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CSWE Annual Meeting: San Francisco, CA October 30, 2007. Cultivating social work expertise with older adults in rural settings: Lessons learned from implementing the Hartford Partnership Program for Aging Education. Fran Wilby, University of Utah School of Social Work

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slide1

CSWE Annual Meeting:

San Francisco, CA

October 30, 2007

Cultivating social work expertise with older adults in rural settings: Lessons learned from implementing the Hartford Partnership Program for Aging Education

Fran Wilby, University of Utah School of Social Work

Linda Durham, The Ohio State University College of Social Work

Nancy Kelly, University of Maine School of Social Work

Jarmin Yeh, Social Work Leadership Institute, New York Academy of Medicine

www.socialworkleadership.org

the utah hartford partnership program for aging education
The Utah Hartford Partnership Program for Aging Education

Challenges of Rural Implementation of the John A. Hartford Foundation Hartford Partnership Program for Aging Education

www.socialworkleadership.org

challenges opportunities unique to utah
Challenges/Opportunities Unique to Utah
  • Population 2,246,553
  • Of 28 counties only 5 are urban
  • One predominant religion
    • 53% of population in Salt Lake City
    • 75% in rural areas
  • Overall lack of diversity in population
    • 95% white
  • Projected life expectancies higher than national projections

www.socialworkleadership.org

challenges continued
Challenges Continued
  • Rural communities are aging
  • Limited access to public transportation, healthcare and other social services
  • Older adults falling through

the “cracks” of social services

  • Youngest state in the nation
  • Isolation issues
  • Changing face of rural communities

in age and diversity

www.socialworkleadership.org

benefits of rural settings
Benefits of Rural Settings
  • Social Workers have interpersonal ties with most government and private systems
  • Able to easily access and affect systems
  • Presence within community

www.socialworkleadership.org

neighbors helping neighbors host site for hppae students
Neighbors Helping NeighborsHost site for HPPAE students

The mission of NHN is to improve the health,

safety and quality of life of older adults living in

this community by promoting independent living

by means of community partnerships among

neighbors, local businesses, and neighborhood

organizations.

www.socialworkleadership.org

interfaith council and neighbors helping neighbors initiative
Interfaith Council and Neighbors Helping Neighbors Initiative
  • Host site, Neighbors Helping Neighbors will partner with Interfaith Council
  • HPPAE students will play integral role in assessment and provision of services to participants
  • Religious leaders will provide volunteers to assist in providing home-based care

www.socialworkleadership.org

action plan
Action Plan
  • Receive call from a religious leader that a senior adult is having problems.
  • Send out one social work HPPAE intern to accompany the clergy to do an assessment which includes assessing both emotional and physical needs.
  • Social work HPPAE intern assumes role of care manager.
  • Make a decision about a care management plan which includes the older adult, family members, and community resources.

www.socialworkleadership.org

action plan continued
Action Plan Continued
  • Support caregivers already working with senior adults.
  • Follow through with the plan and know what is happening each week!
  • Contact religious leaders to provide additional support through the use of volunteers.

www.socialworkleadership.org

rural states have unique opportunities
Rural States have Unique Opportunities
  • Focus on the positive
  • Optimize the resources available
  • Be open to innovative partnerships
  • Celebrate your rural heritage

www.socialworkleadership.org

careers in aging week
Careers in Aging Week
  • HPPAE students present highlights of their experiences during Careers in Aging Week
  • Possibilities are endless!

www.socialworkleadership.org

virginia e richardson holly dabelko and lisa durham
Virginia E. Richardson

Holly Dabelko and

Lisa Durham

The Ohio State University College of Social Workin partnership with theCentral Ohio Area Agency on AgingColumbus, Ohio

www.socialworkleadership.org

www.socialworkleadership.org

goals of partnership
Goals of Partnership

To enhance aging services in rural counties

To train more geriatric social workers in culturally-competent rural social work practice

To increase the number of geriatric social workers employed in Ohio’s rural counties

To develop more geriatric field placements in these rural counties

www.socialworkleadership.org

www.socialworkleadership.org

counties used for hppae
Counties used for HPPAE

Fairfield County - 15% are 65+

Fayette County - 19% are 65+

Licking County - 16% are 65+

Madison County -15% are 65+

www.socialworkleadership.org

www.socialworkleadership.org

characteristics and needs
Characteristics and Needs

Poverty rates

Living alone

Disability rates

Scarce Services and Health Practitioners

www.socialworkleadership.org

www.socialworkleadership.org

social services and health practitioners
Social Services and Health Practitioners

www.socialworkleadership.org

www.socialworkleadership.org

osu hppae enhancing elders and development through elder rural services e l d e r s
OSU HPPAE: Enhancing Elders and Development through Elder Rural Services (E.L.D.E.R.S.)

