Gerontological Social Work: Yesterday, Today and Tomorrow

JeanMunn2016-200x300A Sit-Down with Dr. Jean Munn, Florida State University College of Social Work

Associate Professor Dr. Jean Munn’s office is comfortably situated between colleagues at the College of Social Work’s wing in the University Center. The quiet courtyard that lies behind her window is filled with students milling around and studying, enjoying the spring sunshine. Natural light floods her office, which is kept neat and airy. As I sit down, Dr. Munn’s friendly and comforting demeanor helps me understand why she chose to pursue social work as her academic field. After receiving her M.S.W, and later a Doctorate in Social Work at the University of North Carolina, Chapel Hill, Dr. Jean Munn decided to make her home in Tallahassee, Florida at Florida State University’s esteemed College of Social Work. Her speciality, Gerontological Social Work, first impacted her life when she decided to enter her mother into a nursing home. There are 1.3 million elderly Americans that currently benefit from long-term continuous care. Dr. Munn and her mother, like countless families who rely on nursing homes to provide comfort for their loved ones, were failed by the level of care that the gerontological staff operated on.

“I was interested in Geriatric care because my mother was a resident in a nursing home, and we realized shortly after she got there, that we really didn’t know much about the environment that she was in. We didn’t know how to help her navigate that environment. We didn’t know how to look for care for her.”

Many people struggle with their relatives’ aging process, which can include a plethora of nursing homes, caregivers doctors, social workers, nurses, medicines, and illnesses, making this stage confusing and overwhelming for those who are already overwhelmed with change. Dr. Munn attributes her career path to two poignant events in her life. The mentorship of Dr. Sheryl Zimmerman, Mary Lily Kenan Flagler Bingham Distinguished Professor and Associate Dean for Research and Faculty Development at the University of North Carolina at Chapel Hill influenced her dedication to palliative and geriatric care. Additionally, the passing of her mother under hazy circumstances at a nursing home while receiving Hospice care motivated her to uncover the details of our care system for the elderly.

“Palliative care became important for two reasons; one because I was working with a mentor, Sheryl Zimmerman, at UNC, and she had a grant to study end-of-like and long term care. And then while I was completing my PhD, my mother actually died in a nursing home, and the circumstances surrounding her death influenced my focus on end of life and specifically on nursing home personnel. We had a rather unfortunate experience with hospice, where hospice didn’t actually provide care for her at the end of life as they had agreed to, so it opened my eyes to the necessity that we cannot turn all long term and end of life care over to hospice. We need to make sure that the staff who are always going to be there care for the residents.”

Through her research, Dr. Munn realized that the impact of care staff in geriatric and palliative care can seldom meet every need, and millions of families are left to desperately try to try to compensate without help or guidance. In Spring, 2016, she was awarded with the prestigious Fulbright Fellowship, hosted by Charles University in Prague, Czech Republic, to study the aging process and gerontological care in a country whose social work profession is relatively new. Before 1989, when the Czech Republic was controlled by the Soviet Union, social work was not trusted, and the practice was non-existent. In the past twenty years, efforts have been made to legitimize social work in academic and public spheres. During her studies in Prague, Dr. Munn was surprised with her findings.

“I did some teaching, I also presented workshops at two other universities in the Czech Republic and I interviewed social workers to determine how they saw their roles addressing end-of-life issues and how they worked with residents. These were social workers assigned to care homes, but they also worked with residents in the community, which is a model of care that we don’t have in the United States. I was very surprised with what I found. First of all, I expected social work in the Czech Republic to be focused on social welfare, more political, policy level questions, but what I found was a lot of really young, invested, social workers who were doing direct care with residents in the care homes and the community surrounding them. Social work in the Czech Republic is really unique, because during the communist period, social work was considered suspect. There were no social workers, that term would never be used in the communist period. When the communists left in 1989, the School of Social Work at Charles University was re-energized and reinvented. The School there is really only about twenty-five years old, so it is a really unique situation, because you have one of the oldest universities in Europe, and you have one of the youngest departments of social work.”

Academics who embark on a Fulbright Fellowship bring back a newfound understanding about the international proceedings of their field, and Dr. Jean Munn sees both similarities and differences between American and Czech social workers. “The broadened perception is the recognition that the Czech Republic is now where the United States was about 25 years ago in terms of Palliative care. The commonality is that we as social workers have a lot of difficulty in articulating our roles. In the United States, we also have difficulty articulating our role at the end of life.”

