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G8 Dementia Summit

Following the success of Tony Blair’s HIV/AIDS summit, on Thursday 11th December, David Cameron used his G8 Presidency to hold the first international summit on Dementia. To take this opportunity is to put dementia on the world stage – both as a political issue and as a discussion topic in society – is a significant step. However, the action of the G8 Dementia Summit has to go beyond the political point scoring and facilitate real change.

 

In order to achieve this change, by the summit’s target of 2025, social work has to have a key role. The introduction to the summit clearly highlighted the ‘silent crisis’ that Western society is facing – the number of dementia sufferers is set to treble to 135 million by 2050, with 71% of those coming from low-middle income families.

But what to do about it….

 

Representatives of all the countries that form the G8 (the UK, Canada, France, Germany, Italy, Japan, Russia and the USA) signed a declaration that set out the actions to be taken, between now and 2025, in order to ‘tackle’ dementia. The actions include, but are not limited to, increasing the funding for dementia research, identifying a cure or effective treatment, investing in new care and prevention models, and ensuring that those with dementia are treated with the dignity and respect they deserve.

 

Perhaps one of the most key actions identified by the summit is to engage society in taking action against the stigma that a dementia diagnosis carries. This could fundamentally change social work’s role in the support of dementia sufferers. As a frontline social worker, I often come across those who live with dementia and their families at crisis point. Social work intervention at these times is often vital, but can be traumatic. Not only are the service users and their families trying to navigate this crisis but they also have to cope with the result of the social work intervention; in the most extreme of these cases, this can result in the service user moving away from the family home. Many people with a dementia diagnosis are often struggling to come to terms with this devastating diagnosis and the stigma this brings; therefore, they do not want to approach social services for assistance and support – something which carries its own stigma. However, this means that social workers are unable to support service users and the families during the calmer times to introduce preventative measures and a long term care plan. More investment in social work is required to ensure that social workers can provide these measures and plans as effectively as possible.

 

Prevention and long term care planning are themes that should run through dementia care. The G8 summit clearly identifies that diagnostic and treatment services, in the UK, are lacking in an effective approach. Whilst the current level of austerity should be acknowledged when discussing this, it is estimated that less than 50% of dementia sufferers receive a formal diagnosis; even fewer receive effective and appropriate treatment. The Department of Health has acknowledged that whilst early memory diagnosis clinics exist, much more has to be done to make them effective – at the current time, there are long waiting list for both tests and diagnosis. Results can only be received following the initial referral to a memory clinic; GPs, social workers and other health professionals needs to do more to make sure that they are referring potential dementia sufferers to these clinics for testing.

 

I have recently been working with an older lady, following a number of concerns raised by neighbours and other members of the public. When first meeting this lady, it was very clear that she was experiencing a significant level of cognitive impairment, which went beyond the initial stages. When discussing this with her GP, he acknowledged that this lady was probably experiencing a type of dementia but he had not made a referral to a memory diagnostic service, as he believed that ‘nothing could be done’. This is unacceptable. This has resulted in this lady experiencing a significant amount of distress as she is unsure of what is happening to her, as well as an increased reliance on kindly neighbours and the Police, who were often returning her home when she became lost in town. It is obvious that this case could have been handled so much better, with greater access to diagnostic services and preventative action from the professionals involved.

 

One of the main aims of social work intervention – and identified by the G8 – is for those experiencing dementia to be cared for and supported in the community for as long as possible. As discussed above, prevention and long term care planning have a role to play in this. What is also important, however, is access to other resources, such as flexicare/extra care housing. This is an area in which public health organisation should be involved, not just frontline social workers and primary/secondary health professionals.

 

Flexicare housing schemes are a resource that sits between the provision of sheltered housing and residential care. Similarly to sheltered housing, each resident has their own flat and is able to access communal resources. However, there are also carers on site during the day and night, to ensure that the care needs of the residents are being met. For many of those who experience dementia, this type of accommodation is ideal – they are provided with the care and support that they need, as well as being able to remain in the community. However, there is a significant shortage of these resources around the country. As many areas are struggling with a general shortage of social housing, some housing organisations have stated that only existing social housing tenants can move to flexicare accommodation. This results in those who own their own houses moving straight into residential care, which may not be the most appropriate action. What is required is for each area to have a provision for both existing social housing tenants and existing home owners. It is likely that this would serve to reduce the number of people moving into residential care each year.

