Attempting to sort through all of the services, programs, and benefits available to
older adults sometimes feels like trying to navigate a maze. The lengthy application process, seemingly endless documents, varying requirements, and program choices might seem too confusing for some older adults, preventing them from obtaining care they need. Helping to assist them through this process are geriatric social workers, specialists who increase access to helpful services that improve their lives.
Usually working within hospitals, nursing homes, aging centers, and in the homes of their clients, geriatric social workers are care managers and personal advocates for their clients. They identify programs and services available to older adults, connecting them to other professionals in the care community.
Older adults typically find reaching these programs and services to be a difficult and convoluted process, but geriatric social workers offer them the expertise needed to navigate the bureaucratic process and increase access to these services.
Assessing the Needs of Older Adults
Because older age naturally brings about loss of physical abilities, as well as loss of personal relationships, there are many issues older adults might face before meeting with a geriatric social worker.
To assist them with any of these issues, the geriatric social worker must first determine where the problem areas in the client's life are by conducting an assessment.
According to the book Social Workers and Health Care in an Aging Society, by Barbara Berkman and Linda Harootyan, assessment allows a social worker understand a client's needs, and the scope of a their problem. Without a full picture of the client's life, and current supports, the social worker is unable to develop a care plan.
Berkman and Harootyan write that geriatric assessments should be comprehensive in scope and examine the following aspects of the older adult's life:
- Demographic information
- Health status
- Functional performance
- Cognitive functioning
- Mental health status
- Social and informal supports
- Financial status
One of the most widely used geriatric assessments is the Older Americans Resources and Services (OARS) Multidimensional Functional Assessment Questionnaire. While conducting the OARS, the geriatric social worker interviews the client, asking questions related to transportation, ability to complete daily tasks, and general health.
Based on the answers, the geriatric social worker notes the problem areas in the older adult's life, and begins to develop a future care plan.
Providing Answers for Older Adults
After assessing the client, geriatric social workers begin the care management process by identifying resources in the community for an older adult. Many older adults are unaware of the large number of benefits and social services they are eligible for, or might have gotten confused in the past when applying for services.
For example, a major goal of geriatric social work is linking adults to service providers in the community. Consider an older adult who visits a social worker because he is unable to drive himself to the grocery store anymore. The man is frustrated because his son is not always around to drive him, and he doesn't understand what options are available to him.
Here, the geriatric social worker might discuss the older adult's concerns, and brainstorm different ideas with the client. One option might include connecting him to a transportation service that regularly takes him to the store, while another could involve signing up for a "Meals on Wheels" service that could bring groceries to him weekly.
When the two decide on a care plan, the geriatric social worker begins to contact the appropriate networks, and sets up the program for the client.
While much of geriatric social work involves connecting older adults to social services, they also help clients feel more empowered through individual counseling and advocacy.
Common Concerns of Aging Adults
According to the American Psychological Association, older adults experience a range of physical, cognitive, and social changes that can be difficult to cope with. Some of the most common concerns of older adults include:
- Adjustment issues
- Bereavement issues
- Management of chronic illness
- Family problems
- Financial difficulties
- Loss of mobility
Source: American Psychological Association
Helping Older Adults Recognize their Strengths
Because geriatric social workers aim to improve all aspects of a client's life, they often find themselves in the role of a counselor. Given their established and trusting relationships with clients, geriatric social workers are perfectly suited to assist them with non-clinical mental health concerns.
During the initial assessment, social workers uncover a client's strengths and weaknesses, allowing them to draw upon this knowledge to help older adults overcome limitations that rise from issues like chronic illness or depression.
For example, consider an older adult who is meeting with a geriatric social worker in a nursing home.
The social worker finds that the older adults is feeling a loss of control in her life, and is anxious and depressed after recently moving out of her house into the nursing home. The client laments that her life is "over," and she misses living in her old home surrounded by her neighbors and friends.
According to "Social Work with Older Adults and Their Families: Changing Practice Paradigms," published in Families in Society: The Journal of Contemporary Social Services, a social worker meeting with this client might engage in "narrative gerontology."
Narrative gerontology is a life review therapy based on the idea that past stories contain a larger framework that reflects expectations, values, and strengths. It helps older adults reflect deeply on their pasts, and helps uncover personal strengths that might have been forgotten.
The social worker meeting with the nursing home client might note that she is facing a personal crisis of identity now that she has moved out of her old home. To help explore these feelings in greater detail, the social worker might inquire about past memories and experiences that brought about similar feelings.
Through life review, the social worker discovers that she moved around a lot as a child, and frequently had to make new friends. However, in her twenties, the client settled down in a neighborhood with her husband, and stayed there for years before moving to the nursing home.
The social worker then re-frames these past memories in the context of the current situation. For example, the social worker might note that she must have developed strong interpersonal skills as a child, because of how often she moved to a new town.
Then he could note that the current situation seems fairly similar, and that she has the skills necessary to meet new neighbors and adjust to her new lifestyle. Feeling more comfortable in her situation, she might then acknowledge the similarities and has the skills necessary to develop new friendships, join senior groups, and continue living life.
Outcomes of successful social work with older adults
According to the book Social Work with Older People, successful geriatric social work leads to a range of positive outcomes for older adults. Some of these outcomes include:
- Improvements in physical symptoms, functioning, and mobility
- Improvements in morale and self-esteem
- Meeting basic physical needs
- Ensuring physical safety
- Keeping alert and active
- Having control of daily routines
- Having social contact
Source: Social Work with Older People, by Ann McDonald
Working with Older Adults
If you're interested in a career connecting older adults with helpful services and assisting them with living fuller lives, request information from psychology schools. Also, learn more about the counseling licensing process and what the requirements for licensure are: social work licensure.
Spotting Elder Abuse
Because geriatric social workers have detailed insight into the lives of their clients, they should always be on the lookout for signs that not everything is right in the life of an older adult.
Beyond the difficulties of reaching services and connecting with agencies, it's estimated that many older adults experience elder abuse at the hands of their caregivers - but they're just not revealing this information to the social worker.
According to "Elder Abuse" published in the British Medical Journal, elder abuse might be physical, psychological, sexual, or financial. The article, by author Mark Bradley, notes that caregiver stress and frustration sometimes become too much for the caregiver to handle.
Either purposefully or incidentally, the caregiver may then begin to neglect, or even react angrily toward the large number of responsibilities that comes with caring for an older adult.
As social workers often fully assess the lives of older adults when working with them, they should pay special attention to the living conditions of the older adult, and whether or not any signs of abuse rise during assessment.
Some warning signs of elder abuse include:
- Poor family relationships
- History of domestic violence in family
- History of alcohol or drug abuse in caregiver
- Unexplained falls, burns, and fractures
- Bruises in unusual places
- Unexpected inability to pay bills
- Failure to properly administer medication
If these signs exist, and the older adult acknowledges the abuse, the social worker would then take the steps to intervene, including contact with law enforcement and other social agencies that fight elder abuse.