scholarly journals Social work with older adults in primary health – is it time to move our focus?

2016 ◽  
Vol 24 (2) ◽  
pp. 37-48
Author(s):  
Sue Foster ◽  
Liz Beddoe
Keyword(s):  
Primary Care ◽  
Social Work ◽  
Older People ◽  
Social Workers ◽  
Discharge Planning ◽  
Average Length ◽  
Public Hospitals ◽  
Family Work ◽  
Primary Care Sector ◽  
Medical Wards

Social work has made a significant contribution to the health care of older people for the last 60 years. At any one time, older people make up a significant number of our inpatient population in public hospitals. Social workers have not only had an integral part to play in discharge planning of this vulnerable population but also have played an important advocacy and support role with the patient and their families. Indeed, social work is traditionally the discipline that links the medical world to the patient’s world in the community. Recent data indicates the average length of stay (ALOS) in public hospitals is continuing to decline. Between 2001 and 2010, total ALOS decreased from 4.4 days to 4.1 days and in medical wards from 3.9 days to 3.5 days (Ministry of Health, 2011). (MOH).Ward managers have traditionally relied on social workers to provide safe discharges, particularly for older people who are vulnerable, but the pressure to concentrate on this service has increased as the pressure to manage very high bed occupancy also grows. Anecdotal evidence indicates that some social workers have been directed to attend to discharge planning only and any other issues that are identified are to be referred to their community colleagues. This demanding environment poses challenges for social work and raises the question whether more effective social work intervention for older people could be achieved in the community. Where should social workers concentrate their efforts in order to have the most effective outcomes? Would health social work be more effective if placed in the primary care sector? This article examines the skill base of health social workers in relation to working with older people, and argues that a move into primary care would result in a more effective use of our skill base which is after all centred in family work. 

scholarly journals Hospital social work and discharge planning for older people: challenges of working in a clinical setting

2021 ◽  
pp. 1-18
Author(s):  
Deirdre Heenan
Keyword(s):  
Social Work ◽  
Older People ◽  
Social Workers ◽  
Hospital Discharge ◽  
Discharge Planning ◽  
Small Scale ◽  
Central Function ◽  
Hospital Social Workers ◽  
Hospital Social Work ◽  
Transfers Of Care

Abstract Across the world acute hospitals are under unprecedented pressures due to shrinking budgets and increasing demand, against this backdrop they are also experiencing record levels of activity in Accident & Emergency and delayed transfers of care. Reducing pressure on hospitals by avoiding unnecessary admissions and delayed discharges has risen up the global policy agenda. However, reviews of strategies and policies have rarely involved discussions about the role that hospital social workers play in achieving timely hospital discharge. Yet discharge planning has become a, if not the, central function of these professionals. This paper presents the results of a small-scale exploratory study of hospital social work in an acute hospital in Northern Ireland. The findings reveal that the work of hospital social workers is characterised by increased bureaucracy, an emphasis on targets and a decrease in the time afforded to forming relationships with older people. Hospital social workers highlight concerns that the emphasis on discharge planning and pressures associated with the austerity agenda limits their capacity to provide other more traditional roles such as advocacy and counselling. It is argued that hospital social work should not be narrowly defined as ‘simply’ co-ordinating discharge plans. The tension that arises between expediting hospital discharge and advocating for older people and their families is also discussed.

scholarly journals Social Workers in Primary Care Increase Access to Palliative Care

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 840-840
Author(s):  
Portia Cornell ◽  
Christopher Halladay ◽  
Pedro Gozalo ◽  
Caitlin Celardo ◽  
James Rudolph ◽  
...  
Keyword(s):  
Primary Care ◽  
Palliative Care ◽  
Social Work ◽  
Social Workers ◽  
Hospice Care ◽  
Care Team ◽  
Policy Tool ◽  
Primary Care Teams ◽  
System Leaders ◽  
Episodes Of Care

