1. Workshop for Doctoral Students
Nancy R. Hooyman, Gero-Ed Center Co-Principal Investigator
Gero-Ed Forum
February 18, 2006

2. Overview of National Gero-Ed Center
Curriculum change
Competency-based approach
Faculty and programmatic development
Educational policy and advocacy
Dissemination of gero resources
E-learning
E-newsletter

3. Goals of Curricular Change
Gerontological pervasiveness
Embedded in all aspects of the curriculum and organization
Sustainability
Institutionalizing changes within curriculum and social work program

4. Models of Curriculum Change
Specialization
Integration
Infusion in foundation courses
Policy, Practice, HBSE, Research, Cultural Diversity, Field
1st year MSW or junior/senior year BSW
Transformation

5. Infusion Approach: Rationale
The majority of social workers work with older adults, regardless of practice settings, but lack preparation to do so (NASW, 2005).
Exposure to gero issues/older adults more compassion, interest in gero career
Potential to reach all students through foundation courses

6. Infusion: Rationale
Ensures that all students graduate with foundation gero competencies
Address faculty resistance to adding “one more thing”
Already crowded curriculum (“bucket too full”)
“rearrange or stir the curriculum bucket in new ways”
Enrichment, not adding on or taking away

7. What is Infusion?
Embed aging into every aspect of foundation curricula (objectives, readings, assignments, class exercises, case studies, media)
Build intersections with other curricular areas
Develop cross-cutting conceptual framework

8. Interconnections of Aging
Build linkages/intersections with other substantive areas
Child welfare or school social work grandparenting/kinship care
Mental health and aging: caregiving for older relatives
Health care and chronic disability
Substance abuse among older adults
Interpersonal violence and elders

9. Interconnections/Organizing Themes
Aging as cultural diversity
Intersections of age with race, gender, class, sexual orientation, ability
Social justice, life course inequities
Health disparities: cumulative disadvantage
Multigenerational/intergenerational
Relationships between and among generations
Hook for child welfare students

10. Interconnections
Turn HBSE “upside down;” begin with aging, track older person back earlier phases of the life cycle
Articulate the intersections among early and later life experiences and how inequities in early life and across the life course become exacerbated in old age

11. Characteristics of Infused Syllabi
Gero competencies
Where to turn for resources
Examples of curricular resources on
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12. Example of a Doctoral Students’ Work: Jean Munn, UNC
An Overview of Direct Practice with Older Adults
Developed by Jean Munn, MSW
And the GeroRich Team
with special assistance from
Kerry Krisman, MSW
University of North Carolina
School of Social Work

13. Purpose
This module introduces MSW students to direct practice with older adults and
Presents an overview of this population
Examines geriatric practice typologies: (a) case management and (b) direct clinical practice
Provides specific information on recognizing depression, geriatric assessment and reminiscence therapy.
Describes career opportunities for social work with older adults.
Provides a gerontological reading and resource list for all social workers.

14. Learning Goals At the end of this class the student should be able to:
Understand the role of social workers in working with older adults.
Understand some principles of assessment.
Describe the symptoms of dementia, delirium and depression in older adults.
Acknowledge some appropriate methods for working with older adults.
Recognize the need for gerontological social workers and the career opportunities.

15. WHO are Older Adults? 65-84 30,794,000 10.9% of Total Population
,794,000
10.9% of Total Population
57% Female
85+ 4,267,000
1.5% of Total Population
71% Female
The terms “older adult” and “elder person” typically refer to those over the age of 65.4 Most recent census figures describe older adults in two groups, those between and 85+. This description aids in understanding the heterogeneity of older adults and reflects the current descriptions of this population as old and oldest old. The first group comprises approximately 11% of the total population and is slightly over half female. The oldest old represent a much smaller proportion of the population and are predominantly female.
Source: U.S. Census Bureau, 2004, "U.S. Interim Projections by Age, Sex, Race, and Hispanic Origin," Retrieved March 19, 2004 from

16. WHO are Older Adults?
Between the 1990 and 2000 census, the oldest age groups showed the most rapid growth of any age group. .The population 85 years and over increased by 38 percent, from 3.1 million to 4.2 million.5 This group also has the greatest number of chronic illnesses and declines in activities of daily living, requires the highest levels of medical care, and need assistance social work assistance in multiple areas.