Dr. Munn also recognizes the United States’ advancements in her field, and how our history of academic freedom has led to a refinement and advancement of American social work.“I have greater appreciation for our sophistication of the profession. The social work departments in the Czech Republic were not the only places that had had to reorganize after the communist period. I appreciate more the academic freedom that we have here. You see what happens when academic freedom is taken away, and you see how long it takes to reinstate the universities, religious entities, and monasteries had been taken away, just the upheaval that comes, and then the length of time it takes to actually rebound from that kind of oppression. So I think I have a better appreciation for our opportunities in the US.”

Studying with international academics influenced Dr. Munn’s views of diversity on college campuses, specifically Florida State. Dr. Munn believes that experiences with people from all over the globe opens students’ minds and that college is the opportune time to branch out and explore cultures asides from one’s own. She brings diversity to her classroom in order to better her students’ understanding of the world around them, which is important in the field of social work, as social workers aid people from all kinds of cultural, racial and economic backgrounds. Interestingly, most of those who pursue social work in the U.S. are female, which also holds true for the Czech Republic, and Dr. Munn believes that if this statistic is to be changed, it will be social workers doing the work.

“I think it’s [diversity] important in the same was that it is really important to have experiences outside of the United States. I think that it broadens everyodays view of the world. It takes away some of the fear that people have, being around persons who are different from ourselves, allows us to see commonalities as well as be more comfortable with differences. I think if it doesn’t happen by the time you finish college, it’s probably not going to happen. You need to broaden yourself during a certain developmental period. It doesn’t mean that it can’t happen, but college is definitely the place where we are the most open and the most receptive to learning about diversity. It can start earlier and happen later, but I think those first days of indepence and beginning to see the world outside your family, is the perfect time to understand  people unlike yourselves. To me, that is key to being a human being, to having any kind of kindness or compassion or empathy. Those things happen, not just with exposure, but actually with living with people unlike yourself.”

“I would like to say that we do have a diverse student body. I think the last figure I knew was about 30% minority students. When we talk about anything like family, we talk about diverse family constellations, we talk a lot about cultural competency, understanding the context. A part of social work is understanding people in their environment, so we have to come to know diverse environments. That being said, social work classes have very few males in them, and that is not atypical of the social work profession as a whole, so we do need to look at that as a sort of lack of diversity. I am always happy when I have male students in the class because I feel like that broadens some of the perspectives when we take about roles, changes in the culture, but I will say that the class that I am teaching right now is all female.”

College professors have the rare opportunity to motivate students to fulfill what they see as the future of their fields. As for the future of Social Work, Dr. Jean Munn hopes to see an elevated level of care, which will include interprofessional teams operating together to provide integrative models of care. In 2050, an estimated 81 millions Americans will be over the age of 65, a staggering number which illustrates the importance of the future of palliative and geriatric care.

“For one thing, it will continue to increase as the older adult population increase. I think some of the current trends are toward person-centered care. This means that the goals of the individual guide the medical care and the decision making. Interprofessional teams are/will be providing care. We do training with the College of Medicine and the College of Nursing at FSU, and with the College of Pharmacy at FAMU to acquaint our students with interprofessional team care. We are at the point where everybody recognizes that there are silos of medical care, that the care provision is fragmented, so hopefully there will be moves into more integrative models of care.” By uniting the different professionals involved in geriatric medicine, the gaps in reliability will be filled.

The first piece of advice that Dr. Munn would give to a family entering the trying process of long-term care is to find the social worker. “Any nursing home with 120 beds or more is federally mandated to have a social worker. However, most nursing homes, even smaller ones, have social workers. The first advice I would give is to find the social worker, because the social workers help families navigate the system, help mediate any kind of disagreements, find information for them, and facilitate the transition.  The social worker probably has an open-door office, so if families distressed, they will have somebody to talk to.”

Dr. Jean Munn is an Associate Professor of Social Work with a specialty in Gerontology at the  Florida State University College of Social Work.

If you would like to learn more about Dr. Munn’s publications and grants, please click here.

-Zoe Zirlin, FSU Class of 2020

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