Abstract Clinical trials show that palliative care improves patient experiences and reduces costs, and use of palliative care and hospice care have been increasing over the past three decades. In the Veterans Administration health care system (VA), Veterans may receive palliative care concurrently with other treatments. However, many barriers exist to the use of palliative care, such as patients’ misperceptions. Social workers in primary care teams may increase use of this valuable service by establishing trust between patient and care team, educating patients and caregivers, and coordinating services. Leveraging a national social-work-staffing program as a natural experiment, we evaluated the effect of hiring one or more social workers to the primary-care team on use of palliative or hospice care among Veterans with a recent hospital stay. Our data included 91,675 episodes of care between 2016 and 2018. 1.45 percent of episodes were followed by use of palliative care or hospice within 30 days. The addition of one or more social workers through the staffing program was associated with an increase of 0.53 percentage points (p<0.001) in the probability of any palliative or hospice care, i.e., a more than 30% increase relative to the mean. Policy makers and health system leaders who seek to improve patient experience and reduce costs through increased access to palliative and hospice care could consider social work staffing as a policy tool to achieve those aims.

scholarly journals A Qualitative Study on How Social Workers From Regional and Metropolitan Queensland, Australia Perceive the Impact of the National Prioritisation System on Hospital Discharge Planning: A Study Protocol

2020 ◽  
Vol 19 ◽  
pp. 160940692097354
Author(s):  
Bernadette Dimla ◽  
Denise Wood ◽  
Lynne Parkinson
Keyword(s):  
Qualitative Study ◽  
Home Care ◽  
Older People ◽  
Social Workers ◽  
Study Protocol ◽  
Best Practice ◽  
Discharge Planning ◽  
Home Care Services ◽  
Dissemination Strategy ◽  
The Impact

In 2012, the Australian Commonwealth Government introduced a series of reforms for the aged care sector including the implementation of the National Prioritisation System for a flexible, accessible and demand-driven approach to home care services for older people. Nevertheless, an increasing number of older people continue to wait for months to be assigned home care packages on the national prioritisation queue, a component of the National Prioritisation System. There is limited evidence on the impact of the national prioritisation queue on discharge planning practices of social workers in supporting older people returning home from hospital admission. The aim of the research described in this paper is to explore the perceptions of social workers from rural and urban health services areas on how the introduction of the national prioritisation queue has influenced discharge planning of older people who are still waiting assignment of home care packages. This study protocol establishes the need for this qualitative study and provides an overview of the theoretical framework underpinning the research; discusses and describes the methods for sampling/recruitment and data collection, the approach to be utilised for qualitative analysis and the planned dissemination strategy. Understanding how social workers respond to the perceived challenges to discharge planning posed by the national prioritisation queue and the implications arising from the research have the potential to inform the development of best practice approaches and further enhance social work response to identified issues.

Discrimination and injustice against older people in Uganda: Implications for social work practice

2019 ◽  
pp. 002087281985874
Author(s):  
Charles Kiiza Wamara ◽  
Maria Irene Carvalho
Keyword(s):  
Social Justice ◽  
Social Work ◽  
Older People ◽  
Social Workers ◽  
Social Work Education ◽  
Work Practice ◽  
Legal Framework ◽  
Social Work Practice ◽  
Professional Regulation ◽  
Work Education

This article highlights how older people in Uganda experience discrimination and injustice. It discusses the legal framework for their protection, while acknowledging that not all professionals are aware of or have access to the legal mechanisms meant to safeguard older people’s interests. It also discusses the role social work can play in protecting older people’s rights. It further recommends that social workers work to increase solidarity between generations and bring about social justice and respect for diversity. It concludes by highlighting the need to bring anti-discriminatory social work into mainstream social work education and the professional regulation of social work.

scholarly journals Primary Care Social Work Practice with Older Adult Veterans During the Covid-19 Pandemic: An Application of Ecological Systems Theory

2020 ◽  
Vol 1 (2) ◽  
pp. 118-121
Author(s):  
Lashawn Smith
Keyword(s):  
Primary Care ◽  
Social Work ◽  
Social Workers ◽  
Older Adult ◽  
Work Practice ◽  
Social Work Practice ◽  
Ecological Systems ◽  
Veterans Health ◽  
Health Administration ◽  
The Government

In March 2020, The state of New York became the American epicenter of the Covid-19 pandemic with the most vulnerable of populations including older adults being affected.  As a result of the Government shut-down to slow the spread of Covid-19, many primary care social workers, including this writer pivoted to remote telework detail on short notice. While utilizing an ecological systems theoretical framework, this article will explore how primary care social workers in the Veterans Health Administration worked through the Covid-19 pandemic to effectively provide social work services and case management to older adult Veterans.

scholarly journals The ageing demographic transition: The impact on elderly and social workers

