Building capacity in palliative care for personal support workers in long-term care through experiential learning

Background

Providing palliative care in long-term care (LTC) homes is an area of growing importance. As a result, attention is being given to exploring effective palliative care learning strategies for personal support workers (PSWs) who provide the most hands-on care to LTC residents.

The purpose of this intervention was to explore hospice visits as an experiential learning strategy to increase the capacity of PSWs in palliative care, specifically related to their new learning, and how they anticipated this experience changed their practices in LTC.

This study utilised a qualitative descriptive design.

Eleven PSWs from four Ontario LTC homes were sent to their local hospice to shadow staff for one to two days. After the visit, PSWs completed a questionnaire with open-ended questions based on critical reflection. Data were analysed using thematic content analysis.

PSWs commented on the extent of resident-focused care at the hospice and how palliative care interventions were tailored to meet the needs of residents. PSWs were surprised with the lack of routine at the hospice but felt that hospice staff prioritised their time effectively in order to meet family and client care needs. Some PSWs were pleased to see how well integrated the PSW role is on the community hospice team without any hierarchical relationships. Finally, PSWs felt that other LTC staff would benefit from palliative care education and becoming more comfortable with talking about death and dying with other staff, residents and family members.

This study highlighted the benefits of PSWs attending a hospice as an experiential learning strategy. Future work is needed to evaluate this strategy using more rigorous designs as a way to build capacity within PSWs to provide optimal palliative care for LTC residents and their family members.

PSWs need to be recognised as important members within the interdisciplinary team. PSWs who shadow staff at hospices view this experience as a positive strategy to meet their learning needs related to palliative care.

In and out of home care decisions: The influence of confirmation bias in developing decision supportive reasoning

The aims of this study were to identify the themes Social Workers regard as important in supporting decisions to remove children from, or return them to, the care of their parents. To further elicit underlying hypotheses that are discernible in interpretation of evidence. A case study, comprising a two-part vignette with a questionnaire, recorded demographic information, child welfare attitudes and risk assessments, using scales derived from standardised instruments, was completed by 202 Social Workers in Northern Ireland. There were two manipulated variables, mother’s attitude to removal and child’s attitude to reunification2 years later. In this paper we use data derived from respondents’ qualitative comments explaining their reasoning for in and out of home care decisions. Some 60.9% of respondent’s chose the parental care option at part one, with 94% choosing to have the child remain in foster care at part two. The manipulated variables were found to have no significant statistical effect. However, three underlying hypotheses were found to underpin decisions; (a)child rescue, (b) kinship defence and (c) a hedged position on calculation of risk subject to further assessment. Reasoning strategies utilised by social workers to support their decision making suggest that they tend to selectively interpret information either positively or negatively to support pre-existing underlying hypotheses. This finding is in keeping with the literature on ‘confirmation bias.’ The research further draws attention to the need to incorporate open questions in quantitative studies, to help guard against surface reading of data, which often does not ‘speak for itself.’

Measuring burnout among UK social workers: A Community Care study

Preface Extract: This research was commissioned and funded by Community Care as part of our Stand Up For Social Work campaign. Previous surveys of readers had suggested caseloads, vacancies and stress levels were all on the increase. Community Care decided to do a more scientific examination of burnout on a large scale to assess the real impact of budget cuts and increasing demand on social workers across the UK.

Handbook of Disabled Children's Childhoods: Building Understandings: Child, Youth, Family and Disability. Palgrave Macmillan:Disabled Children in Out-of-Home Care: Issues and Challenges for Practice Kelly, B., Sandra, D. & Winter, K. 2016

This chapter provides an overview of some of the key findings from a large mixed methods study regarding disabled children in care in Northern Ireland

Why are we Waiting? Research, Policy and Practice in Recruiting and Supporting Same Gender Couples in Child Adoption

The adoption process is renowned for its difficulties, however gay and lesbian couples face unique, additional challenges when choosing parenthood through adoption. The Adoption and Children’s Act (2002), Equality Act (2006) and the Sexual Orientation Regulations act (2007) are some of the recent policy changes aimed at ‘smoothing out’ the adoption process for same-gender couples (Cosis-Brown & Kershaw, 2008). Resultantly, there appear to be more cases of gay adoption than ever before (Equality Britain, 2005), however, anecdotal evidence suggests that across the UK the practice of recruiting and supporting gay and lesbian adopters is inconsistent. Whilst some local authorities encourage and emphasise the importance of stability and high quality care for vulnerable looked after children regardless of parental sexuality (Mallon, 2007); yet case studies of gay and lesbian couples seeking adoption demonstrate the unique challenges they encounter in the adoption process because of religious views (Hicks, 2005) or the attitudes towards same gender parenting of adoption panels and social workers within an unspoken hierarchy (Ahmed, 2008; Dennis, 2006). Government’s drive towards adoption (Unwin and Misca, 2013) of children in care as a favoured alternative should lead to recognition of same-gender couples as an under-utilised resource of potential adopters to be used in the best interest of the children who are looked after. The poster will present the results of research undertaken by the authors during 2012-13 highlighting how research on same-gender parenthood over the past decades has influenced the recent developments in the adoption policy and practice in the UK and worldwide. The poster will identify areas of potential barriers encountered in translating these policy changes in the current practice of adoption with a particular focus on professionals’ attitudes towards same-gender couples as potential adopters.

Exploring the Perceptions of Cultural Competence Among Personal Support Workers in an Ontario Long-Term Care Home: A Case Study

Personal Support Workers (PSWs) spend a large amount of time with long-term care (LTC) home residents providing assistance with their activities of daily living. The s limited research on their perceptions of cultural competence presents the need to bridge this knowledge gap. The researcher conducted a qualitative case study at a LTC home in Ontario. Data were collected by conducting a policy document analysis, a key informant interview with the Director of Care (DOC), and two focus groups with PSWs. The five major overarching themes were: The Culture of the LTC Home, Provision of a Supportive Environment, Collaborative Team Approach to Care, Building a Relationship with the Residents, and Maintenance of Staff Morale. The findings illuminated the broad nature of culture, connections to person centered care, and the factors that facilitate or hinder PSWs’ culturally competent care. The ambiguous perception of cultural competence among PSWs suggests further research and education on cultural competence in LTC home settings.