1. Intervention with the Elderly Chapter 8

2. Background The elderly population is growing in industrialized countries. This is due to: – Improved medical treatment – Earlier changes in lifestyle – Reduced mortality rates – Increased financial independence – Old age pensions – Governmental assistance – Advances in technology – Greater mobility and access to health and social services – Formal and informal support networks Despite the exponential growth rates of the elderly population the number of new social workers providing services to older adults is decreasing.

3. Theoretical/Conceptual Framework Studies Overview Social work with the elderly in rural settings may be different than in urban settings. – Rural practice often entails clients with “lower than average” general health, fewer services available within the local community, wide range of economic diversity, limited access to formal service providers, geographic isolation. Issues and legislation that impact social work with the elderly: – Advance Directives – “Right to Die” legislation – Patient Self-Determination act of 1991 – Psychosocial development – Compassion fatigue – Cognitive impairment – Physical impairment

4. Effectiveness Studies with the Elderly Overview Presenting problems of the elderly are more complicated than in decades past with the cost of adequate care being out of reach for many clients. Osteoporosis education-improve functional independence and psychological well-being Pain and depression are two areas that need to be addressed continually. Social isolation is common and may require intervention, especially if the isolation is self imposed. Wellness interventions can significantly improve physical and mental well being among the elderly. This can also include physiotherapy which can help reduce the risk of falling. “Aging in place” and “hospital at home” are two community based interventions allowing elderly to receive care at home and within their community. These interventions stem from the lack of adequate accommodations for the elderly in long term care facilities, nursing homes and long term hospitals; as well as the expressed desires of elderly clients to die at home. – Interventions have demonstrated improvements in overall general health status as well as decrease in depressive symptoms.

5. Intervention and Outcome Studies Overview Interdisciplinary teamwork is essential when working with elderly populations. Group work can be beneficial with this population as it assists in reducing social isolation. Pain and depressive symptoms are connected. Increasing physical functioning my make a world of difference for clients who are dealing with physical and/or mental health issues. Treatment compliance may be low among the elderly with chronic health conditions, such as congestive heart failure. Multidisciplinary interventions may be important to reduce time in hospital care. Rendering care to the elderly must be done using interdisciplinary approaches that include multiple intervention strategies. Elderly clients are experiencing the physical and emotional changes that go along with aging, and need support, as well as targeted interventions throughout this process.

6. All of these areas play a contributing role in social work practice with elderly clients. The current societal understanding of the elderly and their role within society leads into the basic knowledge required for working with this population. Interventions with elderly must be grounded in a strengths-based perspective and be overtly client centered. Gerontological social work practitioners epitomize the essence of advanced generalist practice. Applying evidence from each of these areas allows the practitioner to make informed practice decisions.