What is the role of social work and family liaison during global pandemics (such as COVID-19)?
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TABLE OF CONTENTS
IN A NUTSHELL
The COVID-19 pandemic has been challenging for people of all ages, but has been particularly devastating to adults 65 and older, which has highlighted the critical need for ensuring that all social workers gain the knowledge and skills necessary to work with this population4. Brennan et al commentate on social work in Ireland during COVID-19, in particular focusing on its impact on older adults12. Age-stereotyping has become more evident during the COVID-19 pandemic, according to Swinford et al. The authors detail how social workers, during and after the pandemic, can capitalise on momentum, “to increase advance care planning, to reduce social isolation, and expand the use of on-line technology in the provision of services for older people”5. Social workers must advocate for the value of social relationships, and identify creative ways to enhance the social connections of older adults during pandemic responses, or other situations that require physical distancing measures10. Halvorsen et al review information related to older workers during COVID-19, and how they might be affected by this pandemic and its aftermath. In particular, the authors pay close attention to the most socioeconomically and physically vulnerable older workers. The uptake of technology use amongst older adults and the disparities that remain are discussed8.
Gearing et al, discussing SARS, present one of the first studies using qualitative research to investigate the unique perspective of social workers in an epidemic environment15. Similarly Rowlands qualitative study explores the impact of SARS on social work practice in five different hospitals in Singapore. Her findings discussed include the impact of infection control practices on social work intervention, the range of interventions undertaken, respondents’ reflections and self-awareness, the role of values and ethics, creativity and training, and their recommendations for future emergencies16.
IRISH AND INTERNATIONAL GUIDANCE
What does the Irish Association of Social Workers say?
IASW (2020) Guidance for the medical social work profession response to COVID-19[i]
This guidance document has been developed by Sinéad McGarry and Kaylene Jackson; it aims to support the professional response of Irish Medical Social Work Departments to the COVID-19 pandemic. It is informed by the limited literature available on role of social workers in epidemics, broader research on the implications of pandemic work on frontline staff and by preliminary consultation with healthcare staff in Italy. This guidance will be modified and updated as our professional experience and knowledge expands in the weeks and months ahead.
What does The British Association of Social Workers say?
Social Workers are playing and will continue to play an integral role in responding to the COVID -19 pandemic through direct support to people, providing as much continuity of service as possible and responding to new demands and expectations from people. Primary roles include being part of the multi-professional effort to reduce infection risks and related harms and having a key role in addressing the social and economic consequences of emergency measures such as ‘lockdown’, shielding, school and business closures, home working and severe travel restrictions.
At this point in the pandemic, there is opportunity to recognise and reflect on the role of social workers in the first ‘phase’ of the crisis and to look forward to the role of social workers in subsequent phases. This view is informed by international evidence and experiences of social work in disasters and emergencies, and by pre-existing work in the UK by BASW and others on the necessary role of social workers in the aftermath and recovery phases of crises.
Going forward, BASW advocates that the crucial role of social workers in overall public health and wellbeing strategy in this pandemic and its aftermath, and in subsequent disaster planning, should be better recognised and supported at national level, while social workers remain empowered to act to support the local communities, families and individuals they know well. Social workers are key to local response systems and should be supported better to deliver this in normal and extraordinary times.
What does the International Federation of Social Workers say?
IFSW (18 May 2020) COVID-19: The struggle, success and expansion of social work[iii]
IFSW Secretary-General Rory Truell provides an overview of the first 5 months of the social work response to COVID-19. He says there are clear phases highlighting social workers’ struggles and outcomes:
- Making governments recognise that a social response is imperative;
- Advocating for social services to remain open during lockdown;
- Adapting social services to a new world & managing ethical dilemmas; and
- Integrating transformative practice.
Dr Truell comments: “What has become clear is that this transformative process, though far from painless, has seen a new rising of the profession.”
INTERNATIONAL LITERATURE
What does the international literature say?
Berg-Weber, M et al (5 June 2020) COVID-19 Pandemic: Workforce Implications for Gerontological Social Work[iv]
The COVID-19 pandemic has been challenging for people of all ages, but particularly devastating to adults 65 and older, which has highlighted the critical need for ensuring that all social workers gain the knowledge and skills necessary to work with this population. While there is a critical shortage of gerontological social workers, and we must continue to increase that number, we cannot wait for this to occur. In this commentary, the authors call for infusing the current social work curricula with aging content; providing current social workers with trainings on aging practice; and all social work practitioners, faculty and researchers to address four specific areas that have gained prominence due to the impact of COVID-19: ageism; loneliness and social isolation; technology; and interprofessional practice.
