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The growing aging population in Canada has multi-faceted psycho-social needs. Social workers are well-positioned to address these needs, despite many challenges. This paper reports findings from the World Café at the Gerontology Symposium in Alberta, Canada, held in 2018. The goal was to learn from social work practitioners, researchers, and educators (N = 49) about current and future needs of gerontological social work in Alberta. There were two research questions: 1) What strategies do social workers need on the micro, mezzo, and macro levels to help better serve the growing older adult population in Alberta? (R1) 2) How can social workers promote the value and contribution of gerontological social work within the interprofessional community? (R2) The data were analyzed using qualitative content analysis. Ten R1-related themes emerged: personal traits of a social worker; professional skills; bio-psycho-social needs of older adults; community connections; access to benefits; gerontological social work education; integrated healthcare; aging policy; ageism; and advocacy to strengthen the voice of older adults. The three R2-related themes include strengthening the status of the social work profession; building trust through demonstrated skills; and interprofessional education and practice. [ABSTRACT FROM AUTHOR]

Background: Individuals experiencing socioeconomic inequity have worse health outcomes and face barriers to palliative and end-of-life care. There is a need to develop palliative care programs tailored to this underserved population. Objectives: To understand the characteristics and symptom profiles of a group of urban patients experiencing socioeconomic inequity and receiving palliative care. Design: Descriptive exploratory analysis of a patient dataset. The patient dataset was generated through a pilot research study with patients experiencing socioeconomic inequity and life-limiting illness who received a community-based palliative care intervention. Methods: The intervention took place over 1 year in the Palliative Care Outreach and Advocacy Team, a community-based urban palliative care clinic in Edmonton, Alberta, Canada, serving persons experiencing socioeconomic inequity. Participants had to be at least 18 years of age, be able to communicate in English, require palliative care for a life-limiting illness, and be able to consent to inclusion in the study. Results: Twenty-five participants were enrolled. Participants predominantly identified as male and Indigenous, experienced poverty and housing instability, and had metastatic cancer. Our participants rated their pain, shortness of breath, and anxiety as more severe than the broader community-based palliative care population in the same city. Most patients died in inpatient hospices (73%). Conclusion: Our analysis provides an in-depth picture of an understudied, underserved population requiring palliative care. Given the higher symptom severity experienced by participants, our analysis highlights the importance of person-centered palliative care. We suggest that socioeconomic inequity should be considered in patients with life-limiting illnesses. Further research is needed to explore palliative care delivery to those facing socioeconomic inequity. [ABSTRACT FROM AUTHOR]

Background: Advance care planning (ACP) is a process which enables patients to communicate wishes, values, fears, and preferences for future medical care. Despite patient interest in ACP, the frequency of discussions remains low. Barriers to ACP may be mitigated by involving non-physician clinic staff, preparing patients ahead of visits, and using tools to structure visits. An ACP care pathway incorporating these principles was implemented in longitudinal generalist outpatient care, including primary care/family medicine and general internal medicine, in two Canadian provinces. This study aims to understand clinician experiences implementing the pathway. Methods: The pathway was implemented in one family practice in Alberta, two family practices in British Columbia (BC), and one BC internal medicine outpatient clinic. Physicians and allied health professionals delivered structured pathway visits based on the Serious Illness Conversation Guide. Twelve physicians and one social worker participated in interviews or focus groups at the end of the study period. Qualitative data were coded inductively using an iterative approach, with regular meetings between coders. Results: Clinicians described experiences with the ACP care pathway, impact at the clinician level, and impact at the patient level. Within each domain, clinicians described barriers and facilitators experienced during implementation. Clinicians also reflected candidly about potential for future implementation and the sustainability of the pathway. Conclusions: While the pathway was implemented slightly differently between provinces, core experiences were that implementation of the pathway, and integration with current practice, were feasible. Across settings, similar themes recurred regarding usefulness of the pathway structure and its tools, impact on clinician confidence and interactions with patients, teamwork and task delegation, compatibility with existing workflow, and patient preparation and readiness. Clinicians were supportive of ACP and of the pathway. Trial registration: The study was prospectively registered with clinicaltrials.gov (NCT03508557). Registered April 25, 2018. https://classic.clinicaltrials.gov/ct2/show/NCT03508557. [ABSTRACT FROM AUTHOR]

