Social isolation is both a social and public health problem that is lethal across the life span. Its harmful effects have both psychological and physiological impact and is recognized by social workers and allied health professionals as a major barrier to quality of life for individuals and groups. The effects of social isolation have been reported to be as harmful as smoking 15 cigarettes a day and four times as harmful as obesity. These facts have galvanized the social work profession around eradicating social isolation with a focus on defining social isolation and identifying its causes, strategies for eradication and prevention, and addressing the differences between perceived isolation (loneliness) and objective isolation. Additionally, social isolation is examined through a cultural lens using both micro- and macroperspectives giving attention to social exclusion as well as to groups who have higher risks such as older persons, at-risk youth, prisoners, stigmatized groups, and historically oppressed populations.
Article
Social Isolation
Sandra Edmonds Crewe and Robert Cosby
Article
Deinstitutionalization in Macro Practice
Steven P. Segal
The deinstitutionalization policy sought to replace institutional care for populations in need of care and control with prosocial community-based alternatives. U.S. institutional populations, however, have increased since the policy’s inception by 205%. As implemented, with the assistance of advocacy and cost-cutting factions, it has succeeded only in enabling the divestiture of state responsibility for target groups. It sought to prevent unnecessary admission and retention in institutions. As implemented, deinstitutionalization initiated a process that involved a societal shift in the type of institutions and institutional alternatives used to house its target groups, often referred to as trans-institutionalization. For many in need of institutional placements, it has succeeded in preventing all admissions, expanding admissions for others. In seeking to develop community alternatives for housing, treating, and habilitating or rehabilitating its target groups, it has succeeded in establishing a variety of alternative living arrangements and showcase and model programs illustrating what can be done; yet, it has failed to deliver on investments in such programs to serve the majority of its target groups. It has resulted in the abandonment of substantial numbers to homelessness. It has been documented, from political, economic, legal, and social perspectives, how this policy has affected the care and control of populations such as older adults, children, people with mental illness or developmental disabilities, people under correctional-system supervision, and, more recently, individuals without a home. Suggestions for a truer implementation of deinstitutionalization’s initial aspirations are available.
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Social Work in Moldova
Vadim Moldovan, Eugeniu Rotari, Vadim Tarna, and Alina Zagorodniuc
The Republic of Moldova is a small post-Soviet country that has been “transitioning” from a socialist to capitalist economy since the 1990s. Once a prosperous region of the Soviet Union, it is now among the poorest countries in Europe, facing many social problems that call for a strong social work profession. However, social work is new to the country and the profession is challenged by low societal status, meager resources, and lack of cohesion. Social work in Moldova is struggling to meet these challenges with the help from the West and the emergence of an indigenous model of professionalization. Child welfare, elder care, mental health, as well as the history of social work in Moldova, current state of social work education with its obstacles to and opportunities for progress will be discussed.
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Mental Health and Older Adults
Hee Yun Lee, William Hasenbein, and Priscilla Gibson
As the older adult population continues to grow at a rapid rate, with an estimated 2.1 billion older adults in 2050, social welfare researchers are determined to fill the shortage of gerontological social workers and structural lag to best serve the baby boomers who are expected to need different services than previous generations. Mental illness impacts over 20% of older adults in the world and the United States. The major mental health issues in older adults include depression, anxiety, loneliness, and social isolation. Depression is considered one of the most common mental health issues among this population; however, the prevalence could be underestimated due to older adults linking relevant symptoms to other causes, such as old age, instead of as possible depression. Like depression, anxiety symptoms are often mistaken as results of aging. It is also difficult for providers to diagnose anxiety in this population due to anxiety frequently being coupled with other illnesses and the psychological stress that comes with old age. Because the presence of loneliness or social isolation can manifest depression and anxiety symptoms in older adults, it is also difficult to separate these two issues. With the anticipated increase of the older adult population within the next few years, measurement tools have been created to assess depression and anxiety specifically for older adults. In addition to adapting assessment tools, interventions tailored to older adults are essential to ensure treatment coherence, even though medications are the go-to treatment option.