 

The G8 were keen to explore the current model of dementia care being utilised in France. Steps have been taken to frame dementia as a societal problem, rather than a health-related problem. This has resulted in health and social care services looking beyond a dementia diagnosis and formulated a person-centred approach to assessment and service provision. This approach includes simple actions, such as looking at a person’s life and background in order to explain some of their behaviours, rather than just seeing the behaviours as things that need to be managed. English dementia care has been heading in this direction for some time; however, at times, this can appear to be largely tokenistic. Access to services can be reliant on a formal diagnosis of dementia – something that is often not being provided, as well as symptoms being seen as things to manage rather than explore.

 

Social work should be at the front line of transforming dementia care – with or without a G8 summit. The summit is right to acknowledge the importance of ‘behind the scenes work’, such as scientific research and testing. What cannot be overlooked, however, is the frontline battle with dementia – an issue that frontline professionals experience on a daily basis. Therefore, it is key that further funding and investment is made into these areas, including social work, to ensure that social workers can support those who experience dementia to come to terms with their diagnosis, prevent crisis and develop long term care plans, so that they will, in the future, receive the care they want, when they may not be able to communicate their needs and wishes.

The G8 summit is right to bring dementia to the world stage. Now it needs to act as the catalyst for change – both behind the scenes and on the frontline. We should not be waiting for 2025 to see significant improvements, progress can be made today.

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The trials and tribulations of writing a journal article…

Picture the scene……

Late Summer 2012 and MSc dissertation results are announced! Hurrah! I did better than I ever expected and now the suggestion has been made that my dissertation is amended for journal publication. Wowie!

So there I am, feeling very flattered and I think to myself – by writing the dissertation and completing the MSc course I have completed the biggest challenge I have ever set myself – amending my dissertation can’t be that difficult!!

What a wally!

Once finishing the MSc course, I thought that I would give myself a little bit of time off and then make a start with the article. However, once I gained my evenings and weekends again, I started to enjoy them and not want to give them up again! Then came my involvement with TCSW and Community Care, so some of my evenings and weekends are taken up with this – and that’s if I finish work (reasonably) on time so I actually have an evening, in the first place!

Suddenly I have found myself in August 2013, with only a few days spent on the article. So here I am, sitting in the British Library (yes – this is me procrastinating!) trying to make sense of the work I need to do.

I realise that submitting the article for publication is a now or never thing. If I leave it too much longer, there will be too much updating to do and I may as well start the article from scratch. However, I am a little bit scared – what happens if the article gets rejected – I know that it is likely to be sent back from the publisher’s with some amendments, but it could be sent back with a big fat no stamped on it!

I am also struggling to find the time – I have taken a couple of days off work to get my head down, but I’m worried that after the work of this week, it will get lost in the ether again. Any ideas for increased motivation would be very much welcomed!

I feel frustrated that I cannot dedicate enough time to this project. The chance of me writing another article whilst practising on the frontline is very rare – and again this frustrates me. My article is focusing on self-neglect and its relationship with safeguarding adults practice. There is a huge gap around effective intervention with those who self-neglect. But if those who are experiencing these issues – i.e. frontline practitioners – are, firstly, not given time to examine the evidence/literature base due to poor dissemination and, secondly, are not supported to contribute to the evidence/literature base, then it is unlikely this that gap in the literature will be remedied for some time.

In my workplace, I do not have easy access to resources, such as journals, that may improve my knowledge and practice, and neither have I been supported to write my article. I feel that this needs to be challenged – but how this can be done, whilst LAs are experiencing such cut backs, requires more time and thought.

Back to it now – hopefully, one day, you will see my article added to my ‘publications and press’ page. Fingers crossed…..

