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APHA Scientific Session and Event Listing

Recorded presentation

Bronwyn Keefe, MSW, MPH¹, Susan Enguidanos, MPH, PhD², and Scott Miyake Geron, PhD¹. (1) Institute for Geriatric Social Work, Boston University, 232 Bay State Road, Boston, MA 02215, 617/358-2625, bronwyn@bu.edu, (2) Research Center, Partners In Care Foundation, 732 Mott Street, Suite 150, San Fernando, CA 91340

The majority of older persons who receive health care obtain it in the context of a visit with their primary care provider. In spite of growing recognition of the potential of primary care as a location for the early identification and prevention of health and psychosocial problems for frail elders, the prevalence of treatable and undetected mental health and psychosocial problems among the frail elderly is well documented, as are the structural barriers that primary care physicians face in effectively coordinating or providing assistance with psychosocial issues. Common challenges faced by older adults living in the community (reduced physical functioning, depression, transportation, and falls) exacerbate chronic physical problems and cause unnecessary emergency room and hospital visits and premature entry into institutional settings. The Institute of Geriatric Social Work at Boston University is conducting a randomized controlled trial to test the effectiveness of a project using social workers to integrate primary care and community care. This intervention utilizes Problem-Solving Therapy which is designed to improve patient outcomes and reduce unnecessary hospital and ER utilization. The social workers are located in the primary care offices of Kaiser Permanente in CA. Home-dwelling older adults with multiple chronic conditions, recent hospitalizations, and who are cognitively intact are eligible. Nearly half (48%) live alone, 58% report 3+ medical conditions, 75% report moderate to severe pain, 53% report experiencing anxiety, and 37% have some level of depression. We will present case studies as well as patient outcomes for depression, functioning, problem-solving skills, and quality of life.

Learning Objectives:

• To present findings from the Institute for Geriatric Social Work’s randomized control trial which is being conducted at Kaiser Permanente in conjunction with the Partners in Care Foundation.
• To describe a research study that is designed to test the effectiveness of an evidence-based practice used by social workers for older adults in a primary care setting.
• To present research findings on patient outcomes, utilization and cost.
• To discuss the implications of integrating social workers into primary care settings to address depression and other psychosocial issues.

Keywords: Frail Elderly, Social Work Roles

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation