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Social Work Practice in Long Term Care

Photo from https://unsplash.com/photos/n85taMiq0S4

Course history:

I start thinking about sharing social work practice in a long term care course curriculum in June 2020 after listening to the presentation of the social worker in long term care in Ontario. It was an inspiration to listen to the dedicated professional offering critical long term care services to vulnerable adults and prompted me to think about how I can improve the current state of long term care in Canada.

My initial interest in long term care social work practice started in 2001 when I visited Holy Family Nursing Home and spent time listening to the stories of the residents. I thought social workers are the best professionals to support people in long term care, but later I found very few long term care facilities hire social workers. My students also lack an understanding of the long term care system in Canada. I am grateful that one of the faculty members and a very caring friend of mine shared stories about long term care.

This course was recently inspired by the WLU student who wanted to take a directed studies course in long term care. I will keep updating the course outline to offer in social work programs that currently do not have any long term care social work practice courses in their social work curriculum. Students can also do their practicum in long term care facilities while developing modules for the course.

Course designer:

Oleksandr (Sasha) Kondrashov, PhD, RSW

Course description:

This course critically examines the social work practice in long term care in Canada. The course offers students opportunities to create tools to protect vulnerable groups in long term care and provides an overview of the profession’s role and purpose to improve the long term care delivery system in Canada and internationally.  The students are introduced to the long term care continuum of services and theoretical models and practice frameworks to deliver long-term care services. The history of long term care social work in Canada is highlighted with an overview of the long term care Canadian and international policy and financing. Students learn about ethical decision-making and protection of the vulnerable populations in long term care. The course offers a thorough examination of family and social worker roles in providing long term care services and practicing skills to prevent professional burnout and promote quality of life. Students can research social work practice and policy concerns related to the long term care and its impacts on vulnerable older adults.

Educational Objectives/Learning Outcomes

After this course, the student should be able:

  1. To articulate the roles of the social worker in long term care
  2. To develop adaptive responses to challenges working in long term care facilities
  3. To examine strategies for ethical decision making in planning long term care
  4. To outline social work roles to work in long term care
  5. To discuss the benefits and limitations of the use of technology in long term care facilities.
  6. To develop a professional response to address funding concerns and standards in Canadian long term care.
  7. To recognize the importance of long term care options for older adults.
  8. To advocate for the inclusion of socially vulnerable groups in long term care planning
  9. To examine the history of long term care in Canada
  10. To evaluate federal, provincial, and municipal policy responses to long term care needs of older adult
  11. To promote social work long term care research

Course Materials

Arcus, S. G. (1999). The long-term care Ombudsman program: A social work perspective. Journal of Gerontological Social Work, 31(1–2), 195–205. https://doi.org/10.1300/J083v31n01_11

Armstrong, P. (2020). Restoring Trust: COVID-19 and The Future of Long-Term CareA Policy Briefing by the Working Group on Long-Term Care. Retrieved from https://rsc-src.ca/en/restoring-trust-covid-19-and-future-long-term-care

Banerjee, A.. (2007). An overview of long term care in Canada and selected provinces and territories”. Women and Health Care Reform. Retrieved from http://www.womenandhealthcarereform.ca/publications/banerjee_overviewLTC.pdf

Berkman, B. J., Gardner, D. S., Zodikoff, B. D., & Harootyan, L. K. (2005). Social Work in Health Care with Older Adults: Future Challenges. Families in Society: The Journal of Contemporary Social Services, 86(3), 329–337. https://doi.org/10.1606/1044-3894.3430

Block, S., & Dhunna, S. (2020). What does it cost to care? Improving wages and staffing levels in Ontario’s long-term care facilities. Canadian Center for Policy Alternatives https://www.policyalternatives.ca/publications/reports/what-does-it-cost-to-care

Boscart, V., McCleary, L., Huson, K., Sheiban, L., & Harvey, K. (2017). Integrating gerontological competencies in Canadian health and social service education: An overview of trends, enablers, and challenges. Gerontology & geriatrics education38(1), 17-46.

