Jane M. Thibault

Integrating Content on Organized Religion into Macropractice Courses.

Abstract This paper examines organized religion as a driving force within the social welfare state and looks at religious organizations as human service providers. Following a brief historical overview, the contemporary significance of organized religion for special population groups is discussed. Information is presented on religious institutions, religiously affiliated organizations, and religious congregations for incorporation into existing courses in social work policy, organization, administration, and community practice.

Self-Neglect: An Overview

SUMMARY Initially described in 1953, the concept of self-neglect is complex. Definitional problems exist because it can be redefined by changes in context. This article examines the epidemiology, etiology, detection, ethical/legal issues, management/intervention, and outcome. Prevention is particularly difficult given the nature of the problem, the poorly understood etiology, and the slow insidious progression of the syndrome before it reaches public attention. This complexity is compounded by the fact that respect for autonomy and personal rights is given paramount importance over paternalism when an intervention at an earlier stage could potentially result in a better outcome.

Community Dimensions of Elderly Self-Neglect

SUMMARY Much recent literature has focused on the impact of self-neglecting behavior on elders. Little attention, however, has been paid to the impact of this phenomenon on the communities in which self-neglecting elders live. Family members, neighbors, and service professionals can all be adversely affected by the behavior of these patients. This article reflects on the ways in which the community is affected by elder self-neglect and discusses the inherent conflicts between protecting the rights of the individual and the rights of the community.

A Conceptual Framework for Assessing the Spiritual Functioning and Fulfillment of Older Adults in Long-Term Care Settings

ABSTRACT The 1971 White House Conference on Aging asserted that all persons are spiritual, and that the spiritual well-being of older adults is a significant area of concern for both researchers and practitioners. Many attempts have been made to define and describe spirituality, using instruments designed to measure religious functioning and behavior. While these have been helpful to researchers, they have been of little practical use. This paper presents a conceptual framework for the operationalization of the variable, “spirituality.” Using this framework, the authors chose three qualitative research questions related to spiritual values which were asked of both older adults and service providers. The results were factor analyzed and an instrument was developed which enables the practitioner to assess the type of spiritual functioning and fulfillment desired by older adults in long-term care settings.

Indirect Life-Threatening Behavior in Elderly Patients

SUMMARY Older adults frequently engage in such indirect life-threatening behaviors as extreme lack of self-care, refusal to eat, refusal to take medications, and failure to comply with an understood medical regimen. These behaviors are often classified as non-compliance or passive suicide. Analysis of such phenomena reveals that these actions can represent attempts by the person to gain control of and to ameliorate a negative life situation. A case is presented which demonstrates the ultimate outcome of engagement in such behavior when it is misinterpreted and left untreated. The functions of indirect life-threatening behavior are discussed.

EGRIATRICS PARTNERSHIPS IN HEALTH CARE: THE LIFE SPAN MODEL

Health care professionals are expected to function as partners. However, most professionals are not prepared to work in teams or to develop organizational structures to support a team approach. We describe the development of a successful interdisciplinary partnership program in geriatric health care called LIFE SPAN. Nine factors that contributed to its success are analyzed: common goals, right timing, leadership support, expertise, breadth of ideas, compatibility of organizational design, team building, persistence, and sufficient financial resources.

Using Volunteers with the Elderly in Health Care Settings

In a time of government retrenchment, volunteers may be a great benefit, yet they can present extensive problems if not appropriately trained and supervised. We examine two types of programs using volunteers to work with the elderly in health care settings. One program type uses volunteers as health care guardians, attempting to alleviate the hospitalization-rehospitalization syndrome. A second type program is state sponsored and mandated by the Older Americans Act. Volunteers are representatives of the state ombudsman and work with elderly persons in long-term care. Both types of programs use volunteers, yet they serve under different auspices. Basic principles, however, apply to these advocacy roles. Managing volunteers, professional-volunteer relationships, and implications for practice are examined.

Wholistic Theology as a Conceptual Foundation for Services for the Oldest Old

SUMMARY Social service agencies are focusing more and more on the “old-old.” Some organizations have secular missions that address multiple domains (i.e., physiological, economic, social, etc.). Other agencies, developed by the religious community, designate spirituality as a domain to be addressed in serving the “old-old.” This paper examines interfaces between secular social service organizations and those persons (whether staff, board or religious leaders) who attempt to provide a wholistic perspective for service provision to the “old-old.”

Challenges Faced by Staff in Faith-Related Agencies When Dedicated Volunteers Age in Place

This article is based on increasing requests we have received to help staff of faith-related agencies face challenges posed when dedicated volunteers have “aged in place” and change is needed. We begin by identifying challenges faced when dedicated volunteers “age in place” within established organizations, defining concepts such as psychological contracting and role salience that are pertinent to understanding volunteer and staff commitment. We use constructed case examples of two faith-related agencies to illustrate the types of challenges that can occur and then offer potential guidelines for how to assess and address difficult situations in which dedicated volunteers may not be able to continue in their cherished roles.

Activating the Resources of the Soul: A Psycho-Spiritual Intervention for Pain and Suffering in Later Life

For as long as human beings can remember, times of suffering bring with them the question of “Why me.” This theodicy question can be answered in a number of ways including, “Why not me?” In this article, suffering is addressed through a method of redemptive suffering, involving autobiographical and interpersonal methods. This method invites individuals to examine their spiritual resources to move suffering from “desolation” to meaning.