Improving Emergency Care for the Elderly

Much has been written on the developing role for social workers in hospital emergency rooms but little has focused specifically on social work interventions with elderly emergency room patients in an urban teaching hospital. A group of fifty patients over sixty-five years of age, referred to social service for assessment and assistance with home care issues, is described. The emergency room social worker's role with these elderly patients is highlighted and three case examples are discussed. It is argued that social work interventions improve the quality of both emergency and ongoing care for this growing and often at risk population.     

The Geriatric Worker in a Community Mental Health Clinic:

Special geriatrics services are now a reality in many community mental health clinics, thus making it timely for clinicians and administrators to look at the problems faced by geriatric workers in that setting. This article addresses the problems in the worker's role by first comparing it to those of other special population mental health workers. Systemic difficulties and structural problems of the job are examined with emphasis on the worker's experiences and feelings. The author contends that the worker's issues parallel those of elderly clients. Solutions for changing negative aspects of the separate service role are discussed and their impact on service delivery described.     

The Worker's Role in Collectivity

This paper examines the worker's role in collectivity. Modifications are required because collectivity, as an entity, does not aid the worker as effectively as does a fully-formed social work group. The worker is therefore obliged to move the worker role into the gaps created by the nature of the structure.     

Group Work: Theories and Practices by Siddiqui,H. Y.

This paper describes the use of structured board games as the sole program activity for a small group of maladap- tive Israeli adolescent boys in attendance at a socio-educational community center. The extensive use of groups by non-social work center staff necessitated intensive pre-group planning which included consideration of the setting, the social worker's role, the abilities of otential group members and the classifica- tion and selection orgames. The group met for ten weeks with the social worker actively participating in the games. Positive changes were reported and both emotional growth and behavior change were vistble to the boys and the staff.     

GUIDELINES FOR THE GROUP WORKER'S USE OF MODELING

Social group work, as a method of interpersonal helping, is often chosen because the group makes available a variety of models to help client-members learn new ways of coping with problematic situations. The group worker's use of program activities (including, but not limited to discussion and role playing) creates a number of real-life situations in which the modeling process can occur, with concomitant benefits for both the observer and client-members who may serve as models. This paper presents research-based guidelines for the group worker's use of modeling, and offers some examples of the guidelines in relation to practice situations.     

The Effects of Sociocultural Factors on Older Asian Americans' Access to Care

Most Asian American elders are immigrants to the United States, and sociocultural factors such as English proficiency and immigration status are prominent factors in their lives. Using data from the California Health Interview Surveys to focus on Asian Americans over age 50, this study seeks to identify interethnic differences, and the effects of English proficiency and immigration status in the way older Asian Americans access healthcare. The results indicated that Asian ethnicity, English proficiency, and immigration status have significant independent effects on older Asian Americans' access to care. Implications for social work's role in addressing access disparities are discussed.     

The Purposeful Use of Performance in Groups: A New Look at the Balance of Task and Process

ABSTRACT

This paper explores the purposeful use of performance in an arts-based activity group that is rooted in social group work. It identifies the presence of three interconnected purposes: (1) a skill-acquisition purpose, (2) a performance-based purpose, and (3) a socioemotional purpose. This three-fold purpose introduces certain challenges throughout the life of the group, including the worker's negotiation of her role and the balance of task and process. The paper also discusses the benefits of the task-oriented goal of performance in the context of social group work. Illustrations from a co-ed pre-adolescent dance group are provided throughout the paper.     

The Dance

Abstract

“The Dance” is a story of a young social worker's journey in a HIV+ women's support group. It discusses issues of death, HIV, use of self, and theory application. Most specifically, this essay honors the role of individual strength and love within a group setting.     

Facilitating Forgiveness and Peaceful Closure

Abstract

The importance of addressing psychosocial concerns with dying patients is pivotal to facilitating peaceful closure in end-of-life care. The social worker's role in recognizing and providing skilled, psychosocial intervention with patients and families in hospice programs is significant. In this article, the literature in this area is examined and a case example of a hospice patient's need for closure and the responsive social work intervention for the patient in his moment of death is provided. The case offers social work knowledge and skills and demonstrates the therapeutic benefit of addressing psychosocial needs in end-of-life care. The importance of targeted training and continued skill development for social workers in end-of-life treatment settings is emphasized.     

The client as learner and the clinician as teacher: Working with an educational lens

This article highlights the social worker's role as educator and how that role relates to clinical practice. The educational component of practice is not grounded in a substantial theoretical, research, or practice literature, and yet teaching is a nascent role for most clinicians. For the most part, the educational aspects of clinical practice have languished, at least from a theoretical perspective, in the shadow of therapy. In this paper we advocate for developing and articulating the clinician/teacher role in order to support effective use of the learning relationship as a dynamic and necessary means for assisting clients in managing life transitions, developmental challenges, and adversity. We propose the use of an educational lens derived from the fields of education, developmental psychology, and cognitive science, to provide perspective from which the client is viewed as learner, and the client‐work relationship is seen as an educational transaction. We highlight the transformative power of educational transactions that we think are as significant as primary caregiving, and also provide a working definition of education as it is used in clinical teaching‐learning relationships. And finally, we elaborate on the range of purposes education may serve in social work practice.     

