1. SOCIAL WORK PRACTICE AND COMPETENCY WITH RURAL ELDERS Kristina Hash, LICSW, PhD West Virginia University

2. Topics  Definitions of “rural” and key demographics  Challenges faced by rural elders and the professionals who work with them  Advantages of aging and working in rural communities  Gero competencies and rural practice  Interdisciplinary practice in rural communities  Policies and programs impacting rural elders

3. Definitions of “Rural” and Key Demographics  Defining “rural” is a difficult task. One approach is to consider the dimensions of rural areas and their residents:  Behavioral  Compositional  Cultural  Ecological  Organizational  Social and Economic Resources

4. Definitions of “Rural” and Key Demographics  The ecological definition is the most often used and includes “a place’s population size and density, natural environment, and location vis a vis other communities (e.g. proximity to larger city)”

5. Definitions of “Rural” and Key Demographics  Using the “nonmetro” categorization of the U.S. Census Bureau, compared to their urban counterparts rural older adults are:  Older  More likely to be married  Have lower levels of educational attainment

6. Challenges of Rural Aging  Poverty  Health Disparities  Access to Health and Social Services  Diverse populations (ethnic elders, older women, and LGBTs) may face even greater challenges in these communities  Despite the challenges, rural communities and their residents have many strengths

7. Gero Competency and Rural Practice  Social work educators and scholars have identified areas of special consideration for effective practice in rural areas with persons of all ages:  Generalist training and perspective  Understanding of rural culture and its people  Personal and professional traits  Ability to manage dual relationships  Ability to manage issues of confidentiality and self- disclosure

8. Gero Competency and Rural Practice  The Geriatric Social Work (GSW) Competencies have outlined practice skills standards that every social worker working with older adults and their families should be prepared to meet. They comprise of the following domains of competence: I. Values, ethics and theoretical perspectives II. Assessment III.Intervention IV. Aging services, programs and policies V. Life-long Leadership Access the GSW competency scale here: http://www.cswe.org/File.aspx?id=25445 http://www.cswe.org/File.aspx?id=25445

9. Gero Competency and Rural Practice  In terms of the GSW competencies, social workers practicing in small towns and rural areas will have unique experiences and issues with those that fall under the domains of: Values & Ethics & Theoretical Perspectives (competency 2, 3, & 5) Intervention (competency 6) Programs, Policies, and Services (competency 1, 3, 8, 9, & 10) Leadership (competency 6 & 7)

10. Interdisciplinary Practice in Rural Communities  There are many different disciplines, including social work, that work with older adults and their families in small towns and rural areas.  To best serve rural elders, professionals from different disciplines should work collaboratively and communicate effectively. This is often described as “interdisciplinary teamwork”.

11. Interdisciplinary Practice in Rural Communities  The Institute of Medicine report Retooling for an Aging America (2008), cited a shortage of professionals who are competently trained to work with the growing population of older adults.Retooling for an Aging America (2008)  Similar to the GSW Competencies, the Partnership for Health in Aging developed multidisciplinary competencies for the care of older adults.Partnership for Health in Aging

12. Policies Impacting Rural Elders  The Older Americans Act: http://www.aoa.gov/AoA_Programs/OAA/Introduction.aspx http://www.aoa.gov/AoA_Programs/OAA/Introduction.aspx  The Americans with Disabilities Act: http://www.dol.gov/dol/topic/disability/ada.htm; http://www.ncsc.org/Topics/Access-and-Fairness/Americans-with-Disabilities- Act-ADA/Resource-Guide.aspx http://www.dol.gov/dol/topic/disability/ada.htm http://www.ncsc.org/Topics/Access-and-Fairness/Americans-with-Disabilities- Act-ADA/Resource-Guide.aspx  Medicare: https://www.ruralhealthinfo.org/topics/medicarehttps://www.ruralhealthinfo.org/topics/medicare  Social Security: https://www.ssa.gov/; http://www.globalaging.org/ruralaging/us/index.htmhttps://www.ssa.gov/ http://www.globalaging.org/ruralaging/us/index.htm  Medicaid: http://www.rupri.org/Forms/HealthPanel_Medicaid_Sept2012.pdf; https://www.ruralhealthinfo.org/topics/medicaid http://www.rupri.org/Forms/HealthPanel_Medicaid_Sept2012.pdf https://www.ruralhealthinfo.org/topics/medicaid  The Affordable Care Act: http://www.hrsa.gov/advisorycommittees/rural/publications/elderly.pdf http://www.hrsa.gov/advisorycommittees/rural/publications/elderly.pdf