Education, End-of-Life, Grief/Grieving/Bereavement, Humanity, Social Work/Helping Profession/Mental Health

Dunkirk…How Much do you Know About It?

I just saw the movie Dunkirk with my fiancé. No matter how many WWII movies I watch or how many books I read, I realize there are so many more stories to be told and I will NEVER learn all about the war. It is not possible.

There is much to gain from this movie. Many individuals to focus on and each individual did something small which lead to something great!

The takeaways from the movie are the sense of community that for the most part existed then, but seems to be missing in today’s world.

Imagine being a soldier who fights for your country and is shipped overseas to help other countries fight a war, then you are left behind in …let’s say a place named Dunkirk. You are left behind enemy lines, waiting to be rescued. Will you do as one of the characters from the movie did; you are a French soldier and you find a dead Englishman. Will you bury him and then steal his uniform to be able to leave the war zone?

Would you go back and save fellow soldiers from drowning after the boat that came to save you is torpedoed? How do you think you would both function and survive in a war?

Personally, I have no clue. I cannot imagine such circumstances today. I cannot imagine being stranded with no way to leave a country, but assuming and hoping that the country I am from is going to save me. I cannot imagine an era, although I grew up without the modern technology of today, no cell phones, no laptops, no tablets or Apple watches. No social media, and relying on intelligence and an army that in some ways are beat hoping that someone is going to rescue me and my fellow soldiers.

The death and destruction that was witnessed. The coldness that may have occurred, the uncaring, the ‘do what I need to, to survive mentality’. The symptoms that will show later; shell shock, PTSD, trauma, flashbacks, and I am going to assume after watching this movie, a hate for boats that sink, not liking water, motor oil or planes…

The positive I see is determination, the will to live/survive, hope, not giving up, focus, and a sense of community. Think all able bodied small motor boats in Britain, more than 800 of them were to be utilized or were ‘called up’ to assist the stranded soldiers.

The advancing German Army trapped the British and French armies on the beaches around Dunkirk. 330,000 men were trapped and they were a sitting target for the Germans. The beach at Dunkirk was on a shallow slope so no large boat could get near to the actual beaches where the men were.

The evacuation is often referred to as “the miracle of Dunkirk” because only 30,000 to 45,000 were to be rescued, but in fact, between May 26, 1940, and June 3, 1940, more than 300,000 troops were able to get off the beach. Nearly 80 years later, the “Dunkirk Spirit” remains a touchstone in British culture, and a reminder to face obstacles with the same tenacity and cooperation that got the Second World War troops through that dramatic evacuation.

The lesson(s) I gained from the movie was: determination, hope, stay positive, luck, give back, community, and honour…What about you?

Aging/Gerontology, Education, End-of-Life, Humanity, Social Work/Helping Profession/Mental Health

Social Isolation Amoung Seniors….

As a case manager that works with older adults/seniors in a private community centre, my role is different than a social worker or case manager in a government system.

People choose to be involved with our agency in some way whether through the Wellness Centre, taking courses, volunteering, playing cards, socializing in the cafeteria, attending a group or being involved in the Social Services department.

I have approximately 75 older adults that I personally work with. My contact with them can be only at the centre, through home visits, phone calls, visits in the hospital or rehabilitation, meetings, case conferences, etc.

I also co-facilitate a group for seniors each week and the group’s participants are Holocaust Survivors.

Some of my clients are very private, withdrawn while others are social, active in the centre where I work, volunteer and have more energy than I do! (That is how I want to be when I get older!)

For those that choose to be private, have only a few close friends or for those that have no where to go and are isolated-their life is very different.

This article resonates with me as this should not happen!!

What happened to neighbors saying hi to one another, being friendly, checking up on one another? What happened to the communities of long ago where the younger generations looked out for the older generations!

No one should die alone. No one should lie dead for a month in their home before someone notices!

When I first moved to Canada and my then-husband and I lived in a small upper duplex. We had a senior woman living below us who was extremely private and in the 4 years we lived there, I think I physically saw her in person maybe 3 times.

I heard her, I smelled the cigarettes she smoked and I heard her TV blaring.

One day I realized it was quiet in her apartment; no TV, no radio, no smell of cigarette smoke.