Swinford, E et al (18 May 2020) Applying Gerontological Social Work Perspectives to the Coronavirus Pandemic[v]
Social workers are familiar with the challenges brought on by the coronavirus pandemic. We apply three gerontological social work perspectives that might increase our chances of minimizing negative outcomes and improving health and quality of life for everyone. First, the reality that the older population is very heterogeneous challenges ageism and age-stereotyping that has surfaced with COVID-19. Second, concepts of cumulative disadvantage and intersectionality offer clear explanations of the disparities that are being illuminated and lead us to advocate for fundamental changes to reduce disparities in later life and for people across the life course. Third, a strength-based perspective highlights the assets of the older population and the opportunities for positive developments coming out of the crisis. We can capitalize on momentum to increase advance care planning, to reduce social isolation, and expand the use of on-line technology for service provision. We can bolster our arguments to support older workers, volunteers, and caregivers. The fact that these social work perspectives are so applicable to the COVID-19 situation reminds us of their fundamental relevance. Gerontological social work has much to offer in our roles as researchers, educators, practitioners, and advocates during this crisis, and our foundational principles serve us well.
This letter is a call to action for social workers to make efforts to close the digital divide. As a profession, social workers must make strides to ensure that individuals of all ages have access to, and the ability to use, the technological resources available to improve health and well-being, during and after the COVID-19 pandemic.
Miller, V et al (27 May 2020) [Letter] Social Work Values in Action During COVID-19[vii]
COVID-19 has ravaged through the lives of individuals, families, communities and societies, and, in the process, exacerbated existing vulnerabilities, oppression and poverty among our most at-risk community members. Social workers, guided by values and ethics, are counteracting these ailments in society, concentrating on protecting the most vulnerable, older adults. In this letter we describe the impact of COVID-19 on older adults, note social work values from the National Association of Social Workers, and expand on the current role of the practicing social worker values in action during COVID-19.
It has long been the goal of many gerontological social work scholars to increase the ability and opportunity for people to be engaged in paid and unpaid work throughout the life course. Yet the COVID-19 pandemic is revealing and exacerbating the financial insecurity of many older adults. In this paper, we review information related to older workers and how they might be affected by this pandemic and its aftermath, paying particular attention to the most socioeconomically and physically vulnerable older workers. We also offer first-hand experiences from our careers working with and conducting scholarship on older workers, paying particular attention to recent actions by many in the Senior Community Service Employment Program (SCSEP) network to provide paid sick leave to its low-income, older adult participants. We conclude with implications for social work scholarship and teaching, noting the uptick in technology use among older adults and the disparities that remain, as well as teaching that integrates discussions on the lifelong and cumulative effects of inequalities and marginalization and the need for additional researcher, student, and community collaborations.
In the United States and many other countries, nursing homes are not the only congregate setting that serves older adults with underlying chronic medical conditions. More so, they have been a shrinking component of the residential long-term care system, with some of the largest growth having been in assisted living. Assisted living communities provide supportive care, at least 2 meals a day, and 24- hour supervision to individuals who need daily supportive care, but not daily nursing care. Importantly, assisted living communities are not the same as nursing homes. In fact, there are several distinct components of assisted living that make this a unique setting and one not to be ignored in relation to COVID-19 planning and response. This editorial summarizes key differences and their related implications for care.
The public health response to the COVID-19 pandemic involves physical distancing measures which have the potential to lead to increased social isolation among older adults. Implications of social isolation are potentially wide-ranging including poorer health outcomes, disruption of social interactions and routines, reduced meaningful activity, reduced social and emotional support, loneliness, potential for grief, loss, and trauma responses, limited access to resources, and reduced physicality. Social workers must advocate for the value of social relationships and identify creative ways to enhance the social connections of older adults during pandemic responses, or other situations that require physical distancing measures.
Despite COVID-19 being a novel experience, it is neither the first example of, nor the first instance where, the social work profession has played a significant role. Human history is punctuated by tragedy, often troubled by social barriers influencing the depth and breadth of response. It is here where social workers have, historically, been on the frontlines, responding to pandemics and emergency situations. The current global health crisis provides opportunity to reflect on prior social work responses to prior pandemic situations and serves to inform future research and practice for vulnerable older adults.
Brennan, J et al (18 May 2020) Social Work, Mental Health, Older People and COVID-19[xii]
In this commentary, we will explore the work of social work in Ireland in addressing the impact of the coronavirus 2019 (COVID-19) crisis on older people in general, and older people who have an enduring mental illness.
