Stress and resilience in the oral histories of rural older women.

Oral history research has seldom focused on the reflections of rural older women. The purpose of this qualitative study was to identify: (a) stresses associated with major historical events that affected the lives of rural older women, and (b) strategies they used to deal with those stresses. Oral histories were gathered from a cross-section of 25 older women living in a small rural Midwestern community and analyzed using the method of constant comparison (Glaser & Straus, 1967). Content analysis revealed that economic hardship, disruption of family life, and fears and uncertainties were stressors associated with the Great Depression and world wars of the 20th century. Resilience was demonstrated by frugality, reliance on social supports, and acceptance. Implications for intervention with rural older women are discussed.

Health professions students' perceptions of interprofessional relationships.

PURPOSE: To make a preliminary assessment of the perceptions of health professions students about interprofessional cooperation. METHOD: Health professions students (588 students from eight professions) at the Iowa Geriatric Education Center's partner institutions received a questionnaire of demographics questions and the Interdisciplinary Education Perception Scale (IEPS). The IEPS is an 18-item questionnaire that uses a six-point Likert-type scale to measure attitudes toward interprofessional cooperation on four factors: competence and autonomy, perceived need for cooperation, perception of actual cooperation, and understanding others' value. RESULTS: Total mean IEPS scores differed significantly among professional groups (p =.001), with physician assistant students scoring highest (most positive attitudes) and chiropractic students scoring lowest. The medical students' mean total score was significantly lower than was that of physician assistant students (p =.003) and higher than was that of chiropractic students (p =.000), but medical students' scores did not differ significantly at the alpha =.05 level from those of osteopathy, physical therapy, nursing, podiatry, or social work students. CONCLUSION: This study provides the first normative data for the IEPS for students from these eight health professions. This instrument may be valuable when designing an evaluation scheme for training programs that have interdisciplinary components, which may be increasingly prevalent in the future.

Family support for hospice caregivers.

This qualitative study investigated family supports for primary caregivers of hospice patients, as perceived by both the primary caregiver and other family members involved in patient care. Family support was conceptualized in terms of (1) who offers support; (2) types of support; (3) frequency of support; (4) family communication; and (5) change in family relationship during the caregiving process. Twenty-four interviews were conducted with 10 primary caregivers and six family members identified by the caregiver as the person they could most call on for help. Interviews were conducted shortly after admission to hospice and approximately two months after the death of the hospice patient. Primary caregivers and other family members involved in care agreed that the primary caregiver provided most care. They also agreed that family members provided instrumental and emotional support, the frequency of assistance was appropriate, and families had grown closer since learning of the terminal illness. There was less agreement regarding family communication during the caregiving process. Implications for interventions with families of hospice patients are discussed.

Geriatric enrichment in social work education: lessons learned from the GeroRich projects.

The Geriatric Enrichment in Social Work Education (GeroRich) initiative was a critical step in addressing the national shortage of social workers interested in gerontological practice. Sixty-seven social work programs participated in the 3-year GeroRich project designed to infuse gerontological content into the BSW and MSW curriculum. This study analyzed the lessons learned by participating institutions about the curriculum enrichment effort. Five themes emerged from the qualitative analysis of GeroRich final reports: (a) obtaining faculty buy-in and faculty development, (b) increasing student interest and engagement, (c) developing community partners, (d) developing interdisciplinary linkages, and (e) facilitating institutional commitment and sustainability. The findings from this study provide valuable information on the implementation of curricular enrichment efforts in gerontology that can benefit social work and other health care disciplines.

Characteristics of nursing home social services directors: how common is a degree in social work?

PURPOSE: To report the percentage of nursing homes whose social services director has a degree in social work, to report the characteristics of social service directors, and to describe the characteristics of nursing homes most likely to employ a degreed social worker. These questions are important because social workers are core members of the interdisciplinary team in nursing homes and have responsibilities for the psychosocial well-being of residents. DESIGN AND METHODS: Cross-sectional nationally representative survey of 1071 social service directors employed in US nursing homes certified to receive Medicare and/or Medicaid. RESULTS: Most nursing homes do employ at least one (and typically only one) social service staff person. Most are employed full-time and half have a degree in social work. About 20% do not have a college degree. The vast majority of social service directors are white and are women. Close to 40% are licensed social workers. Full-time salaries varies enormously from less than $15,000 to over $60,000 per year. Most do not belong to an organization that helps them keep apprised of developments in nursing home social services. Using logistic regression and controlling for the effects of other independent variables, for-profit nursing homes with fewer than 121 beds, in sparsely populated counties in the West are the least likely to hire a degreed social worker as social service director. IMPLICATIONS: The wide range in educational preparedness and salary indicates 2 roles: a social work role and a social services role. The different roles have implications for initial role preparation and continuing education. Clear communication about the role expectations associated with social services and social work would benefit residents, family, staff, and physicians, who would then be better prepared to draw on their skills in helping to meet the psychosocial needs of residents.

An evaluation of the GeroRich program for infusing social work curriculum with aging content.

There is a national shortage of social workers who have the knowledge and skill competencies needed for practice with our rapidly growing older adult population. In the last decade, research has identified many reasons for the lack of interest in gerontological social work and steps that could be pursued within social work education to remedy the situation. The Geriatric Enrichment in Social Work Education (GeroRich) Program, funded through the John A. Hartford Foundation, engaged 67 social work programs throughout the United States in a process of curriculum change to increase the amount of gerontological content in the foundation social work curriculum. This study examined how the GeroRich program was instrumental in infusing gerontological content into the curriculum. Based on common outcome measures, the GeroRich program was found to be effective in (1) increasing the amount of gerontological content in the curriculum, (2) engaging faculty in the change process, and (3) exposing students to gerontological content. Relatively few variations were found among different program types or geographic settings. The model of curricular change implemented by the GeroRich program may be effective with other curriculum enrichment efforts.

Evaluating the outcomes of gerontological curriculum enrichment:a multi-method approach.

This study describes a multi-method approach to evaluating a gerontological social work curriculum enrichment initiative funded by the John A. Hartford Foundation. The project involved all required first year core courses in the BA and MSW curricula. Data were collected from students at three geographically dispersed academic centers of a School of Social Work at a major Midwestern state university. Evaluation instruments included quantitative pre- and post-tests to assess change in undergraduate and graduate students' gerontological attitudes, knowledge, and skills, qualitative and quantitative pre- and post- tests to evaluate an intergenerational service-learning option, and an open ended question to assess the gerontological content students had been exposed to in required core courses. Results for all students showed strong positive change in general attitudes toward elders, gerontological knowledge, and gerontological skills. There was only marginal support, however, for increased willingness to work with elders. Results for service learning students revealed positive reactions to the service-learning experience and a significant increase in gerontological knowledge.

A diffusion of innovations approach to gerontological curriculum enrichment: institutionalizing and sustaining curricula change.

This article describes a gerontological enrichment model for institutionalizing and sustaining curricular change utilizing Rogers' (1995, 2003) diffusion of innovations approach to organizational change. The goal of the project, funded by the John A. Hartford Foundation, is to transform the social work curriculum at a major state university so that age and intergenerational connections are important organizing principles in the diversity emphasis of the program. Components of the model include: (1) increasing faculty competence; (2) infusing gerontological/ geriatric competencies into all foundation courses; (3) community partner involvement; (4) intergenerational service-learning; (5) developing field and practicum sites; and (6) evaluation. Implications for gerontological/ geriatric education are discussed.