Social Work with the Elderly - Essay Example

 Social Work: The Elderly The practice of social work covers a wide array of clientele group; and, perhaps, one of the most challenging aspects of this profession is in working with the elderly. The quality of service provided to this sector is somewhat influenced by a sub-conscious hopeless belief in the worker’s capacity to effect change in their lives as they are already approaching their ‘twilight’ years, which means to some that the only thing left to do is to ensure that they will live a comfortable and decent life for whatever is left of their time. Their ways are long set and because they are older than the professionals working with them, it is difficult to obtain their participation in the case management process, wherein the worker is the initiator. Most of them have feelings of the ‘been there, done that, I can take care of myself’ sort of attitude – at least those who are still in command of their faculties. Another challenge is the fact that it is common for the clients to be afflicted with different kinds of diseases and disabilities: physically, mentally, or emotionally. This paper aims to give an in-depth discussion of the challenges involved in working with the elderly, and how the clients’ identity issues affect their relationship dynamics with the worker. First, let us explore the clients’ perspectives and situations from the beginning of things – as they enter the residential home for the elderly. Some have existing and financially capable relatives by they themselves choose to stay in a residential facility so as not to burden their family members with their needs. It could due to reasons of pride, or perhaps a deeply ingrained sense of independence that spurs them to instead opt for professional and paid help. It could be a defense against possible future rejection and the hurt that would succumb from it. Others would have preferred to stay with their children and/or grandchildren, as is in most cases in Asian countries for example, but the family members are either too poor, too disgusted at the prospect of being solely responsible of taking care of an elderly person, or too concerned with having their own lifestyles cramped. Many times the older persons in these cases are admitted to residential homes despite wanting to stay with their families or remain in their own homes. They perhaps just weren’t given a choice. The majority of the elderly have been placed in residential homes because of a physical or mental disability and/or because they do not have anyone around to take care of them anymore. These factors, one way or another, have a crucial impact on the clients’ psychological state and invariably affect their responsiveness and cooperation during the course of case management. As each and every human being has unique identities and personalities, the dynamics of an elderly person and his or her identity is profoundly affected. “Community care policy…reflects contradictory aspirations (simultaneously) promoting research efficiency and cost effectiveness while advocating a process of needs-led assessment, which provides time for individuals to make their own decisions.” (Wistow, 1995, p227-240). In no way and nowhere are these tensions more apparent than when “…older people, and particularly frail and vulnerable older people, are considered.” (Nolan et al, 2001, p11). Measuring the quality of what is truly a priority to these individuals is incredibly important: their own sake, their careers and their families. Social justice is an indefinite core value to the mission of social work altogether. “Older people are among the most vulnerable populations for whom social workers are called on to advocate,” (Larkin, 2004). The elderly population (considered to be around 65 and older), reached 28 million in 1984. This number equalled 11.9% of the population or approximately one out of every eight Americans. “By the year 2000 individuals 65 and older are expected to 13% of the citizenry, and by 2030 as much as 21%, or 2.5 times the number in 1980.” (Lewis, 1989). For a long while, virtually no data was available to those who worked in social care with persons with disabilities. As Roberta B. Trieschman, in Aging with a Disability, wrote: “There is another population…that has been overlooked – those who experienced a major disability in the earlier years of their lives, who have adjusted to the altered lifestyle, and who are now experiencing another decline in scope and intensity of activities…The issue of aging with a disability is a new problem for western societies, one that has caught our health care system by surprise.” There are an increasing number of persons with physical disabilities who are entering the aging phase of life, and this phenomenon “…demands the immediate attention of speciality long-term care centres, as well as community agencies and professionals, to ensure the development of effective and sensitive treatment, care and support services.” (Lewis, 1989). Older persons are each confronted with their own varying degrees of losses, whether physical, social, or emotional; older persons with a disability often find themselves in an even more difficult place than the rest. Understanding the aging process and having at least a somewhat confident knowledge in the area of disabilities is certainly one constructive way that those who work with older persons with disabilities “…can be better prepared to help their clients cope with stress, loss and consequences of growing older.” (Lewis, 1989). The term ‘disability’ may include such things as the following: the surfacing of sensory deficits as one grows older (such as sight and hearing), confusion and disorientation, feelings of increased dependency, and