Resilience-Enhancing Nursing Home Social Work: Psychosocial Care Functions

The authors of this editorial alert readers to the long-standing nursing home crisis.They make suggestions for how social workers in nursing homes may contribute to the improvement of psychosocial care by implementing resilience-enhancing care strategies.The results of a survey of a small panel of expert social workers about their perceptions of a list of resilience-enhancing care functions are presented.For more than four decades there has been an attempt to improve the quality of care for nursing home residents.Early efforts to spearhead this activism were undertaken by a national group of nursing home reformers known as the National Citizens' Coalition for Nursing Reform.These efforts were underscored by the publication of the 1986 Institute of Medicine report Improving the Quality of Care in Nursing Homes, which drew attention to the neglect and abuse of nursing home residents and their poor quality of life.Nursing homes were also criticized for their excessive cost, inconsistent oversight, and lack of high-quality data.The passage of the Omnibus Budget Reconciliation Act of 1987, which encompassed the Nursing Home Reform Act, was spurred on by this critique.The law established new, more stringent resident-focused nursing home standards and laid out several quality-of-life rights.It also inaugurated an enforcement system for noncompliant nursing homes that incorporated a range of sanctions.In addition, the law merged Medicare and Medicaid standards, and the survey and certification processes for nursing homes were merged into a single system [2].Most important, it mandated that nursing homes with 192 beds or more hire social workers to augment the delivery of psychosocial care.According to the Henry J. Kaiser Family Foundation, although progress has been made in providing an improved quality of care to nursing home residents since the enactment of the Omnibus Budget Reconciliation Act of 1987, significant problems remain.As the COVID-19 pandemic grew more intense, these long-standing problems became more apparent and pronounced.As a result, the National Academies of Sciences, Engineering, and Medicine (which arose from the Institute of Medicine) [3] established a committee to update the 1986 Institute of Medicine study on the status of nursing home care in the United States.The recent National Academies of Sciences, Engineering, and Medicine [4] report called for "each and every resident in every nursing home" to receive "high-quality physical care, behavioral health, safety, and psychological support" (p.xviii) [4].