I knocked on her door-no answer. I tried this for 2 days and then being a social worker, professional instinct kicked in, and I went to the janitor of the small apartment complex. The police were called in. Her door had to be broken down and guess what? She was dead. She had fallen and hit her head on the side of her dresser. She had no family that I knew of. No visitors. She had her food delivered as she was not very mobile.

To me that is wrong on so many levels, but if I had not noticed the absence of smoke, no TV-how long until someone else noticed……

Please as a personal plea from me, be aware, notice when a senior is not seen or heard from, get to know your neighbors. Rebuild that sense of community from long ago…….

 

http://www.cbc.ca/news/canada/montreal/quebec-coroner-report-senior-social-isolation-1.4200146

Healthcare, News

Patient-Centered Care Awareness Month: October

When I saw a link posted on LinkedIn re: Patient-Centered Care Awareness month, I thought this is great! I recently attended a 2 day conference in the Toronto area that focused on Patient Experience and the importance of healthcare making a transition or shift that involves the patient in every aspect of healthcare.

I am currently reading the book, Journey to Wellness: Designing a People-Centered Health System for Canadians by Dr. R. Vaughan Glover. It is a good book that discusses why the healthcare system needs to change and adapt and ‘update’ to modern times, where the patient should be involved every step of the way. Some institutions and organizations may resist this need to change, but in reality that would be a mistake. The current system where the health professionals know best does not work in today’s world. With the technological advancements available through social media, the internet, instant messaging and texting; there are no secrets in a sense. The patient is informed and does the necessary research. Whether something good or bad happens, it is shared instantly through Facebook, Twitter, LinkedIn, texting and other social media avenues.

So, back to Patient-Centered Care; what does this mean? To me and from what I heard at the National Forum on Patient Experience conference, it means the patients are the highest priority and should be involved in any decision-making process whether it is in healthcare, community, private practice, volunteer opportunities or as a consumer in retail.

Organizations, institutions, and the various healthcare settings need to focus on and involve patients/clients. Some may ask how does one do this? Ask, listen, reflect, involve patients/clients/consumers in solutions. Ideas need to be generated and then the needed and necessary changes have to occur. After that comes the, ‘how is it working’ process which should include surveys and telephone calls to further initiate dialogue and discuss other needed changes.

Everyone should be willing to listen to and involve clients/consumers and patients, as without them, none of us would be employed.

What are your thoughts? How will you raise awareness of a particular issue? How will you advocate for change?

By Victoria Brewster, MSW

Healthcare, Resources

National Forum on Patient Experience Conference- Day 1

The conference opened with Dr. Vaughan Glover, CEO, Canadian Association for People-Centered Health (CAPCH) welcoming everyone and he was also the moderator for the two-day conference. He generously gave all three hundred attendees a copy of his book, Journey to Wellness: Designing a People-Centered Health System for Canadians.

The opening address was with Leslee Thompson, CEO and President of the Kingston General Hospital and what a speaker! She was engaging, informative and very clearly and easily discussed the changes implemented by the hospital and the necessity to do so. The changes had to be on all levels from the top to the bottom.

Patient Centered-Care, is just that, care and solutions focused on the patient, their needs, their wants and their involvement at all levels. Former patients sit on various committees and offer suggestions and solutions.

The next event of the morning was a panel discussion titled: Build a Resilient Experience Advisor Program that Drives Change. Jennifer Rees, Executive Director, Patient Experience, Alberta Health Services; Bonnie Nicholas, Lead, Patient & Family Centered Care, Thunder Bay Regional Health Sciences Centre; and Caryl Harper, Director, Patients as Partners of Primary Health Care, Vancouver Island Health Authority. An engaging and thought-provoking panel where each speaker gave great examples of the shift in focus for their organizations and agencies that involves patients.

The next presenters were Lena Cuthbertson, Provincial Director, Patient-Centered Performance Measurement and Improvement, British Columbia Ministry of Health and Rick Swatzky, PhD, RN, Canada Research Chair in Patient-Reported Outcomes; Associate Professor, Trinity Western University; Research Scientist, Centre for Health Evaluation and Outcome Sciences, Providence Health Care. Their topic was Measure the Patient’s Experience: Demonstrate Value and Generate Insights. They are analyzing data and creating surveys to be used by providers to assist with answering the question of what changes are needed. Research and analyzing of date are needed to transition to the next level.