17. WHO are Older Adults?
95% Are living in non-institutional settings 76% own their homes % live alone % are married
16% Are minority 49% African American 30% Hispanic 14% Asian
12% Are living in poverty
9% Are foreign born
This older segment of the population is heterogeneous.
Despite the misconception that most older people live in nursing homes, 95% of the population over 65 live in non-institutional settings. Approximately 76% of those 65 and over own their own homes18 and 64% of those homeowners live alone.
Based on census 2000, the percent of people 65 years and over living in nursing homes declined from 5.1 percent in 1990 to 4.5 percent in This percent decline occurred for people 65 to 74 years, 75 to 84 years, and especially in the population 85 years and over, where only 18.2 percent lived in nursing homes in 2000, compared with 24.5 percent in However, 1,560,000 older adults do live in nursing homes and 745,000 in live in assisted living.3 Demographic trends based on the “baby boomers” who will begin reaching 65 in 2011 indicate large numbers of older adults who will require some type of residential care in the future.
1994 data indicate that almost 3.7 people over the age of 65 live in poverty. More significantly, some older adults become poor only after becoming old. A much larger proportion, 26% were near poverty, having incomes under 150% of the poverty level.
In March 2000, the foreign-born population of the United States reached 28.4 million. Eleven percent of this group, or 3.1 million, were aged 65 and over.17 This number constitutes 9% of those 65 and over.
Pynoos, J. & Golant, S.M. (1996). Housing and living arrangements for the elderly. In R.H. Binstock and L.K. George (Eds.), Handbook of aging and the social sciences (4th ed.) San Diego: Academic Press.
He, Wan, U.S. Census Bureau, Current Population Reports, Series P23-211, The Older Foreign-Born Population in the United States: 2000, U.S. Government Printing Office, Washington, DC, 2002.

18. Ethnic Minority Composition
Minority populations are increasing even more rapidly. The overall proportion of minorities in this age group is expected to reach 25% by the year Hispanics are the most rapidly growing minority older adults and are expected to increase by 320% by 2030 and account for 15% of the elder population.2 The African-American population is projected increase130% and constitute almost 11% of the total population over 65.
In summary, it is well-established that those who are both old and have minority status are greatly disadvantaged. 27% of African American older adults fall below the poverty level compared to 10% of whites. Poor, African American women can be considered the most at risk, especially those over the age of 85.6

19. WHO are Older Adults? Personal Health (Self rating health, disability and knowledge level)
The National Council on Aging (NCOA) produced a study, American Perceptions of Aging, in 2000 that replicated key questions from an earlier (1974) study to describe the myths and perceptions of aging in the 21st century. The 2000 study involved a sample (n = 1155) of community dwelling older adults who were interviewed on a variety of issues. These two slides indicate that older adults included in the study generally viewed themselves as healthy and were happy to have lived to the age of 75 years and older. This information is also included in a pamphlet that is available from the website.
National Council on Aging (2002). American perceptions of aging in the 21st century. Retrieved March 24 from

20. WHO are Older Adults?
The older adult population is quite heterogeneous.
The majority of older adults are healthy.
Most are living in the community, many in their own homes.

21. WHAT are Their Needs?
Social workers may first interact with older adults when their needs reach a crisis point.
These meetings may be precipitated by a caregiver’s death, a medical, cognitive or behavioral incident that puts the older adult, and his/her family, in an extremely stressful situation.

