CAREGIVING is UbiquitousSANDRA EDMONDS CREWE, PHD, ACSW
My personal metaphor for caregiving is a bundle of tangled cords connectingvarious equipment and peripherals sometimes resulting in frustration and a senseof utter confusion. Social workers are often the ones to make sense of some of theconfusion. Caregiving is common to so many that we perhaps don’t unpack allof its effects on individuals, families and their neighborhoods and communities.The generation-to-generation exchange of information about caregivingsometimes hides its complexities (Gibson & Crewe, 2014). While families are atthe heart of caregiving in this country, they are supported or hindered by multipleinterlocking systems including health care, legal, financial, housing, criminaljustice, and more. Not only are caregivers relatives, they are also friends and other acquaintances as well.
The Work and Families Researchers Network define caregiving as “the act of providing unpaid assistanceand support to family members or acquaintances who have physical, psychological, or developmentalneeds. Caring for others generally takes on three forms: instrumental, emotional, and informational caring.Instrumental help includes activities such as shopping for someone who is disabled or cleaning for an elderlyparent. Caregiving also involves a great deal of emotional support, which may include listening, counseling,and companionship. Finally, part of caring for others may be informational in nature, such as learning howto alter the living environment of someone in the first stages of dementia.”
As implied by this definition, caregiving can take place both inside and outside of the home. Thus, the scopeof social work practice expands to all of the settings that caregiving takes place. In addition, social workersare present in the systems that support quality caregiving such as home health agencies.
The NASW Standards for Social Work Practice with Family Caregivers of Older Adults (2010) provideadded context for this discussion. According to the report, there are numerous challenges associated withfamilies who “struggle to provide physical, emotional, financial, and practical support to their agingmembers.” The role of caregiver is often defined by the tasks performed to enhance quality of life. Roles areas varied as the individuals who perform them and the recipients of the services. What seems to permeatethe caregiving experience is that it changes, in some ways—all parties involved—sometimes for better andsometimes for worse.
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IT’S A FACT: Profound changes in family structure have many four-and –five generation families.
Sandra Edmonds Crewe, PhD, ACSW, ChairHilary Quentin Bresner, LCSW, ACSWFanta Gibson, LMSWEdward A. McKinney, PhDJohn Paul Tuanqui Abenojar, MSW
AgingCommitteeMembers
NASW PRESIDENTDarrell Wheeler, PhD, MPH, ACSW
CHIEF EXECUTIVE OFFICERAngelo McClain, PhD, LICSW
NASW STAFFDirector, Professional andWorkforce DevelopmentRaffaele Vitelli, CAE
Specialty Practice Section ManagerYvette Mulkey, MS
Project CoordinatorRochelle Wilder
Rosalyn Carter, formerUnited States First Lady,stated there are onlyfour kinds of people in
the world:
Those who have beencaregivers.
Those who are currentlycaregivers.
Those who will be caregivers,and
Those who will need acaregiver.
Many of us relate strongly toher observation and as socialworkers see caregivers on thevarious stops on the continuumand the associated challengesand joys. As social workers, itis important that we provide abridge that helps to make thecaregiving experience morepositive during all of its variousstages. Many caregivers areconfused about their feelings
and the available resources.Social workers should embracethe NASW slogan “Help StartsHere.” We do this by informingourselves about caregiving andlearning from the uniqueexperiences of each person weencounter. Through their storiesand translation to practice, weare positioned to make adifference in what is oftenconsidered by the caregiver aslonely and overwhelming. Toooften, the joy emerges in a postreview of the experience.
Today, more than ever,caregiving for and by olderpersons is front and center inthe lives of the families andindividuals that social workersserve. Caregiving and agingare inextricably linked. Olderadults are both caregivers andcare receivers and often carefor each other. The older carereceiver-caregiver dyad
requires that social work beespecially vigilant aboutunderstanding and meeting theneeds of both parties in therelationship. Not only are olderpersons caring for each other,they are caring for youngeradults as well as children.