The morning continued with a presentation by Kimberly Morrissea, Manager, Cultural Proficiency & Diversity, Winnipeg Regional Health Authority on the topic of Cultural Proficiency, Improving the Quality of Care for Aboriginal Peoples.  She discussed the challenges faced by various health providers in supporting a rich and diverse area of individuals who are from various cultures and speak many languages.  Providers need to understand that aboriginals come from different cultures and hold various values, religious beliefs and morals that are different from the mainstream society. Health providers and healthcare professionals need to be respectful of this, along with learning to collaborate by working together with leaders of the different aboriginal sects/divisions, show a willingness to learn the many languages spoken, along with learning the spiritual beliefs and cultural traditions.

The last presentation of the morning was by Jolinda Lambert, CEO of Innovatient and she discussed, How to Engage Patients and Families Post-Discharge to Improve Outcomes. Providers from the public and the private sectors need to collaborate to ensure a patient leaves the hospital, rehabilitation facility or similar centre with a discharge plan in place that will best assist the client and family. Without this collaboration, a patient could be discharged from the public sector into the community sector with no services in place to assist the patient/client in their home environment. I.e., 86 year old senior is discharged from the hospital in a hospital gown, sent home in a taxi without any community organizations or family being notified. Client returns to home environment with no services in place, but needing home care and home visits by a local government/public clinic nurse. This should not happen.

After a much needed lunch break, the afternoon session began. Kira Leeb, Director, Health System Performance Canadian Institute for Health Information presented a Case Study titled: Canadian Hospital Reporting Project.

The next presenter, David Mosher, Director of RelayHealth, McKesson CANADA spoke on the topic of Fostering a Culture of Communication between Physicians and Patients. His examples focused on a system that is a pilot project in the province of Nova Scotia where technology is being implemented, a portal of sorts where patients can log in and share information with their physician and other health care providers. Appointments can be scheduled online, test results, lab work and exam information is at the fingertips of the patients and the healthcare system.

The second to last presentation of the afternoon was a Patient Engagement Panel, Patients as Partners: Improve Outcomes through Patient and Family Engagement by Dawn Sidenberg, Lead, Patient Centered Care Project, Humber River Regional Hospital;  Jill Carmichael Adolphe, Partner, Care 2 Collaborate;  Elke Ruthig, Manager, Patient Education, Toronto General Hospital;  Patient Advocate, Zal Press, Executive Director & Patient, Patient Commando Productions with Sydney Graham, Co-Founder and Partner, Care 2 Collaborate.

A wonderful and informative discussion panel re: what each organization/institution is doing re: implementing Patient-Centered Care and how the patients are part of every decision-making experience from participating on committees and projects to being a part of the hiring committee for professional staff.

The afternoon ended with a presentation by Chris Cashwell, Senior Vice President, Global Marketing & Strategy, Lincor Solutions. Again, a good presentation that grabbed the attention of all present due to his engaging, energetic and passionate talk about the advances that are being made in technology. Imagine being a patient in a hospital and having an interactive board in your room where you control the lights, heat, summon a nurse or request a meeting with one of your various physicians along with ordering TV, movies and being connected to the internet. Nothing like a speaker who is able to present for 45 minutes and not glance at notes or cue cards; a speaker that talks and shares from the heart and with passion.

It was a long day that began at 8:15 and ended at 5:15 and was followed by a cocktail and networking hour. Much information was shared and I looked at all of it as a learning opportunity. I was one of the few front-line workers in attendance and as I work in community, my take on all the information presented was how it could be easily transitioned from institution and healthcare to community and education systems.

Now maybe it is just me, but as a professional with a MSW degree, a lot of this is common sense. This is how social workers engage clients. We are a team; the professional and the client. Change and movement must be made in collaboration and as a team.

Stay tuned for Day 2 of the conference!

By Victoria Brewster, MSW

Humanity, Social Work/Helping Profession/Mental Health

Social Work, Leadership and Community

A fabulous leadership book which has  important lessons for any profession is Mandela’s Way: Fifteen Lessons on Life, Love and Courage by Richard Stengel. Where Westernized society is focused on individualism with its roots in the Renaissance,  the culture that Mandela comes from believes in ubuntu-brotherhood.

