Leadership challenges and strategies to dementia care in Chinese faith-based nursing homes: A qualitative study.

AIM: To address the need and fill a knowledge gap in understanding challenges and coping strategies from the perspectives of nursing home leadership. BACKGROUND: The rapid increase of older adults with dementia in China highlights the need for research on dementia care in long-term care facilities. METHODS: Semistructured interviews were conducted among 20 facility directors employed by faith-based nursing homes across 12 provinces in China via phone or in-person in their native language. Two researchers fluent in Mandarin Chinese- and English-coded interview transcripts; thematic analysis was conducted to identify patterns. RESULTS: Four primary challenges were identified, including recruiting and retaining nursing staff, funding, lacking governmental support and discord with family members. The coping strategies included using external resources, incorporating religious beliefs, teamwork, rewarding performance and improving staff skills and empathy. CONCLUSIONS: This study contributes to nursing home practice knowledge by disseminating insights of administrators regarding culturally relevant dementia management strategies in China. IMPLICATIONS FOR NURSING MANAGEMENT: Implications for nursing management are as follows: teamwork and staff encouragement; advocate for a sustainable governmental financial support; staff training and staff-resident ratio regulations and policy; seeking external resources; integrate faith-based means for problem management and service quality improvement.

About a Third of Nursing Home Social Services Directors Have Earned a Social Work Degree and License.

Nursing home (NH) residents have high psychosocial needs related to illness, disability, and changing life circumstances. The staff member with the most expertise in addressing psychosocial needs is the social worker. However, federal regulations indicate that only NHs with 120+ beds need hire a social services staff member and that a "qualified social worker" need not have a social work degree. Therefore, two-thirds of NHs are not required to employ a social services staff member and none are required to hire a degreed social worker. This is in stark contrast to NASW professional standards. Reporting findings from this nationally representative sample of 924 social services directors, we describe the NH social services workforce and document that most NHs do hire social services staff, although 42% of social services directors are not social work educated. 37% of NHs have a degreed and licensed social worker at the helm of social services. The odds of hiring a degreed and licensed social workers are higher for larger NHs, especially if not-for-profit and not part of a chain. NH residents deserve psychosocial care planned by staff with such expertise. Quality of psychosocial care impacts quality of life.

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

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.