Social Work in Long-Term Care: Placement Reflection

by M. Diaz

I have had the privilege as a third-year social work student to complete my remote practicum at Family Councils Ontario. I would like to share with FCO readers what I have learned over the last four months.

I had the opportunity to collect information on ethno-specific cultural homes in the surrounding area, making note of a few important details. Some things that I observed were whether mission statements were available and inclusive, whether the homes had frontline social workers or social service workers, and whether there were visuals or statements depicting a LGBTQIATS+ friendly environment. It was also important to note the specific cultural communities that were being served, to later track which communities were less prevalent than others. As a social work student, I am interested in finding ways that social workers can help in long-term care, as well as identifying gaps within the long-term care sector.

Therefore, after collecting information on around 58 long-term care homes, it was interesting to find that only 21 of those long-term care homes were equipped with social workers or social service workers. Additionally, religious-focused long-term care homes had the least amount of social workers or social service workers compared to culturally-focused long-term care homes. Meanwhile, long-term care homes that are operated through the municipality appeared to be slightly more inclusive to LGBTQIATS+ older adults with two homes using welcoming statements, while only one culturally-focused home was found to use visuals to represent an positive and inclusive space. Other things that I noticed were the limited amount of Indigenous-centered long-term care homes, with only two found in the area, indicating a greater need in the long-term care sector. They were also located far from urban settings, with fewer than 59 beds available, which is significantly smaller in comparison to other long-term care homes. Overall, the long-term care homes that are most prevalent in the Toronto area are designed for the Chinese community, while religious-focused homes were most prevalent around the Hamilton region.

I personally would like to see more social workers working in long-term care homes. According to the Canadian Association of Social Workers (CASW), social workers in long-term care homes can play a large role in advocating on behalf of the residents and their families, ensuring that they feel supported at every step of the way when it comes to the care of their loved one. As social workers, we consider the social and emotional impacts of a person’s physical and mental impairment, the preservation and development of their physical and social functioning, and the promotion of physical and mental health. In addition, we recognize the strengths in individuals and utilize their abilities for empowerment, along with making adaptions or modifications that increase a person’s overall quality of life in long-term care, while maintaining their self-determination in the process. We can further help to support and ensure that the participation of family and residents amount to a person-centred approach.

Social workers diverse skills and abilities expand beyond the development and implementation of residential programming. Not only can social workers help navigate services, provide education around various topics or respond to enquiries families might have, but also we can support both staff and residents when it comes to emotional issues that might occur within long-term care homes. For example, we can provide counselling, bereavement support, even mediation and conflict resolution. We can also provide additional support to the team by helping to brainstorm ways to resolve interpersonal or behavioural issues with the least amount of harm.

Something that is incredibly important in social work is our ability to establish and maintain a positive, helpful, and healthy therapeutic relationship with residents and their families, ensuring that everyone is treated with respect and dignity. We can provide advocacy to ensure voices and opinions are being heard, provide support at Family Councils, and make it easier for families to connect and find community services that they need.

We are also educated in various approaches that can enhance residents’ care, such as holistic and individualized approaches, as we understand that what works for one person might not work for everyone else. In addition, we recognize intersectionality, understanding that there are multiple layers to a person that have various impacts on the individual, such as disability, age, gender, race, class, particularly for Indigenous, Black, People of Colour and LGBTQIATS+ individuals. Personally, I bring a trauma-informed approach to my practice, understanding the importance of acknowledging someone’s social history that have experienced trauma at any point in their lifetime and the long-term effects, such as Adverse Childhood Experiences (ACEs).

Most significantly, we care about fostering a positive environment for everyone in the long-term care home, which means taking the initiative to challenge the status quo to reduce and address stereotyping, stigmatization, and discrimination towards social justice.

https://www.publichealthontario.ca/-/media/documents/a/2020/adverse-childhood-experiences-report.pdf?la=en

https://www.cdc.gov/vitalsigns/aces/index.html

https://www.casw-acts.ca/en/social-work-long-term-care

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