“We want more than just to be alive and kicking”: developing innovative care to promote normalisation of individual older persons

By Henglien Lisa Chen

Social work with older people in some countries is an area which has received less acknowledgement and investment – the recent global economic crisis has further diminished adequate care services and decreased the provision of well-qualified social work professionals for older people. In contrast, in other countries, there has been increased investment in ageing care innovation and professional training. As a social worker and academic, I would argue that older people, just like everyone in society, deserve not only just to be alive and kicking but to be able to live meaningful and dignified lives. This requires (student) social workers to gain multi-disciplinary knowledge about ageing and to pay attention to working with older people. Therefore, International Social Work Week provides a most appropriate opportunity to share a few observations on ageing care from a number of countries with you. By doing so, the hope is to stimulate more awareness on the importance of ageing care and greater action in innovating appropriate care support.

My interest in cross-national research into ageing care came from my experiences as a local authority social worker in England. During that time, I often wondered about ways of supporting older people based on a needs-led approach. The examples I visited in Denmark , the Netherlands and Taiwan show that care providers (e.g. care homes, day centres, etc.) are able to provide buffet-type meals, so older people can decide on what they like to eat at the dining table. Similarly, the care in one of the Danish care centres involved an indoor leisure room provided with various things that an individual can chose from with support from staff and volunteers. Both examples demonstrate a needs-led approach involving maximising choices and flexibility of support in meeting the need for normality of the individuals.

Social inclusion and service accessibility is important in ageing care to prevent isolation and depression. In the Netherlands, the project reports A City of All Ages and Generation in Action have provided guidelines for inter-generational participation. Relevant local services (e.g. schools, social clubs, day centres, care homes, etc.) and authorities (e.g. education, welfare, social care, housing, etc.) look to increasing participation between children, young people and older people through intergenerational working projects in community development. Similar projects can also been found in some parts of Germany.

Various methods of care support for older people across the countries mentioned above can be understood by welfare typologies which explain the welfare state involvement in care and the impact on the roles and models of the social worker. It also shapes the different focus on social work education across countries. For example, while social work education in England focuses on problem-based learning to develop the student social worker’s capability in working with individuals, programme-based learning (for more information, search for books with the keyword ‘programme evaluation’) is one of the focuses of social work education in Taiwan to develop the student social worker’s capability in identifying the needs of older people and innovating care support services with relevant carers, professionals and agencies.

Apart from the direct support through services for people and an accessible environment as mentioned earlier, there has been increasing technological innovation in ageing care to promote the well-being  of older people, e.g. devices to help prevent falls and protect older people (and people with impairment and disability). These can be as simple as exercise bands to as technically advanced as a robot nurse. The exercise bands assist older people with slow-movement exercises (e.g. raising the arms/legs) to strengthen their gait and balance to help prevent falls. The robot nurse invented by a Japanese institute could potentially help older people to move from chair to bed, room to room or toileting when they are alone. So they will be unlikely to need to wear incontinence pads or be admitted to a care home due to mobility restriction. It also prevents the staff risks related to moving and handling an older person.

There is little doubt that ‘home is where the heart is!’ To promote ‘ageing in place’, we need social workers who understand their local needs and to invent support services in meeting those needs. From the examples shown above, I learn that to maintain the dignity of older people we need high-quality care and caring professionals that can offer the maximum of choices, accessibility and privacy in meeting the need for normalisation and social inclusion of local individuals.

Social work faces a new level of challenges and opportunities on ‘how’ we can possibly promote the dignity and worth of older people in the 21st century when there is increasing expectation of the quality of care in later life:

  • How to provide a wide-range of holistic, personal and technical support to individuals in a sustainable and accessible environment?
  • How to take advantage of global learning in advancing indigence care?
  • How to provide an increasingly broad range of multi-disciplinary knowledge to student social workers within a 2-4 year higher education programme?

Let’s share our thoughts!

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March 20, 2012. Tags: , , , , , . World Social Work Day. Leave a comment.

Using digital technology in practice teaching- what a difference a decade makes

By Hilary Lawson

I have been working with practitioners involved in the teaching of social work practice for over 10 years, and World Social Work Day has given me an opportunity to reflect on how the increased availability of digitalised audio and visual technology has positively impacted on teaching and learning techniques.

Good social work practice rests and falls on the practitioner’s ability to build trusting purposeful relationships with others. The same applies to the teaching of social work students. The practice teaching relationship, where small gestures and phrases convey understanding and collaboration, can be the site of enormous learning and change. How can we help practice teachers get this right?

