where older adults experiencing homelessness receive health care, an understanding of the types of supports needed upon hospital discharge is limited. The researchers examined the unique characteristics of older homeless adults and the health and psychosocial supports required upon hospital discharge. Design and Methods: Guided by principles of community-based participatory research (CBPR), the researchers conducted 20 in-depth, semi-structured interviews with shelter/housing and health care providers in Metro Vancouver.Results: Thematic analyses revealed 6 themes: (a) older people experiencing homelessness have unique vulnerabilities upon hospital discharge; (b) following hospital discharge, general population shelters are inappropriate for older adults; (c) shelter/housing options for older adults who have complex health and social needs are limited; (d) shelter/housing for older adults who require medical stabilization and convalescence after hospital discharge is needed; (e) a range of senior-specific shelter/housing options are needed; and (f) unique community supports are needed for older adults upon hospital discharge. Discussion and Implications: As the population of older adults increases across North America, there is a parallel trend in the increased numbers of older adults who are experiencing homelessness. Not only is there often a need for ongoing medical care and respite, but there is a need for both shelter and housing options that can appropriately support individual needs. (Edited publisher abstract)
Social work assessment: what are we meant to assess?
- Author:
- WILSON Hilary
- Journal article citation:
- Ethics and Social Welfare, 14(1), 2020, pp.84-88.
- Publisher:
- Taylor and Francis
- Place of publication:
- Abingdon
The social work assessment, which takes account of a range of factors, contrasts starkly with health assessment tools which focus individually on one small part of a patient’s functioning. The social work assessment may be viewed with suspicion, or even outright hostility, by hospital professionals particularly if the outcome is different to the prevailing opinion of the multi-disciplinary team. Increasingly, obtaining a global, holistic assessment is becoming difficult as hospitals develop a range of strategies to ‘speed up’ the discharge process. These strategies impact patients’ physical and mental health. Older patients with a cognitive impairment are disproportionately affected – the very group whose hospital admissions are rising fastest. As hospital stays shorten, the assessment is done earlier. Social work managers allocate dwindling resources on a basis of need. The social work assessment is increasingly driven by indicators of ‘critical’ and ‘substantial’. Lower levels of need or need that cannot be met by current service provision is simply not recorded. Thus, the social worker bases the assessment on less information, on a patient subjected to additional factors, using indicators designed to control budgets. However, social work resources are charged so patients themselves may pay the price for an inaccurate assessment. (Publisher abstract)
How a rapid response can keep beds free
- Author:
- VALIOS Natalie
- Journal article citation:
- Community Care, 31.8.00, 2000, pp.28-29.
- Publisher:
- Reed Business Information
Reports on how a rapid response team in the north west of England has freed hospital beds and saved money by giving GPs a better option than referring patients to hospital.
Using the eco-map and ecosystems perspective to guide skilled nursing facility discharge planning
- Authors:
- MILLER V.J., et al
- Journal article citation:
- Journal of Gerontological Social Work, 60(6-7), 2017, pp.504-518.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Growing numbers of seniors across the United States require skilled nursing facility care after an inpatient hospital stay. Previous studies indicate that roughly 20 percent of all hospitalised Medicare beneficiaries are admitted to a skilled nursing facility following a qualifying hospital stay. Social workers address psychosocial problems, social support, networks, and healthcare needs during transitions in care, particularly discharge planning. Ecosystems perspective and the eco-map as a discharge planning tool is presented. Social workers can use these tools to examine the patient with respect to their transactional relationships with systems. This will further will facilitate provision of wrap-around services upon discharge. (Publisher abstract)
A role for social workers in improving care setting transitions: a case study
- Author:
- BARBER Ruth D.
- Journal article citation:
- Social Work in Health Care, 54(3), 2015, pp.177-192.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
High 30-day readmission rates are a major burden to the American medical system. Much attention is on transitional care to decrease financial costs and improve patient outcomes. Social workers may be uniquely qualified to improve care transitions and have not previously been used in this role. The authors present a case study of an older, dually eligible Latina woman who received a social work driven transition intervention that included in-home and telephone contacts. The patient was not readmitted during the six month study period, mitigated her high pain levels, and engaged in social outings once again. These findings suggest the value of a social worker in a transitional care role. (Edited publisher abstract)
Show me the way to go home: a narrative review of the literature on delayed hospital discharges and older people
- Authors:
- GLASBY Jon, LITTLECHILD Rosemary, PRYCE Kathryn
- Journal article citation:
- British Journal of Social Work, 34(8), December 2004, pp.1189-1197.
- Publisher:
- Oxford University Press
This Research Note reports findings from a narrative review of the literature on the rate and cause of delayed hospital discharge in the UK. In addition to summarizing our knowledge to date in this important area, the Research Note raises a series of questions about aspects of current hospital discharge policy and practice (and in particular, the recent reimbursement policy to charge social services departments for delayed discharges).
Understanding transitional care provided to older adults with and without dementia: a mixed methods study
- Authors:
- PRUSACZK Beth, et al
- Journal article citation:
- International Journal of Care Coordination, 23(1), 2020, p.14–23.
- Publisher:
- Sage
Introduction: There are numerous effective transitional care interventions yet they are not routinely implemented. Furthermore, few interventions exist for older adults with dementia. A first step in developing effective interventions for dementia patients and increasing intervention uptake for all patients is to understand the current delivery process of transitional care. Methods: A mixed methods study using an explanatory multiphase design was conducted. Guided by provider interviews, medical charts were reviewed to collect information on the day-to-day transitional care being delivered to older adults. Then providers were interviewed again to assess the accuracy of those results and provide context. Results: The medical charts of 210 older adults (126 with dementia and 84 without) were reviewed and nine providers representing various professional roles including social work, nursing, and case management were interviewed. Social workers and case managers were primarily involved in discharge planning, communicating with providers outside the hospital, advanced care planning, providing social and community supports, and making follow-up appointments. Registered nurses were the primary providers of patient education and medication safety while physicians were primarily involved in ensuring that necessary information was available in the discharge summary and that it was available in the chart. Discussion: This study found distinct patterns in the delivery of transitional care, including the unique roles nursing, social work, and case management have in the process. Furthermore, these patterns were found to differ between patients with and without dementia. These findings are both consistent and inconsistent with the existing literature on transitional care interventions. (Publisher abstract)
Risk factor: state of confusion
- Author:
- GEORGE Mike
- Journal article citation:
- Community Care, 9.3.00, 2000, pp.30-31.
- Publisher:
- Reed Business Information
A social care manager talks to the author about the difficulties she faced when trying to help a confused 72-year-old who was at risk but did not want to accept social services' help.
'It is the loss of social work's contribution to rehabilitation which others in the clinical team regret'
- Author:
- PLATT Denise
- Journal article citation:
- Professional Social Work, December 1995, pp.8-9.
- Publisher:
- British Association of Social Workers
The author, Under Secretary (Social Services) at the Association of Metropolitan Authorities gave the Social Work Centenary Public Lecture last month on the theme of "Then, now, onwards". In this extract from her lecture, current commissioning systems which leave vulnerable people still frail and isolated on discharge from hospital are condemned. Proposes a new, more comprehensive system.
Social services law
- Author:
- WILLIAMS John
- Publisher:
- Fourmat
- Publication year:
- 1988
- Pagination:
- 338p.
- Place of publication:
- London