Social Work Role in Staff, Resident, and Family Training

8-27-15 DRAFT CG team

Social Work Role in Staff, Resident, and Family Training

483.40 Behavioral Health Services

“These competencies and skill sets include, but are not limited to, knowledge of and appropriate training and supervision for:

(1)  Caring for residents with mental illnesses and psychosocial disorders, as well as residents with a history of trauma and/or post-traumatic stress disorder, that have been identified in the facility assessment conducted pursuant to 483.70 (e) and

(2)  Implementing non-pharmacological interventions.”

483.95 Training Requirements

“A facility must develop, implement, and maintain an effective training program for all new and existing staff; individuals providing services under a contractual arrangement; and volunteers, consistent with their expected roles. A facility must determine the amount and types of training necessary based on a facility assessment as specified at 483.70 (e). Training topics must include but are not limited to:

(a)  Communication [Direct Care/Direct Access personnel]

(b)  Resident’s rights and facility responsibilities

(c)  Abuse, neglect, and exploitation. [483.12]

(d)  QAPI

(e)  Infection control

(f)  Compliance and ethics [483.85]

(g)  Required in-service training for nurse aides. In-service training must

(1)  Be sufficient to ensure the continuing compliance of nurse aides, but be no less than 12 hours/year

(2)  Include dementia management training and resident abuse prevention training

(3)  Address areas of weakness as determined in nurse aides’ performance reviews and facility assessments at 483.70 (e) and may address the special needs of residents as determined by facility staff.

(4)  For nurse aides providing services to individuals with cognitive impairments, also address the care of the cognitively impaired.

(h)  Required training of feeding assistants

(i)  Behavioral health. A facility must provide behavioral health training consistent with the requirements at 483.40 and as determined by facility assessment at 483.70.”

Social workers are uniquely qualified to provide training to staff, residents and families in the areas of resident rights, dementia management, abuse prevention, trauma informed care, effective communication, ethics, and cultural competence. Social workers are trained to consider the physical, mental, social and cultural aspects of a person and they offer a comprehensive approach to human development. This comprehensive view of human needs provides a much needed perspective in the use of interdisciplinary training for nursing assistants (Simons, et al. 2012).

The critical role of social workers in providing assessment and intervention strategies in abusive and escalating nursing home situations has been demonstrated to be effective within interprofessional collaborative environments (Bonifas, 2015). Social workers can train staff to recognize inappropriate behavior, develop effective coping strategies in working with challenging resident and staff situations, and engage in effective techniques to address resident on resident aggression.

The positive contributions of social workers and social work students on employee work performance is demonstrated in one qualitative study (Galambos, et. al, 2015). Social work contributions to one facility helped staff at all levels to communicate more effectively with residents and their family members. In addition, social workers taught staff at all levels helpful responses in working with persons with dementia, and how to understand and approach residents with mental health issues. Social workers’ expertise in diversity and working with diverse populations contributes positively both from a development and a delivery perspective to the training needs of staff. For example, one recent study demonstrated the change among nursing home staff in attitudes about homosexuals through a social work training in this area (Pelts, 2015). Another study demonstrated positive results in work with Holocaust survivors (Adams, 1994).

One group of staff that require special consideration in terms of intensive training and education is nurse aids. They are the staff that en have just a certification to be able to practice, yet have the most resident staff interaction. The current training for nurse aides lacks adequate content on issues related to dementia, behaviors, and mental health needs. While nurse aides work populations that encounter these problems every day, they are not prepared to meet needs in these areas (Kusmaul, 2015).

References

Adams, K. (1994). Holocaust survivors in a Jewish nursing home: Building trust and control.

Clinical Gerontologist. 14(3), 99-117.

Bonifas, R. P. (2015). Resident to resident aggression in nursing homes: Social worker involvement and

collaboration with nursing colleagues. Health and Social Work, 40, 3, e101-e109.

Galambos, C., Starr, J., Musterman, K., & Rantz, M. (2015). Social work student contributions to home

health care services at an independent living facility. Home Health Care Now, 33, 4, 206-211.

Kusmaul, N. (2015). The Content of Education for Direct Caregivers. Educational Gerontology. Advance Online Publication. doi:10.1080/03601277.2015.1059142

Pelts, M. (2015). A Study of Intergroup contact theory: Using storytelling to increase awareness of

lesbian and gay older adults in long term care settings. Unpublished dissertation draft.

Simons, K., Connolly, R.P., Bonifas, R., Allen, P.D., Bailey, K., Downes, D., & Galambos, C.

(2012). Psychosocial assessment of nursing home residents via MDS 3.0:

Recommendations for social service training, staffing, and roles in interdisciplinary care.

Journal of the American Medical Director’s Association, 13, 190.e9-190.e15.