22. WHAT are Their Needs? Physical
Activities of Daily Living (ADLs)
Eating
Dressing
Toileting
Bathing
Transferring
Ambulation
Instrumental Activities of Daily Living (IADLs)
Shopping
Preparing Meals
Managing Money
Using Telephone
Taking Medications
As mortality rates have declined, morbidity rates have increased; therefore, there are more older persons with chronic illnesses, functional limitations and cognitive impairments. One widely accepted way of describing the needs of older adults is by examining their abilities to perform two sets of activities: (a) activities of daily living (ADLs) and (b) instrumental activities of daily living (IADLs). ADLs include the abilities to independently eat, dress, toilet, bathe, transfer and walk or move without the assistance of another person. Eating is a “late loss” ADL, in other words, an elderly person is likely to be able to feed himself or herself after other abilities have declined. Fourteen percent of older adults have difficulties with one or more ADLs. Increases in age correlate with greater ADL limitation. Persons living in institutions also have greater functional limitation.4
IADLs are likely to precede the decline and ADLs and have a strong cognitive component. Twenty-one percent of older adults have problems with IADLs. Many older adults continue to live in the community with help in IADLs provided by family, friends and professional caregivers. A sharp functional decline, often following an accident, injury or significant medical event may require that an elder person seek additional support. However, as noted above, only 5% of older adults actually require institutional care. The most likely trigger for institutional placement may be closely related to the death or decline of a caregiver rather than the elderly person himself or herself.

23. WHAT are Their Needs? Mental Health–Cognitive Decline
Dementia: “a category of usually slowly progressing cognitive disorders that involve memory loss and loss in mental and intellectual functioning.”
5 Common Signs of Dementia Impairment of memory Multiple disturbances of cognition Impairment of executive function Disorientation Behavioral changes
Delirium: “an impairment of consciousness with a sudden onset.”
Many aging people have the same mental health problems as the rest of the population. In fact, one reason it is so important for social workers to be aware of the needs of older adults is that they are appropriate clients for social workers dealing with families, substance abuse, spousal abuse, and affective disorders, etc. Yet, older adults’ mental health needs are also complex as they may have embedded issues different from the general population. These may include physical impairments, loss of resources, generations differences and ageism.
The most frequently discussed mental health needs are “the three Ds:” (1) Dementia (2) Delirium and (3) Depression.
Dementia describes “a category of usually slowly progressing cognitive disorders that involve memory loss and loss in mental and intellectual functioning.”4 Dementia is commonly associated with aging, but is not a “natural” result of the aging process; it is, however, irreversible. Dementia occurs in about 5% of the aging population. The most common form of dementia is senile dementia of the Alzheimer’s type (SDAT) which is characterized by loss of the cognitive executive functioning, including disorientation to time and place. About half of all dementia patients have SDAT. It is also highly prevalent in the nursing home population, reaching frequencies of 50-60% of the skilled nursing home population.8
Delirium is characterized by the sudden onset of disorientation which may include delusions, high arousal or hallucinations. Delirium can respond rapidly to treatment; however, if left untreated delirium can result in premature death. This fluctuating change in consciousness is often associated with physical problems such as heart failure or chemical intoxication or withdrawal. Delirium among the hospitalized elderly is frequent, with estimates as high as 40%.8
Naleppa, M J & Reid, W.J. (2000). Gerontological social work: A task-centered approach. New York: Columbia University Press.
Butler, R. N., Lewis, M. I., & Sunderland, T. (1991). Aging and Mental Health (4th ed.). Boston: Allyn and Bacon.