A phrase that comes from a Zulu proverb, Umuntu ngumuntu ngabanto which is translated as:  “A person is a person through other people.”  Community, where we do nothing on our own is very different from individualism. “Ubuntu sees people less as individuals than as part of a complex web of other human beings.”

To me, there is a link with social work and other helping professions. We are not an island to ourselves. The end goal is to help others, but also to integrate individuals into society at large. We are not just individuals, but individuals that are part of a larger community.

Those that choose to live with others of their own culture or ethnicity do so for the sense of community, similar values, similar beliefs, similar food preferences; because of culture and familiarity. In reality no matter what religion or culture we are, all humans are part of the ‘larger’ community.

After reading this book I admired Mandela’s vision and end goal even while in confinement in prison. He wanted the people of South Africa to live together. He wanted blacks to have freedom in their land and to be part of the overall community and for whites to accept and welcome this. Now, many may not agree, but when you think about it, we are all humans who happen to have different religious beliefs and practices, who come from different cultures and have a mixture of traditions, values and morals.  This does not mean that we cannot work towards the larger goal of the community. This larger community is all cultures, ethnicities and religions mixing; living in neighborhoods together, attending school together, working together while respecting one another.  Perhaps this is a dream of mine, but I think it is a great dream.

A leader is one who shows his leadership in public and private and they are the same. The values are the same and no contradictions. Leaders at times will disappoint and not fulfill promises, but the goal is to reach the majority. Leaders listen to both sides and hope each will see and hear what the other is stating. Typically the two sides can merge their ideas together to some extent and come up with a new goal/vision and it is done in such a way that neither side feels they lost or were unheard.

Some characteristics that make one a leader are: Self-discipline, confidence, willingness to share credit, willingness to listen, self-control, sensitivity, vulnerability and the ability to verbalize when one has made a mistake. Leaders can be charismatic and charming, generous, polite, cruel and selfish, but the end goal should be about community.

Mandela was a man of courage. He also triumphed as he did not let prison destroy his goal or his integrity. He wanted to unite South Africa. Courage plays a part here as one who stands up to the opposition has to have courage. One who stands up to his persecutors (prison) has to have courage. Those of us who believe social work is not respected enough, valued enough or embraced often enough have to have courage.

I continue to read and hear of grumblings amongst social workers and often pause and think why is this so? Social work and teachers-two needed professions, but not valued by society and the pay is low. Why is this? Imagine even if only for 1 day, all social workers and teachers walked off the job- would we be missed? Would we have more value in society’s eyes? Why do social workers not unite and challenge society on this issue? Some are well paid, many are not, but the reasons for going into the profession are admirable; the desire to help others, to follow a calling and to make a difference-same for teachers.

What are your thoughts and do you value being part of a community that unites rather than divides? Do you have the courage to stand up for what is right? Will you stand by your professional beliefs and values even if they are not embraced by the majority? Sometimes the basic question is: Do you want to be a leader or a follower?

By Victoria Brewster, MSW

Healthcare, News, Social Work/Helping Profession/Mental Health

Seeking Action for Safety in Long Term Care Facilities

Advocacy, one of the core competencies in the profession of social work. It is one skill that I was taught both in graduate school and as a professional over the past 15 years, it is a skill I take to heart.

On February 9, 2013 a documentary W5, Crisis in Care, reported by Sandi Rinaldo and the CTV team of investigators, was released. This investigation uncovered horrific statistics and stories of abuse taking place in Long Term Care facilities in Canada. The focus was on residents with dementia assaulting and killing other residents.

http://watch.ctv.ca/w5/latest-episodes/w5—crisis-in-care—february-9-2013/#clip862011

After viewing it, the natural human response is to wonder how something this horrendous could happen. Further questions of who is at fault and what solutions will facilitate the needed changes, come to mind as well. Finger pointing and blaming will not provide solutions or changes. Staff that work in residences and Long Term Care (LTC) facilities, for the most part, are very good at their job and demonstrate the skills of empathy, compassion, and hard work.