Social Workers and Policy- Practice: The Role of Social and Professional Values

ABSTRACT

Although policy practice is regarded as an essential component of social work, the actual involvement of social workers in policy practice is apparently very limited. This article presents the findings of a study that seeks to explore the role of social and professional values in support by social workers in Israel for engagement in policy practice and their actual involvement in this type of practice. The findings indicate that socioeconomic orientations and professional values have an impact on social worker's perception of policy practice and the degree to which they are actually involved in the social welfare policy process. In particular, it was found that attitudes toward social justice played a major role in the social worker's perceptions of, and involvement in, policy practice.     

Zelda Foster and Her Contributions to Social Work in End-of-Life Care

ABSTRACT

This article is both a memoir of one social worker's professional collaboration with Zelda Foster and a tribute to Zelda's legacy in the form of an educational resource on end-of-life care. It reviews achievements of Zelda Foster in social work practice and teaching related to death and dying. Resources presented in this article were supported by the Soros Foundation's Project on Death in America, a funded grant project to which Zelda contributed. The end-of-life care education, training and informational tools discussed in this article are examples of ongoing efforts in the social work profession to improve the lives of the dying and bereaved.     

The Role of the Nursing Home Social Worker in Terminal Care

This study examines the role of the nursing home social worker in terminal care. Questionnaires were distributed to 60 social workers in 14 nursing homes in the greater Milwaukee area. The hypothesis was that the presence of policies/procedures governing terminal care would be related to a decreased amount of stress for social workers. This correlation was not supported by the survey results. Although 71% of respondents indicated no policies were available to them, only 32.6% of social workers reported that terminal care was a source of stress. In fact, 59% reported that the social worker's role in terminal care had not been discussed in the social services department of their facility. Comparative lack of stress for social workers may be related to the lack of perception that social workers play a significant role in the terminal care of residents.     

Reciprocity and Affection

This paper provides a view of the creation of social services to meet the needs of the elderly since the turn of the century. The framework herein reveals that the development of the social worker's role in dealing with the elderly remains historically consistent. Differentiations within the profession since 1900 have not affected services to the elderly as they have other client groups. Furthermore, social policies designed to provide services to the elderly have not met their needs.     

Putting the parity into service‐user participation: An integrated model of social justice

Models of service‐user participation have derived from citizenship or consumerist agendas, neither of which has achieved the structural reforms important for the most marginalised social work clients. This article proposes Fraser's model of ‘parity of participation’ as an appropriately multifaceted frame for capturing the social justice aspirations of service‐user participation. A qualitative case study compared the experiences and expectations of people who had used Australian mental health services with a sample who had used Australian homelessness services to examine their expectations of participation at individual and representative levels. The findings reinforce concerns from Fraser's research about the tendency for identity‐based consumerist notions of participation to reify group identity. This leads to tokenistic service‐user involvement strategies that have little impact on participation at a structural level. Fraser's parity of participation is shown to have untested potential to reshape service‐user participation to meet the social justice aspirations of social work clients. Key Practitioner Message: ● Innovative, service‐user driven strategies for collaboration will be those which challenge existing power structures; ● Service users want their contributions to decision making to generate identifiable change in the system of social services; ● The success of service‐user participation strategies might be the extent to which political, economic and cultural opportunities are enhanced.     

CLINICAL ASPECTS OF SOCIAL GROUP WORK WITH THE DEAF

Social Group work with deaf clients is virtually non-existent although there is a need for it in the deaf community. The author describes some of the psychosocial factors that should be considered when working with the deaf, and some of the skills that social workers should have before attempting it. In addition, some of the author's own experiences in working with a group of deaf clients are described and related to the foregoing psychosocial factors.     

Ethical Assessment of the Use of Influence in Adult Protective Services

The role of influence in social work practice has been generally understated despite its importance to the course and outcome of the clinical process. This paper examines the influence strategies used by adult protective service workers with clients who refuse the services that the workers think the clients need for their own protection. It then discusses the moral justifications provided by the workers for using influence to overcome their clients' reluctance to comply with their recommendations. Finally it suggests questions to guide an ethical assessment of the use of influence in practice.     

Culture and context: exploring attributions and caregiving approaches of parents of children with an intellectual disability in urban India

We utilized a sociocultural lens and a qualitative approach to examine causal attributions and caregiving approaches of parents of children with an intellectual disability in a mid‐sized Indian city. Sixteen mothers and three fathers participated in a semi‐structured interview. Findings elucidate participants' active processing of the cause of their child's intellectual disability. They seemed to simultaneously draw upon religious, biological and situational factors to construct an explanation. As far as caregiving approaches, most parents reported moving away gradually from mainstream medicine to alternative medicine and physiotherapy and from regular education settings to special schools. The themes highlight the role of sociocultural factors and also cross‐cultural similarities in parental causal attributions and caregiving approach. The findings are discussed in the context of implications for social work practice and policy in India.     

Primary Health Care Workers' Views about Social Work

Summary SUMMARY A comparison of the views about social work held by 188 primaryhealth care workers—118 GPs, 31 health visitors and 39district nurses—working in the same teams is presentedhere.^* The study focussed particularly on their perceptionsof social workers, their role and performance. The data indicatea general acceptance of the social work role, but a lack ofknowledge of or extensive criticism about, social work performance.Significant differences of view emerged about social work training,role and clients, indicating occupation is a significant factorin perceptions held. In particular, the client group predominantlydealt with appears to have had an impact on perceptions. However,views about social work performance did not differ greatly,suggesting the influence of occupation on perceptions shouldnot be overstated.