2010 ◽  
Vol 22 (2) ◽  
pp. 4-12 ◽  
Author(s):  
Robyn Aldrich
Keyword(s):  
Social Work ◽  
Older People ◽  
Social Workers ◽  
Demographic Change ◽  
Demographic Transition ◽  
Work Practice ◽  
Social Work Practice ◽  
Ageing Population ◽  
The Impact ◽  
Severe Shortage

The issues associated with an ageing population pose substantial challenges for governments globally. Social workers are well suited to respond to the challenges of this demographic change. However, there is a severe shortage of social workers that are skilled in working in this field. This article looks at the ageing demographic transition, how support for the increasing older population will be a problem, and the issues that may impact older people,as well as social workers. How discrimination, culture and ethics inform social work practice, and the legislation and policies that are available for the aged. The article also looks at the knowledge, skills, values, beliefs and models of practice that are used by social workers in working with the older generation. 

scholarly journals Collaboration between Social Workers and Families of Patients with Mental Illness

1993 ◽  
Vol 74 (2) ◽  
pp. 104-115 ◽  
Author(s):  
Neal DeChillo
Keyword(s):  
Mental Illness ◽  
Social Work ◽  
Clinical Outcome ◽  
Severe Mental Illness ◽  
Social Workers ◽  
Family Involvement ◽  
Discharge Planning ◽  
Family Members ◽  
Inpatient Unit ◽  
High Degree

The author examines collaboration between families of patients with severe mental illness and inpatient social workers as measured by a study that assessed the degree to which families and practitioners collaborate, factors that influence collaboration, and the effects of collaboration on clinical outcome. Social workers and family members were surveyed at the time of the patient's discharge from the inpatient unit. Findings revealed a relatively high degree of collaboration. The strongest predictor of collaboration was the practitioner's attitude toward family involvement in the patient's treatment. In addition, higher levels of collaboration were significantly correlated with increased family involvement in discharge planning and satisfaction with social work services.

scholarly journals How are people with dementia involved in care-planning and decision-making? An Irish social work perspective

Dementia ◽  
2018 ◽  
Vol 18 (7-8) ◽  
pp. 2985-3003 ◽  
Author(s):  
Sarah Donnelly ◽  
Emer Begley ◽  
Marita O’Brien
Keyword(s):  
Decision Making ◽  
Social Work ◽  
Older People ◽  
Social Workers ◽  
Social Care ◽  
Practice Research ◽  
Care Planning ◽  
Client Group ◽  
People With Dementia ◽  
Health And Social Care

In recent years, there have been national and international policy advances around capacity and decision-making and an apparent burgeoning rights-based approach to the issue, all of which have the potential to impact on the experience for people with dementia in Ireland. There is little evidence however on whether these policies and principles are being translated into practice and whether traditional paternalistic approaches to decision-making are being challenged. To gain insight into current practice, research was undertaken with social workers working with older people in Ireland; reporting on the involvement of people living with dementia in care-planning processes. Data collection included a mixed method approach; an on-line survey of social workers from across the country who reported on their open caseload during the month of June 2015 (N = 38 social workers reporting on the experiences of 788 older people, of which 39% of older people had a formal diagnosis of dementia). In addition, semi-structured telephone interviews were conducted with social workers working in the nine Community Health Organisation areas (N = 21). Findings show that people with dementia were high users of social work services, accounting for 44.5% of the client group. Social workers reported that there were no standardised approaches to how Health and Social Care Professionals involved people with dementia in care planning and decision-making. Overall, people with dementia were more likely to be excluded from decision-making processes due to (i) assumptions that they lacked capacity, (ii) family members preferences that the person was not involved, (iii) communication difficulties, (iv) time constraints, (v) little or no opportunity given or (vi) the person delegated decision-making to others. Good practices were identified through multidisciplinary team approaches and formal care planning meetings. This research highlights variability in how people with dementia participate in decision-making around their care. It sheds light on existing barriers which challenge the full implementation of the Irish Assisted Decision-Making legislation; highlighting the need for appropriate guidance and education for Health and Social Care Professionals. The findings also show that family dynamics and existing relationships can play a role in how people with dementia participate and are involved. To ensure consistent opportunities for participation, effective practices and approaches to supporting the participation of people living with dementia in care planning needs to be developed and rolled out in all care settings through increased training and adoption of standardised approaches.

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