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Community-Based Aging Services
Jan Ivery
As individuals age, their physical community continues to be a primary entry point of intervention because of their attachment to place, social connections, and limited mobility to travel as far and as often as they would like or desire. The environment provides a context for understanding an older adult’s social interactions and the availability of and access to supportive services that reduce isolation and increased risk for reduced health status. When individuals age in place, social workers need to understand how community-based services can work with older adults in their community where they have lived for some time and have developed social networks. This knowledge will better assist social workers in their ability to effectively connect clients with appropriate resources. Unfortunately, it is not uncommon for an older adult’s environment to not reflect or adapt to their changing health status and physical mobility. Healthy aging (also referred to as age-friendly) and NORC (naturally occurring retirement communities) initiatives have emerged as examples of how to provide supportive, community-based services that will enable older adults to remain engaged in their community as they experience changes in their health status, mobility, and financial security. These community-level interventions emphasize the adaptability to an older adult’s changing lifestyle factors that influence how they navigate their community. These initiatives engage older adults in planning and implementing strategies to connect older adults with services and activities that promote aging in place. Social workers play a very important role in the provision of community-based aging services because they can serve as a bridge between older adults and the local, state, and federal level programs that may be available to them.
Article
Filial Responsibility
Rita Chou
With the rapid rise of the aging population, how to provide support and care for older adults has become an increasingly important issue across the world. One way of such provision in many societies has been through adult children. An important concept, attitude, and practice in this regard is filial responsibility. This article first looks into the definition of filial responsibility and its ethical foundation or theoretical underpinning as manifested in various theories. Next, the article examines changes and continuity in filial responsibility in the face of modernization and other social and cultural changes. To better understand the many faces of filial responsibility, the article discusses parental expectations of filial responsibility and the attitudes and practices of adult children. The extent of offspring’s filial responsibility attitude as a predictor of actual support and care to parents is discussed. In addition, to comprehend the effects of filial responsibility on individual well-being, this article examines not only the effects of parental expectations of filial responsibility on their well-being but also the consequences of fulfilling filial responsibility on offspring’s well-being. Finally, the article examines the relationship between filial responsibility and policy and the implications of filial responsibility for the helping professions, including social work.
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International Council on Social Welfare
Sergei Zelenev
The International Council on Social Welfare (ICSW) is a nongovernmental organization (NGO) focused on advocacy, knowledge-building, and technical assistance projects in various areas of social development carried out at the country level and internationally. Created in 1928 in Paris to address the complexities and challenges of social work, the ICSW has evolved through the years to embrace the major issues of social development, becoming a global organization committed to improving human well-being. Establishing common ground on issues of international significance and acting with partners through its nine regional networks, ICSW represents national and local organizations in more than 70 countries throughout the world. Membership also includes major international organizations. By virtue of its constitution, it operates as a democratic and accountable organization.
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Positive Emotion
Jessica M. Black
Scientific findings from social sciences, neurobiology, endocrinology, and immunology highlight the adaptive benefits of positive emotion and activity to both mental and physical health. Positive activity, such as engagement with music and exercise, can also contribute to favorable health outcomes. This article reviews scientific evidence of the adaptive benefits of positive emotion and activity throughout the life course, with examples drawn from the fetal environment through late adulthood. Specifically, the text weaves together theory and empirical findings from an interdisciplinary literature to describe how positive emotion and activity help to build important cognitive, social, and physical resources throughout the life course.
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Ageism and Retirement
Lynn McDonald
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.
Article
From Caregiving to Caresharing
Roberta R. Greene and Nancy P. Kropf
With the growth in the older population, especially people in the latest years of life, the need for care provision by both formal and informal sources of support will need to increase and be more innovative in design. This article begins by tracing the roots of caring and examines diverse caregiving structures and social conditions. Drawing upon a concept first studied by Covan in Florida and augmented by European models, the authors articulate practice principles from a caresharing perspective. These models emphasize caresharing by combining strengths and resources from multiple sources; however, they are still under development. The article concludes by examining 16 principles that are aligned with practice from a caresharing paradigm.
