Arriving old: A qualitative study of elder refugee women's self-perceptions of the first year of resettlement.

This qualitative study examines eight elder women's experiences of resettling with their family and the protective factors that enhanced their resiliency. The implications for social work include the need to assess elder refugees' strengths, resilience, pre-resettlement functioning instead of services that might encourage integration into the dominant culture and community, and that the refugee experience is a lifelong experience that shapes and informs various stages of life.

Current realities and future vision: Developing an interprofessional, integrated health care workforce.

This article shares findings from an interprofessional symposium that took place in Boston in the spring of 2015. Educators and practitioners from various disciplines shared challenges, successes, and ideas on best interprofessional collaboration (IPC) and curricula development. The findings include the importance of patient-and-family-centered care, which includes the patient and his/her family in the decision-making process; increased education regarding IPC in universities and major hospitals; and educational opportunities within health care systems.

Self-perception of when old age begins for Cambodian elders living in the United States.

OBJECTIVE: To deepen the understanding of the life course of refugees this study explores the question: when do Cambodian elders perceive the beginning of old age? METHODS: In-depth interviews were conducted with 32 Cambodians, age range 53-82, who attended an elder day center in an urban setting in Massachusetts. Interviews were transcribed and analyzed using the modified grounded theory approach. RESULTS: The analysis revealed that the participants primarily reported two determinants to defining when old age begins: 1) the body "has too many illnesses" due to harsh working conditions; and 2) social role transition into grandparent. DISCUSSION: This study extends research on cultural differences in aging, specifically identifying the cultural difference in the definition of when "old age" begins. Age is culturally derived and creates expectations for social roles, health, self-identity, and behavior. Understanding how refugees experience the cultural discrepancies in their expectations of aging can inform providers who serve this population.

Social Workers' Views of Ways to Engage Communities in Refugee Resettlement.

The refugee crisis has been keenly felt by communities as they perceive the new arrivals as threats to the community's resources. Preparing the community for future arrivals can help, as can involving the community in the welcoming of refugees. This study explores how social workers engage communities to support refugee resettlement programs. Social workers are on the frontlines of providing services to refugees while also managing the fears and needs of the community members. A community that was once welcoming can become reactionary and xenophobic. This is a qualitative study using the content analysis of 32 social workers in four countries: the United States, Iceland, Switzerland, and Germany. Key factors influenced social workers' facilitation of community integration among new arrivals and community members: prior experiences with displaced populations, social workers' expectations, and strengths within the community. Social workers need training and support to include communities in resettlement services. Training and policy implications are discussed. Communities can be a partner in the resettlement process if care is given to work with the community before the arrival of new refugees.

Resiliency with Forced Migrants: A Qualitative Study of Providers and Forced Migrants through a Resilience Perspective.

In the last ten years, the world has experienced unprecedented, forced migration due to civil unrest, political persecution, and the ever-growing climate crisis. This is a qualitative study of the professional experiences of social workers (n = 73) working with forced migrants (n = 34) and the lived experiences of forced migrants in several countries: Germany, Greece, Iceland, Mexico, Switzerland, and the United States. Social workers reported that most of their interventions involved short-term case management that focused on securing initial housing and healthcare. Cognitive Behavioral Therapy (CBT) was the primary intervention for behavioral health issues. The recipients of these services were appreciative of the pragmatic approach of case management as it helped them meet concrete needs. When resiliency enhancing interventions were used, recipients reported a greater sense of self-control, greater optimism for the future, and less anxious symptoms. The resiliency model used is discussed. This is a possible universal approach to working with forced migrants.

Who cares for the caregivers? Why medical social workers belong on end-of-life care teams.

Changes within the health care industry have resulted in a shift that, to a large extent, places patients in the position of managing their own health care. While self-determination is desirable, it can also lead to new challenges, as when patients who are critically ill and/or dying must rely on family members to function as primary caregivers and managers of their treatment plans. Typically, patients and their families lack the guidance and oversight of a medical professional to coordinate a multifaceted health care regimen instituted by the variety of specialists involved in patients' diagnoses and treatments. As the patients' health declines and treatment plans become more complex, so too does the level of involvement of family caregivers, who often must manage treatment plans in addition to providing bedside care. This article cites the example of a woman who was exhausted by her role as sole caregiver for her dying husband and describes her feelings of powerlessness within the hospital setting as she struggled to coordinate assistance from her husband's medical specialists during end-of-life decision making. This case illustrates the importance of the following: (a) in cases involving hospitalized patients who require complex care from multiple specialists, it should become standard practice to enlist medical social workers to provide an overall assessment of the patients' status, prognoses, and home care plans, (b) in cases involving prolonged home care culminating in end-of-life decisions, the needs of nonprofessional caregivers must be recognized, evaluated, and addressed.

A qualitative study of the perceived effectiveness of refugee services among consumers, providers, and interpreters.

This study explored the perceptions of accessibility and cultural effectiveness of refugee services in the northeast region of the United States from refugees, interpreters who work with refugees in accessing these services, and the providers of the refugee services. The study examined the perceptions of 51 refugees from 10 countries, five individual interviews with providers and 26 provider survey responses representing 31 different agencies, and four interviews from interpreters. Qualitative interviews were conducted using a semi-structured interview schedule, were audiotaped, and transcribed. Further data were collected through a survey. All data were analyzed using constant comparative analysis. Participants shared feelings of frustration that services seemed poorly coordinated among the agencies and that the agencies appeared ill-prepared for the unique experiences of separate refugee groups. The three perspectives of refugee service delivery, as a consumer, a provider, or an interpreter, shared the perception that there was not a mechanism for the different services to collaborate effectively with each other, to create a network of coordinated services that would enhance services while decreasing burdens on individual centers, nor was there a system to best prepare the centers for new refugees.

A Qualitative Study of Older Adults and Staff at an Adult Day Center in a Cambodian Community in the United States.

PURPOSE: Adult day care programs in the United States are seeing an increase in culturally diverse patients. The purpose of this study was to better understand the subjective experiences of staff and Cambodian refugees attending an adult day center in the United States that provides services focused on the cultural needs of the older adults, such as Cambodian food, activities, and Cambodian staff. DESIGN: This is a qualitative study using grounded theory to analyze 10 individual interviews from staff members and 80 individual interviews from participants who attend an adult day care program for Cambodians in a city in the northeast United States. FINDINGS: Three primary themes emerged: The participants felt respected, there was a generational tension between the young staff and the participants, and the center acted as a cultural liaison between the medical providers and the participants.

Interpreters' subjective experiences of interpreting for refugees in person and via telephone in health and behavioural health settings in the United States.

Interpreters, whether in person or via telephonic means, are used in healthcare settings to aid communication between clinicians and clients when the same language is not shared. Refugees seeking health and behavioural healthcare often have multiple needs and experiences of trauma that can complicate the provision of services. Little is known about the interpreters' experiences in providing in-person and telephonic interpreting for refugees. This qualitative study sought to understand the subjective experiences of interpreters in providing in-person and telephone interpretations to refugees in healthcare settings in the United States. Constant comparative analysis was used to analyse the transcribed, audio-taped individual, semi-structured interviews of 36 interpreters. These interviews were conducted between July 2013 and July 2014. Two themes were identified: (i) the importance for the interpreter to develop trust with the client; and (ii) working with refugees requires more attention from the interpreter. The interpreters of this study describe experiencing additional challenges in working with refugees versus other clients. Recommendations based on the findings are made.