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Care management and professional autonomy: the impact of community care legislation on social work with older people
- Author:
- LYMBERY Mark
- Journal article citation:
- British Journal of Social Work, 28(6), December 1998, pp.863-878.
- Publisher:
- Oxford University Press
This article explores the extent to which the role of care manager has altered the nature of social work practice with older people. It outlines key theories of professions and their applicability to social work, and critically analyses the impact of the 'new managerialism' within social services departments. The article also examines the nature of social workers' practice with older people following the impact of community care legislation, and concludes that the impact on the social work profession has been to locate an increasing control of practice with social work managers, with potentially serious consequences for the continuation of a distinctive social work role in relation to services for older people.
Gerontological social work practice in the community. (Journal of Gerontological Social Work, vol.8, no.3/4)
- Authors:
- GETZEL George S., MELLOR M. Joanna
- Publisher:
- Haworth Press
- Publication year:
- 1985
- Pagination:
- 274p., bibliogs.
- Place of publication:
- New York
Social work with older people of tomorrow: restoring the person-in-situation
- Author:
- SILVERSTONE Barbara
- Journal article citation:
- Families in Society, 86(3), July 2005, pp.309-319.
- Publisher:
- The Alliance for Children and Families
The author proposes that, in practice with older adults, the social work profession revisit its traditional allegiance to the person-in-situation paradigm and redress an imbalance that has obscured older clients as persons in their own right. The case is made that older adults and their subjective reality must be restored as a focus of social work practice if the profession is to play a significant and much-needed role in community-based services to a growing future population of older persons living in their own homes and directing their lives but in need of support. Building on the practice wisdom of the past and current generic models of social work practice in North America, guidelines are presented as a starting place for building practice models applicable to older clients. The broader context of community health and social services programs is examined from the perspective of the obstacles to and potential opportunities for increasing professional social work services to older persons and their families.
Things fall apart: the centre cannot hold; deconstructuring and reconstructing social work with older people for the 21st Century
- Author:
- POSTLE Karen
- Journal article citation:
- Issues in Social Work Education, 19(2), Autumn 1999, pp.23-43.
- Publisher:
- Association of Teachers in Social Work Education
The NHS and Community Care Act 1990 radically changed the task of social workers, usually termed 'care managers', working with older people. Many staff express dissatisfaction with this change, contrasting care management's bureaucratisation with this change, contrasting care ménage's bureaucratisation with social work's interpersonal nature. However, 'social work', with unresolved disputes about professional identity, and its ambiguous nature, was never clearly defined. This article argues that care management is located within a contemporary, postmodern society, characterised by uncertainty, change and lack of clarity, presenting threats as well as opportunities for challenge and change both for the social work role in effectively and appropriately meeting the needs of older people, and for social work education in training staff to undertake this task.
Social workers in community care practice: ideologies and interactions with older people
- Author:
- SULLIVAN Mary Pat
- Journal article citation:
- British Journal of Social Work, 39(7), October 2009, pp.1306-1352.
- Publisher:
- Oxford University Press
This paper explores community care practice with older people, emphasizing the ideological underpinnings in practice and their influence on practice interactions. Social work practitioners working on older people's teams in two contrasting communities in England were interviewed to discuss their assessment and care management interactions with older people. Using grounded theory and Goffman's theoretical constructs within frame analysis, a conceptual model for practice emerged, reinforcing that practitioners' understandings of social events, anchored in government and professional discourse and individual perceptions about older people, enabled them to organize and influence the interaction to lead to a professionally determined outcome. The routine work of assessment and care management became very powerful in absence of strategic intention by the practitioner. A move to more strategic behaviour occurred when practice dilemmas required practitioners to intervene, informed by their professionally based values juxtaposed against those supported within official discourse. The findings provide an insight into how social work practitioners manage to deliver community care in a complex environment. The outcomes also reinforce the need for practitioners to develop an understanding of how they construct their social realities, as this may impact on the experience of community care for older people.
Alice Johnson: case study research of collaborative practice within community care
- Authors:
- HIGHAM Patricia, SPOONER Anne-Karin
- Journal article citation:
- Health Care in Later Life, 3(2), 1998, pp.111-128.
This research-based case study of Alice Johnson, the pseudonym for an elderly Afro-Caribbean woman living in the UK, analyses the practice outcomes of a 'real life' situation. In order to identify the most helpful interventions, the research evaluated collaborative practice from the different perspectives of the service user and the care providers, using the care management of one elderly individual, Mrs Johnson, as a focus. Although no generalisations can be claimed from one example, the single case study design provided a valid analysis of collaborative practice outcomes in an elderly person from an ethnic and cultural minority and living in the UK, who received community care. The use of a research perspective based on a qualitative life history approach is an analytical tool that can contribute to increased practice expertise.
Making sense of needs assessment
- Author:
- RICHARDS Sally
- Journal article citation:
- Research Policy and Planning, 12(1), 1994, pp.5-9.
- Publisher:
- Social Services Research Group
Underlying the community care reforms is an ambiguous approach to the concept of need. Outlines the implications of this for practitioners and describes the development of an ethnographic study of the assessments of elderly people which explores how the concept of need is handled in practice.
Development of a test of physical performance for the nursing home setting
- Authors:
- DIWAN Sadhna, et al
- Journal article citation:
- Gerontologist, 41(5), October 2001, pp.680-686.
- Publisher:
- Oxford University Press
This article presents a brief screening tool to help case managers in the USA. Identify clients in a home and community-based services (HCBS) programme who need more intensive social work case management (CM). Using existing data from a case management time study and a content analysis of 70 cases in a Medicaid waiver-funded HCBS programme, this study highlights a number of issues, such as dementia-related behaviour problems, noncomplicance with treatment, poor informal caregiver health and mental health, and conflicted or problematic relationship between client and caregiver, which are useful in predicting need for intensive case management. Kappas for inerrater reliability and tests for discriminant validity show these items to be reliable and valid. This tool will allow for better allocation of CM resources in terms of case manager time and type expertise needed to address these issues.
Breaking the cycle
- Author:
- GEORGE Mike
- Journal article citation:
- Community Care, 24.8.00, 2000, pp.30-31.
- Publisher:
- Reed Business Information
An older woman with mental health problems has been going back and forth from her house to hospital for many years. Now, she has been referred to an assertive outreach team. Her social worker explains how the team has attempted to improve the well being of the client.
Older people, care management and interprofessional practice
- Authors:
- STANLEY David, REED Jan, BROWN Sharon
- Journal article citation:
- Journal of Interprofessional Care, 13(3), August 1999, pp.229-237.
- Publisher:
- Taylor and Francis
Research conducted by the authors into care management and user satisfaction with older people identified a lack of clarity concerning role function of the care manager. This article presents data from that study. It focuses on the views of older people, carers, health professionals and care managers. Interprofessional working implications for the development of the care manager role, the development of services and for training are explored.