24. WHAT are Their Needs? Mental Health
Affective Disorders
Depression
Anxiety
Other
Alcoholism
Drug abuse
Schizophrenia
Personality disorders
Depression is the most commonly diagnosed affective disorder in the elderly. It affects up to 20% and is probably under diagnosed in most settings. Depression does respond to treatment when diagnosed and should not be considered a natural part of the aging process. older adults may suffer from major depression, bipolar disorders or dysthemic disorder. Major depression is usually characterized by “a marked loss of interest for at least two consecutive weeks.” Other symptoms include changes in sleep patterns, loss of appetite, unplanned weight loss, chronic fatigue and suicidal ideation. 6 Older persons with major depression are quite similar to younger patients, but moderately depressed older adults are more likely to express depression in somatic terms such as abdominal pain, sleeplessness or lethargy. Further, diagnosing depression in the elderly is confounded by concurrent medical conditions. Depression and SDAT may have overlapping neurological changes and symptomologies, making the differentiation between diagnoses difficult. There is also a high incidence of SDAT following depression characterized by mild cognitive impairment, sometimes referred to as a “conversion to dementia.” Several medical conditions are commonly associated with depression including: (a) coronary artery disease; (b) neurologic disorders; (c) metabolic disturbances; (d) cancer; and (e) chronic obstructive pulmonary disease.

25. HOW Do Social Workers Make a Difference?
Meet Charlene. She obtained her MSW from UNC and is currently working with Elderwatch.
There is current documentation of the small number of social workers specializing in gerontological or geriatric social work. The Sage-SW project reports that in 1987 there were fewer than 30,000 U.S. social worker practicing in with older adults. An estimation by the National Institute on Aging (NIA) states 60,000 to 70,000 social workers will be needed to meet the needs of aging baby boomers.
In 1998, the National Association of Social Workers (NASW) established gerontological social work as a specialty section on aging. Currently, the John A. Hartford Foundation is sponsoring a Geriatric Social Work Initiative which includes funding for dissertation fellowships, support of junior faculty and infusion of geriatric social work content into foundation social work education. Other national organizations such as the Gerontological Society of America (GSA) have described the urgent need for trained social workers to support the needs of the anticipated “silver tsunami.”

26. HOW Do Social Workers Make a Difference?
I love it! I love working with older people and their families. The part I love about my job---a family comes in and they’re so stressed out they don’t know what to do but once we sit down and work out a plan, then they say: “Oh, that’s how it works.” They know what to do and it’s not so horrible any more. Most people don’t know there are so many options out there. What I like is putting together a plan and putting together a team and getting it all to work. I always tell family members that what they say about it takes a village to raise a child--- that same thing is true for older adults. Most of the people I work with don’t have Alzheimer’s, so they can participate and you can empower them to make decisions—give them back some control.
-Charlene
There is current documentation of the small number of social workers specializing in gerontological or geriatric social work. The Sage-SW project reports that in 1987 there were fewer than 30,000 U.S. social worker practicing in with older adults. An estimation by the National Institute on Aging (NIA) states 60,000 to 70,000 social workers will be needed to meet the needs of aging baby boomers.
In 1998, the National Association of Social Workers (NASW) established gerontological social work as a specialty section on aging. Currently, the John A. Hartford Foundation is sponsoring a Geriatric Social Work Initiative which includes funding for dissertation fellowships, support of junior faculty and infusion of geriatric social work content into foundation social work education. Other national organizations such as the Gerontological Society of America (GSA) have described the urgent need for trained social workers to support the needs of the anticipated “silver tsunami.”

27. What Do Social Workers Do?
Care/Case Management
Conducting assessments
Helping clients access services
Monitoring service delivery
Providing counseling services
Casework has been described as “a hallmark of gerontological social work.”12 Gerontological caseworkers are often members of interdisciplinary teams and function to advocate for clients, represent the clients psycho-social needs in the midst of the medically oriented teams and aid in accessing services. Service delivery is often fragmented and complex, requiring a large portion of the caseworkers attention. It is common that the caseworker become involved at the time of a catastrophic medical or personal event. These events may occur in the context of family dynamics requiring the caseworker to simultaneously deal with a number of issues. Casework is generally problem oriented, although skillful caseworkers frequently emphasize the strengths perspective, building on the life-time accomplishments of the older adults who now have diminished physical, psycho-social and financial resources.