A 2015 research report onCaregiving in the United Statesby AARP and the NationalAlliance for Caregiving affirmsthat caregivers are diverserepresenting every age,gender, socioeconomic statusand racial/ethnic group. Thisstudy reports that approximately34.2 million Americans haveprovided unpaid care for anadult over 50 in the past year.And of particular importance isthat caregivers’ responsibilitiesoften extend beyond thetraditional ADLs and IADLs.While many report theircaregiving responsibilities as
choice or obligation, others feelthey had no choice. Of importantnote is that those who hadchoice report higher stress. Forsocial workers, a particularlysalient finding of this researchis that caregivers are nothaving conversations withhealth care providers includingsocial workers about complexcare situations and self-care.
Social workers are alsocaregivers. They too canbenefit from the professionalconsultation of their peers. Theyare not immune from the stressesthat are often associated withcaregiving and often experienceprofessional embarrassmentwhen they confront challengesin their personal lives (Gibson& Crewe, 2016). Thus, self-care is also an importantdimension of caregiving thatdoes not receive adequateattention. Formal and informal
been brought on by the increase of longevity, which has resulted in
self-care resources areimportant parts of the tool kitfor social workers who providesupport to caregivers and theprofessionals who servecaregivers.
Our aging specialty practicecommittee has chosen to devotethe next two issues to thisimportant topic of caregiving.Using both a micro and macrolens, the authors delve intoaspects of caregiving thatsocial workers face on a dailybasis. These topics are intendedto stimulate conversation aboutstrategies and effectivetechniques related to supportingindividuals, families, andcommunities with caregivingneeds. The articles in this issuefocus specifically on guilt,nursing homes and advocacyfor home care workers.
Many social workers can relateto the guilt associated withdecisions surroundingcaregiving. These feelings of
guilt are influenced by the lifecourse and relationships. Theyfind their way into the lives ofcaregivers. Hilary Bresneraddresses laying the groundworkto minimize guilt in her article.
Nowhere is guilt more evidentthan in long-term care. Socialwork practice in nursing homesis an area where skills andadvocacy are required tosupport the transition. John PaulAbenojar shares his experienceas a social worker in thisenvironment and emphasizesthe importance of navigatingmultimorbidity and crises.
Finally, Edward McKinneyreminds us that human rightsand social justice are embodiedin the core values of socialwork. He focuses on the homecare worker and emphasizesthe important role that they playin caregiving and makes itclear that social workers have anatural alliance with thesemembers of the caregiving
team and employs us to supportpolicies that respect theirgeneral welfare. By doing this,we contribute greatly to qualitycare for older persons andolder caregivers.
As we explore caregivingthrough the lens of social work,we hope that you will identifyresources that will assist insupporting those you serve aswell as yourselves.
Sandra Edmonds Crewe, PhD, ACSW,is dean and professor of social work,Howard University, Washington, DC.She is also director of the HowardMultidisciplinary Gerontology Center.
REFERENCESAARP Public Policy Institute &
National Alliance forCaregiving (2015).Caregiving in the U.S.Available online:www.caregiving.org/wp-content/uploads/2015/05/2015_CaregivingintheUS_Final-Report-June-4_WEB.pdf.
Gibson, P. & Crewe, S.E.(2014). Introduction tospecial edition on relativecaregivers. Reflections 20(3).Available online:www.reflectionsnarrativesofprofessionalhelping.org/index.php/Reflections/article/view/1451
National Association of SocialWorkers (2010). NASWStandards for Social WorkPractice with FamilyCaregivers of Older Adults.Available onlinesocialworkers.org/practice/standards/NASWFamilyCaregiverStandards.pdf.
Work and families researchersnetwork. Definitions.Retrieved January 2016online: https://workfamily.sas.upenn.edu/glossary/c/caregiving-definitions.
