Role of education in nursing home social worker knowledge of national reform initiatives that affect discharge planning: A review of the literature

Purpose: The nationally-supported policy initiative, Choices for Independence, and the general preference of older adults to live in the community have encouraged greater utilization of home and community-based services (HCBS). Nursing home (NH) social workers are a critical pathway to achieving greater utilization in that they educate, inform, and assist residents in making choices about their long-term care (LTC) plans. They play a vital role in planning and coordinating discharge; thus, they require extensive knowledge of HCBS. This literature review examines how education prepares NH social workers to be knowledgeable about national reform initiatives that affect discharge planning practices. Methods: A comprehensive literature review resulted in 15 peer reviewed articles that were published in 12 social science journals from 1992-2006. Nationally-supported publications from government organizations and professional associations were also used. Findings: NH social workers have various levels of education, skills, and specialized training; those who have accredited degrees often do not demonstrate competencies in aging-related issues. Continuing education efforts have primarily highlighted psychosocial topics even though NH social workers have self-reported their need for additional training on policy-related topics. Implications: The nation is working to rebalance its LTC system; however, there is no mechanism by which NH social workers are educated on the nation's current reform initiatives. Potential benefits associated with NH social worker knowledge of national reform initiatives include: a larger resource pool to draw from when educating, informing, and assisting older adults with LTC decision-making and an increased contribution toward achieving greater HCBS utilization.