28. The Task-Centered Case Management Model10
Parallel Function Core Intervention Model Modular Treatment
Access & Intake
Assessment
Task-Centered
Case Planning
Monitoring/Task Review
Reassessment
Termination
Client Oriented
Interagency Coordination
Class Advocacy
Resource Indexing
Existing Task Planner
Alternative Modules
Agency Oriented
Accountability & Outcomes
New & Revised
Task Planners
The task-centered model of casework was initially developed in the 1970s. It consists of “clearly defined and sequenced activities that are collaboratively carried out by the practitioner and client to solve problems.”13 p. 99 This model emphasizes client definition of problems. It is also characterized by the emphasis on empirical theories and has been tested and developed through empirical research. Tasks are seen as methods for bringing about change. The relationship between the client and practitioner is a collaborative one. The model is designed to be time-delimited and the intervention is expected to completed within a four month time frame. There is a focus on the present.
The client targets the problems he wants to work on. By participating in the interventions, the client develops problems solving skills, decision making capabilities and therefore enhanced autonomy.
There are three phases to the core intervention in the task-centered model: (a) Initial or “setting the stage;” (b) middle or “addressing the problems;” and (c) final or “ending intervention.”
The initial phase includes an intake session, explanation of the approach, and assessment. Problems are identified, prioritized and a specific problem specified. The client and practitioner collaboratively set goals and complete an intervention plan. There is a contract in place at the end of this phase.
The middle phase includes developing tasks alternatives, selecting tasks, agreeing upon tasks to be performed as part of the intervention. At this point, incentives are introduced into the model. The implementation is planned in detail and obstacles anticipated. There are opportunities for rehearsal, but the actual tasks are implemented between sessions. There is also a monitoring component to this session. The final phase may include recontracting but typically consists of review and reinforcing accomplishments. There is some review of the problem solving skills the client has developed and plans for the future.13
ACTIVITY: Have the class break into dyads and role play the case study of
Mrs. Walker adapted from Gerontological Social Work, p Each member of the dyad will have information from the appropriate sheet as either the caseworker or Mrs. Walker. In addition to the problems included in the set-up, students may identify other potential problems based on information included in the module. At the end of the role play, the students should have completed Form 1 with a list of problems. The class can then share the problems identified and prioritize them as a group.
The class as a whole can then complete Form 2: Summary of tasks by adding tasks that would be appropriate for resolving problems and reaching goals identified on Form 1. Sample completed forms are available to the instructor.
Naleppa, M. (2003). Gerontological social work and case management in B. Berkman & L. Harootyan (Eds.) Social Work and Health Care in an Aging Society. New York: Springer Publishing.

29. Geriatric Assessment Look at the whole person.
Examine the physical environment.
Assess for cognitive and sensory deficits.
Sit in front of the elderly person.
Speak clearly and slowly.
Monitor for fatigue.
Geriatric assessment may involve persons whose physical limitations influence the appropriateness of the physical environment. For example, geriatric social work offices should be easily accessible for persons using walkers or wheelchairs. The desks should face the door, so the client can see the social worker easily. During assessment, the social worker should sit where the client can see the social worker’s face, allowing him or her to “read lips.” Team meetings should occur in rooms that are handicap accessible with configurations amenable to communication with persons who have hearing deficits.
As older persons may tire more easily than other clients, assessments should be short or broken into multiple settings. Throughout the assessment process, the social worker should be monitoring for signs of fatigue such as increased asking that the questions be repeated or restlessness. Other indicators of fatigue may include agitation or drowsiness. The respondent may become uncooperative or even combative. It is usually wise to stop administration if such symptoms are noted.
The social worker may need to be more formal than with younger clients. The older client should be addressed as Mr. or Mrs. unless he or she has asked to be called by a first name.
ACTIVITY
ROLE PLAY: Administration of the Folstein’s Mini-Mental State Exam. Operationalization of the exam for informal administration.