A team of three dedicated professionals who all belong to the professional LinkedIn group, Gerontology Professionals of Canada, decided to team up to formulate a response to the W5 documentary, Crisis in Care. Eleanor Silverberg, BA, Psych, MSW, RSW drew up the initial draft and is the main author, asked Angela Gentile, BSW, RSW and  Victoria Brewster, MSW for their contributions. Seeking Action for Safety in Long Term Care Facilities was completed on February 20, 2013, and was forwarded to the following individuals/organizations as of February 23, 2013:

•W5, Sandi Rinaldo, the investigative team and the producers
•Federal Health Minister, the Honourable Leona Aglukkaq
•Alzheimer Society of Canada, CEO, Mimi Lowi-Young
•Alzheimer Society of Ontario, CEO, Gale Carey
•Alzheimer Society of Manitoba, CEO, Sylvia Rothney
•Federation of Quebec’s Alzheimer Society, CEO, Sandro di Cori
•Ontario Minister of Health and Long Term Care, Deb Matthews
•Quebec Minister of Health and Social Services, Dr. Réjean Hébert
•Manitoba Minister of Health, Hon. Theresa Oswald
•Canadian Alliance for Long Term Care
•Healthy Living, Seniors and Consumer Affairs Minister of Manitoba, Hon. Jim Rondeau
•Misitere de la santé des Services sociaux- Services Quebec

The site, Action for Safety, created by social worker, Angela Gentile will continue to be a place where updates will be provided, as well as a place where other professionals, families and concerned individuals can express their views, working together on behalf of the vulnerable residents in Long Term Care facilities.

It is worthwhile to read the full response which describes the issues, provides some examples of assaults and deaths that have occurred in Canada while making suggestions for solutions. It is not possible that these horrible tragedies have only occurred here in Canada. It is not possible that budget cuts, reduced staff, lack of education, and a lack of awareness only effect Canada when it comes to LTC facilities and the disease of Dementia.

The link to Action for Safety has been shared with friends, family, colleagues, on social media through LinkedIn, Twitter, and Facebook with an end goal of obtaining solutions to a very serious issue. This will continue along with contacting media to further bring the issue to light and raise awareness.

It is necessary for professionals to unite over a cause while advocating for needed change and I consider myself fortunate to have been a part of this project. A special thank you to Eleanor Silverberg and Angela Gentile!

Written by Victoria Brewster, MSW

Emotional Intelligence (EQ), Humanity, Social Work/Helping Profession/Mental Health

Emotional Intelligence and Preventive Mental Health Care

by Victoria Brewster, MSW

I read the following article (http://www.kevinmd.com/blog/2012/12/society-honor-dead-children.html) and the first thing that came to my mind is that the events of Friday and all the other events that have occurred in the world where someone who was angry and full of hate either attacked and injured or murdered innocent people is not about gun control!

Instead, I focus on the next paragraph for the article that discusses Mental Health Care. This is the focus. Society helping society. More services for those that are suffering from either serious Mental Health issues or the episodic depression, anxiety, anger, self-loathing, low self-esteem and negative internal dialogue that is happening for so many.

We need to take a look at why so many people feel this way. I am sure our consumeristic, materialistic, gotta have the latest electronics, more money, more status seeking society is to blame. Or perhaps the unacceptance of those that have physical or developmental challenges to face every day? Intolerance of different cultures, religions and ethnicities?

We as humans need to return to a more basic lifestyle that focuses on family, friends, community- a ‘village’ type of atmosphere where neighbors actually say hi to one another, help one another and watch each others kids. The book, “It Takes a Village” by Hillary Clinton describes this kind of lifestyle.

Acceptance, compassion, empathy, tolerance and respect need to be a focus and taught to youth on a regular basis. By doing so and having these qualities become the norm, things will change…..

EQ or Emotional Intelligence should be taught in every school as part of the core curriculum with older students acting as mediators for the younger students to assist with leadership skills, the ability to identify feelings, to raise self-worth. Imagine the school environment! Teachers and educational staff along with parents also learn these skills and it becomes part of the school environment and hopefully is carried over into the home environment.

To me, youth should be the focus. If we have positive impact on their learning now, change will follow them as they grow up and go through high school, university and into their adult lives after.

http://www.Edutopia.org and http://www.6seconds.com are worth taking a look at on this topic.