2016 INTERSECTIONS IN PRACTICE Call for Articles Intersections in Practice, the annual bulletin of the National Association of Social Workers (NASW) Specialty Practice Sections(SPS) will be accepting submissions for the 2016 publication, The Role of Social Work in Promoting Social Change until August 1,2016. Submissions should focus on how social work and social work practice can be used for social change.
Article submissions should follow the author guidelines set forth for the Specialty Practice Sections. Articles should contain timely,practice related content applicable to one of the following Sections: Administration/Supervision; Aging; Alcohol, Tobacco and OtherDrugs (ATOD); Children, Adolescents, and Young Adults (CAYA); Child Welfare; Health; Mental Health; Private Practice; SchoolSocial Work; Social and Economic Justice and Peace (SEJP); Social Work and the Courts.
Visit www.socialworkers.org/sections for Author Guideline details.
Guilt has a purpose inlife. If we are mean, weshould feel guilty. If weowe someone an
apology, we should be bigenough to do so. But guilt is acomplicated emotion. We takeon the expectations of ourculture, our religion, our family.And then we take on theexpectations of our toughestcritic: ourselves. That committeethat meets in our head tells uswe are not doing thiscaregiving thing well enough. If we were “good” people,we’d just keep answering thephone endlessly until Momfound something else to do.
The above quote, from CarolBradley Bursack, an elderconsultant, sums up the feelingsmany caregivers have.
One of the most difficult issuesfor a caregiver is how she or hecan set boundaries withoutfeeling guilty. In my jobworking for a health careorganization, both the patientand the family member oftenask me this question. As a
licensed clinical social worker,I became interested in helpingbaby boomers to find thesupport they need to continueproviding care to their lovedones while maintaining theirown lives. Some of the otherquestions I am asked are:Should I move in with myfather? Should I quit my job tocare for him? Can I be paid tobe his caregiver? Is he able tolive independently? Does hehave the finances to move to afacility? What do I do if myparent needs help and I don’tlive nearby?
These questions are just someof the tough decisions caregiversare forced to make. I oftenwonder how hard I will findthese decisions when the timecomes to assist my own parents.
As social workers working withbaby boomers, we know thatone of our goals is to providethe necessary support andresources to family membersstruggling to answer the toughquestions. I find NASW to berich with resources and various
means of support that I provideto my members’ families. First,it is necessary to find out whateach of our own states offers interms of support, caregiving,and laws. In Colorado,financial assistance can beprovided to family memberswho complete a caregivingcourse. Some of the nationalresources I highly recommendturning to agencies forassistance, and I suggest thatall of us provide these agencyresources to the communitieswe serve.
It is most critical to begin opencommunication early in theaging process to ensure that thecaretaker’s and the caregiver’sneeds are met. It is vital to havespecific plans in place. Hereare some topics that need to beconsidered and discussed: Isthere long-term health care?What is the financial situationof both parties? Does the lovedone find it essential to stay inhis home, or does a lessindependent lifestyle bettermeet his needs? Does he haveinsurance, and what is beingprovided to him through hisplan? Are there multiplecaregivers? If so, what willeach person’s role be?
In my experience as a socialworker, I have found that when
this groundwork is laid before acrisis develops, the transition issmoother and all parties feelmore comfortable—andexperience less guilt.
Hilary Bresner, ACSW, LCSW, hasexperience working with adolescents,adults, older adults, couples, groupsand families. She helps clients reachnew levels of happiness through self-exploration and personal growth. Shecan be reached [email protected].
