Care Coordinator (MSW)

Julie Orfanidis, Local Health Integration Network

After completing high school, Julie Orfanidis initially travelled with a theatre company for a couple of years and wasn’t exactly sure where to take her career path after returning home. While heading to the University of Waterloo one day to apply for a job, she bumped into a friend that suggested the Social Development Studies program would be a good fit for her because of her desire to help people. It was this moment that changed the trajectory of Julie’s life.

Julie graduated in 1990 from the social development studies program and went on to work with young offenders for nine years. Julie realized she was burning out and needed a change, and due to the political and economic climate at the time, Julie held many different jobs either on a contract basis or would secure a longer position only to find that funding was cut. Places Julie worked included teaching a Social Service Worker program, working at homes for abused women, homeless women and group homes, running a pilot project for homeless families, assisting women in a federal prison with their discharge plans, and having a variety of roles within a Community Health Centre to name a few.

Because of the amount of experience Julie gained, she found it more difficult to obtain jobs due to organizations feeling she was over-qualified, or because she did not have a Bachelor of Social Work, she was not eligible for other jobs. After being laid off again, Julie decided to remain at home with her young children and to focus on upgrading her education. She completed the BSW program on a part-time basis and was able stay connected to social services by having casual jobs such as serving as a group facilitator for parents and children, a youth worker with a House of Friendship group home, as well as a crisis intervention worker with Lutherwood Family Counselling in their crisis outreach phone support. 

Realizing that she may end up caught between over-experienced and under-educated again, Julie ultimately completed her Master of Social Work. She was hired as a Care Coordinator after completing her work placement at the Community Care Access Centre, now known as the Local Health Integration Network (LHIN), which is the health authority organization responsible for the regional administration of public healthcare services in Ontario. Julie found that all her experiences built on each other and have ultimately assisted her in better understanding people and their histories, which has helped her in developing care plans for her patients.

A typical workday as a Care Coordinator involves connecting with patients and their families, as well as health care providers. Conducting home visits with patients to complete an assessment to determine what home supports are needed is a key aspect of her job duties. People’s needs vary based on what their health issue is, and the assessments help determine what level of care is needed. The LHIN provides services such as Personal Support Workers, Nurses, Occupational Therapists, Physiotherapists, Speech Language Pathologists and Social Workers. Care Coordinators also connect patients with community resources such as Meals on Wheels, day programs and housekeeping supports. Key to the assessment is supporting patients and their caregivers to keep people in their own homes for as long as it is safe to do so. If a caregiver becomes unable to manage the care their loved one needs, or if a person does not have family or friends who are able to help, a Care Coordinator will assist with accessing other housing options such as Long Term Care, Supportive Housing or Retirement Homes. Regular reassessments are important to determining when more support is required or if the person has regained independence. Compassion and problem-solving skills are essential to make sure the clients have the resources they need. Care Coordinators rely on a team to discuss more difficult cases as it helps to have different perspectives and experiences in order to determine the best plan.

What Julie appreciates most about her role is meeting many people and hearing their stories. Julie feels her position allows for excellent work-life balance and a nice sense of control and flexibility over her own schedule. Challenges can include dealing with limited resources (e.g., long waitlists) when the urgency for assistance is immediate. An example of this could be a caregiver who wants to keep their spouse at home but can no longer handle the level of care required. Often when they realize it is too much, they need the person moved to a home quickly, and yet still need to wait to access a bed in long term care.
Other challenges include dealing with clients who choose to live in situations where there are safety risks or when people have difficulty deciding what is the best option. Julie notes that a lot of social work is about providing options to people but ultimately accepting that clients make their own choices. Above all, your role is to simply support, rather than judge them. Julie believes that the ability to empathize is a key skill to be successful with this type of position, as well as a genuine desire to hear people’s stories and understand their history, culture and background. She also highlights the ability to take care of oneself and to separate work and home life to ensure you do not experience burn out.

Future trends in the social work profession likely include expanded resources for the aging population. It is hard to determine where the needs will be in in 5, 10, or 20 years time, as a wide range of events may contribute to the trauma that clients experience. Even this interview took place before the 2020 Covid-19 pandemic and has undoubtedly impacted the stress levels of clients and their subsequent health care needs. Whatever societal factors are involved, trauma will need to be continually addressed to help clients lead healthy lives.

Julie would advise students who want to increase their chances for success in this area to conduct research based on their specific social issues of interest, whether it be working with the homeless population, in schools or in healthcare. Julie also encourages students to take risks and try things that may be out of their comfort zone. For example, volunteering to find your fit, as well as connecting with social work professionals. If you are particularly interested in health-related social work, Julie recommends subscribing to the regular newsletters published by the LHIN to keep up with healthcare trends, as well as accessing information from the College of Social Workers and Social Service Workers, and the Ontario Association of Social Workers.