Once in a century, in the era of global warming and globalization, there are international warnings about the outbreak of the virus COVID-19. People are facing increasing threats from potential isolation, infection and even death. We are uncertain about when it will end and where outbreaks might occur, or who is afflicted. Human interactions are tempered by uncertainty and even fear that a colleague or ourselves could unknowingly be contagious. The virus does not recognize different governments, money, ideologies, national boundaries, ethnicity, class or identity. Our response must be as one global village, and social work can play a leadership role.
Rauktis et al, in their letter, put forward the concept of pet ownership as a potential aid to older adults in the community living in fear and isolation of COVID-19. They discuss the role social workers may have in examining the relationship clients have with their pets, as potential strengths, stressors or both.
This study is the first using qualitative research to investigate the unique perspective of social workers in an epidemic environment. The results reflect the social workers’ subjective experience of their interventions with patients and families and indicate that a number of professional tenets such as advocacy, family-centered approach, knowledge of systems, open communication and ethics effectively supported social work practice in a crisis environment.
Rowlands, A (2007) Medical Social Work Practice and SARS in Singapore[xvi]
This article reports on the findings of a qualitative study exploring the impact of SARS on social work practice in five different hospitals in Singapore. The study sought to examine the range of interventions adopted by 28 medical social workers and the theoretical orientations underpinning them. The findings discussed include the impact of infection control practices on social work intervention, the range of interventions undertaken, respondents’ reflections and self-awareness, the role of values and ethics, creativity and training, and their recommendations for future emergencies. While the findings of the study relate specifically to hospital social work practice, the crisis and trauma nature of the work makes it applicable to a broader range of practice in these areas and a range of populations. The findings from this study could also inform the development of training programs for social work and other clinical health workers, and emergency management planning.
Rosoff, P (October 2008) The Ethics of Care: Social Workers in an Influenza Pandemic[xvii]
The challenges of caring for the incurable, the uncured, healthcare workers and the survivors and their families will place almost unprecedented demands on mental health workers. This article discusses these ethical and medical challenges and the role that social workers will be called on to play.
This article explores the experiences of foreign residents during the period of the Middle East Respiratory Syndrome (MERS) outbreak in South Korea and discusses from a social work perspective the implications of their experiences and needs. Data were obtained from interviews with 22 foreigners who either live and work or study in South Korea. The data were then interpreted using a thematic analysis approach in a multilingual research context. The findings from the study show that foreign residents experienced a wide range of social and psycho-emotional difficulties during the MERS health threat. Implications for social work practice in an epidemic emergency are presented.
OTHER SOURCES
Casey, A (May 2020)[Blog] Medical Social Work Teams: The Impact of the COVID-19 Pandemic[xix]
The changes in work practice required during the COVID 19 pandemic have impacted on the delivery of the social work service in the Mater Misericordiae University Hospital (MMUH), Dublin. These changes apply to both how we interact with patients and service users and also how we communicate internally as a team. This paper aims to examine of the impact of this crisis on social work teams. Whilst the team in the MMUH is an integral part of a wider multidisciplinary structure, there are key features particular to the social work profession which have been profoundly impacted by this crisis. Equally significant is the underlying ethos and culture within our department which has been challenged by the necessary adaptations presented by COVID-19.
Right now, as we live through the time of COVID 19, it is even harder to be at home, together all the time. We are living through uncertain and strange times. Normal routines are disrupted. It is almost impossible to escape the tension and stress if you’re living with it all the time, without the break usually brought about through the separation thanks to school, training course, work or getting together with friends. There is uncertainty about when and how all our lives can begin to return to some sort of normal routine. In lots of different ways, we have all had to adapt the ways we work and live.