Assign students to counties and rotate them through selected programs (see next slide)

Expand the roles of field supervisors and faculty liaisons with in-county liaison meetings

Offer team-taught didactic seminars

Recruit appropriate MSW students to the program

Evaluate the efficacy of the program

www.socialworkleadership.org

www.socialworkleadership.org

rotations
Rotations

Rotation A: Orientation

Rotation B: Well-Elderly

Rotation C: Functionally-Impaired

Rotation D: End-of-Life Care

www.socialworkleadership.org

www.socialworkleadership.org

programs involved
Programs Involved

Senior Centers

PASSPORT (Pre-Admission Screening Providing Options and Resources Today)

VGP (Voluntary Guardianship Program)

NFCSP (National Family Caregiver Support Program

Hospices

www.socialworkleadership.org

www.socialworkleadership.org

central ohio area agency on aging coaaa
Central Ohio Area Agency on Aging (COAAA)

VISION - a community leader that understands that complex issues involved with aging and offers a well-funded range of services offering choices in long term care that support a high quality of life.

MISSION - to plan, coordinate and advocate for the development and delivery of services for older adults, families and the community.

GOALS - to increase awareness of the aging process, aging issues, and COAAA program; to improve access to quality in-home care; to develop long-term care services; to expand community services; to ensure that minority elderly are aware of senior services offered with cultural competence.

www.socialworkleadership.org

www.socialworkleadership.org

passport
PASSPORT

Ohio Medicaid-Waiver Program

Nursing Home Diversion Program

In-home services to Eligible Seniors

www.socialworkleadership.org

www.socialworkleadership.org

nfcsp
NFCSP

Information and referral

Training

Counseling

Support groups

Other related supplemental services.

www.socialworkleadership.org

www.socialworkleadership.org

slide23
VGP

Matches qualified volunteers with people who need a substitute decision maker, but who are without family or assets.

Volunteers become “guardians” of the person or individuals whose mental impairment incapacitates them and are unable to care for themselves or make sound personal decisions. Special emphasis placed on nursing home residents.

www.socialworkleadership.org

www.socialworkleadership.org

successes and outcomes
Successes and Outcomes

Dispelling Myths

Outcomes

Challenges and Lessons Learned

www.socialworkleadership.org

www.socialworkleadership.org

dispelling myths
Dispelling Myths

A great deal of effort was put forth by our students to reduce the amount of misperceptions regarding rural communities

Specifically, in relation to access to services and professional social workers

Culture/diversity in each community

www.socialworkleadership.org

www.socialworkleadership.org

challenges and lessons learned
Challenges and Lessons Learned

Variability across rural counties

Dispel myths about rural aging

Discontinuity in long term care in rural counties and emphasis on nursing home care; limited informal supports

www.socialworkleadership.org

www.socialworkleadership.org

lessons learned and challenges cont
Lessons Learned and Challenges (Cont.)

Lack of knowledge and awareness especially among caregivers

Dearth of social workers especially well-trained social workers

Funding problems in rural areas and limited health and social services

www.socialworkleadership.org

www.socialworkleadership.org

lessons learned and challenges cont1
Lessons Learned andChallenges (Cont.)

Neglect of Mental Health Issues

Limited Clinical Interventions

More Advocacy Needed

www.socialworkleadership.org

www.socialworkleadership.org

university of maine center on aging school of social work

University of MaineCenter on Aging/School of Social Work

Cultivating Social Work Expertise With Older Adults in Rural Settings

October 30, 2007

www.socialworkleadership.org

maine s rural nature
Maine’s Rural Nature
  • Third most rural state in country
  • Over 55% live in rural areas
  • 39th in geographic area
  • 40th in population (approx. 1,322,000)

www.socialworkleadership.org

special characteristics land
Special Characteristics: Land
  • Approximately 5,000 miles of marine coastline, including hundreds of islands
  • Majority of inhabited islands are accessible by boat only
  • Northernmost county is east of Mississippi but has population of only 73,240

www.socialworkleadership.org

economic considerations
Economic Considerations
  • Maine is divided into 2 very different parts, “wealthier southern” and “the rest”
  • Maine is ranked as having the highest tax burden of any U.S. state
  • 11.5% Mainers are living in poverty

www.socialworkleadership.org

demographics
Demographics
  • Oldest state in nation with average age of 41.2 years
  • 14.6 % of Mainers 65+ ( app. 193,000)
  • 96.5% non-Hispanic white - tied with Vermont for the most homogeneous state in nation
  • Three Native American reservations in eastern Maine representing 4 distinct tribes, one within a few miles of university

