Bronx Social Work Director Speaks of the Job’s Challenges and Rewards

It is no easy task or ever a quiet day as a social work director in healthcare, especially at skilled nursing facilities where the ordinary person may not know all of the complexities of post-acute care. From understanding the ever-changing laws and intricacies of Medicaid to meeting the everyday needs of all their residents’ cases, the world of social work has many challenges. Still, it can be capped off by the profession's rewards, from meeting with the families at the onset when the resident arrives to the discharge when the resident graduates from rehabilitation and goes back home to the love of their family.

"Maintaining the balance and understanding of knowing what your residents are going through, while their prognosis has nothing to do with you, at the same time, the challenge is that it will always fall on you," says Williamsbridge Center’s Director of Social Work Maya Clarke. "It is your responsibility to be someone they can always lean on. With so much going on in their world, the challenges become even harder for the social worker. When you know, for some reason, that you cannot do what you really want to do for some families because of various limitations, that is a challenge. Whatever the family case, it can still be attainable, but now a tough obstacle."

Ms. Clarke also stresses that another significant challenge is to be on the same page with the families regarding their loved ones' timing expectations. She says some families may incorrectly predict when their loved ones will be discharged, which may not be the best thing. Residents may have a setback for whatever reason, or their mood may change, delaying their estimated discharge time frame.

Maya also says it is essential for the social worker to keep positive energy in-house for the residents as they deal with their family issues and dysfunctions. Down the road, Ms. Clarke points out, that other challenges arise when overseeing the department of social work at a skilled nursing facility. For many of the residents, Ms. Clarke has to be part of the team when evaluating residents for a proposed discharge date if and when it looks like they will be graduating from receiving solid rehabilitation, or then living comfortably as a long-term resident. Social workers don't make clinical decisions or decide when or if they may be discharged. They are there to keep everyone on the same page with the facility, from families to residents.

According to Ms. Clarke, families, rightfully so, can be overprotected by their loved ones, especially if they are at a young age. Therapy will know when a patient has met their goals to move about within the facility on their own and even outside of the facility. She continues to point out that the challenges here fall under psychological, where residents have met their goals. Families may disagree because they are worried about their loved ones being out and about in the community, hoping to thrive again. Here, the social worker will demonstrate to the family that they "can do it" outside of the facility, and at the same time, they are telling them that they are not ready yet. Psychologically, residents may start regressing if they don't move forward, as per their therapy consultation. Additionally, the psychological aspects should not be an obstacle to their progress.

"What you don't use, you will lose," said Clarke. "It's also essential, in addition to the progress they made in rehabilitation, that residents need to be back in society, be outdoors, in the environment, for progress to happen."

Every reward is gratifying. According to Ms. Clarke, seeing residents thrive after you have worked with them for some time alone brings rewards. Additionally, families who once questioned their loved one's course of care and now see positive results are significant rewards.

"Social work is never easy, but hard work pays off when challenges turn into rewards," said Clarke.

One advice Maya Clarke tells social workers who are just starting their careers is keep focus on the end result and that is it's always about the residents and their families.

"Always be patient and stay the course. We all have trying days, and many of these days can lead to future rewards," she said.