To face the challenges of an ageing population, many Western countries nowadays stimulate an ageing in place policy to empower older adults to grow old in their own homes with the highest degree of self‐reliance. However, many community‐living older adults experience limitations in (instrumental) activities of daily living ((I)ADLs), which may result in a need for home‐care services. Unfortunately, home‐care workers often provide support by taking over tasks, as they are used to doing things for older adults rather than with them, which undermines their possibilities to maintain their self‐care capabilities. In contrast, reablement focuses on capabilities and opportunities of older adults, rather than on disease and dependency. Consequently, older adults are stimulated to be as active as possible during daily and physical activities. The 'Stay Active at Home' programme was designed to train home‐care workers to apply reablement in practice. To explore the experiences of home‐care workers with this programme an exploratory study was conducting in the Netherlands, between April and July, 2017. In total, 20 participants were interviewed: nine nurses (including a district nurse), 10 domestic support workers and the manager of the domestic support workers. The semi‐structured interviews focused on the experienced improvements with regard to knowledge, skills, self‐efficacy and social support. Furthermore, the most and least appreciated programme components were identified. The study has shown that home‐care workers perceived the programme as useful to apply reablement. However, they also need more support with mastering particular skills and dealing with challenging situations. Future implementation of the 'Stay Active at Home' programme can potentially benefit from small adaptions. Furthermore, future research is needed to examine whether the programme leads to more (cost‐) effective home care.
The guidance offered here is intended to assist social workers in thinking through the specific ethical challenges that arise whilst practising during a pandemic or other type of crisis. In crisis conditions, people who need social work services, and social workers themselves, face increased and unusual risks. These challenging conditions are further compounded by scarce or reallocated governmental and social resources. While the ethical principles underpinning social work remain unchanged by crises, unique and evolving circumstances may demand that they be prioritised differently. A decision or action that might be regarded as ethically wrong in ‘normal’ times, may be judged to be right in a time of crisis. Examples include: prioritising individual and public health considerations by restricting people’s freedom of movement; not consulting people about treatment and services; or avoiding face-to-face meetings.
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This report summarises the findings of an international study of the ethical challenges faced by social workers during the Covid-19 pandemic, undertaken during 6th-18th May 2020. 607 responses from 54 countries were received via an online survey, additional interviews and local surveys. Six key themes relating to social workers’ ethical challenges and responses were identified: 1. Creating and maintaining trusting, honest and empathic relationships via phone or internet with due regard to privacy and confidentiality, or in person with protective equipment. 2. Prioritising service user needs and demands, which are greater and different due to the pandemic, when resources are stretched or unavailable and full assessments often impossible. 3. Balancing service user rights, needs and risks against personal risk to social workers and others, in order to provide services as well as possible. 4. Deciding whether to follow national and organisational policies, procedures or guidance (existing or new) or to use professional discretion in circumstances where the policies seem inappropriate, confused or lacking. 5. Acknowledging and handling emotions, fatigue and the need for selfcare, when working in unsafe and stressful circumstances. 6. Using the lessons learned from working during the pandemic to rethink social work in the future.
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