This entry presents information about group settings that provide residential long-term care for older adults, focusing on nursing homes and residential care/assisted living communities. It provides an overview of both settings, and describes their scope of services, funding, and clientele. The section Issues in Residential Long-Term Care addresses issues of special relevance to social workers: dementia and other psychosocial care needs; quality of life and quality of care; access to and disparities in care; end-of-life care; family involvement; and abuse and neglect. It ends with a section on the role of the social worker in residential long-term care.
Older workers make important contributions to the workplace, its productivity, and its culture. Work remains important for older adults for financial security, to give meaning to later life, to maintain social networks, and to promote lifelong learning. However, ageist beliefs about the capacity of older adults to remain productive and contributing workers in the workforce can create barriers for older workers. Understanding how older workers experience ageist behavior in the workplace can help employers, policy makers, and social workers learn more about how to address this social problem. Organizations can become more age friendly through enabling workplace programs, supportive management, and proactive human resource managers. Social workers serving older adults in employee assistance programs and in private practice can help them to challenge ageism in the workplace. Finally, legislation such as the Age Discrimination in Employment Act protects the rights of older workers; however, more legislation is needed to address bullying and harassment of older adults in the workplace.
Retirement is a modest social institution that appeared in most industrialized nations near the start of the 20th century. The aim of retirement was to solve the societal dilemma of an increasingly aged labor force by moving older workers systematically out of their jobs so as to not cause them financial harm (Atchley, 1980, p. 264). Although retirement has been considered benign since its inception, the history of retirement indicates that it is one of the main progenitors of ageism in society today (Atchley, 1982, 1993; Haber & Gratton, 1994; McDonald, 2013; Walker, 1990). Retirement and its accompanying stereotypes have been used as a tool for the management of the size and composition of the labor force contingent on the dictums of current markets in any given historical era. Ever-changing ideologies about older adults that extend from negative to positive ageism have been utilized by business, government, the public, and the media to support whatever justification is required in a particular era, with little thought to the harm perpetrated on older adults. Unfortunately, society has subscribed to these justifications en masse, including older adults themselves. In this article the ageism embedded in retirement is examined to make what is implicit explicit to social work practitioners and policymakers in the field of aging.
Nancy R. Hooyman and Amanda Barusch
The rapidly growing older population is more heterogeneous than any other age group. Although many face vulnerabilities and inequities as they age, most are resilient. This entry explores the “greying of America,” examines the definition and measurement of aging, reviews the diversity among older adults in the United States, discusses productive, successful, and active aging, and suggests leadership roles for social workers in enhancing the well-being of elders and their families.
Lenard W. Kaye
Social workers address older adult issues at all levels of service planning, policy-making, and delivery and across a wide range of community and institutional settings. While various models of practice intervention with older adults exist, more recently the focus is on the integration of micro and macro strategies with an emphasis on strength-based perspectives to geriatric social work practice. The older adult population will expand dramatically and become increasingly culturally, racially, and ethnically diverse in the future and social work services will need to be sensitive to the variety of issues faced by a more heterogeneous and sophisticated older adult population.
Jeanette C. Takamura
Public policy advances in the field of aging in the United States have lagged compared to the growth of the older adult population. Policy adjustments have been driven by ideological perspectives and have been largely incremental. In recent years, conservative policy makers have sought through various legislative vehicles to eliminate or curb entitlement programs, proposing private sector solutions and touting the importance of an “ownership society” in which individual citizens assume personal responsibility for their economic and health security. The election of a Democratic majority in the U.S. House and the slim margin of votes held by Democrats in the U.S. Senate may mean a shift in aging policy directions that strengthens Social Security, Medicare, and Medicaid, if the newly elected members are able to maintain their seats over time. The results of the 2008 presidential election will also determine how the social, economic, and other policy concerns will be addressed as the baby boomers join the ranks of older Americans.
Daniel S. Gardner and Caroline Rosenthal Gelman
Minority and immigrant elders constitute a greater proportion of the population than ever before and are the fastest growing segment of the older population. Within these racial and ethnic groups there is considerable variation with regard to age, gender, country of origin, language, religion, education, income, duration of U.S. residency, immigration status, living arrangements, social capital, and access to resources. The authors summarize research on older adults regarding racial and ethnic disparities, barriers to health and social service utilization, and dynamics of family caregiving. Implications are offered for social-work practice, policy, and research.