When a new course for practice teachers was introduced in the early 1990s we experimented with the idea of asking the practice teachers to tape themselves working with their student. The tape was brought to the seminar and discussed in a small supportive group of other trainee practice teachers. This intense focus on the way the practice teacher conducted the session – their manner, their responses, how they helped the student reflect on theory and practice- was consistently rated as producing huge learning for all involved. However, it always felt that such was the difficulty in finding and using the technology, it was a fine line between the technology both facilitating  but also hindering learning.

Back then, making a video tape of a practice teacher supervising a student required an enormous amount of setting up. Family centres were one of the few places where a video recorder could be found, and these were large cumbersome things on tri-pods. The practice teacher and student had to visit the centre to record themselves. When we then watched the resultant video in the seminar there would be acres of footage of both the student and practice teacher looking at the camera with anxious expressions and the practice teacher shouting to some off-camera assistant “is it on? Is it recording?”. When they had satisfied themselves that it was indeed “on” it could take many minutes before the pair relaxed into anything that resembled their “normal supervision”.

Watching the video in the small group of peers could also be stressful for the practice teacher. Their obsession with how often they saw themselves twiddle their hair, their astoundment at “do I really sound like that?” would interfere so much with what they could learn about their supervisory practice, that I often gave them the tape at the end for them to look at again at home once they had become more sensitised to what they looked like on camera.

So, when, last week, I was teaching another generation of practice teachers I reflected on the difference a decade makes. When I set them the task of bringing in a recording of themselves, there was little fuss.  Today we are used to using technology to capture moving images of ourselves and most people were able to lay their hands very easily on a smartphone, portable camcorder or pocket sized digital recorder. They transferred their recording onto a dvd or usb stick and we viewed their work huddled around lap-tops or, for those who could bear seeing themselves movie-star size, on the seminar room projector screen.

Sometimes the student had opted to remain audible but invisible and in these cases we watched just the practice teacher and her responses – still a very valuable learning experience for those who are worried about compromising their student’s or supervisee’s confidentiality. I hope the use of visual and audio technology will play an increasingly important role in both teaching social work students and indeed in the continuing professional development of supervisory staff throughout the organisation.

March 18, 2012. World Social Work Day. 3 comments.

The challenges facing social work managers

By Sharon Lambley

Whatever country a manager works in, and however social work is organised in that country, the policy changes sweeping through welfare systems across Europe are proving immensely challenging for managers to implement. International Social work Day provides a welcome opportunity to reflect upon these challenges.

The social work managers I teach are looking for answers to some very complex management problems.  They want to know how, for example, they can balance resource allocations, legal, policy and risk considerations, service user expectations and social work values, within complex (and often hostile) systems that are over-stretched and driven by imposed performance targets.  They know that the decision they make with others will have life changing consequences for citizens. Whilst the negative impact of neo-liberal policies and managerialist practices are well documented, what is less understood is what might be working and why, which makes teaching in this area challenging.

Some recent research by Dustin (2007), Evans (2010) and Munro (2011) in England has provided insight into what is shaping social work and its management practices (in very different ways) which helps to de-construct the lived experiences of practitioners and managers. Consumerist approaches that engage citizens through complaints processes (even in child protection work – see Slettebo, 2011 research in Norway) contrast with co-production strategies that provide opportunities for shared power, and in some situations, citizen led services (Needham, 2009).  These provide a useful context for understanding the different business models that are emerging to support social work.  In addition, these perspectives help to make sense of why social work roles are being transformed or indeed replaced by new workers, who have been described in Denmark as ‘professionals without a profession’ by Van Beerkel et all, (2011).  However, the management solutions that are being adopted from general management theories and approaches are problematic, and this knowledge needs to be challenged as it’s often inappropriately adapted for social work (Lawler and Bilson, 2010). Some academics are trying to bring together the world of management and social work.  Simmonds, (2010) work on relating in supervision, Wilsons work on leading practice improvement in front line child protection, and Ruch’s (2011) work on feelings in relationship based management are very interesting papers that try to bridge the gap between management and social work practice.  My own research is revealing how supervision practices are changing to accommodate new business models and citizen expectations, and my co-researcher colleagues and I are seeking evidence of what might be working well, and why.  There is much more to do.

This blog has enabled me to share my thoughts with you and I am now interested in knowing what you might be working on (or thinking about).  Lets share our thoughts on international social work day!

March 18, 2012. World Social Work Day. Leave a comment.

Different horizons and perspectives: the importance of lifting one’s head from the immediate tasks from time to time

By Cath Holmström

As I write this blog I am aware of all that I am not doing instead: all the paperwork that I am a little behind with and the meetings that I have not yet prepared for. I am aware of the immediately pressing needs that appear as ‘reminders’ on my computer screen (so long as I have filled in my online diary correctly!) and am are of the unanswered emails in my inbox.

