Rachel Filinson

Developing and Evaluating an Interdisciplinary Clinical Team Training Program: Lessons Taught and Lessons Learned.

The training of clinicians in working together as an interdisciplinary team has received growing support in geriatrics. Most teamwork training programs have focused on group process and development as the core competencies of team practice necessary to improve levels of team functioning. The experience of the Rhode Island Geriatric Education Center (RIGEC) in developing and implementing an ongoing teamwork training program, including the training of several geriatric teams from a variety of health care settings, suggests that additional objectives should include the empowerment of teams for advocacy in rapidly changing health care settings increasingly shaped by economic forces. The lessons learned by RIGEC for the development and implementation of teamwork training include the importance of defining team membership, dealing with the shifting shoals of the health care system, understanding individuals and systems under stress, and redefining the objectives of teamwork training.

“No Secrets” and Beyond: Recent Elder Abuse Policy in England

ABSTRACT This paper provides an overview of English elder abuse policy including guidelines developed for adult protection by their Department of Health in 2000, a report released from the House of Commons Health Committee in 2004 on elder abuse, related policy changes affecting older adults, the mentally incapacitated, and social care regulations, and the launching of public awareness campaigns. In contrast to the U.S., English policy subsumes elder abuse within the larger category of vulnerable adult protection, steers clear of mandatory reporting, emphasizes abuse by formal caregivers rather than domestic violence, relies on a multi-agency approach to investigation and intervention, and supports more remedial, less punitive regulatory oversight.

ASSESSING OUTCOMES OF A GERONTOLOGY CERTIFICATE PROGRAM

A follow‐up study of alumni of a gerontology certificate program was designed to answer the following questions: (1) What were the outcomes for alumni, and were successful graduates differentiable by characteristics distinguishing them at entry into the program? (2) What were the subjective expectations of the alumni and do they perceive that the outcomes have met their expectations? (3) If the data indicate that outcomes are attributed to the program, by what means does it transform the student? Through skills and knowledge conveyed, links with employers, or the credential conferred? (4) Do curricular changes make a difference in influencing the process elucidated above? The results indicate that a substantial minority of graduates never worked in the field of aging, while a majority was not recently working in the field. Neither age, gender, degree held, prior work experience, previous educational experience, nor matriculation in a concurrent degree program differentiated those who eventually entered th...

Kicking and Screaming: How One Truculent Sociology Department Made Peace with Mandatory Assessment

The authors provide an account of their department’s minimalist and largely reluctant approach to mandatory assessment in the past decade. A decade earlier, the department had gone all out in an experimental assessment effort supported by the Fund for the Improvement of Post-Secondary Education, an effort the department was neither willing nor able to make once the college’s accreditation agency mandated assessment in 2000. The authors describe another “less-than-ideal design” that has nonetheless involved many of the assessment elements described elsewhere (e.g., alumni and student surveys, classroom assignments, external reviewers, research papers) and has nonetheless yielded usable and utilized feedback for both teaching and curriculum construction.

Why should they be abused any more than children? Child abuse protection and the implementation of No Secrets

The parallels between child abuse and adult abuse have been frequently noted as public awareness of both has increased in recent decades. Both can involve the concealed victimisation of a weaker family member, for both interventions are difficult to implement because practitioners are loath to intrude into the privacy of the family and risk causing harm, and combating abuse of either type demands multi‐agency working. Significant differences between the two abuse constituencies have also been stressed, namely that adults are not invariably dependents reliant for care on the persons mistreating them and have the autonomy to resist efforts to intervene on their behalf.

Multinational corporate penetration, industrialism, region, and social security expenditures: a cross-national analysis.

This study examines the determinants of spending on social security programs. We draw predictions from industrialism and dependency theories for the explanation of social security programs. The explanations are tested with data on seventy-five nations, representative of core, semipheripheral and peripheral nations. Industrialization variables such a the percentage of older adults and economic productivity have strong effects in models involving all nations, as does multinational corporate (MNC) penetration in extraction, particularly when region is controlled; such penetration is negatively associated with spending on social security. We then look at industrialism and dependency effects for peripheral and non-core nations alone. The effects of all industrialization variables, except economic productivity, appear insignificant for peripheral nations, while the effects of region and multinational corporate penetration in extractive and agricultural industries appears significant. Models involving all non-core nations (peripheral and semi-peripheral) look more like models for all nations than for peripheral nations alone.

Evaluation of the Impact of a Volunteer Ombudsman Program: The Rhode Island Experience

ABSTRACT The research assessed the impact of a major innovation in the Long-Term Care Ombudsman Program that occurred in Rhode Island in 1997–the introduction of a volunteer component in which community members were trained and certified as advocates for residents in long-term care. Based on reports to the state ombudsman office, the findings indicated that the placement of volunteer ombudsman was associated with the generation of more complaints and more serious complaints about the facilities in which they were placed, some of which could not be resolved despite the greater intensity of interventions applied in these cases. Dat derived from nursing home inspections revealed a negative and significant correlation between the length of time a volunteer had been at a facility and the number of deficiencies.

AGING 2000: CONSUMER EMPOWERMENT THROUGH EDUCATION

Aging 2000 is a statewide, private, non-profit, grassroots organization of community-based networks of providers and consumers working to improve geriatric health care delivery through consumer empowerment. Among its programs are educational workshops led by trained volunteers on how to better ones health behaviors and navigate the current health care system. The theoretical underpinnings , range of topics covered, the utilization of older adult volunteers as educators , and evaluation outcomes of these workshops are discussed.

Ethnic aging in Canada and the United States: A comparison of social policy

Abstract Most research on ethnic aging in the U.S. has been dominated conceptually and empirically by a narrow focus on the economically disadvantaged minority aged. Despite the monopoly of the research agenda by “visible minorities,” the U.S. has witnessed declining participation of these groups in federally funded programs for the aged, and optimal policy solutions remain elusive. Heuristically, Canada provides a useful comparison because although the two countries have striking similarities, Canada has carried out research on ethnic aging that focuses on cultural variation rather than economic disadvantage, and has in its policies, responded to demographic change with significantly different values and social structures for health care, income maintenance and the accommodation of ethnic minorities. Canadas preference for universal health care and income maintenance systems, and a “multicultural mosaic” rather than melting pot philosophy of ethnic relations would suggest that the ethnic aged might fare better under the Canadian system. Nevertheless, the evidence indicates that Canadian policy may be more ideologically, than practically distinct from the U.S. equivalent.

Welfare Reform and The Long-Term Care Workforce

The research reported in this paper examined the role of welfare reform in increasing the availability of entry-level workers to meet the rising demand for long-term care employees. Findings from national and statewide evaluations of welfare programs show mixed results in the extent to which beneficiaries could be shifted from welfare caseloads to the ranks of the paraprofessional labor force. Analysis of a welfare-to-work program in Rhode Island demonstrates the potential for recruiting welfare recipients to long-term care employment. It also shows the need for resources, supportive services, case management, and enhanced training to counteract the “work-first” philosophy of welfare reform.