Patricia J. Volland

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.

Strong Social Support Services, Such As Transportation And Help For Caregivers, Can Lead To Lower Health Care Use And Costs

A growing evidence base suggests services that address social factors with an impact on health, such as transportation and caregiver support, must be integrated into new models of care if the Institute for Healthcare Improvements Triple Aim is to be realized. We examined early evidence from seven innovative care models currently in use, each with strong social support services components. The evidence suggests that coordinated efforts to identify and meet the social needs of patients can lead to lower health care use and costs, and better outcomes for patients. For example, Senior Care Options--a Massachusetts program that coordinates the direct delivery of social support services for patients with chronic conditions and adults with disabilities--reported that hospital days per 1,000 members were just 55 percent of those generated by comparable patients not receiving the programs extended services. More research is required to determine which social service components yield desired outcomes for specific patient populations. Gaining these deeper insights and disseminating them widely offer the promise of considerable benefit for patients and the health care system as a whole.

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.

Strengthening field education in aging through university-community agency partnership: the Practicum Partnership Program.

Abstract The Practicum Partnership Program (PPP), an innovative field education model developed and implemented by six demonstration sites over four years (2000-2004), uses a structured university-community partnership, or consortium, as the foundation for designing, implementing, and evaluating internships for graduate social work students specializing in aging. This paper describes the site consortia and PPP programs, presents evaluation findings, and identifies future directions for the PPP. Student learning outcomes were positive and both students and consortia agencies reported positive PPP experiences. The PPP model underscores the value of the community agencies as equal partners in educating future geriatric social workers.

Social Work Knowledge of Facts on Aging: Influence of Field and Classroom Education.

Palmores Facts on Aging Quiz (FAQ) was used to measure aging knowledge outcomes of 323 practicum students engaged in aging-focused practica at pre- and posttest across 11 universities. Significant improvement in knowledge scores (p = .0001) was found for graduates of the enhanced field education programs. Taking aging course work was a significant (p = .0001) influence on knowledge outcomes. Combined with coursework, the practicum students experienced increased knowledge of aging. When experiential and didactic learning is combined, increased knowledge about facts of aging occurs.

Geriatric social work career tracking: graduates of the Hartford Partnership Program for Aging Education (HPPAE).

Despite a growing need for geriatric social workers, there is a question as to whether MSW graduates who are gerontologically prepared actually enter the workforce to serve older adults. By tracking MSW graduates who had special training in aging, this study aims to explore their job search and career experience. Findings show that most graduates located aging-related jobs 4 months postgraduation and remained committed to the field 1 to 2 years later. The majority were working in direct service provision in clinical settings. Their salaries compare favorably with those of generic social workers. Implications for geriatric social work education are discussed.

Articulating the evidence base for effective social work practices: building a database to support a geriatric social work policy agenda.

SUMMARY In an era that demands accountability and cost-effectiveness, health care and social service professionals are increasingly expected to demonstrate the effectiveness of their interventions and treatments. Social workers, specifically those serving the elderly, have been markedly slow in embracing the need to measure outcomes and produce evidence of their practices, which stymies efforts at advocacy and policy development for the profession. Using a modified systematic review method, the New York Academy of Medicines (NYAMs) Center for Aging Policy created an evidence database comprising peer-reviewed journal articles on social work interventions and outcomes research on cost-effectiveness and other measures of effectiveness. The evidence database, though focused on care of the elderly, draws on research studies involving age groups across the lifespan. A key product of this initiative is a series of white papers on cost-effective interventions in areas such as care management. A work group of social work professionals and a team of NYAM staff with diverse expertise reviewed articles based on their content, key topics, and outcomes. This article describes the steps taken, from the conceptualization of the review process to the development and implementation of the Web-based interface for user access to the evidence database. Though originally conceived as a tool for supporting a policy agenda for the Center for Aging Policy, the evidence database is also a useful reference tool for social workers, policy makers, and others interested in quality of care for elderly.

“Just Like I'm Saving Money in the Bank”: Client Perspectives on Care Coordination Services

Older adults face many challenges to community living. The literature has not sufficiently explored the roles of care coordination in the maintenance of housing and access to health care among older adults, particularly from their own perspectives. This qualitative study analyzes the findings from 25 interviews and 6 focus group discussions (48 participants) with a multiethnic sample of older adults in the New York City area. Care coordination services appear to assist older adults access health care, and to a lesser extent, maintain affordable housing. Disparities in access to care coordination appear to remain for immigrant, minority and suburban populations.

Social Supports: The Authors Reply

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