Social Work: Profession of Choice – and Choices

March was social work month, and the theme this year was “Social Work – Profession of Choice.”

Connie Pilgrim chose the area of long-term care 16 years ago, at the beginning of her career, and has been there ever since. The regional social work coordinator says it’s a truly rewarding profession and an inspiring area of practice.

“As social workers, we are often one of the first people a new resident and their family meet when they come to the nursing home,” Connie adds. “This can be a difficult time in people’s lives and a time when you learn so much about people’s strengths and their resilience.”

(l-r) Masonic Lodge resident Mary Doyle with Connie Pilgrim, regional social work coordinator with Eastern Health

(l-r) Masonic Lodge resident Mary Doyle with Connie Pilgrim, regional social work coordinator with Eastern Health

Connie says throughout her career, she’s often paused to think about how she would cope if it were her or her family member moving into a nursing home.

“It’s so important to find out about who each resident is as an individual, to recognize the richness of their lives and their strengths, and to find out about their goals and their values.”

Debbie Hollett agrees. A regional social worker for palliative care within long-term care, she says, “Being a social worker for palliative care in long-term care, truly gives you the opportunity to become involved with residents and their families at an important and critical time in their lives,” she says.

“To journey with residents and their families throughout their illness and at the end of their lives is incredibly humbling and teaches us things that we never thought possible.”

Both Debbie and Connie believe that one particularly valuable area of their profession is to be able to make a difference in the lives of people who are at the end of their life.

And in many ways, that time of life is about choice, as well.

“Working in long-term care, I’ve learned a lot about people’s hope and how people’s views and values can change as their circumstances change,” Debbie says. “Being able to talk with residents and their families about what their hopes and wishes are around end of life is one area that brings meaning to my work.”

Both Debbie and Connie share a passion in promoting the importance of advance care planning. This kind of planning is about the conversations you have with family, friends and health care providers about your health care wishes – at a time when you can no longer speak for yourself.

Eastern Health social workers Connie Pilgrim and Debbie Hollett

(l-r) Eastern Health social workers Connie Pilgrim and Debbie Hollett

Eastern Health is getting ready to launch an organization-wide policy on advance care planning later this year – so the conversation will be started at all levels – acute care, community care and long-term care.

“Research shows us that the majority of Canadians feel it is important to have a conversation with their loved ones about their wishes for care in the event that they cannot speak for themselves,” emphasizes Debbie. “We also know that, while they recognize that it is important to have these conversations, the majority have not – and even fewer have completed an advance health care directive (plan) to communicate their wishes.”

An Advance Health Care Directive (AHCD) is a written document that describes your health care wishes, in the event you cannot speak for yourself. A Substitute Decision Maker (SDM) is the person(s) who will make medical decisions on your behalf if you are unable to communicate your wishes because of illness and /or injury.

Sometimes what is missing is the information – and comfort level – in discussing these hard topics. “As social workers, we recognize the need is there for people to have information and education,” Debbie points out. “It gives me a sense of accomplishment and value in my work when I am able to help people with this.”

In the past year or so, the pair has developed posters about advance care planning and, with the help of social workers in long-term care, displayed them in all nursing homes in Eastern Health. They also offered presentations to residents, families and staff at various nursing homes and personal care homes.

Debbie Hollett giving presentation on advance care planning

Debbie Hollett giving presentation on advance care planning

Connie says the presentations were well-received, promoting a discussion among many who would not have expressed their wishes otherwise.

“During one of the sessions a woman spoke up when we were reviewing information regarding a Substitute Decision Maker,” Connie added. “She told us that she didn’t have any family to act as her decision maker, and pointed to a friend sitting next to her and said ‘she is all that I have.’ So Debbie and I met with her following the session and helped her complete her Health Directive in which she appointed her friend as her decision maker.”

Connie says this provided the woman with the opportunity to make the decision while she had the mental capacity to do so – an opportunity that might have been lost if her capacity changed and she didn’t have a decision maker previously appointed.

Debbie adds that although the conversations can sometimes be difficult, the majority of participants said they were more comfortable talking about advance care planning than they were before attending the session. They heard comments like: “It will get people talking,” and “It is such an important topic and this stresses it.”

The work that Debbie and Connie have done for advance care planning has been referenced in an article on the National Advance Care Planning website entitled “Getting the conversation started in Newfoundland and Labrador.”

And the conversation continues for Advance Care Planning Day this year – on April 16, 2015.

This year the pair will offer information sessions on advance care planning to clients waiting for long-term care placement, while their social work colleagues within long-term care continue to put up poster displays and co-facilitating information sessions, including ones at:

  • Placentia on April 14 at 1 p.m. at Lion’s Manor
  • Clarenville on April 15 at 1 pm. at Dr. O’Mahoney Manor
  • John’s on April 16 at 10 a.m. at Mount Pearl Square

IMG_Advance Care_470

They encourage people to have conversations with their family, with their friends, with their family doctors about their wishes, even though we all struggle with discussing such sensitive topics, and they take great pride in the fact that the conversations they initiate, in turn, makes those conversations easier.

“When working with families whose loved ones are not able to make their own decisions, it becomes abundantly clear the sense of relief that people feel when they’ve had those conversations with their loved ones in advance and are able to carry through with their wishes,” says Debbie.

“To me, that is truly a gift that someone can give their family member.”

Connie adds: “I feel blessed that I’m in a profession that has prompted me to have these conversations with my own family – while helping those I work with to have these conversations with their loved ones.

“Sometimes, as social workers we lose sight of how privileged we are with the education we have received and the opportunities this provides us with. As I’ve always said, ‘I wouldn’t choose to do anything else.’”

For more information on Advance Care Planning sessions within Eastern Health, contact: Debbie Hollett at (709) 752-8731 or Connie Pilgrim at (709) 752-8795. To learn more, please visit the national website on Advance Care Planning.

This story was submitted by Janice Dalton, a manager with long-term care at Eastern Health, in consultation with social workers Connie Pilgrim and Debbie Hollett.

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