30. What Do Social Workers Do?
Clinical Practice
With individuals
With groups
With families
In residential facilities
In addition to casework, there are opportunities for psycho-social direct practice with older adults. Social workers can provide essential services to older adults at critical periods of their lives: during transitions, at times of personal or physical loss, and in situations involving abuse or neglect. At these times, the social worker is a clinician, using practice skills to provide opportunities for emotional growth in very challenging situations. Here, the social worker is needed not to navigate service systems, but to navigate life. Practice with elder individuals is often overlooked in describing the role of social workers with older adults. Ageism may be embedded in this perspective, based on the idea that older adults are not capable of emotional growth or that they cannot participate in traditional methods of individual counseling. While it is important to understand the unique challenges of working with older adults who may have physical and cognitive limitations, social workers can provide immensely meaningful counseling services that improve the quality of life for older adults throughout their lives, even during the dying process. One specific method of direct practice with older individuals is known as life review or reminiscence therapy. This technique will be discussed in more detail.
Older adults are amenable to group work as it provides an important social context that may be missing in the often isolated social environments of older adults. Courses in group work need to include information on appropriate skills and settings for group work with older adults.
Families are frequently part of the geriatric or gerontological social work clientele. Social workers often first meet the client when he or she is brought for agency help by a family member or members. Frequently, long-standing family dynamics play themselves out in the presence of the social worker and become critical in working with the elder client.
Social workers are also essential members of the care team in residential settings. The Omnibus Reconciliation Act of 1987 required that social workers be present in skilled nursing facilities that house more than 100 residents. They are active advocates for residents’ rights and investigate allegations of abuse in these settings. Unfortunately, the role of the social worker in long-term care is not highly esteemed and is seen as the only setting for gerontological social work practice.
In truth, all social workers are likely to have elderly clients or at least work with families who have older members. For example, intergenerational caregiving has brought child welfare social workers into direct contact with grandparents raising grandchildren.

31. WHERE Do Social Workers Practice?
Case management firms
Hospitals
Outpatient medical centers
Home health agencies
Mental health agencies
Hospices
Senior centers
The Council of Social Work Education reports that in 1987 fewer than 30,000 U.S. social workers were working either full-time or part-time with the elderly. Projections indicate that 60,000 to 70,000 gerontological social workers are needed by 2010.
In one response to this issues, the federal Bureau of Health Professions commissioned a White Paper on geriatric education for social work19 that identified unique theoretical and strategic challenges for social work. Social workers also attended the 1996 White House Conference on Aging servers as planners and participants. National organizations such as NASW, CSWE and the Gerontological Society of America have lead in acknowledging the urgency of addressing the disconnect between availability and need for well-trained social workers to meet these needs. However, schools of social work have been slow to respond. Further, experts in the field recognize the subtle presence of ageism in the reluctance of many schools of social work to develop programs in gerontological social work or infuse aging content into foundation programs.
The CSWE states: “Given the need to prepare a great number of social workers for practice with the aging and their families, there is a significant challenge in generating sufficient incentives such as were used to increase the numbers of students graduating directly into positions in public child welfare. The Department of Veterans Affairs (our nation’s largest employer of social workers), John A. Hartford Foundation, Hearst Foundation, and others are leading the nation in their investments in geriatric social work. At local and state levels, donors should also be sought to provide incentive-based stipends to students to enhance student interest in pursuing careers in geriatric social work.”22

