Running between the raindrops: The obligation dilemma of the social worker in the nursing home

Sagit Lev, Liat Ayalon

Research output: Contribution to journalReview articlepeer-review

11 Scopus citations


The authors examined perspectives of social workers working in nursing homes concerning their obligation to the older adult, the family, and the facility, and identified the dilemmas and difficulties that arise from these sometimes conflicting obligations. Authors conducted semistructured in-depth interviews with 15 social workers employed in nursing homes in Israel. Inter-theme consistencies and contradictions were elucidated, and descriptive and then interpretive categories were created to represent interview data. Social workers acknowledged their multiple, often contradictory loyalties to the older resident, the management of the institution, the staff, and the resident's family. The obligation dilemma was particularly evident in relocation decisions and suspected cases of elder abuse. The findings highlight the importance of the obligation dilemma in the work experience of social workers. Potential implications for the care provided to older adults in nursing homes are discussed.

Original languageEnglish
Pages (from-to)10-18
Number of pages9
JournalHealth and Social Work
Issue number1
StatePublished - 1 Feb 2015

Bibliographical note

Publisher Copyright:
© 2014 National Association of Social Workers.


  • ethics
  • long-term care
  • nursing homes
  • obligation dilemma
  • older people


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