Barbara Berkman

An Interdisciplinary Geriatric Consultation Service: A Controlled Trial

The structure and function of a newly created interdisciplinary Geriatric Consultation Team (GCT) are described. The GCT was introduced on a single medical unit, where consultations were given to 46 consecutive patients aged 75 years and over. The GCT patients had, on the average, 5.5 illnesses and were receiving 3.7 medications. Anemia (50 per cent), hypoalbuminemia (65 per cent), and elevated blood urea nitrogen (BUN) (58 per cent) were frequent. Functional assessment showed frequent dependence on others for assistance with ambulation (59 per cent), transfers (54 per cent), and dressing (52 per cent); cognitive impairment was found in 52 per cent and clinical depression in 11 per cent of the patients. In comparison with control units, the GCT increased use of physical therapy by 357 per cent, occupational therapy by 390 per cent, and speech therapy by 300 per cent without increasing length of stay. In comparison with control subjects, GCT patients had no decrease in hospital readmission rates (43 per cent) over 10.5 months of follow up. It was concluded that a GCT in an acute‐care hospital promotes geriatrics, teaches interdisciplinary teamwork, improves awareness of functional problems of patients, and increases use of rehabilitative services, but does not decrease the high rate of readmission of hospitalized geriatric patients.

Social Work Gerontological Practice: The Need for Faculty Development in the New Millennium

ABSTRACT There is a pressing need to upgrade the gerontological knowledge and skills of practicing social workers. Geriatrics and gerontology, as specialized fields of knowledge, have not been sufficiently integrated into formal academic training programs. There are major trends in the health care environment which impact on social work education, including technological advances, a shift from inpatient to outpatient and community care settings, increasing diversity of the older population, and client and family participation in decisionmaking. These trends necessitate social work education to emphasize new content areas in gerontology and the development of new skills in clinical, case management, care coordination, and teamwork. A significant obstacle to the preparation of future social workers to deliver the complex services needed by older adults and their families is a serious shortage of social work faculty in gerontology. Sustained and broad initiatives, such as the John A. Hartford Foundation funded Geriatric Social Work Faculty Scholars Program, are needed to develop academic and practice-based faculty in gerontology. This is crucial if social work is to maintain an important service role in the new millennium.

Social work education for health care: addressing practice competencies.

Abstract The study discussed in this article examines how social work graduates are prepared to help clients and families who need health and mental health services. The study identifies recent shifts in social work practice in health care settings, calls for greater integration of practicum and classroom education, and proposes curriculum enhancement to ensure competence in three key areas: self-directed practice, population-based practice and a refocus on basic skills. Findings are based on a New York Academy of Medicine study conducted from 1997-1999 which included a survey of course offerings at 128 CSWE-accredited schools; literature review of current practice models, focus groups, and review by an expert advisory council.

Dementia care: A global concern and social work challenge

The implications of global aging for professionals in the fields of health and aging cannot be ignored, particularly for those who confront disorders of dementia. This article reviews the care needs of individuals with dementia and their family members, and examines the state of readiness of the social work profession for responding to the needs of these individuals. The authors assess professional social work roles and the size and scope of the supportive evidence base for social work practices in dementia care, and suggest several important areas for research attention.

Social work and aging in the emerging health care world.

Summary Social work practice with older adults and their families is increasingly recognized by the profession as a major field of practice in a wide range of health care and community-based settings. This article reviews emerging trends and issues in the fields of aging and health care, drawing on gerontological health care research which bridges these areas. Given the growing number and diversity of older adults in our society, and dramatic changes in the organization and delivery of health care, the authors suggest skills and competencies essential to enhancing the well-being of older adults and their families in the 21st Century.

Linking the NIH Strategic Plan to the Research Agenda for Social Workers in Health and Aging

Although social work has a long and distinctive tradition of practice-relevant research aimed at enhancing the health and well-being of older adults, the profession has been underrepresented among the ranks of academic researchers and the National Institutes of Healths (NIH) scientific endeavors. In this article, the inherent capacities of social workers to generate and disseminate empirical health-related knowledge are discussed and recent developments in social works geriatric research infrastructure are described. Emerging domains for advancing the professions contribution to practice-relevant geriatric research on the federal level are identified and the next steps toward advancing the fields research agenda are posed.

Social work in health care: Directions in practice

As technological advances within biomedicine uncover more complex and confusing situations, social workers are forced to deal with the patient and family with greater uncertainty. To competently address todays biomedical environment with an anticipation of tomorrows advances is an incredible challenge. The focus of the theoretical framework necessary as the foundation for health care practice has shifted from an emphasis on psychopathology to a focus on what people do well, on their adaptive capacities with the goal of preventing maladaptive behavior. Therefore, the focus of practice must be on factors that affect normal or typical growth and development in the course of living and must include an understanding of the interaction between the biological, psychological, cognitive, social, cultural, and environmental dimensions of social functioning.

Mentoring new social work faculty:a gerontological perspective.

Abstract The John A. Hartford Foundation, in collaboration with the Gerontological Society of America, has developed new models to create geriatric faculty capacity within social work. The Faculty Scholars Program is building faculty leadership in academic geriatric social work through a strategic approach that includes long-distance national and institution-based mentoring. While mentoring models have proven to be effective means of career development, this is relatively new in academic social work and little is known about the impact of long-distance mentoring in association with sponsorship from a mentor at the scholars home institution. This paper describes the mentoring model and its conceptual underpinnings. Evaluation data from an ongoing evaluation is presented in discussion of the strengths and limitations of the mentoring model.

Course Content for Social Work Practice in Health Care

Abstract The challenge faced by social work faculties interested in education for health care practice is to develop curricula which integrate health-specific content with traditional foundation content. This paper presents guidelines for developing such curricula. The authors propose specific course content for practice in human behavior, social environment, organization, and policy sequences which are essential to prepare social work students for careers in health care.

Knowledge Base Needs for Effective Social Work Practice in Health

There are increasing numbers of social workers employed in the health care field. Social work education is currently lacking in the preparation of students for work in health. This paper delineates 13 knowledge base content areas considered necessary for social workers in health care. It is determined that the educational thrust must provide both micro level and macro levels of practice specialization. However, the question is raised as to whether todays education should focus on todays health care social work practice, or whether educational programs for future designs of practice should be developed.