Aged Care: opportunities for social work to make a difference

Building an Integrated Practice in the Private Sector

By Lynne Harrold

The community aged care sector for older adults is growing exponentially and will continue to do so as our population ages. The facts are there and the projections are clear, but despite this knowledge it seems that private social workers are lagging somewhat behind other professions in moving into this sector.  The challenge has in part been to do with the reluctance of this current aged cohort to seek our services,  and the restrictions of Medicare funding for residents in high care facilities. However all that is changing.

The current ageing of the very psychologically minded baby boomers has begun to change the culture in this sector with the demand growing for any type of service that can assist their needs. Furthermore funding streams are opening up. Prior to the introduction of My AGED CARE and the NDIS, private work in this field has been primarily limited to accredited mental health social workers via Medicare and DVA.

Changing systems creates opportunities and this is the time to start embracing these changes and start claiming our space in the market. We are needed and if we do not take leadership as a profession to claim that space, social workers will miss out and so will our clients.

The sector is becoming increasingly competitive with corporate enterprises vying for their share, in what is expected to be an increasing consumer driven market. Large GP super clinics employing allied health teams are partnering with some of the larger retirement villages and residential aged care facilities, which in effect make it difficult for the sole practitioner to access clients. Psychologists are developing specialist gerontology courses and positioning themselves in Aged Care facilities.

So how does the lone social worker navigate this terraine? How do we position ourselves in the market? Do we go it alone or are there safer options?

I would like to share my experience of how I am attempting to navigate this changing system on the NSW Central Coast an area which has the highest proportion of people aged 65 and over in the country. After many years of working as a sole practitioner in Sydney I made the decision only 12 months ago to resettle.  I also wanted to work with a team of like- minded social workers. The professional isolation of the sole practitioner was no longer for me.  I wanted to build a service that included a team of social workers who could deliver an array of services to the community aged care sector. My vision was to create mobile services for older adults living at home, and educational support to the aged care workforce. Not quite 10 months later I now have three people on that team with huge potential to grow.

So how has this been achieved?

We have aligned ourselves with several other private allied health services to set up the Central Coast Allied Health network. This network provides an array of mobile services to give wrap -around assistance to older adults  at home. Being able to offer a more holistic service to our clients is something that is crucial in being able to work with this age group who often have complex physical, social and mental health needs.

The network includes occupational therapists, dieticians, speech therapists, exercise physiologists, physiotherapists, podiatrists, naturopaths and of course social workers. It is this alliance and the cross referrals from these services that has created the foundation from which we grew our business in the early months. We facilitated this by educating each business as to our role, when referrals would be appropriate to our service and how we could best work together.

Apart from the advantages of cross referral the network is an effective way to market our service as a team or as individual service which is another bonus. It is a much easier way to access clients than attempting to market directly to GP’s. We did attempt to see individual GP’s when commencing the service but there was little interest in us as social workers. As our service has grown we are now beginning to get referrals directly from the GP’s! A sign to us of emerging success.

As a large network of specialised allied health providers we are also more strongly positioned to apply to funding bodies like our local Primary Health Network, which is more interested in funding larger conglomerates than individual providers.

We are not aligned to a large medical conglomerate choosing to keep autonomy of our business and our work and not be restricted to a medical model. The strength in this is that we are not paying the exorbitant rent and commission fees that many allied health providers are forced to do if they work in a large medical practice, or are contracted by many of the emerging corporate allied health companies that are now emerging.

As private social workers we are guided in business by our strong social work values and ethics, which in fact lend themselves beautifully to growing an ethical business.

As the business develops new opportunities arise.

Recently we signed up with two major community care providers as the sole service to provide counselling & general social work services to their clients and carers. Our services are being funded through the new care packages and also through Medicare and DVA. We are extremely interested to see how these packages work for our clients and for us. By working closely with these organisations, educating them on the bio/psycho/social needs of their clients and how we can assist them with their clients we believe that we are facilitiating cultural change within these organisations to better care for the needs of this age group.

We are very much aware that if our service is to survive and grow into the future there are real challenges ahead. Our challenges are the challenges that we as a profession are needing to address now if we are to secure a space for social work .

The first is recruitment. It is difficult to find social workers who have mental health accreditation and experience in either working with older adults or knowledge of the aged care system. Both are needed as are social workers with palliative care experience.

Secondly we need to stand out from the crowd as offering specialist skills.

Community aged care organisations provide untrained support workers and pastoral care positions to largely service the emotional distress needs of their clients. We need to be able to market ourselves as offering specialist skills. Credentialing gerontology and palliative care social work is much needed as is the opportunity to develop evidence based individual and group programs.

We also need the infrastructure as a profession to be able to network each other not only for recruitment purposes but to be able to strongly advocate for our clients. We are dealing with some of the most marginalised people in our society and need to be united in our quest for social justice in this sector.

I can truly say that I have never felt more of an advocate for my clients or for my profession since moving into the private sector. I strongly encourage others to get involved. Yes it is challenging but extremely rewarding and there is more than enough work for all of us now and in the future.

Lynne Harrold BSW/MSW had over two decades of working in community mental health before moving into fulltime private practice in 2006.She has subsequently worked predominantly in the private Aged Care sector. She is  the convenor of the NSW self-employed practice group as well as an executive member of MHSWiPP.

It was a pleasure to host this article on my blog. It was originally slated to appear in the AASW magazine- In Focus- but was pulled as it was deemed to give unfair publicity to Lynne during the AASW election period!