Bourgeault, I. L., Atanackovic, J., Rashid, A., & Parpia, R. (2010). Relations between Immigrant Care Workers and Older Persons in Home and Long-Term Care. Canadian Journal on Aging / La Revue Canadienne Du Vieillissement, 29(1), 109–118. https://doi.org/10.1017/S0714980809990407

Czaja, S. J. (2016). Long-term care services and support systems for older adults: The role of technology. American Psychologist, 71(4), 294–301. https://doi.org/10.1037/a0040258

Decker, C. L., & Adamek, M. E. (2004). Meeting the Challenges of Social Work Research in Long-Term Care. Social Work in Health Care, 38(3), 47–65. https://doi.org/10.1300/J010v38n03_03

Dhooper, S. S. (2011). Social work in health care: Its past and future (Vol. 33). Sage Publications. Chapter 7

Elliott, S., Golds, S., Sissons, I., & Wilson, H. (2015). Long-term care: a review of global funding models. British Actuarial Journal20(1), 167-208.

Gao, G. I.-A. (n.d.). Indigenous Peoples’ Self-determination and Long- term Care: Sápmi and Nunavut. 40.

Gerling, K., Hebesberger, D., Dondrup, C., Körtner, T., & Hanheide, M. (2016). Robot deployment in long-term care: Case study on using a mobile robot to support physiotherapy. Zeitschrift Für Gerontologie Und Geriatrie, 49(4), 288–297. https://doi.org/10.1007/s00391-016-1065-6

Geron, S. M. (1998). Assessing the Satisfaction of Older Adults With Long-Term Care Services: Measurement and Design Challenges for Social Work. Research on Social Work Practice, 8(1), 103–119. https://doi.org/10.1177/104973159800800108

Hanson, L. C., Eckert, J. K., Dobbs, D., Williams, C. S., Caprio, A. J., Sloane, P. D., & Zimmerman, S. (2008). Symptom Experience of Dying Long-Term Care Residents. Journal of the American Geriatrics Society, 56(1), 91–98. https://doi.org/10.1111/j.1532-5415.2007.01388.x

Kane, M. N. (1999). Factors Affecting Social Work Students’ Willingness to Work with Elders with Alzheimer’s Disease. Journal of Social Work Education, 35(1), 71–85. https://doi.org/10.1080/10437797.1999.10778948

Kane, R. L., & Kane, R. A. (2001). What older people want from long-term care, and how they can get it. Health Affairs, 20(6), 114–127. https://doi.org/10.1377/hlthaff.20.6.114

Lai, D. W. L. (2008). Intention of use of long-term care facilities and home support services by Chinese-Canadian family caregivers. Social Work in Health Care, 47(3), 259–276. https://doi.org/10.1080/00981380801985382

Levine, C., Halper, D., Peist, A., & Gould, D. A. (2010). Bridging troubled waters: Family caregivers, transitions, and long-term care. Health Affairs, 29(1), 116–124. https://doi.org/10.1377/hlthaff.2009.0520

Malench, S. S. (2004). Family and social work roles in the long-term care facility. Journal of Gerontological Social Work, 43(1), 49–60. https://doi.org/10.1300/J083v43n01_05

Martin, D., Miller, A. P., Quesnel-Vallée, A., Caron, N. R., Vissandjée, B., & Marchildon, G. P. (2018). Canada’s universal health-care system: Achieving its potential. The Lancet, 391(10131), 1718–1735. https://doi.org/10.1016/S0140-6736(18)30181-8

McDonough, K. E., & Davitt, J. K. (2011). It takes a village: Community practice, social work, and aging-in-place. Journal of Gerontological Social Work, 54(5), 528–541. https://doi.org/10.1080/01634372.2011.581744

McGrail, K. M., McGregor, M. J., Cohen, M., Tate, R. B., & Ronald, L. A. (2007). For-profit versus not-for-profit delivery of long-term care. Cmaj176(1), 57-58.

