Social Work Decision-Making: Need Factors of Older Adults That Affect Outcomes of Home-and Community-based Services

The purposes of this study were to examine social work decision-making outcomes of home-and community-based services (HCBS) referrals provided to older adults with unmet physical and psychosocial needs discharged from acute care to a community setting, and to understand older adults' (N = 247) responses to receiving referrals for HCBS. Older adults with inadequately or marginally met basic needs was a statistically significant predictor of the number of HCBS referrals home health social workers provided to older adult clients (p <.01). The adapted three-step models were statistically significant: activities of daily living model [F(15) = 1.95, p <.05] and instrumental activities of daily living model [F(15) = 2.06, p <.05]. Most older adults accepted the HCBS referrals provided to them at the time of the social work home visit. Implications for practicewere suggested for clinical social workers and case managers providing HCBS referrals to older adults with unmet physical and psychosocial needs discharged from acute care or skilled care to community settings.