www.socialworkleadership.org

special characteristics people
Special Characteristics: People
  • Professional community is generally non-competitive and friendly
  • New programs like HPPAE are generally met with enthusiasm rather than distrust
  • Large percentage of supervisors in agencies have ties to UM SSW
  • Most graduates stay in Maine to work
  • Implementing change often not overwhelming challenge

www.socialworkleadership.org

school of social work
School of Social Work
  • Relatively small school with 60-70 full and part-time advanced year MSW students between main campus and satellite program in Belfast, Maine
  • Students from all over the state, including the Maritime Provinces in Canada
  • One of 3 MSW programs in Maine

www.socialworkleadership.org

rationale for hppae model
Rationale for HPPAE Model
  • Advanced generalist program training students to work in settings where practitioners assume many roles
  • Very few specialized agencies
  • Wide based knowledge of needs and services critical to best serving Maine’s geriatric population
  • Need to train students to be “watchdogs” for clients and therefore essential to understand political processes as well as policies

www.socialworkleadership.org

realities of social work practice in rural maine
Realities of Social Work Practice in Rural Maine
  • Agency staff assume multiple roles
  • Lack of collegial support in many settings due to isolation
  • Few professional and educational opportunities

exist

  • Lack of services for clients results in staff frustration
  • Lack of transportation is a major issue for clients trying to access services

www.socialworkleadership.org

challenges field
Challenges : Field
  • Few agencies deal primarily with older adults
  • Budget cuts result in fewer staff to supervise students
  • Rotation model involves many agencies from wide geographic area

www.socialworkleadership.org

challenges field cont
Challenges : Field - cont.
  • Model is labor intensive
  • Geography can be a barrier to student participation
  • Experiences with diverse groups

must be sought out

www.socialworkleadership.org

field lessons learned
Field : Lessons Learned
  • Be creative
  • Start small and expand in succeeding years
  • Program’s reputation brings new supervisors on board

www.socialworkleadership.org

field lessons learned cont
Field: Lessons Learned - cont.
  • Supplement diversity experiences via guest speakers and field trips
  • Still labor intensive but making contacts all over state
  • Develop alternative ways of letting students participate for whom geography is an issue

www.socialworkleadership.org

challenges academic
Challenges : Academic
  • Due to size of school and budget, there is an identified need for more electives in aging
  • Size of school hasn’t allowed for gerontology specialization

www.socialworkleadership.org

academic lessons learned
Academic : Lessons Learned
  • HPPAE has provided opportunity for gerontology specialization
  • HPPAE recruitment easy due to word of mouth and access to student body
  • Many more students than we thought are interested in aging

www.socialworkleadership.org

academic lessons learned1
Academic : Lessons Learned
  • Because of HPPAE, SSW now has a geriatric field seminar and will be offering clinical geriatric courses
  • Use outside speakers such as members of consortium and others
  • Sponsor conference annually and invite HPPAE students at no charge

www.socialworkleadership.org

challenges consortium
Challenges: Consortium
  • Consortium members from southern to northern parts of state
  • Transportation and weather can provide obstacles to onsite meetings
  • How to get practitioners to see involvement in HPPAE as a support and benefit to them and their agencies
  • Members wear many hats in agencies which makes time for involvement difficult

www.socialworkleadership.org

consortium lessons learned
Consortium: Lessons Learned
  • Geographic distance among members means extensive network
  • Don’t make assumptions about consortium members’ interest in traveling to meetings
  • The many roles each member plays within agencies can result in rich discussions
  • Make use of listserv and websites to keep those involved who can’t travel to meetings
  • Include students at consortium meetings

www.socialworkleadership.org

consortium lessons learned cont
Consortium : Lessons Learned - cont.
  • Provide as many forms of appreciation as possible to consortium members
  • free continuing education
  • university “perks”
  • publicity for agency through “featured site” on HPPAE website
  • letters of support to agency administrator

on member’s behalf

www.socialworkleadership.org

consortium lessons learned cont1
Consortium : Lessons Learned - cont
  • Have different agencies host consortium meetings
  • Consortium has created referral and professional network throughout state

www.socialworkleadership.org

final reflections
Final Reflections
  • A truly exciting and rewarding endeavor
  • Becoming a vibrant statewide program
  • New field agencies for SSW as a result of

consortium

  • Generating interest in looking at unique needs of older clients among practitioners

www.socialworkleadership.org

reflections cont
Reflections - cont.
  • UMaine SSW becoming seen as the “gerontology school”
  • Consortium members who have a range of ages on their caseloads are developing skills in gerontology through HPPAE involvement
  • Consortium members are envious of the way students being trained

www.socialworkleadership.org

slide52
SWLI:

Kadia Darby

Analeah Ho

Bethany Joseph

Jeannine Melly

Pat Volland

Acknowledgements

Thank you!

www.socialworkleadership.org

www.socialworkleadership.org