Nikki x

p.s. tips, advice, words of inspiration are all welcome!!

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SW: when professional and personal collide

Hello all – haven’t written for a while. It has been a hectic few weeks/months.

In the last few months, it has transpired that two of my older relatives have required significant health and social care input: one requiring acute hospital treatment and then home care and respite provision, and the other requiring a variety of palliative care resources. 

Needless to say it has seemed that my role as a SWkr in Older People services has breached the work:home divide – and at times, this has become very difficult to manage.

Our role as SWkrs is one that already tests our work life balance and there can be days where ‘switching off’ can be a challenge. This is without bumping into a home carer in the kitchen first thing in the morning, and completing visits to hospital, hospices and nursing homes straight after work. And these situations are of course also very sad and emotive – on a personal level.

Despite the sadness and the stress, I have learnt several things from this experience.

Firstly, I have gained an insight into the battles service users and their families have with health and social care services, and how it can take several days to resolve these. Also, I have seen home carers in action, and the stress and responsibility placed on family carers. Whilst my SW role has previously given me some understanding of these things, I now have an empathy that can only be garnered from experiencing them first hand. I hope that these experiences can and will benefit and improve my practice with the service users and families I work with on a daily basis.

These experiences have also reinforced the importance of emotional resilience during our professional lives and also during difficult times in our personal lives. There have been times over the last few months, when I have slipped into ‘professional’ mode, when actually I should have a let a little more ‘personal’ mode peek through. Yes, it is important for me to check care plans and nursing notes etc to ensure that I and the family have up to date information and that our relatives are getting the appropriate level of care, but not to the extent that the normal, more personal emotions attached to these experiences are suppressed. My ‘professional’ knowledge may be an advantage in these situations, but it is not all I am – the personal and professional need to sit side by side, rather than in a hierarchy. 

As Community Care (www.communitycare.co.uk) has recently been stressing – the importance of meaningful supervision is key – and not only on a professional level. I am by no means a perfect example, but I have made sure that my Supervisor has been aware of what has been happening in my personal life. By doing so, we have been able to explore my feelings and how some of my professional experiences have been impacted by them. After all, you cannot strike out the ‘personal’ completely from the ‘professional’. 

I have also made sure that I have had ‘personal’ supervision. I have talked to my partner about my feelings and views – and listened to his. I have also discussed the issue with friends/family that are more separated from the relatives involved. This has allowed me to reflect and gain different perspectives on my current situation. My partner and I also make sure we take some time out for ourselves when we can. I am always telling family carers that they cannot look after others if they do not look after themselves – I may as well try and practice what I preach!!

Employers should be promoting the development of emotional resilience – especially in these times of significant change. I’d like to think that many employers run training sessions on emotional resilience and/or mindfulness. Check out if yours do now – if they don’t, perhaps this could be raised as a possible option.

Emotional resilience cannot be perfected – as people and professionals we are always in a state of flux and development and will have days that we are more wobbly than others – however, by embracing the key principles of emotional resilience we can prime ourselves with the tools required to make those wobbly days a little less jelly-like.

There is a good blog on resilience at http://www.socialworkbalance.com (and on Twitter @socialworkbalance), which is also a good read. Community Care with the University of Bedfordshire have produced an informative guide to emotional resilience:

http://www.ccinform.co.uk/articles/2012/07/04/6743/guide+to+developing+social+workers%27+emotional+resilience.html

Also, Google is packed with different resources – just search for ’emotional resilience in social work’.

If any of you have an resilience tips, it would be great if you could share them. We can all learn from each other.

I’ll back to write again soon.

This article is dedicated to B.L and E.C – with love. x

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Social Work and the Media

On Friday, I attended a Media Training course at The College of Social Work. It was incredibly interesting – although a tad scary! Nothing like a mock TV interview to get the old palms sweating!! After digesting a long lists of dos and don’ts, what to wear and what not to wear, what to say and what definitely not to say (!), I was grilled about the stereotypes of SW, how to get young people interested in SW as a career, should people take responsibility for their ‘problems’ without involving the state, and the over-political correctness of SW – it was a long few minutes! But all of this had a positive purpose – to promote the College, and in turn promote SW practice.

