A Study on the Roles and the Difficulties of Social Workers in Nursing Homes

• Main Authors: CHENG,HUI-HSIN, 鄭惠心
• Other Authors: HOU,CHIEN-CHOU
• Format: Others
• Language: zh-TW
• Published: 2015
• Online Access: http://ndltd.ncl.edu.tw/handle/39t2nj

碩士 === 玄奘大學 === 社會福利與社會工作學系碩士在職專班 === 103 === Abstract According to statistics show that total 1,046 elderly welfare agencies under social policy system, and there are 447 registered nursing homes under health and welfare system in 2013.However, aging process is inevitable associated with physiological function weakening, and as a result, the demand for nursing homes of Medicare function is rising over recent years.In the meantime, lawmakers and all kinds of statistics are taking seriously of the importance of aging index.On the other hand, manpower and consistent investment in long-term care is not only necessary but also crucial. Nursing homes mainly focus on medical care, and affiliated professionals are usually given distinctly duties. On the contrary, people often turn a blind eye to professional ability of social workers and their unique position under health and welfare system. As a former social worker, the research will discuss what roles do social workers play in nursing homes, their expectation and self-awareness according to own experience. The purpose of this research is to illustrate for four following topics: First of all, to understand the professional role and functions of NHSWs; secondly, to discuss what kind of difficulties that NHSW face during servicing process; thirdly, to figure up action plans for HNSWs who might face difficulties in a process of providing services; and finally, to propose comprehensive suggestions to improve NHSWs working conditions. This study was conducted with qualitative methods and literatures reviewing, and incorporated with semi-structured interview outline. The experienced researcher selected six interviewees which were social workers or department managers from independent agencies or nursing homes attached to hospitals, all of them were received a in-depth interview till data saturation. The researcher studied macro, intermediate, and micro perspectives, and summed up the result that indicated NHSWs usually acting different roles with specific functions, and moreover, the difficulties that they faced in nursing homes.According to the analysis, there are seven factors that influenced HNSWs working conditions: (1) Human resource shortages;(2) HNSWs’are isolated from professional position or their actual roles; (3) Inefficient team communication;(4) Limited working time for part-time social workers;(5) Approaching to a “Gold Standard” of evaluation could be difficult;(6) Cost consideration might lead to poor service quality; and (7) Human resource is insufficient to serve all the needs. In practice all those difficulties that HNSWs are facing. Nevertheless, the researcher came up strategies according to the point of view of policies, systems and in practice.There are three strategies of policy: (1) Boost government funding to resolve the problem of human resource shortages; (2) To manipulate the greater resource from the agencies which are attached to hospitals as an advantage, and (3) To be positive of seeing the evaluation as a benign action. Furthermore in system point of view, the strategies could be (1) To affirm certificate in related professional fields; (2) Social workers need to stand up for themselves and assert their value; (3) Constantly training in order to improve self-skills; (4) Strengthen self-awareness and proficient in changing situations; (5) Allocate human resource effectively; and (6) To grow the sensibility of social workers. Finally, in practice strategies could focus on： (1) To build up team work atmosphere of respect, and (2) To hold advantages to further contribute greater value. In conclusion, there are some recommendations given to improve the whole health and welfare system: (1) The lawmakers foster an overhaul of the evaluation system to increase the number of social workers according to KPI and so on; (2) Well manage on social workers resource, establish a comprehensive system of training and job replacement and further help social workers exert themselves to contribute their professional in nursing homes.(3) Expand nursing professional training over schools to bring up qualified social workers; and last,(4) Assign experts as case managers to consolidate medical care and social workers duties. All these suggestions above are proposed to integrate long-term medical care service through professional case managers, put both welfare agencies and nursing homes, which under social policy and health and welfare system respectively forward to a single medical care system. As a consequence, all of the elderly people can be well taking care of both physical and psychological needs.