As social workers in long-term care, one of our primary roles is to advocate for our residents’ needs. According to the federal regulations, the facility must provide medically related social services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident. Our advocacy efforts often tend to focus on immediate physical needs, such as obtaining medical equipment – even difficult to obtain mobility devices such as electric wheelchairs. We may work to ensure the residents’ mental wellbeing by advocating for the provision of psychological services when their insurance does not cover it. To promote psychosocial wellbeing, we may advocate for a change in facility policy to allow a resident to take a shower more than twice a week.

These are only a few examples of the numerous ways in which social workers advocate for change to promote physical, mental, and psychosocial well-being for our residents. Advocacy implies going “above and beyond” the way things are typically done to promote positive change. Although many social workers have a strong desire to promote change, the day to day demands of excessive caseloads, paperwork, and meetings drain us of the energy, motivation, and time needed to be effective advocates. We also take on the responsibility of feeling we need to do everything ourselves, rather than using other resources and organizations that are available to help us.

One organization that shares our vision of enriching the lives of seniors and advocating for change in the way this nation views and treats them is the Twilight Wish Foundation. Cass Forkin, who founded this non-profit, charitable organization in 2003 in Bucks County, PA, explains, “Our mission is to enrich the lives of elders that have serviced others by performing wish granting, group celebrations, retirement home visits, and sundry item distributions, etc., to those deserving individuals who need it the most. Our mission includes advocacy for senior issues and building awareness through education and hands on multigenerational experiences.” To date, Twilight Wish has granted over 750 individual wishes. The first wish fulfilled was for Margaret, a nursing home resident, to obtain a headstone for her son’s unmarked grave (see photo). Other wishes have included a 100th birthday ride in a motorcycle sidecar, a trip to a ballgame to meet a favorite player, obtaining a lift chair, and reuniting someone with a long lost sibling.

The Twilight Wish Foundation offers some unique ways to help us advocate for our residents. To start with, it opens the door for us to consider the wishes and dreams of our residents – to acknowledge that their lives are not over and that their wishes are still important. The granting of a wish could fulfill a lifelong dream, or simply bring some joy and happiness to their lives, something that can be in short supply for many residents. It’s possible that wishes could be granted through the intervention of the social worker or facility. It could also be a great way to get families involved and help them feel they are doing something important for their loved one. If this isn’t possible, a referral can be made to Twilight Wish to fulfill the wish.

Another way that Twilight Wish can bring fulfillment to residents is by giving them the opportunity to help others. Individual residents or the facility as a group could assist in wish granting or fundraising efforts. The website, www.TwilightWish.org, offers the opportunity to review and fund specific wishes. The facility, Family Council, or Resident Council could do a special event fundraiser to benefit Twilight Wish. Providing ways for residents to help others and to feel that they are still contributing members of a community can be even more effective in fulfilling their psychosocial needs than granting their particular wish.

A facility’s involvement in wish granting for a resident or fundraising for Twilight Wish is also a great way to garner positive publicity and improve the facility’s community image, since the local media (and sometimes even national media) have been very supportive of Twilight Wish events. As social workers, we tend to shy away from things related to marketing and publicity. Instead, we need to look to this as an advocacy opportunity to change the way the public views nursing homes and the elderly. We need to promote the fact that positive, affirming things occur in long-term care much more often than abuse or neglect.

Advocacy can take many forms, most of which entail “thinking outside the box”. As we strive to make long-term care more person-centered, we need to find ways to integrate residents back into the community. Working with organizations like the Twilight Wish Foundation can go far to promote residents’ psychosocial well being (and in turn, can promote physical and mental wellbeing) by wish granting or reaching out to help others, both of which validate and enrich residents lives.

For more information about the Twilight Wish Foundation, specific wish requests, eligibility requirements for wish recipients, and ways to support the organization, visit www.TwilightWish.org.

Lori Ammon, LSW
SSWANH Newsletter/Website Editor
Twilight Wish Foundation Board Member