Carole B. Cox
Dementia is not a disease, but a group of symptoms so severe that they inhibit normal functioning. Alzheimer's disease is the most common type of dementia in older persons impacting not only the person with the illness but the entire family. Obtaining an accurate diagnosis is essential in order to assure appropriate and timely care and to exclude reversible causes of dementia. Social workers can play key roles throughout the course of the illness as educators, therapists, supporter and advocates for improved policies and services.
Margo A. Jackson
Despite the significant life and work experiences that a growing number of older adults have to contribute to the workforce, pervasive ageism operates in overt and covert ways to discriminate against older workers in hiring and workplace practices. This article provides a current overview of definitions, prevalence, types, and effects of ageism in the U.S. workplace. For social workers counseling older adult victims of workplace ageism, this article discusses theories, foundational knowledge, and ongoing self-awareness and training needed for bias awareness. Counseling strategies and resources are highlighted, including coping and resilience strategies to counteract ageist stereotypes and discrimination, facilitate job-seeking support, and advocate for older workers by promoting awareness and serving as a resource for employers to reduce workplace ageism.
Martha A. Sheridan and Barbara J. White
Effective social work practice with deaf and hard-of-hearing people requires a unique, and diverse, collection of knowledge, values, skills, and ethical considerations. Salient issues among this population are language, communication, and educational choices, interpreting, assistive devices, cochlear implants, genetics, culture, and access to community resources. Competencies at micro, mezzo, and macro levels with a deaf or hard-of-hearing population include knowledge of the psychosocial and developmental aspects of hearing loss, fluency in the national sign language, and an understanding of deaf cultural values and norms. In the United States, the use of American Sign Language (ASL) is the single most distinguishing factor that identifies deaf people as a linguistic minority group. This entry presents an overview of the practice competencies and intervention approaches that should be considered in working with deaf and hard-of-hearing people, their families, communities, and organizations. It introduces the knowledge base, diversity in community and cultural orientations, social constructions, and international perspectives, current research and best practices, interdisciplinary connections, trends, challenges, and implications for effective social work practice with this population. An integrative strengths-based transactional paradigm is suggested.
Elder abuse is now recognized internationally as a social problem among the aging population. Intentional abuse, neglect, and exploitation among caregivers to frail and isolated elderly create serious risks across diverse formal and informal care settings. This field has expanded continuously since the early 1970s. Accurate prevalence and incidence rates have not been determined. There is a national system of elder victim protection operating within each state. The social work profession is legally mandated to report situations where an elderly person is suspected to be at risk of abuse. Social workers are involved in all aspects of elder abuse prevention and intervention services.
Katharine Briar-Lawson and Toni Naccarato
Over the decades, family services have been one of the overarching features of social work practice, education, and research. Efficacy studies help to reinforce the focus on serving individuals in the contexts of their families and to address intergenerational family systems. Families provide the bulk of services to their members but require tailored resources, effective services, and supports. The growing diversity in families compels more cross-cultural competence, responsive policies, and evidence-based practices. Family service practitioners must increasingly address the social exclusion of many families while integrating economic and employment supports with counseling, skill training, and other interventions.
Susan F. Allen and Elizabeth M. Tracy
Home visiting and home-based intervention are two strategies used by social workers when working with individuals or families in direct practice. The basic rationale for home-based work is the benefit to social workers’ assessments and understanding of clients, as well as the benefit of more relevant practice with families who are seen in the setting where difficulties are occurring. Home-based interventions have been shown to be effective in improving health and decreasing family discord. When visiting the home, the social worker has the added responsibility of respecting the privacy of families as a guest in their homes.
Nancy P. Kropf
Although the terms older adult and senior citizen are commonly defined as individuals 60 years and above, later adulthood contains various life-course phases and developmental periods. The “young-old,” defined as individuals in the age range of 60–75 years, often experience various health, social, and economic transitions. Both the individual and family systems must negotiate some of the concomitant changes that accompany the journey into later life. Therefore, this first decade of older adulthood is one that can simultaneously be enjoyable, exciting, demanding, and stressful for aging persons and their family.
Judith G. Gonyea
As a result of rising life expectancies, America’s older population is itself aging. The U.S. Census Bureau projections suggest that by the middle of the 21st century, more than 40% of Americans aged 65 and older can expect to live to at least the age of 90. Although the oldest-old is a diverse population, advanced old age is associated with a greater risk of experiencing economic hardship, disabling illnesses or health conditions, and social isolation. A growing public policy challenge will be ensuring the economic well-being, the health, and the dignity of society’s very oldest citizens.