OverviewThe medical social work team in Mercy University Hospital supports the day-to-day implementation of the Mercy ethos. The department is particularly focused on addressing the needs of patients and their families in a spirit of promoting compassionate social justice.
In practical terms, this means that we often deal with issues such as homelessness, domestic violence, and alcohol and drug abuse, as they present in the emergency department and among admitted patients. In addition, there are social workers attached to the specialist care of the elderly, paediatric haematology / oncology, adult oncology and palliative care multi-disciplinary teams.
The social work department takes the lead in the implementation of Children First national guidelines in the hospital.
For more detailed information, please see below.
HomelessnessPatients are referred to our social workers with issues around housing (e.g. homelessness or very inappropriate accommodation). Very rarely is there only one reason for a person becoming homeless; there is usually a range of complex interacting factors involved. It is helpful, however, to make a distinction between those who have been long-term homeless and those newly at risk of homelessness.
Our team is dependent upon other services in Cork which provide direct services to the homeless population. Good working relationships have been formed with The Homeless Persons Unit in Drinan Street, Cork which co-ordinates available emergency accommodation. Nevertheless, significant difficulties remain with an overall shortage of hostel beds. Direct contact is also made with the Cork Simon Community - homeless charity and The Society of St. Vincent dePaul (SVP) shelters for men and Cuanlee Refuge which provides crisis accommodation and support for women and children who are victims of domestic violence. Edel House is part of the Good Shepherd Services which supports homeless girls, women and children. More long-term accommodation is provided by Oakdene House, Ltd., SVP Deerpark House and O'Connell Court.
For those at risk of being out-of-home who present in the emergency department or are admitted medically, the social work team can discuss temporary options and the state supports which are available (deposit / rent allowance / housing assistance payment). Threshold Housing Advice service and Focus Point provide free and confidential advice and support on housing issues.
Domestic Violence"Domestic violence is common, serious and frequently not identified. It can occur in any intimate relationship. While men may be the victims, most severe domestic violence is perpetrated by men against women and their children. For the majority of victims, violence is endured as a chronic long-term condition that escalates over time ..." (Irish College of General Practitioners - ICGP).
Victims of domestic violence are most likely to present in the hospital emergency department following an assault, sometimes in the context of alcohol use. Providing assistance to victims of domestic violence is a key aim of the hospital social work department. At the same time, it is acknowledged that there are often no quick solutions and that the seemingly obvious decision to flee a threatening situation is complex, difficult and with life-altering consequences for a woman and her children.
The role of the social worker is to acknowledge a disclosure of violence to be able to link the patient with the appropriate local services and to explain how these services work. If appropriate, a safety plan can be discussed with the patient. The proximity of the domestic violence support agency (OSS Cork, Ltd.) to the hospital, is of assistance in this task. Contact can also be made with the other domestic / sexual assault services. Because of the criminal assault implicit in domestic violence, the Gardai will often have been involved from the outset. The involvement of the Gardai is useful if there is to be an application for protection, safety or barring order. If the Gardai are not already involved, the social worker may discuss making a report with the patient.
Violence towards an adult partner is a warning sign for risk to dependent children; so in keeping with the Children First national guidelines, consultation with the relevant Tusla / Child and Family Agency child protection team is mandatory where there are children at risk of abuse.
Alcohol and Drug MisuseAlcohol and drug misuse is quite prevalent in Irish society. Social workers meet with patients in the hospital whose life style choices are causing problems for their physical or mental wellbeing. The initial interview, conducted in person or by phone, attempts to ascertain if addiction is an issue and if the person has some motivation to change. The process of accessing addiction treatment (with which the patient must agree to) is explained, as are the various treatment options: residential and non-residential.
The social worker will also use motivational interviewing to encourage sobriety and attendance at walk-in services, such as Alcoholics Anonymous (AA) / Narcotics Anonymous (NA) meetings or the Samaritans, while preparing to atttend a formal treatment programme. The social worker will support the person to attend or to engage with addiction services, if this is required. Families may also need support to address the impact of addiction in the wider family; and this is also included in the social worker's remit.
Care of the ElderlySocial work with patients who are over 65 years of age involves assessment and case management as part of a multi-disciplinary team. Issues can include extreme self neglect, social isolation, poor social support, inadequate accommodation and alleged elder abuse. Assessment and intervention in the specialist older person's unit is discussed at a weekly multi-disciplinary meeting so that the patient's discharge can be planned.