REFERENCEBursack, C. Feel at peace: Lose
the caregiver guilt. Retrievedfrom www.agingcare.com/Articles/caregiving-guilt-stop-feeling-guilty-126209.htm
AGENCY RESOURCES• AARP• A Place for Mom• Center for Medicare
Advocacy • Medicare.gov • National Alliance for
Caregiving,• National Association of
Area Agencies on Aging• U.S. Living Will Registry• Visiting Nurse Associations
of America
GUILT in CaringHILARY BRESNER, ACSW, LCSW
INTRODUCTIONThe current occupational crisisamong home health careworkers has potential negativeimplications for the olderpopulation. For instance,workers carrying out their dailyduties could become distractedby some of the occupationalinjustices that exist in anindustry where workers areroutinely undervalued. Toensure that patients arereceiving the highest quality ofcare, workers need to be asfree as possible from dailyoccupational stressors. Socialwork advocates, historicallyrecognized as social changeagents, are needed to ensurethere are occupational policiesin place that allow workers toperform their duties with theminimum amount of stress.
DUTIES, PROFILE, AND THEINCREASING DEMAND FORHOME HEALTH CARE WORKERSHome health care workersprovide care for older adults,including those with disabilities.Duties include monitoringhealth status, administeringmedications, helping withfeedings, assisting mobility,changing medical dressings,accompanying patients to their
appointments, and helping withexercise routines (Woodrum,2015). Although it is seldommentioned, workers provide alevel of companionship,especially for those with suchproblems as isolation, loneliness,and depression—all of whichare frequently observed in anaging population.
Ninety percent of home healthcare workers are female, andone-third of all workers arepeople of color. This industry isjust another example of apredominantly female andgrossly undervalued occupation.Forty-four percent receive someform of public assistance, 50percent earn less than $9.46per hour, and 40 percent earnless than the median hourly wagefor all occupations: $16.47(Woodrum, 2015). Fifty percentor more are without healthinsurance or other traditionaloccupational benefits, such asfor retirement. As the agingpopulation continues to increase,so too will the demand forworkers. In 2014 there were913,000 home health careworkers, and the projections for2050 are 1,261,900, anincrease of 38 percent (U.S.Department of Labor, 2015).
FACTORS CONTRIBUTING TODEMOGRAPHIC GROWTHAND DEMAND FOR HOMEHEALTH CARE WORKERSThe astronomical growth in thepopulation of adults who areages 65 and older, includingthose 85 and older—the fastest-growing group among theaging population—can beattributed to the baby boomers.These individuals were bornbetween 1946 and 1964, andthey began to turn 65 around2011. By 2050, those survivingbaby boomers will have reachedthe 65-plus category. The 65-plus population will doublebetween 2012 and 2050, from43 million to 83.7 million(Census Bureau, 2014). Otherfactors, such as advances inmedicine and public health,especially health educationpractices, and improvements in
the overall standard ofliving have played amajor role in thedramatic increase in lifeexpectancy. Also, socialpolicies and programs—suchas Social Security, Medicareand Medicaid, AffordableHealth Care, Older AmericanActs, social and healthprograms, and especially foodand nutrition programs—havealso contributed significantly.Currently, Medicare andMedicaid funds 80 percent ofhome health care services(Woodrum, 2015).
The growth of the 65-pluspopulation will continue to havea significant impact on familiesas well as on the health, medical,economical, and politicalsystems. The preference of themajority of older persons is to
THE OCCUPATIONAL CRISIS OFHOME HEALTH CARE WORKERS:Implications for a Growing Older PopulationEDWARD A. MCKINNEY PHD, MPH, MSW
live in their own homes andcommunities as long as it isreasonable to do so, a practicereferred to as “aging in place”(AARP, 2011). The goal of theOlder American Act, as outlinedin its policies and programs, isto foster and support aging inplace. If this is indeed the goal,then adequate funding andsupportive services, includinghome health care, are needed.Studies indicate that home careis more effective than living in anursing home—and lessexpensive (U.S. Department ofLabor, 2015).