Mois, G., & Fortuna, K. L. (2020). Visioning the future of gerontological digital social work. Journal of Gerontological Social Work, 63(5), 412–427. https://doi.org/10.1080/01634372.2020.1772436

Moody, H. R. (1983). Ethical dilemmas in long-term care  Journal of Gerontological Social Work, 5(1–2), 97–111. https://doi.org/10.1300/J083V05N01_06

Munn, J. C., & Adorno, G. (2008). By invitation only: Social work involvement at the End of Life in Long-Term Care. Journal of Social Work in End-Of-Life & Palliative Care, 4(4), 333–357. https://doi.org/10.1080/15524250903081491

Munn, J. C., & Zimmerman, S. (2006). A good death for residents of long-term care: Family members speak. Journal of Social Work in End-Of-Life & Palliative Care, 2(3), 45–59. https://doi.org/10.1300/J457v02n03_05

Munn, J. C., Zimmerman, S., Hanson, L. C., Williams, C. S., Sloane, P. D., Clipp, E. C., Tulsky, J. A., & Steinhauser, K. E. (2007). Measuring the quality of dying in long-term care. Journal of the American Geriatrics Society, 55(9), 1371–1379. https://doi.org/10.1111/j.1532-5415.2007.01293.x

Nakashima, M., Chapin, R. K., Macmillan, K., & Zimmerman, M. (2005). Decision making in long-term care: Approaches used by older adults and implications for social work practice. Journal of Gerontological Social Work, 43(4), 79–102. https://doi.org/10.1300/J083v43n04_06

NASW (2003). NASW Standards for Social Work Services in Long-Term Care Facilities. Retrieved from. https://www.socialworkers.org/LinkClick.aspx?fileticket=cwW7lzBfYxg%3D&portalid=0

National Institute on Aging (2019). Enabling the Future Provision of Long-Term Care in Canada. Retrieved from https://krasunca.files.wordpress.com/2020/08/e3f62-enablingthefutureprovisionoflong-termcareincanada.pdf

Parish, S. L., & Lutwick, Z. E. (2005). A critical analysis of the emerging crisis in long-term care for people with developmental disabilities. Social Work, 50(4), 345–354. https://doi.org/10.1093/sw/50.4.345

Perrin, N., & Polowy, J. (2008). The role of the social worker in the long term care facility. Retrieved from https://health.mo.gov/seniors/ombudsman/pdf/RoleLTCsocialworker.pdf

Rai, G. (2010). Burnout among long-term care staff. Administration in Social Work, 34(3), 225–240. https://doi.org/10.1080/03643107.2010.480887

Richards, M. (2005). Spirituality and social work in long-term care. Journal of Gerontological Social Work, 45(1–2), 173–183. https://doi.org/10.1300/J083v45n01_10

Simons, K., Shepherd, N., & Munn, J. (2008). Advancing the evidence base for social work in long-term care: The disconnect between practice and research. Social Work in Health Care, 47(4), 392–415. https://doi.org/10.1080/00981380802258458

Solomon, R. (2004). The role of the social worker in long-term care. Journal of Gerontological Social Work, 43(2–3), 187–202. https://doi.org/10.1300/J083v43n02_13

Stein, G. L., Beckerman, N. L., & Sherman, P. A. (2010). Lesbian and gay elders and long-term care: Identifying the unique psychosocial perspectives and challenges. Journal of Gerontological Social Work, 53(5), 421–435. https://doi.org/10.1080/01634372.2010.496478

Super, N., Burstein, A., Davis, J., & Servat, C. (2020). Innovative strategies to finance and deliver long-term care. SSRN Electronic Journal. https://doi.org/10.2139/ssrn.3663471

Tang, S. Y., & Browne, A. J. (2008). ‘Race’ matters: Racialization and egalitarian discourses involving Aboriginal people in the Canadian health care context. Ethnicity & Health, 13(2), 109–127. https://doi.org/10.1080/13557850701830307

