1. Demystifying Social Work With Older Adults Monmouth University School of Social Work Prepared by: Professor Christa Hogan

2. Picture Yourself at Age 75  List 4 characteristics that you would like to have at age 75.  List 4 characteristics that a 5 year old passing you on the street would see.

3. Picture Yourself at 100  List 4 characteristics that you would like to have at age 100.  List 4 characteristics that a 25 year old passing you on the street would see.  What has changed since you were age 75?

4. Ageism  Term was coined by Robert Butler (1969).  “ A process of systematic stereotyping and discrimination against people because they are old” (Butler, 1987, p. 22).  “[Ageism] reflects a deep seated uneasiness on the part of the young and middle-aged…a personal revulsion to and distaste for growing old, disease, disability; and fear of powerlessness, ‘uselessness’, and death” (Butler, 1969, p.243).

5. Personal Attitudes About Aging:  Stereotypes about older people are usually negative.  These attitudes convey that older adults are less valuable as human beings.  They contribute to inferior or unequal treatment.  Attitudes about aging develop early on.  This attitude hinders our ability to adjust to normal changes in aging McInnes-Dittrich, 2009 McInnes-Dittrich

6. Ageism and End of Life Issues:  “…a highly agitated emotional response, invoked by reference to or discussion of death and dying.” (Green, 1986)  Working with older adults is a “constant reminder to the Social Worker of the logical progression of the life cycle-from youth to aging and death”. (McInnis- Dittrich, 2009)  Society responds by avoiding these topics and populations  Even Social Worker’s working with this population tend to avoid it! McInnis-Dittrich

7. What do you think fosters ageism?

8. Some Facts:  Aging is a developmental stage  We all will experience aging ourselves or through watching our loved ones age.  At some point we may all face the death of a loved one, family, friend, co-worker, or neighbor.  This reality influences our work with the elderly on both a conscious and subconscious level. McInnis-Dittrich

9. The Influence of Ageism on Social Work with Older Adults as a Career Choice:  Older adults make up nearly 13% of the population yet less than 6% of Social Worker’s who belong to NASW want to work with older adults!  Do we internalize negative social attitudes about the elderly?  Do we believe the negative messages we hear about Social Work with Older Adults? McInnes-Dittrich

10. The Reality About Social Work with Older Adults:  High level of skill is needed  Requires a very broad knowledge base  Must be a specialist and an advanced generalist  Requires more, not fewer, skills than many of the more popular fields of practice  Must be able to interact with all ages groups  Must be an expert at preserving self- determination  Very complex work  Requires the most highly developed intervention and family work skills.  Must be able to integrate alternative interventions McInnes-Dittrich, pg. 21, 2009

11. Empathy: “The act of perceiving, understanding, experiencing, and responding to the emotional state and ideas of another person.” Barker (1999)

12.  “Empathy, the accepting, confirming, and understanding human echo evoked by the self, is a psychological nutrient without which human life, as we know and cherish it, could not be sustained.” Kohut (1978)

13.  “…entering the private perceptual world of the other and becoming thoroughly at home in it. It involves being sensitive, moment to moment, to the changing felt meanings which flow in this other person, to the fear or rage or tenderness or confusion or whatever that he or she are experiencing. It means temporarily living in the other’s life, moving about in it delicately without making judgments.” Rogers (1980)

14. Look Closer-See Me “What do you see nurses, what do you see? Are you thinking when you look at me A crabbit old woman, not very wise. Uncertain of habit with far away eyes Who dribbles her food and makes no reply

15. When you say in a loud voice, “I do wish you’d try.” Who seems not to notice the things that you do. And forever is losing a stocking or shoe. Who unresisting or not, lets you do as you will with bathing and feeding, the long day to fill. Is that what you’re thinking, is that what you see?

16. Then open your eyes, nurses, you’re not looking at me. I’ll tell you who I am as I sit here so still. As I move at your bidding, as I eat at your will. I’m a small child of ten with a father and mother. Brothers and sisters who love one another. A young girl of sixteen with wings on her feet.

