This role supports the medical social work team in case management, act as the ward liaison to keep residents meaningfully engaged, track and monitor residents mental and psychosocial status and other adhoc duties.
KEY RESPONSIBILITIES
1. Pre-admission/Admission Support
- Orientate new residents and their NOKs to the nursing home
- Ensure residents settle well in the nursing home
- Conduct financial counselling and apply for grants and financial assistance as needed
2. Casework(non-complex case)
- Engagement and Assessment
- Establish rapport and build professional relationship with resident and significant others
- Identify and clarify the key issues to the problem situation and gather relevant information from residents and NOKs
- Conduct bio-psycho-social-spiritual assessment to assess and identify the severity and key risks and protective factors for intervention
- Engage residents, families, multi-disciplinary team and relevant stakeholders to gather holistic and relevant information to support holistic care plans for residents
2.2 Goal Setting and Intervention Plans
- Analyze and evaluate different courses of action, when appropriate with multi-disciplinary team and relevant stakeholders
- Formulate appropriate strategies for action
- Conduct care planning and goal setting with residents based on standard guidelines and professional assessments
- Set clear contracts and goals with residents - Engage residents and NOKs to sustain effort in problem-solving
- Apply appropriate assistance schemes
- Collaborate and negotiate with stakeholders to mobilize community resources
2.3 Case Review and Documentation
- Follow up and review care plans and provide recommendations to modify care plans where necessary
- Evaluate the process as well as the outcome objectively and recommend future improvement
- Provide documentation and timely updates of assessments and interventions to be used by multi-disciplinary professions
- Work with MSWs on providing social reports with proper consent to relevant
- stakeholders to ensure continuity of care
3. Keep residents meaningfully engaged
- Understand interests of individual residents
- Organize activities that are of interest to residents
- Engage and motivate residents to participate in the activities
- Work with the Volunteer Manager and volunteers in the planning and implementation of activities
- Review and evaluate the effectiveness of activities in improving the well-being of residents
4. Support volunteer programme
- Provide feedback on possible new volunteering opportunities based on the needs observed on the ground.
- Work closely with the Volunteer Manager on effective mobilization of resources to support volunteer programme
5. Support during activities
- Provide supervision during implementation of activities
- Provide feedback to volunteers on areas of improvement via Volunteer Manager
- Support Advance Care Planning (ACP) programme
- Initiate ACP awareness with residents and their NOKs
- Facilitate General ACP or PPC with residents and their NOKs for those who are ready
- Review ACP plans regularly
- Assist residents in fulfilling their care preferences and last wishes.
JOB REQUIREMENTS
EDUCATION,TRAINING AND EXPERIENCE
- Preferably Diploma / Certificate in Social Sciences and/or Counselling
- Proficient in Microsoft Office, good spoken and written communication skills, meticulous, reliable and independent.