World social work day/week has reminded me of the need to lift my head from time to time from the more tangible and immediate tasks and to re-connect with the global agenda and the values and priorities that are shared across very different contexts. This week is a good reason, if one is needed, to re-examine what we are individually and collectively contributing to the global debates and how we are responding to global, as well as local, needs.

It is only 3 months since I had the fortune to travel to Taiwan with a colleague (see blog at: http://sussexswsc-taiwantripdecember2012.blogspot.com/) where I experienced the very different social work (and social work education) context, but where familiar debates and priorities were being discussed. Being in the position of  (a very welcome) ‘outsider’ and confronted with the unfamiliar provided me with a much needed reminder of what was shared across two very different contexts. In particular, a commitment to systemic approaches to practice and a genuinely relationship based approach to preparing students for practice were topics for lively discussion. I have vivid memories of being exceptionally well hosted (the lunchtime banquet was superb) with lively discussions about the importance of student-led group work and the importance of process-learning for social work students, often despite student protestations about the time this involves etc. So starting with the familiar and shared was comforting and may lead to future collaborative and comparative work.

However, more challenging for me was moving from the excitement of seeing the autonomous way in which their social workers were practicing (memories are of the outreach Karaoke service that also provided basic medical care/information and the University specifically for older people that ws co-located with dementia care facilities) to the reality of much of UK social work provision whereby our students will not generally be responsible for setting up community initiatives and interventions …. or maybe they will in the new horizon that promises significant changes ahead.

One thing that the visit left with me, and that is reinforced when thinking about what world social work day means to me is how important it is for us to develop a collective sense of professional pride and ambition within social work and to support our students to find their own way through this challenging territory.

March 13, 2012. Tags: , , , , , , . World Social Work Day. 2 comments.

Promoting children’s participation and voice across the globe

By Michelle Lefevre

World Social Work day seems an appropriate time for social workers everywhere to consider how they are promoting the principles of the United Nations Convention on the Rights of the Child.  Ratified by most governments around the world, this sets out the basic human rights to which all children should be entitled and should have central relevance to social work practice with children and their families/carers wherever they are in the world.  Indeed the influence of the UNCRC can be seen across policy, law and practice guidance for social work in England where I am located.  Article 12 states unequivocally that children have a right to express their own opinions and to have them taken into account in any matter which affects them.  This principle underpins the Children Act 2004’s requirement for social workers to ascertain the wishes and feelings of children who might be in need of services, protection, or the involvement of the courts.   Children’s right to freedom of expression and to receive information is defined in Article 13.  This indicates the need for a child-centred philosophy of practice, in which social workers should provide information to children in ways which make sense to them and provide a facilitating environment which helps them reflect on, process and convey issues of concern to them.

However, the extent to which these principles are embodied within actual practice is in question.  In England, the amount and quality of social workers’ direct engagements and interactions with children and young people has provoked particular disquiet.  Serious case reviews and public inquiries, such as those into the tragic deaths of Victoria Climbie and Khyra Ishaq, suggest that the dire nature of these children’s circumstances might have been better understood had social workers managed to engage them in direct conversations away from those who posed risks to them. Research studies and consultations, such as those by the Children’s Rights Director for England, uncover how children in foster or residential care can be left feeling confused and that they do not matter when professionals do not spend time building relationships of trust with them, explaining complex matters and helping them confide their concerns.

In England it is likely that some of these deficiencies in practice stem from the too busy caseloads and overly bureaucratised context for current practice recently uncovered by the Social Work Task Force and Eileen Munro’s review of Child Protection.  However, research studies from a number of countries, such as a comparison of Australia and Norway, suggest that problems such as the marginalisation of children’s involvement in decision making are more widely experienced.  This suggests that at least some of the factors which interfere with effective dialogue and relationship-building between children and their social workers are more universal in nature.  For example, social workers are often speaking about traumatic and unsettling matters with children who have been abused, neglected or displaced.  Such conversations are unlikely ever to be easy and children may be more likely to convey their wishes and feelings about important issues via indirect means, such as through their play or body-language, rather than in clear and coherent verbal or written form.

Social work education globally has a central role here in helping prepare students in training for the complex and demanding nature of this work.  While we can be clear about what qualities and skills children need their social workers to embody, such as consideration, warmth, empathy, respect, and child-centredness, we still need to understand more about how best to help students develop these for the variety of social work roles and tasks across the globe and to consider how methods and approaches need to be adapted for different contexts and cultures.  By increasing knowledge about this we might become more confident that our profession is equipped to meet the aspirations of the UNCRC.

March 7, 2012. Tags: . World Social Work Day. 1 comment.