excessive fear of death. Aging itself makes people prone to effects of medical conditions associated with physical deterioration, falls and other accidents, depressions, functional mental illness and even forms of dementia. Direct understanding of these such things is a definite requirement essential to the success of any service and personnel employed in that service to support elderly residents with disabilities properly and considerately. “The term ‘older people’ can encompass two complete generations, as retirement takes place between 50 and 70 or more, and the numbers living into their 90s and beyond grow rapidly.” (Joseph Rowntree Foundation, 2004). Adults with learning difficulties, impairments, and other forms of disabilities are becoming an increasingly high number of those categorized into living into old age. The majority of older persons, and often especially so when involving those with disabilities of any sort, find themselves more angry and more depressed each time there is a shift and they become more dependant. Whether it’s the loss of a spouse, the onset or discovery of an illness, a fall and loss of confidence, being the victim of burglary, or simply having someone taking care of them who makes them realize just how dependant they actually are – it is a blow to their self-esteem, and can deeply impact their well-being and their life altogether. There has been a great amount of research and testing completed – over the past decade or two especially – and successful treatment can often make a patient feel incredibly reassured and genuinely happy again. “Conversely, successful treatment or effective aids to alleviate a mobility or sensory problem, moving to manageable accommodation, gaining a valued role or establishing a new relationship, can all restore confidence and self-esteem and enable people to regain different degrees of independence.” (“SEP”, 2005). The fact that the outcome of a person’s physical, mental, and emotional state and well-being often times rests primly on the social care workers’ shoulders, creates the unchangeable understanding that they must be not only properly educated, but understanding and compassionate for each and every client. Proper social work with older persons entails the following: The encouraging of all professionals involved to take and keep taking an all-round view from the person’s perspective Working together with the person and others on strategies for their own empowerment, independence and control of their own lives; which in conclusion makes them feel happier and more confident Identifying the person’s abilities, assets and potential for capacity-building, and enabling them to develop to the full extent Assisting the person to explore and access alternative living situations, including those with the benefits of ‘smart housing’ and housing-based support schemes Assisting the person with the assessment of their support needs and preferred solutions, and with securing satisfactory arrangements Where the person wishes, helping them to access direct payments and establish and manage support arrangements to their specifications Assisting the person and their family through the transition to higher levels of support needs, whether through increased disability, ill-health or bereavement, or in order to access opportunities for independence and participation. These are only a few of the many requirements needed for a social care worker to properly do his or her job. Irregardless of anything else, the most important factor to be understood is how important and relevant the relationship between the older person and the social care worker actually is. It is much more than simply ‘worker/patient’; there must be understanding, commitment, consideration, and most importantly compassion. Older persons with disabilities often times find themselves in denial, not wanting to admit that they are at least somewhat dependant, and can no longer take care of themselves. Something which may not particularly affect a younger person can seriously traumatize someone at an older age that is more frail and vulnerable. The self-esteem and confidence level of these persons must always be considered and not taken for granted. Each person has their own separate thoughts and emotions, and their own identity, and that must be understood first and foremost. Older persons with disabilities have various identity issues, and what they often consider their ‘biggest disability’ is the fact they are no longer independent and able to live on their own or take care of themselves. This is where the ‘been there, done that, I can take care of myself’ attitude tends to come from, but through the efforts and understanding of a social care worker, these people can be shown that a disability is simply that – a disability - and that with strength and confidence they can overcome it. The end result from this will be positive on both sides. References Nolan, M., Davies, S., & Grant, G.. (2001). Working with older people and their families. Philadelphia: Open University Press, p11. Larkin, Heather. (2004, July). Justice implications of a proposed Medicare prescription drug policy. Retrieved January 16, 2006, from http://www.findarticles.com/p/articles/mi_go2040/is_200407/ai_n6292812 Lewis, Ken. (1999, Oct-Dec). Persons with disabilities and the aging factor. Retrieved January 15, 2006, from http://www.findarticles.com/p/articles/mi_m0825/is_n4_v55/ai_8265669 “SEP”. (2005, Dec). Social work with adults of working age and older people. Retrieved January 15, 2006, from http://www.scotland.gov.uk/Publications/2005/12/16105307/53091 Wistow, G.. (1995). Aspirations and realities: Community Care at the crossroads – Health and Social Care in the Community. 3(4)p227-240. Read More