Taylor, B. J. (2006). Professional perspectives on decision making about the long-term care of older people. British Journal of Social Work, 36(5), 807–826. https://doi.org/10.1093/bjsw/bch322

Student Evaluation & Assessment

EvaluationPercentageDue Dates
Professional Learning20 % 
Class Project Part 130 % 
Class Project Part 250% 
Total100% 

Course Schedule

Week Topic(s) ReadingsAssignments / Remarks
 Introduction, positioning and course overview, definitions of Long Term CareKane, R. L., & Kane, R. A. (2001); McDonough, K. E., & Davitt, J. K. (2011). Chapter 7 from Dhooper, S. S. (2011); Boscart, V., McCleary, L., Huson, K., Sheiban, L., & Harvey, K. (2017).  
 Understandings of ‘Long Term Care’: Models and Theoretical FrameworksHanson, L. C., Eckert, J. K., Dobbs, D., Williams, C. S., Caprio, A. J., Sloane, P. D., & Zimmerman, S. (2008). McGrail, K. M., McGregor, M. J., Cohen, M., Tate, R. B., & Ronald, L. A. (2007). 
 History of Long Term Care Social Work in CanadaMartin, D., Miller, A. P., Quesnel-Vallée, A., Caron, N. R., Vissandjée, B., & Marchildon, G. P. (2018); Munn, J. C., & Adorno, G. (2008). 
 Thinking Long Term Care Policy: Canadian and International standardsBanerjee, A.. (2007); National Institute on Aging (2019); Arcus, S. G. (1999); NASW (2003).Professional Development
 The Economics of Long Term Care: Poverty, Services and FinancingSuper, N., Burstein, A., Davis, J., & Servat, C. (2020); Block, S., & Dhunna, S. (2020); Elliott, S., Golds, S., Sissons, I., & Wilson, H. (2015).Professional Development
 Ethical Decision-Making in Long Term CareTaylor, B. J. (2006); Nakashima, M., Chapin, R. K., Macmillan, K., & Zimmerman, M. (2005); Moody, H. R. (1983);Class project part 1
7.Long Term Care and Selected Vulnerable PopulationsStein, G. L., Beckerman, N. L., & Sherman, P. A. (2010); Parish, S. L., & Lutwick, Z. E. (2005); Bourgeault, I. L., Atanackovic, J., Rashid, A., & Parpia, R. (2010); Lai, D. W. L. (2008).Class project part 1
8.Family and Social Worker Roles in Long Term Care: Preventing Burnout.Solomon, R. (2004); Rai, G. (2010); Kane, M. N. (1999); Levine, C., Halper, D., Peist, A., & Gould, D. A. (2010); Malench, S. S. (2004). 
9.Long Term Care and Resistance: Indigenous People and Activism for Social TransformationArmstrong, P. (2020); Berkman, B. J., Gardner, D. S., Zodikoff, B. D., & Harootyan, L. K. (2005); Gao, G. I.-A. (n.d.); Tang, S. Y., & Browne, A. J. (2008). 
10.  Long Term Care and the Use of TechnologyCzaja, S. J. (2016); Gerling, K., Hebesberger, D., Dondrup, C., Körtner, T., & Hanheide, M. (2016); Mois, G., & Fortuna, K. L. (2020).   
11.Spirituality, Quality of Life and Long-Term CareMunn, J. C., & Zimmerman, S. (2006); Munn, J. C., Zimmerman, S., Hanson, L. C., Williams, C. S., Sloane, P. D., Clipp, E. C., Tulsky, J. A., & Steinhauser, K. E. (2007); Richards, M. (2005).Class project part 2
12.Long Term Care and Research: Reclaiming KnowledgeDecker, C. L., & Adamek, M. E. (2004); Geron, S. M. (1998); Simons, K., Shepherd, N., & Munn, J. (2008).Class project part 2
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