Lesson 101 : glossary of social workers for caregivers
This article is a short lesson on basic terms usually used by social workers in the practice of their profession with seniors. Let’s have a closer look…
Ms. Carole Dubé told me last month: "My elderly mother suffers from Alzheimer's and is followed by a CLSC Social Worker. She called me to tell me that her ISO SMAF is too low to have a place in a IR. Ms. Dubé hung up, confused.
What should be understood from this conversation?
This means that the social worker at the local community service centre (CLSC) has determined a level of autonomy for her mother, in order to obtain a classification score of access to services and accommodation in the public service network (this result is called: ISO SMAF rating). Her mother is eligible to receive home care services to compensate for her loss of autonomy. However, for the moment, she cannot get a place to stay in a facility for a semi-autonomous person in the public network, called intermediate resource(IR). In IRs, the cares provided for basic needs represent approximately 1h30 to 3 hours a day. The residents in RIs are usually able to walk, are continents and are with mild to moderate cognitive losses, at the most.
Ms. Aline Côté is a natural caregiver for her father. He lives alone in his house in Montreal. Although he is able to live alone, Aline visits him three times a week since the death of his wife. She has been shopping and cooking for him for almost 15 months. She is always worried about her father and fears that he is bored. Her father sees that she is exhausted and feels guilty. He then makes the decision to sell his house and explains that this place reminds him too many memories in the company of his beloved wife. Ms. Côté calls the CLSC to receive help. A social worker advises her to find herself a private residence for his father and give her a list of resources.
She wonders, "Why the CLSC Social Worker does not help me find a residence for my father. I thought the public network was taking care of seniors? "
It must be understood that the public network manages admission to its public accommodation resources only, so the places in the IR and CHSLD described above. The big network of private residences is parallel to the public network. Families must contact them independently. The public network does not offer accommodation to the autonomous persons or in slight loss of autonomy for acts of domestic life, like in Alice's father’s case.
Mr. Alain Gingras describes me his situation. His mother suffers from Alzheimer's and her cognitive impairment is currently to a moderate level. She used to live in her home in Saint-Hyacinthe with her husband. She received home care services from her CLSC: respite services to the caregiver and help with hygiene care. Her husband, his caregiver, suddenly died, a few weeks ago. Following a short hospitalization, she obtained a place in a CHSLD of the CISSS Montérégie East.
What does that mean?
The CLSC of Saint-Hyacinthe is part of the Integrated Health and Social Services Center of the Montérégie East (CISSS). The term integrated means that several types of public institutions are grouped over a large area. Around 2015, the public network experienced a big reorganization. The CISSS cited above, now brings together specialized institute hospitals, CLSCs and youth centres, among others. Some groups use the term CIUSSS. The U of the acronym refers to the mission of university training allowed within their institutions. The CIUSSS trains medical students by welcoming them as residents. The organization also trains interns in social work and physiotherapy, for example.
Following the loss of her natural caregiver, which allowed a home stability, Ms. Gingras obtained a place in a residential and long-term care centre (CHSLD). This type of accommodation welcomes seniors who experience a loss of autonomy that requires three hours of care a day and more. The cares usually provided compensate for a severe disability, a heavy loss of mobility, incontinence and moderate to severe cognitive impairment.
Mr. Alain Gingras adds that his mother can no longer be followed by the CLSC Social Worker because she just got a place in a private conventioned CHSLD in Beloeil. He wonders if his mother is accommodated in a quality public institution?
When Ms. Gingras received services at home, she had a social worker from the CLSC assigned to her: she and her relatives could refer to the Social Worker for support. In changing her public institution, Ms. Gingras' social file is automatically closed after 30 days. The Gingras family will now be followed by the CHSLD social worker if she needs it. She cannot be followed by two social workers from the network simultaneously. The family had grown a bond for three years with the CLSC team and is now mourning these professionals in their lives.
The private conventioned CHSLDs are institutions run by individual owners of their building. They obtain a licence granted by the Ministry of Health and social services (MSSS) authorizing them to manage a care facility with places from the public network. These beds are at the same price as a public CHSLD. Employees are supervised by different collective agreements, but obtain similar working conditions. The quality of services is identical: the private CHSLDs are governed by the same standards. Access mechanisms to obtain a place and to complain are also those of the public network.
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Author: Julie Mailhot, Social Worker in Private Practice Specializing in Evaluation of Inaptitude