OCCUPATIONAL PROBLEMS OFHOME HEALTH CARE WORKERSIn addition to low wages, theproblems for workers includeunpredictable working hours, nocompensation for overtime—primarily due to a lack ofsufficient record-keeping—highturnover rates, and no travelallowance. Most important isthe lack of a collectivebargaining system foraddressing grievances andconcerns, such as insufficientwages and the absence of suchbenefits as health care, sickand vacation leave time, andretirement benefits. The need towork one or two jobs to makeends meet is a major problemamong these workers. In thewords of one employee: “But Ineed the night shift—I have towork 60 hours to pay the rent.”In the words of a family member:“These women…keep our lovedones healthy, but they themselvesoften don’t get benefits likehealth insurance and retirement”(Patton, 2015, p. 3).
LEGISLATIVE INITIATIVES TOSUPPORT THE PLIGHT OF HOMEHEALTH CARE WORKERSIn recent months, home healthcare workers, with support from
organized labor, have beencalling on politicians to raisethe minimum wage to $15.00per hour. Two candidates forpresident have expressedsupport. Bernie Sanders wouldlike the minimum wage raisedto $15.00 per hour by 2020,and Hilary Clinton would liketo see minimum waged raisedto $12.00 per hour with notimeline (National Alliance forCaregiving, 2015). TheDepartment of Labor hasintroduced a set of new rules tobe included in the Fair LaborStandards Act. The rules wouldrequire that a federal minimumwage be paid to all workers, aswell as payment for all hoursworked, including overtime,travel time, and overnight shifts.They would also require thatworkers complete time sheetswith a specific definition ofwhat constitutes work. A federaldistrict court has vacated theaforementioned rule changesfrom the act, but the Departmentof Labor is appealing thatdecision to a federal appealscourt (Patton, 2015).
Several states and cities havetaken the initiative to raise theminimum wage this year.Although these efforts are noted,they do not take away the needfor a federal uniform policywith a time frame and a dollaramount defining the minimumwage. Twenty-one statescurrently do not require aminimum wage beyond thefederal level of $7.25 (NewYork Times, 2015). New York isan example of why a federalpolicy is necessary. The minimumwage for workers in the fastfood industry and stategovernment was increased to$10.50 by the end of 2015and to $15.00 by 2018. In therest of the state’s occupational
industries, the increase to$15.00 will not occur until2021 (New York Times, 2015).
SOCIAL WORK ADVOCACYHuman rights and social justiceare foundational to the valuesand ethics of the social workprofession. Part of this is thebelief in the worth and dignityof every human being, includingthe undervalued women andminority workers in the homehealth care industry. Theprofession’s values and ethicsare compatible with the UnitedNations Declaration of HumanRights, Articles 23 and 25; theycall attention to the right to ajust and favorable remunerationfor one’s work, the right to astandard of living adequate forhealth and well-being, and theright to collective bargainingfor improving workingconditions. The values andethics of the profession providesocial workers with thejustification and incentivesneeded for a call to action onbehalf of the rights of homehealth care workers.
Advocacy efforts should includethe monitoring of aging policiesto determine their relevancy inlight of population growth trends.The analysis and conclusionsshould be shared with publicofficials and other stakeholders.Based on findings, advocatesshould recommend modificationsin existing policies and offerrecommendations for newlegislative initiatives in responseto demographic trends andresulting concerns.
Edward A. McKinney, PhD, MPH,MSW, is professor emeritus at theCollege of Liberal Arts and SocialSciences, School of Social Work, atCleveland State University. He is alsoa member of the NASW AgingSpecialty Practice Section committee.
REFERENCESAARP. (2011, December).
Aging in place, state surveyof livability policies. ResearchReport by the NationalConference of StateLegislators – Nicholas Farberet al, AARP Public PolicyInstitute, Washington, DC.
National Alliance forCaregiving. (2015, Fall).“Discussion by thepresidential candidates.” The Caregiving Exchange.
New York Times. (2015,December 26). Newminimum wages in the newyear [Editorial].
Ortman, J., Velkoff, V., Hogan,H. (2014, May). An agingnation: The older populationin the United States. U.S.Department of Commerce,Census Bureau, PopulationEstimates and Projections.