There were seven of us at the training – all social workers from various backgrounds and roles. What was amazing was the range of media experience we had, how we perceived the media, how we used social media etc – but we were all agreed on one thing – the skewed interpretation of the SW profession by the media. We are here to change it!

As we are all aware, negative SW stories dominate any media attention that SW receives – and there is a significant focus on child protection – which, after all, is only one aspect of SW. It’s our role to change this and spread good news stories and increase the awareness of other areas of SW practice.

The College has a large role in how a more positive interpretation of SW can be garnered, but as frontline, everyday social workers, we are the ones to drive this forward. Those people who blog, contribute to the trade, local and national press are starting the ball rolling. But working to change the perception of SW does not have to be as formal as this. It can be sharing stories with colleagues and peers in the office, at team meetings, in supervision. It can be raising awareness of the media in training sessions or as part of CPD. It can be sharing good news stories with friends and family (obviously within the remit of confidentiality and data protection). It can be sharing links and articles on facebook, retweeting comments from others on Twitter.

Only social workers and the College have the power to change the public face of SW. My aim for this week is to share at least one good new story and/or challenge the stereotype of social work – and you can do it too! So go forth, my dear social workers, and share, share, share!!!

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Post Numero Uno

So. Hello. This is my first blog post – so please bear with me as I make take a while to warm up!
This post won’t be focusing on anything specific, but rather will give you and me a chance to explore what I will get up to.

I am in my first year of SW practice, and whilst I had some experience via my unqualified role before my training, adapting to my SW role has still been a challenge. There have been policies and procedures to get my head around, which no SW training course can teach you about, and there have been ethical dilemmas when I have had to reconcile the ‘ideal’ SW role with the one that have to battle with procedure, low staff morale and fewer resources. But more about that later, I am sure.

I also feel that it is important for me to raise my head out of the front line social worker bubble and dip my toe in academia and the SW evidence base. I am a big believer in research and I hope that one day I can help to remedy the issues with the dissemination of the theory and research finding to the frontline. I try, in my own way, by contributing to Community Care, and here are some examples:

http://www.communitycare.co.uk/blogs/social-work-blog/2013/03/defending-the-use-of-qualified.html

http://www.communitycare.co.uk/blogs/social-work-blog/2013/03/quantifying-a-protected-caseload-is-difficult.html

My particular passion is Safeguarding Adults procedure and practice and I will be commenting on this later, along with my thoughts on the Draft Care and Support Bill.

My SW training has bolstered my drive and passion for SW and SW best practice, and I hope to share of the wisdom of my SW training with you on this blog – along with my thoughts on recent SW developments.

Any SW student will agree that completing a SW degree (either undergraduate or postgraduate) is not an easy undertaking and needs a serious level of commitment and determination. So I am very proud of myself for completing the course – and still having the energy to practice at the end of it! 🙂  However, I certainly didn’t complete this course on my own, I had a lot of support around me.

Firstly, my partner who was also completing a Masters degree and therefore had competing demands for his time. Despite this, he was always there for me, to offer a shoulder to cry on (especially at dissertation time) and steady the ship when there was a storm in the port. A big thank you to him.

Secondly, my Mum and Dad. They let me spout on about SW time and time again, without telling me to be quiet! They also offered my food, water and laughter when times were hard – and proof read my essays! Most importantly they gave me the motivation to carry on and bought me up with a strong sense of care and compassion for others and a commitment to social justice. Characteristics that are vital to my SW practice.

And finally, my Little Bro, who provided non-SW talk and laughs, and culture amongst the dreaming spires.

I’ll stop gushing now. But the point is a serious one, none of us are or should be alone in the battles we fight and challenges we face on a daily basis. If there are people who are alone, then it’s my role to provide the support and guidance they need to fight the next battle, reduce the challenges they face and find their pathway to recovery.

First blog done….more to follow soon….

Nikki x