Background: Family violence, which includes intimate partner abuse, child abuse, and elder abuse, is a serious public health concern. Primary healthcare (PHC) offers a vital opportunity to identify and address family violence, yet barriers prevent the effective implementation of family violence interventions in PHC settings. The purpose of this study is to improve family violence identification and response in Alberta's PHC settings by exploring readiness factors. Methods: An integrated knowledge translation approach, combining implementation science and participatory action research, was employed to develop a readiness assessment tool for addressing family violence within PHC settings in Alberta. The research involved three phases: phase 1 involved a rapid evidence assessment, phase 2 engaged a panel of healthcare and family violence experts to explore readiness components in the Alberta context, and phase 3 utilized a 3-round Delphi consensus-building process to refine readiness indicators. Results: Phase 1 findings from a rapid evidence assessment highlighted five main models/tools for assessing readiness to implement family violence interventions in PHC settings. In phase 2, additional concepts were identified through exploration with healthcare and family violence expert panel members, resulting in a total of 16 concepts for assessing family violence readiness within the Alberta PHC context. The 3-round Delphi consensus-building process in Phase 3 involved nine panelists, who collectively agreed on the inclusion of all concepts and indicators, yielding a total of 60 items for the proposed readiness assessment tool for addressing family violence in PHC within Alberta. Conclusion: The current study lays the groundwork for future family violence intervention programs, offering insights into key components that promote readiness for implementing comprehensive programs and supporting PHC organizations in effectively addressing family violence. [ABSTRACT FROM AUTHOR]

Background: Care aides (certified nursing assistants, personal support workers) are the largest workforce in long‐term care (LTC) homes (nursing homes). They provide as much as 90% of direct care to residents. Their health and well‐being directly affect both quality of care and quality of life for residents. The aim of this study was to understand the impact of COVID‐19 on care aides working in LTC homes during the first year of the pandemic. Methods: We conducted semi‐structured interviews with a convenience sample of 52 care aides from 8 LTC homes in Alberta and one in British Columbia, Canada, between January and April 2021. Nursing homes were purposively selected across: (1) ownership model and (2) COVID impact (the rate of COVID infections reported from March to December 2020). Interviews were recorded and analyzed using inductive content analysis. Results: Care aides were mainly female (94%) and older (74% aged 40 years or older). Most spoke English as an additional language (76%), 54% worked full‐time in LTC homes, and 37% worked multiple positions before "one worksite policies" were implemented. Two themes emerged from our analysis: (1) Care aides experienced mental and emotional distress from enforcing resident isolation, grief related to resident deaths, fear of contracting and spreading COVID‐19, increased workload combined with staffing shortages, and rapidly changing policies. (2) Care aides' resilience was supported by their strong relationships, faith and community, and capacity to maintain positive attitudes. Conclusions: These findings suggest significant, ongoing adverse effects for care aides in LTC homes from working through the COVID‐19 pandemic. Our data demonstrate the considerable strength of this occupational group. Our results emphasize the urgent need to appropriately and meaningfully support care aides' mental health and well‐being and adequately resource this workforce. We recommend improved policy guidelines and interventions. [ABSTRACT FROM AUTHOR]

This study explored social service providers' perceptions of risk and resilience while caring for their vulnerable clients during COVID-19. Participants (N = 68) from two agencies completed an online survey. Over half of participants had shifted to virtual service delivery; about 30% continued to have direct contact with clients. Using regression modeling, we found that age, gender, confidence in providing COVID-related care, worries about spreading SARS-CoV-2, and information and supports explained 36% of variance (Adjusted R2 =.357) in provider resilience. Social service agencies need to address provider worries, which may contribute more to resilience than providing information. [ABSTRACT FROM AUTHOR]

This 2.5-year longitudinal, Canadian tri-provincial study (Alberta, Saskatchewan, Manitoba) of women abused by intimate partners examined the nature of the partner abuse, physical and mental conditions, disabilities, child abuse history, and quality of life (QOL). The women retained at 30-months (419 of 665) were identified as Indigenous (48.5%), White (46.6%), or visible minority (4.9%). Physical and mental health conditions were noted by 62.3%; 41.8% of these were disabilities. Over half (54.5%) reported histories of child sexual abuse, with 24.2% reporting other childhood abuse, and 21.3% were not abused as children. Consistent with similar longitudinal studies, over time the women significantly improved their QOL and had less mental stress (SCL-10) and PTSD symptoms (PCL); however, neither PCL nor SCL-10 scores were clinically problematic at any time period. Depression symptoms (CES-D-10) remained constant over time but were not in the clinical range over the 2.5 years. Only IPV severity and having a disability were associated with more severe mental health/well-being scores at 30-months. Implications for practice such as training IPV advocates and counselors to better address disabilities and to avoid stigmatizing women abused by partners as necessarily having mental health issues are presented. [ABSTRACT FROM AUTHOR]