Patton, W. (2015, June). Newrules for home care workers.Policy Matters Ohio.[Online]. Retrieved from:www.policymattersohio.org
U.S. Department of Labor,Bureau of Labor Statistics.(2015, December 17).Occupational outlookhandbook: Home healthaides. Washington, DC:Author.
Woodrum, A. (2015, Spring).Low wages, high turnover inOhio’s home-care industry.Policy Matters Ohio.[Online]. Retrieved from:www.policymattersohio.org/homecare
It has been said that thecharacter of any society isrevealed by how that societycares for its most vulnerablemembers—typically the veryyoung, the disabled, and theelderly. Aligning with andobserving this principle isparticularly poignant for thosein the health care field ingeneral and the social workprofession in particular. From itsinception, social work, aspracticed by its founders MaryRichmond and Jane Addams,has been dedicated to elevatingthe living conditions and well-being of those least able to doso for themselves. The coremission of social workersincludes providing service,justice, dignity, humaninteraction, integrity, andcompetence to this population(Bradley, Machi, O’Brien,Morgen, & Ward, 2012).Although social workers can befound serving in many contexts,circumstances, and capacitieswith vulnerable, oppressed,and poor populations and agegroups, the primary challengefor nursing home social workersis how to improve educationand advocacy (NASW, 2005).
Forging ahead in these areas,as it turns out, has proven to bedaunting, in part because ofmany obstacles. For example,Kane (2003) discussed theincreasing numbers of olderpersons in long-term carefacilities/nursing homes whoseneeds are not being met. Onereason for this situation is thatmost nursing home residentspossess either multiple chronicdiseases or a condition on thespectrum between physicalmorbidity and cognitivemorbidity (Centers for Medicare& Medicaid Services [CMS],2013). Chronic diseases arepersistent diseases—such ascardiovascular disease, cancer,bronchitis, diabetes, depression,dementia, and Alzheimer’sdisease—that affect individualsfor a long time; they areresponsible for 70 percent ofall deaths in the United States(Centers for Disease Controland Prevention, 2015).Another term for chronicdisease is “multimorbidity.”Most adults in nursing homeshave multimorbidity: 75 percentof all adults 65 years old orolder have multiple chronicconditions (Tinetti, Fried, &Boyd, 2012). Additionally,CMS reported in 2013 that
there were approximately 1.4million residents living in15,700 nursing homes in theUnited States. At that time, ahigh percentage of thoseresidents needed daily assistancewith bathing (96.1 percent),dressing (90.9 percent),toileting (86.6 percent), andeating (56 percent), because48.5 percent of nursing homeresidents had some form ofdementia, including Alzheimer’s,as well as physical disabilities.Also notable in this context wasthat 35 percent were between65 and 85 years old, 42.3percent were 85 years old andolder, and 7.7 percent wereover 95 years old. Additionally,36.6 percent had mild cognitiveimpairment, 63.4 percent of theresidents had both cognitiveand functional impairment, and15.8 percent had severecognitive and functionalimpairment. In a study of 1,817nursing home residents whodied between 1992 and 2006,the mean age of decedents was83.3, the mean length of staywas five months, and 53 percentdied within six months ofplacement (Kelly et al., 2010).
Because a multifacetednursing home life is agiven, social workersmust be able to properlyassess psychosocial needs:physical and psychosocialstatus, spiritual preferences,values, satisfactions, socialfunctioning, and quality of life(Allen, Nelson, Netting, & Cox,2007); however, this assessmentmay not be possible—oreffective—given multimorbiditystatus. Thus, social workersthemselves may experiencegaps between what is expectedof them and what they actuallydo or are supposed to do(Koren & Doren, 2005).Multimorbidity makes takingaction by a multidisciplinarynursing home staff complicated,because the clinical reality isthat successful treatment andmanagement of multimorbidityis uncertain and, more likely,potentially harmful, as there areunintended consequences ofsimultaneous treatment. Thisunderscores the importance ofcommunicating the tradeoffs oftreatment options to residentsand their families, and helpingto guide shared decision-
making (Tinetti et al., 2012).This process would be easier ifthere were only a singlemorbidity to consider. However,treatment within the nursinghome adds to the complexity,because at least two specialiststreat each of the residents,sometimes with conflictingtreatment plans. Moreover, thecombination of physical frailty,poor health, and dementia inmost of the residents creates asituation in which there is ahigh risk of traumatic crisis frominjury or chronic disease from afall, for example, resulting inhip fracture and other potentiallylife-threatening injuries.