In instances where a patient needs long-term nursing care, the social worker works with the patient, family members or anyone significantly involved in the community so that funding can be granted for long-term care. The application for the 'Fair Deal' nursing homes support scheme is jointly managed by the social work team and the discharge co-ordinators.
In situations where a patient's discharge home is complex, the social worker frequently works with outside agencies such as public health nurses and Health Service Executive (HSE) social workers in the adult safeguarding teams. Home visits are carried out in certain circumstances (e.g. situation of extreme self-neglect).
Paediatric Haematology / OncologyIllness can affect anyone from any age, race, gender or religion. Respect, at all times, is essential to assist one of the most vulnerable groups in our society -- children.
The social work team provides service to the patients who attend our consultant paediatric haematologist in relation to a haematology or oncology diagnosis. Mercy University Hospital functions as a shared-care paediatric unit with Our Lady's Children's Hospital Crumlin, Dublin. The patients attending range in age from a few months to older teenagers. The diagnoses include leukaemia, brain tumour, Wilms' tumour, aplastic anaemia, sickle cell disease, as well as other conditions. Sickle cell disease is a life-long illness which affects people from hot Mediterranean countries and Africa.
The social worker provides practical support (e.g. assistance with medical card and social protection applications, home tuition application [absences from school due to illness] revenue and housing applications). The social worker can also liaise with local charities that provide financial assistance: Children's Leukaemia Association, The Mercy University Hospital Foundation and Irish Cancer Society.
The medical social worker will provide ongoing emotional support to the parents and children of the families concerned (which can include home visits). Direct work with parents and children regarding coping strategies is given if necessary. Each family is different and this must be respected. Referrals to external counsellors / therapists are facilitated, especially in relation to anxiety, needle / hospital phobias, or an inability to accept the diagnosis. In a minority of cases the prognosis is not good and support is given regarding poor prognosis, death and dying, and funeral arrangements. Follow-up bereavement support can also be part of the social work role within the family.
Adult OncologyA diagnosis of cancer can result in significant life adjustments for both patient and family. In these circumstances, the medical social worker can provide support and information that will assist in coping with a diagnosis and any issues that may arise as a result. If required, your medical social worker will work with the patient and family throughout the course of treatment.
- Counselling and emotional support.
- A range of publications to help children and adults cope with the diagnosis of cancer in a parent or spouse.
- Assistance with planning discharge from hospital.
- Advocacy, mediation and the provision of information on social welfare issues, medical cards and community supports.
- Information on the Irish Cancer Society Volunteer Driver Service and other transport schemes for patients travelling to the hospital for chemotherapy.
- In the case of exceptional need, co-ordination of applications for small grants provided by the Irish Cancer Society and other charities.
Palliative CareMercy University Hospital provides a dedicated palliative care social work service. Palliative care focuses on a holistic approach to care when the intention of treatment is no longer of a curative nature. This care involves tending to the needs of patients and their families, who have been diagnosed with a life-limiting condition. Care continues along the path of the illness to include end-of-life care and bereavement support.
The role of the palliative care social worker is informed by the 2001 Report of the National Advisory Committee on Palliative Care, the HSE Palliative Care Competence Framework (2014), CORU - The Health & Social Care Professionals Council and MUH values.
Referrals to this service are typically made by the Palliative Care clinical nurse specialists; however, patients and families who are known to the palliative care service at MUH are welcome to contact the social worker.
Children First / Child ProtectionMercy University Hospital provides services to children and families; and the welfare of children always comes first. Staff have a corporate duty and responsibility to safeguard the welfare of all children and young people by protecting them from physical, sexual and emotional harm and neglect. MUH works to ensure that children have their rights upheld, are treated with respect and that our contact with children reflects the principles and objectives of the Child Care Act (1991). MUH adopts the Children First National Guidelines for the Protection and Welfare of Children (2011), The Child Protection and Practice Handbook (2011) and Our Duty to Care (2002).
The principal social worker is the designated liaison person for the hospital. Any staff concerns prompted by the presenation of a child or a parent to the hospital are directed in the first instance to the hospital social work team. MUH maintains direct, frequent and co-operative contact with the local Tusla / Child and Family Agency child protection teams.
QualificationsSocial workers in the health service are all qualified to post graduate level and are registered by the statutory regulator CORU - the Health & Social Care Professionals Council (www.coru.ie).
ContactPrincipal Social Worker - Mr. Colman Rutherford
021-427 1971 (bleep 6668)