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Leeway Inc., a skilled nursing center in New Haven that cares for individuals with HIV/AIDS, was founded in 1995. Its continuum of care includes skilled nursing care, residential care, independent housing, and community case management. It provides a wide variety of care, which includes medical, behavioral, and nursing services, as well as mental health services and addiction treatment. One of Leeway’s priorities is to address the psychiatric disorders that many HIV/AIDS patients have, such as depression, anxiety, addiction, and substance-related disorders (Leeway, 2012). Among patients admitted to Leeway between October 1995 and December 1999, 25% had severe, long-term comorbid psychiatric disorders. Each year, the prevalence of psychiatric comorbid disorders has increased. Between 1996 and 1998, the prevalence of psychiatric comorbid disorders increased from 38% to 53%. This trend could be due to low discharge rates and longer lengths of stay among these individuals (Goulet, 2000). Leeway places a significant emphasis on creating a plan of care that addresses and manages these disorders (Leeway, 2012).

Some of the obstacles faced by the residents include social stigma, lack of engagement in their community, and lack of companionship. Moreover, the resident population is unique for several reasons, one of which is age. Leeway residents are younger than those at the typical nursing home facility, which introduces a variety of challenges to keep them engaged in activities. A current volunteer program has attempted to address many of these obstacles, but demonstrates the need for improvement. Residents reported differing levels of interest in both the frequency and structure of volunteer engagement. Staff also expressed the needs to balance the benefits and drawbacks of an individualized program, a “buddy” or more group activities facilitated by volunteers which would help increase companionship and engagement among residents. Residents also frequently expressed satisfaction with activities outside of the facility, which is one way in which the program could be expanded in the future.

Recommendations and Products: 1. Advertise the volunteer positions as “Community Programming Volunteers” to boost enrollment and encourage a sense of agency and investment, 2. Hire a volunteer coordinator to serve as a point of contact, summarize feedback for staff, lead new initiatives, and perform basic administrative tasks, 3. Divide the year into three terms, and hold one orientation session at the beginning of each term, 4. Replace the ad hoc system of volunteer applications, training, and feedback with concise online platforms that automatically feed into a central system of records, 5. Create a separate but converging program structure that allows for two screening and orientation processes for regular and sporadic volunteers, 6. Create a two-part schedule for volunteer sessions: a. Matching interested residents with regular volunteers based on interests. Residents and volunteer buddies will meet for a 10-20 minute check-in with the option of joining the group activities and b. Regular and sporadic volunteers engage in a group activity or game, 7. Implement a hybrid individualized-group volunteer program structure, 8. Provide volunteers with nametags, and 9. Connect with schools and colleges throughout New Haven to access new volunteer pools.

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Community Health and Preventive Medicine

Building Capacity for Volunteerism and Social Support at Leeway, Inc., a Skilled Nursing Facility