Robin P. Bonifas

Nursing home social workers and allied professionals: Enhancing geriatric mental health knowledge

Research has highlighted the challenges social services professionals face in providing quality psychosocial care to persons living in skilled nursing facilities (SNFs). A primary area of difficulty is addressing the needs of persons with mental health conditions, including problematic behaviors associated with dementia. This study evaluated the geriatric mental health knowledge of a sample of SNF social service directors (n = 120) and found that although, on average, practitioners have a good level of general knowledge, their understanding is limited regarding the symptoms of dementia and effective interventions that can address associated problematic behaviors. Implications for social work education are discussed.

Aging and Place in Long-Term Care Settings Influences on Social Relationships

Objective: This article presents results of a qualitative research study that examined how living in a long-term care (LTC) home influences the quality of residents’ relationships with peers, family members, and outside friends. Method: Semistructured interviews using a phenomenological approach were conducted with 23 residents of a LTC home. Thematic analysis was employed to illuminate residents’ perspectives on the nature of social relationships in this setting. Results: Four key themes were identified that highlight the role of place in social relationships. Residing in a LTC home influences the context of social interactions, impacts their quality and process, clusters individuals with health and functional declines that hinder socialization, and poses structural and cultural barriers that impede social interactions. Health and functional limitations posed the greatest challenge to socialization relative to characteristics of the facility itself. Discussion: Residents’ insights emphasize how personal characteristics influence community culture and the experience of place.

Effects of Self-induced Unclassified Therapeutic Tremors on Quality of Life Among Non-professional Caregivers: A Pilot Study.

Background: Chronic stress has a negative effect on health-related quality of life. In challenging environments with multiple stressors, limited access to mental health resources, and cultural impediments to health care delivery, effective and accessible methods of stress management are critical. Activation of self-induced therapeutic tremors (SUTT) may mitigate excess stress and improve quality of life (QoL) under such conditions. Objectives: To investigate (1) the feasibility of a 10-week SUTT training and practice intervention and (2) the association between participants’ use of SUTT and any changes in their self-reported health-related QoL. Methods: All staff members of the SOS Childrens Village in Cape Town, South Africa (n=21) received 10 weeks of SUTT weekly training and group practice along with independent SUTT practice 2 to 3 times weekly. A wellness-based QoL questionnaire was administered before and after the intervention, and participants were instructed to keep a diary of their experiences. Results: Following 10 weeks of SUTT instruction and practice (1) there was a 91.3% adherence rate to the intervention protocol and (2) participants reported their overall impressions of changes in all five QoL domains increased at a statistically significant level: mean scores were 3.81 at pre-test and 4.35 at post-test (P<.05). Conclusions: A 10-week SUTT instruction and practice protocol is both highly feasible among non-professional caregivers and a potential therapeutic method for improving QoL.

Becoming Culturally Competent: Mindful Engagement with American Indian Clients

Social workers are often sensitive to American Indian cultural norms with the intention of teaching and providing services in the best interest of the client. However, developing cultural competency may best be learned by practicing mindfulness. Mindfulness can be viewed as intentionally being present on purpose without judgment. Living in the present moment is inherent in American Indian culture. When social workers are mindful they are able to empathically acknowledge, intentionally pay attention, and accept without judgment their experiences. Responding versus reacting to ones experience helps facilitate setting the stage for effective change and transformation. This article offers a framework for developing a mindfulness practice to enhance cultural competence with American Indian clients.

An Examination of the Factor Structure of the Hartford Geriatric Social Work Competency Scale-II Assessment and Intervention Subscales

The Hartford Geriatric Social Work Competency Scale II (GSWCS-II) is the gold standard for assessment of social work competency and confidence in gerontological practice behaviors, but minimal research to date has examined the factor structure of this important instrument. This study employed exploratory factor analysis to determine the underlying structure of the measures subscales related to assessment and intervention. Results indicate that the Assessment and Intervention subscales each have two underlying components that differentiate between core geriatric competencies necessary for all social workers and competencies required for specialists in aging. Findings have implications for the evaluation of competency and self-efficacy in gerontological social work, furthering the application of the GSWCS-II for both social work education and practice settings.

Gerontological Social Workers' Perceived Efficacy for Influencing Client Outcomes

Using a sample of practitioners (n = 269) from the 2004 National Study of Licensed Social Workers, this article employs a quality assurance structure–process–outcome model to examine factors at the practitioner, workplace, and service delivery levels that influence the perceived efficacy of licensed gerontological social workers to affect client outcomes in the context of a highly challenging health care environment. A regression model accounted for 33.9% of the variance (adjusted R 2 = .291) in perceived efficacy with 3 aspects of service delivery satisfaction having significant effects: ability to address complex/chronic care, to influence the design of services, and to help clients navigate the system.

Professional and practice characteristics associated with self-efficacy in assessment and intervention among social workers in aging

ABSTRACT This study examined professional and practice characteristics associated with assessment and intervention self-efficacy among gerontological social workers in Ontario, Canada who participated in online surveys. Results from multivariate analyses indicated that higher client acuity, longer duration of practice experience, smaller caseloads, and a greater proportion of clients 85 and over were significantly associated with greater assessment self-efficacy. Greater client acuity and smaller caseloads were also significantly associated with greater intervention self-efficacy. Implications for education include the importance of providing practical experience with the oldest old and with clients with greater biopsychosocial complexity. Also recommended is the need for manageable caseloads, especially when older adults with complex needs are part of the practice milieu.

The prevalence of elder bullying and impact on LGBT elders

This chapter reviews bullying and relational aggression among LGBT older adults. The intent of this chapter is to define and characterize late-life bullying in general and discuss unique manifestations of this phenomenon for LGBT elders. Special attention is given to peer victimization associated with intersectionality and microaggressions for this population, as well as common types of bullying and the impact bullying experiences have on emotional well-being and quality of life. Promising interventions to minimize bullying related to sexual orientation and gender identity in senior living environments are discussed and include civility training, bystander intervention, and policies and procedures that guide respectful social interactions and prohibit discriminatory actions.

Developing a Model to Address African Americans’ Spiritual Needs During Hospitalization

Research suggests that African Americans are disproportionately likely to have their spiritual needs ignored in hospitals. To help address this disparity, the present study developed and tested a model for addressing the spiritual needs of hospitalized African Americans. Structural equation modeling was used with a sample of older African American inpatients (N = 2,217) consecutively discharged over a 12-month period from hospitals from four geographic regions. As hypothesized, addressing spiritual needs had a positive effect on overall satisfaction with service provision. The relationship between spiritual needs and satisfaction was fully mediated by five variables: nursing, the discharge process, physicians, visitors, and room quality.