[i] IASW: https://www.iasw.ie/page/568
[ii] BASW guidance for The role of social workers in a pandemic and its aftermath: learning from COVID19. Published 28 May 2020 (version 1)
[iii] IFSW: https://www.ifsw.org/wp-content/uploads/2020/05/2020-05-18-COVID-19-the-struggle-success-and-expansion-of-social-work-1.pdf
[iv] Berg-Weger M, Schroepfer T. COVID-19 Pandemic: Workforce Implications for Gerontological Social Work [published online ahead of print, 2020 Jun 5]. J Gerontol Soc Work. 2020;1‐6. doi:10.1080/01634372.2020.1772934
[v] Swinford E, Galucia N, Morrow-Howell N. Applying Gerontological Social Work Perspectives to the Coronavirus Pandemic [published online ahead of print, 2020 May 18]. J Gerontol Soc Work. 2020;1‐11. doi:10.1080/01634372.2020.1766628
[vi] Gibson A, Bardach SH, Pope ND. COVID-19 and the Digital Divide: Will Social Workers Help Bridge the Gap? [published online ahead of print, 2020 Jun 5]. J Gerontol Soc Work. 2020;1‐3. doi:10.1080/01634372.2020.1772438
[vii] Miller VJ, Lee H. Social Work Values in Action during COVID-19 [published online ahead of print, 2020 May 27]. J Gerontol Soc Work. 2020;1‐5. doi:10.1080/01634372.2020.1769792
[viii] Halvorsen CJ, Yulikova O. Older Workers in the Time of COVID-19: The Senior Community Service Employment Program and Implications for Social Work [published online ahead of print, 2020 Jun 5]. J Gerontol Soc Work. 2020;1‐12. doi:10.1080/01634372.2020.1774832
[ix] Zimmerman S, Sloane PD, Katz PR, Kunze M, O’Neil K, Resnick B. The Need to Include Assisted Living in Responding to the COVID-19 Pandemic. J Am Med Dir Assoc. 2020;21(5):572‐575. doi:10.1016/j.jamda.2020.03.024
[x] Campbell AD. Practical Implications of Physical Distancing, Social Isolation, and Reduced Physicality for Older Adults in Response to COVID-19 [published online ahead of print, 2020 Jun 5]. J Gerontol Soc Work. 2020;1‐3. doi:10.1080/01634372.2020.1772933
[xi] Tyrone C. Hamler, Sara J. English, Susanny J. Beltran & Vivian J. Miller (2020) A Reflection of and Charge to Gerontological Social Work: Past Pandemics and the Current COVID-19 Crisis, Journal of Gerontological Social Work, DOI: 10.1080/01634372.2020.1766629
[xii] Brennan J, Reilly P, Cuskelly K, Donnelly S. Social work, mental health, older people and COVID-19 [published online ahead of print, 2020 May 12]. Int Psychogeriatr. 2020;1‐5. doi:10.1017/S1041610220000873
[xiii] O’Leary, P., & Tsui, M.-S. (2020). Ten gentle reminders to social workers in the pandemic. International Social Work, 63(3), 273–274. https://doi.org/10.1177/0020872820918979
[xiv] Mary E. Rauktis & Janet Hoy-Gerlach (2020) Animal (Non-human) Companionship for Adults Aging in Place during COVID-19: A Critical Support, a Source of Concern and Potential for Social Work Responses, Journal of Gerontological Social Work, DOI: 10.1080/01634372.2020.1766631
[xv] Gearing RE, Saini M, McNeill T. Experiences and implications of social workers practicing in a pediatric hospital environment affected by SARS. Health Soc Work. 2007;32(1):17‐27. doi:10.1093/hsw/32.1.17
[xvi] Rowlands A. Medical social work practice and SARS in Singapore. Soc Work Health Care. 2007;45(3):57‐83. doi:10.1300/J010v45n03_04
[xvii] Philip M. Rosoff MD (2008) The Ethics of Care: Social Workers in an Influenza Pandemic, Social Work in Health Care, 47:1, 49-59, DOI: 10.1080/00981380801970814
[xviii] Park HJ, Lee BJ. The Role of Social Work for Foreign Residents in an Epidemic: The MERS Crisis in the Republic of Korea. Soc Work Public Health. 2016;31(7):656‐664. doi:10.1080/19371918.2016.1160352
[xix] Irish Social Work Blog: https://irishsocialwork.wordpress.com/2020/05/05/medical-social-work-teams-the-impact-of-the-COVID-19-pandemic/
[xx]Irish Social Work Blog: https://irishsocialwork.wordpress.com/2020/05/01/challenging-behaviour-non-violent-resistance-nvr-and-parents-carers-in-a-time-of-COVID-19/
Produced by the members of the National Health Library and Knowledge Service Evidence Team†. Current as at 16 June 2020. This evidence summary collates the best available evidence at the time of writing and does not replace clinical judgement or guidance. Emerging literature or subsequent developments in respect of COVID-19 may require amendment to the information or sources listed in the document. Although all reasonable care has been taken in the compilation of content, the National Health Library and Knowledge Service Evidence Team makes no representations or warranties expressed or implied as to the accuracy or suitability of the information or sources listed in the document. This evidence summary is the property of the National Health Library and Knowledge Service and subsequent re-use or distribution in whole or in part should include acknowledgement of the service.
Dympna Lynch, Librarian, Cavan General Hospital [Author]; Leona Burgess, Revenue Library and Research Centre, Office of the Revenue Commissioners, D’Olier Street, Dublin [Author]; Margaret Morgan, Librarian, Mullingar General Hospital [Author]; Brendan Leen, Area Library Manager, HSE South [Editor]
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.