Strengths and Struggles for Families Involved in Hospice Care During the COVID-19 Pandemic.

The COVID-19 pandemic presented unique health and social challenges for hospice patients, their families, and care providers. This qualitative study explored the impact of the pandemic on this population through the experiences and perceptions of social workers in hospice care. A survey was distributed through national and local listservs to social work practitioners throughout the United States between May 15 and June 15, 2020. The study was designed to learn the following: (1) Concerns patients experienced as a result of the pandemic, (2) strengths/resilience factors for patients during the COVID-19 pandemic, and (3) the personal and professional impact of the pandemic on social workers. Themes uncovered in hospice care included isolation, barriers to communication, disruption of systems, issues related to grieving, family and community support, adaptation, and perspective. The authors provide recommendations for social work practice related to virtual communication, emergency planning, and evidence-based intervention for Persistent Complex Bereavement Disorder. Recommendations for policy include uniform essential worker status for social workers, telehealth reimbursement and expanded caregiver respite benefits.

Hierarchies in interprofessional training.

Adverse patient outcomes are often the result of conflict or poor communication among healthcare professionals. Use of interprofessional care teams can improve healthcare and delivery of services. Healthcare systems have been historically hierarchical in nature with physicians regularly taking a leadership position. The presence of hierarchy can be a source of conflict in interprofessional healthcare teams. This article analyzes qualitative data from a four-day interprofessional training for family medicine residents, pharmacy students, nurse practitioner students, and counseling psychology students. Data was collected through journals, participant observation, and focus groups. Findings from this study demonstrate three key themes related to hierarchy: (1) tension regarding the idea that the physician is the team leader or "quarterback," (2) experiences of marginalization by team members while working in interprofessional teams, and (3) the tendency for issues regarding hierarchy to go unresolved. Additionally, authors briefly address structures within healthcare that contribute to hierarchy as well as a discussion of alternative models of teamwork and healthcare delivery.

Silver Alerts: A Notification System for Communities with Missing Adults.

As the U.S. population ages, the prevalence of dementia will grow and communities will face the problem of older adults wandering or becoming lost. Silver Alert systems are programs designed to locate missing older adults with dementia or other mental disabilities. Such programs have been initiated in all but five states. Data collection for these programs is often minimal or incomplete. Social workers should be involved in prevention, follow up and education with caregivers, community members and law enforcement officers. When reviewing Silver Alert policy, special attention must be given to ethical concerns and protection of older adults' civil rights.

Reporting Policy Regarding Drivers with Dementia.

PURPOSE OF THE STUDY: States have various policies regarding physician reporting of drivers with dementia to the Department of Motor Vehicles (DMV) for testing. Some states have mandatory reporting policies, others have optional reporting policies, and some have no policy regarding this issue. Arkansas has no reporting policy. Physicians in Arkansas face the risk of liability if they report a patient against their will to the DMV. DESIGN AND METHODS: Three research questions were developed to identify how the problem of drivers with dementia is defined among neurologists and geriatricians in Arkansas: (i) What knowledge do these specialists have of state policy regarding reporting of drivers with dementia to the DMV; (ii) What are their opinions regarding various policy options for reporting such drivers; and (iii) What are their reporting practices for drivers with dementia? A survey was distributed to Arkansas neurologists and geriatricians. RESULTS: There was considerable uncertainty among respondents, regarding the process of assessing and reporting at-risk drivers with dementia. Support for optional reporting policy was strong. Mandatory reporting policy was less favored. Conversations with patients and caregivers regarding cessation of driving were described as being contentious and ongoing. IMPLICATIONS: These findings lead to the recommendation that the Arkansas legislature adopt an optional reporting policy. There is also a need for physician education regarding state reporting policy, as well as training for assessment of fitness to drive for patients with dementia.

Sustaining Our Nation's Seniors through Federal Food and Nutrition Programs.

Food insecurity is a pressing issue in the United States where one in six people suffer from hunger. The older adult population faces unique challenges to receiving adequate nutrition. The federal government currently employs four food and nutrition programs that target the senior population in an effort to address their specific needs. These are the Congregate Meals and Home Delivered Meals Programs (provided through the Older Americans Act), and the Senior Farmers' Market Nutrition Program and Child and Adult Care Food Program (provided by the United States Department of Agriculture). As the older adult population continues to grow, it will be important to evaluate and improve these programs and the social policies related to them. This manuscript describes each policy in depth, considers economic and political elements that have shaped each policy, describes the level of program success, and offers suggestions for future research and program development.

Second-generation individual development account research: preliminary findings.

Historically, the poor have been excluded from asset-building policies, and consequently have accumulated very little wealth. The discrepancy between those with the highest incomes and those with the lowest continues to widen dramatically, with little hope of change unless asset-building polices are created to include the poor. Not only is this an issue of economic inequity, but of social and personal inequities as well. This paper describes the first year of a bi-state, longitudinal study that compares and contrasts specific measures of well-being between participants in Individual Development Account programs and low-income and low-wealth individuals who are not participating in an Individual Development Account program.