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The practice of social work within communities: A key asset

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Karine Levesque RSW
Social Worker, Grand Falls, NB
Board Member Canadian Association of Social Workers

I have been practising social work for nearly 20 years and have been with a small rural unit of a home health care program – the New Brunswick Extra-Mural Program (EMP) – since 2000. EMP’s mission is to provide home health care and end-of-life care to people living with mobility issues, from young children to elderly clients.

Over the course of my career, my perspective of the profession and the role of social work has expanded and developed significantly. Through my education, I was introduced to general practice tools and techniques, but I think many health service providers would agree that it is only through real-life experience that practitioners truly come to understand the depth and complexity of a client and their community. Are we ever truly prepared to intervene in lives shattered by illness or grief or to accompany a person and their family towards the end of life?

Throughout my career, I have had to consider many challenging questions: What will happen to the increasing number of elderly people struggling with mental illness or the stigma still attached to it? How are we protecting the increasing number of those presenting symptoms of dementia and related illnesses? How do we alleviate types of suffering that are often so much more than physical in nature? How can we improve the quality of life of those people suffering and often living in poverty?

I finally realized that my real training has come through the experiences I have had, as I have supported people through difficulty and become a part of their success, despite their health challenges along the way. Today more than ever, as social programs are shrinking and the eligibility criteria to access them are becoming increasingly restrictive, as many rural communities continue to be faced with limited resources, and as the dialogue around privatization of primary care grows ever louder, the key to care is in addressing the needs of a community.

Given that Canada is faced with a growing number of seniors living longer and in poor conditions, I believe that the profession of social work must promote and defend the value and the importance of supporting communities. Spouses, extended family members, other caregivers and secondary community support programs are becoming the pillars of health care for seniors. It seems that we can no longer rely on government programs as we did in the past: hospital stays are becoming shorter and shorter, and access to home end-of-life care is becoming increasingly restricted. In light of these realizations, upon whom can we rely to supplement care? My answer: the community!

As a social worker, I must recognize that the community, family and paid caregiver are all parts of my client’s system and that I have a deeply invested responsibility to defend, protect and support their role in the care provided to my client. Care remains client centred, but if I understand a client as part of a larger system made up of networks and connections – and if I help to foster those connections – a client only stands to gain. Fundamentally, this is social work’s approach to collective well-being.

Social workers help to take care of communities by facilitating access to resources such as safe and affordable housing, fostering social support networks, providing referrals to mental health services or medical care as required, and providing counselling around treatment or how to cope with certain conditions, to give only a few examples. Because of this holistic approach, social work is a profession of choice when it comes to keeping seniors and communities united.

I will conclude by saying that although social workers are often in the minority among their colleagues from the larger health professions, they provide a voice for the community: theirs is a voice for the system of stakeholders and loved ones around a single client, a voice influencing decision-making and the resolution of ethical dilemmas in support of a client, a voice that can keep the various approaches of health professionals focused on the same goal.

One of my colleagues often says that my work with EMP is “real social work,” because my role and my commitments extend far beyond any job description on paper. Like so many other social workers across Canada, my role engages me directly in my clients’ homes and communities, often through some of life’s most difficult times. If the definition of “real social work” is that I approach my work and my clients with compassion each day, having chosen a path that is so much more than just a job, then it remains the best recognition of my work to this day.