17. Dreaming that soon a lover she’ll meet. A bride soon at twenty-my heart gives a leap Remembering the vows that I promised to keep. At twenty-five now I have young of my own Who need me to build a secure, happy home. A woman at thirty, my young now grow fast. Bound together with ties that should last.

18. At forty my young sons have grown and gone. But my man’s beside me to see I don’t mourn. At fifty once more babies play ‘round my knee Again we know children, my loved ones and me. Dark days are upon me, my husband is dead. For my young are all rearing young of their own. And I think of the years and the love that I’ve known.

19. I’m an old woman now and nature is cruel. ‘Tis her jest to make old age look like a fool. The body, it crumbles, grace and vigor depart. There is stone where I once had a heart. But inside this old carcass a young girl still dwells. And now and again my battered heart

20. swells. I remember the joys. I remember the pain. And I’m loving and living life over again. I think of the years, all too few, gone too fast. And accept the stark fact that nothing Can last. So open your eyes, nurses, open and See Not a crabbit old woman. Look closer-see me”. -Anonymous-

21. Some Tips to Remember: If a person who is visually impaired needs to be guided, offer your arm-don’t take their arm. If you have trouble understanding a person with a speech impairment, ask them to repeat themselves. Try not to finish sentences for them or pretend you understand them. Never shout at an older person, assuming they cannot hear.

22. Speak directly to the older person, not to their family member, companion or caregiver. Don't ask wheelchair users to hold things for you if you are transporting them. Respect their personal space. Be sure to always knock before entering a person’s room. Don’t talk “baby talk”.

23. Always ask a person in a wheel chair if it’s ok for you to transport them before doing so. It can be very disorienting to be pushed without knowledge that it's happening. Never pull a wheelchair backwards. Be sure not to obscure your face when speaking to a person who is hearing impaired. Always respect the older person’s right to dignity and respect.

24. Some Important Terms: Autonomy: “An individual’s sense of being capable of independent action; the ability to provide for one’s own needs.” “Independent from the control of others.” Barker 1999

25. Self-determination: “An ethical principle in social work that recognizes the rights and needs of clients to be free to make their own choices and decisions.” Barker 1999

26.  Empowerment: “…the process of helping individuals, families, groups, and communities increase their personal, interpersonal, socioeconomic, and political strength and develop influence toward improving their circumstances.” Barker 1999

27.  Resilience: “The ability to recover, spring back, or return to previous circumstances after encountering problems or stresses. This is a factor that social workers consider in assessing their clients and in developing prognoses and treatment plans.” Barker 1999

28. The Universal Declaration of Human Rights Article 1. All human beings are born free and equal in dignity and rights. They are endowed with reason and conscience and should act towards one another in a spirit of brotherhood. Article 25. Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control. UN Universal Declaration of Human Rights (1948)

29. References  Barker, R. (1999). The Social Work Dictionary. Washington, DC: NASW Press.  Butler, R. N. (1987). Ageism In G. Maddox (Ed.), The encyclopedia of aging. New York: Springer.  Butler, R. N. (1969). Age-ism: another form of bigotry. The Gerontologist, 9, 243-246.  Greene, R. R. (1986). Countertransference issues in social work with the aged. Journal of Gerontological Social Work, 9(3), 79-88.  Hooyman, N. R., & Kiyak, H. (2011). Social Gerontology: A multidisciplinary perspective. Boston, MA: Allyn & Bacon.  Kastenbaum, R. J. (2009). Death, Society, and Human Experience. Boston, MA: Pearson.  Kohut, H., & Goldberg, A. (1978). The Psychology of Self: A Casebook.

30. References continued.  McInnes-Dittrich (2009). Social Work with Older Adults: A Biopsychosocial Approach to Assessment and Intervention. Boston, MA: Allyn & Bacon.  Nordenfelt, L. (2009). Dignity in Care for Older Adults. Oxford, UK: Wiley-Blackwell.  Novak, M. (2009). Issues in Aging. Boston, MA: Pearson.  Rogers, C. R. (1980). A Way of Being. Boston: Houghton-Mifflin.