Profiles in Social Work
Improving Living and Dying in Nursing Homes
Mercedes Bern-Klug, MSW, MA
Mercedes Bern-Klug, MSW, MA, has been interested in
aging and the elderly since her youth. "Some of
the most interesting people I ever met were over 80,"
she recalls. She first got a chance to explore her interest
in aging as an undergraduate at the University of Iowa.
"When I found out the university had a certificate
program in aging, I was thrilled," she says. "I
took as many aging classes as I could because I just
loved learning about older adults and the issues they
faced." Bern-Klug went on to complete an MSW at
the University of Iowa, followed by a master's in demography
at Georgetown University seven years later. Her interest
in demography was piqued after listening to a Georgetown
professor testify before Congress on aging-related issues.
"I was so taken by her ability to talk to members
of Congress about demography and aging, to translate
research for non-researchers," explains Bern-Klug.
"And I just thought, I want to be able to do that,
Several years later, while pursuing a PhD in Social
Welfare at the University of Kansas, Bern-Klug received
an opportunity to combine her dual expertise in aging-related
social work and demography. In 2000, Bern-Klug, a Senior
Research Associate at the university's Center on Aging,
was tapped to head a project called Kansas ElderCount.
Devised by State Senator Sandy Praeger, ElderCount gathered
a wealth of data on Kansas's older population, including
their economic status, health, access to services, and
nursing home use. The project's findings, organized
by county, were published as a book and a popular wall
During the project, Bern-Klug applied for and received
a Hartford Doctoral Fellowship. She has found it to
be invaluable to her career development. "The Hartford
Fellowship changed my life," she says. "It
connected me with ideas and people I otherwise wouldn't
have met, with leaders in the field. Before I became
a Hartford Doctoral Fellow, I didn't really think that
much about my future career. Now I realize I have to
take into consideration what the field needs."
What geriatric social work needs, Bern-Klug concluded,
is good information about the un-met needs of nursing
home residents and how social workers can help address
them. "Instead of trying to convince people with
emotion about what social workers can do, I think we
need to show the data," says Bern-Klug.
Bern-Klug's Hartford-funded dissertation project, which
will be completed by summer 2003, is a step toward this
goal. Called "The Social Construction of Advanced
Chronic Illness Among Nursing Home Residents,"
it explores the culture of illness and dying in nursing
homes. Because many nursing home residents have chronic,
serious illnesses or conditions, they are caught in
limbo between being classified as sick and classified
as dying. Although most are too ill or frail to have
hope of recovery or rehabilitation, few are clearly
sick enough to qualify for hospice-style care. This
makes it unclear as to whether doctors' orders or patients'
and families' wishes should dictate care. By analyzing
data collected through observation of nursing home care
and interviews with residents and their families, Bern-Klug
hopes to define the ethnography of advanced chronic
illness in the nursing home environment.
In a related project, Bern-Klug is also investigating
the psychosocial status of nursing home residents. In
a study sponsored by the Soros Foundation's Project
Death in America, Bern-Klug is examining the emotional
and social issues encountered by nursing home residents
and their families as they try to cope with advanced
chronic illness in an institutional setting. In particular,
she is trying to identify unmet emotional and social
needs and determine how residents are using their own
strengths to meet some of those needs.
Bern-Klug believes her research will show that most
residents' concerns are psychosocial in nature. "Once
I get a better handle on the perspective and needs of
nursing home residents and their families, then I want
to focus on the nursing home social worker's role,"
Bern-Klug explains. "I think that a lot of the
unmet needs of residents are a perfect match for social
workers' skills. I believe we can refashion the role
of the nursing home social worker to make it more fulfilling
for the social workers and also provide better service
to families and residents."
Here for a complete list of Profiles in Social Work
Updated on November 18, 2010