As baby boomers age, therewill be an increase in nursinghome placement. Finding theright placement in the righthome can be traumatic to thesenior—as well as to their lovedones—and this trauma can bemost commonly felt in the lossof independence, privacy, andautonomy. Social workers needto support and be an advocatefor future residents and familymembers so that they willhandle this transition and theinevitable traumas and crises tocome; I would call this kind ofsupport “Nursing Home 101.”This includes explaining thedaily routine and expectation—in other words, getting
everyone involved on the samepage so that misunderstandingand confusion can be prevented.Involving family members canserve as a best resource to planand execute the individualizedcare of each resident.
John Paul T. Abenojar, MSW, is adirector of social services at TheJefferson, a Sunrise Senior Community in Arlington, Virginia. He can be contacted [email protected].
REFERENCESAllen, P.D., Nelson, H.W.,
Netting, F.E., & Cox, D.M.(2007). Navigating conflict;A model for nursing homesocial workers. Health and Social Work, 32(3),231–234.
Bradley, C., Machi, T., O’Brien,H., Morgen, K., & Ward, K.(2012). Faithful but different:Clinical social workers speakout about career motivationand professional values.Journal of Social WorkEducation, 48(3), 459–477.
Centers for Disease Control andPrevention (CDC). (2015).Chronic disease preventionand health promotion.[Online]. Retrieved fromwww.cdc.gov/chronicdisease/index.htm.
Centers for Medicare andMedicaid Services (CMS).(2013). Nursing home datacompendium 2013 edition.Washington, DC: Departmentof Health & Human Services.
Kane, R.A. (2003). Definition,measurement, and correlatesof quality of life in nursinghomes: Toward a reasonablepractice, research, and policyagenda. The Gerontologist,43(2), 28–36.
Kelly, A., Conell-Price, J.,Covinsky, K., Cenzer, I.S.,Chang, A., Boscardin, W.J.,& Smith, A.K. (2010). Lengthof stay for older adultsresiding in nursing homes atthe end of life. Journal of theAmerican Geriatric Society,58(9), 1701–1706. doi:10.1111/j.1532-5415.2010.03005x.
Koren, C., & Doren, I. (2005).The social worker’s role inhomes for the aged: The real,the ideal, and the gapsbetween. Journal ofGerontological Social Work,44(3/4), 95–114.
National Association of SocialWorkers. (2005). NASWstandards for clinical socialwork in social work practice.Washington, DC: Author.
Tinetti, M E., Fried, T.R., &Boyd, C.M. (2012).Designing health care for themost common chroniccondition—multimorbidity.Journal of the AmericanMedical Association,307(23), 2493–2494.
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Did You Know?
Baby boomers have assumed
leadership roles during their lives.
They often find themselves as
caregivers, squeezed in between
caring for younger loved ones such
as children and their elderly parents
or other elderly family members.
Call for Social Work Practitioner Submissions
NASW invites current social work practitioners to submit brief articles for our specialty practice publications. Topics must be relevant to one or more of the following specialized areas:
For submission details and author guidelines, go toSocialWorkers.org/Sections. If you need more information, email [email protected].
• Administration/Supervision• Aging• Alcohol, Tobacco, and
Other Drugs• Child Welfare• Children, Adolescents,
and Young Adults
• Health• Mental Health• Private Practice• School Social Work• Social and Economic