32. WHERE Do Social Workers Practice? (Cont’d)
Departments of Social Services
State agencies
Federal agencies
Attorneys’ offices
Continuing Care Retirement Communities
Skilled nursing facilities
The Council of Social Work Education reports that in 1987 fewer than 30,000 U.S. social workers were working either full-time or part-time with the elderly. Projections indicate that 60,000 to 70,000 gerontological social workers are needed by 2010.
In one response to this issues, the federal Bureau of Health Professions commissioned a White Paper on geriatric education for social work19 that identified unique theoretical and strategic challenges for social work. Social workers also attended the 1996 White House Conference on Aging servers as planners and participants. National organizations such as NASW, CSWE and the Gerontological Society of America have lead in acknowledging the urgency of addressing the disconnect between availability and need for well-trained social workers to meet these needs. However, schools of social work have been slow to respond. Further, experts in the field recognize the subtle presence of ageism in the reluctance of many schools of social work to develop programs in gerontological social work or infuse aging content into foundation programs.
The CSWE states: “Given the need to prepare a great number of social workers for practice with the aging and their families, there is a significant challenge in generating sufficient incentives such as were used to increase the numbers of students graduating directly into positions in public child welfare. The Department of Veterans Affairs (our nation’s largest employer of social workers), John A. Hartford Foundation, Hearst Foundation, and others are leading the nation in their investments in geriatric social work. At local and state levels, donors should also be sought to provide incentive-based stipends to students to enhance student interest in pursuing careers in geriatric social work.”22

33. Gerontological Jeopardy!
Developed by Jean Munn, MSW
University of North Carolina
School of Social Work

34. Who What How Potpourri $100 $100 $100 $100 $200 $200 $200 $200 $300
$400
$400
$400
$400
$500
$500
$500
$500

35. WHO? $100
95%

36. WHO? $200
This is the current percentage of the US population that is 85+ years old.

37. This is the largest minority elder population in the United States.
WHO? $300
This is the largest minority elder population in the United States.

38. WHO? $400
These are two main factors influencing the predicted growth of the US elderly population.

39. WHO? $500
The 85+ segment of the US population is expected become ____ times larger between the years 2000 and 2050?

40. Current percentage of US elders living in non-institutional settings.
WHO? $100-Answer
Current percentage of US elders living in non-institutional settings.

41. WHO? $200-Answer
What is 1.5%

42. Who are African Americans?
WHO? $300-Answer
Who are African Americans?

43. What are the “baby boomers” and increased life expectancy.
WHO? $400-Answer
What are the “baby boomers” and increased life expectancy.

44. WHO? $500-Answer
What is 5?

45. WHAT? $100
Name three ADLs.

46. WHAT? $200
This is the most commonly diagnosed affective disorder in this population.

47. WHAT? $300
This is the most prevalent chronic medical condition in persons 70 years old and older.

48. WHAT? $400
This condition is characterized by impairment of memory, multiple disturbances of cognition, impairment of executive function, disorientation, and behavioral changes.

49. As ______________ has declined, _____________ has increased.
WHAT? $500
As ______________ has declined, _____________ has increased.

50. Bathing, Transferring, Ambulation?
WHAT? $100-Answer
What are (3) Eating,
Dressing, Toileting,
Bathing, Transferring, Ambulation?
Thanks, any more?

51. WHAT? $200-Answer
What is depression?

52. WHAT? $300-Answer
What is arthritis?

53. WHAT? $400-Answer
What is dementia?

54. What are mortality and morbidity?
WHAT? $500-Answer
What are mortality and morbidity?

55. HOW? $100
This is a casework model with clearly defined and sequenced activities that are collaboratively carried out by the practitioner and client to solve problems.

56. HOW? $300
These are five things social worker should do when working with older clients.

57. HOW? $500
These are:
(a) historical perspective; (b) spirituality; (c) individual autonomy; (d) education; (e) ethnic background; (f) cultural perspective; and (g) health status.

58. What is the task-based model of casework?
HOW? $100-Answer
What is the task-based model of casework?

59. HOW? $300-Answer What are: Look at the whole person;
Examine the physical environment for obstacles;
Speak clearly and slowly;
Sit in front of the client so he/she can see your face and mouth;
Monitor for fatigue; and
Assess for cognitive difficulties and sensory deficits?

60. What are primary influencing factors?
HOW? $500-Answer
What are primary influencing factors?

61. This is an example of a geriatric cognitive status assessment tool.
Potpourri $100
This is an example of a geriatric cognitive status assessment tool.

62. These are the “three Ds” of gerontological mental health?
Potpourri $200
These are the “three Ds” of gerontological mental health?
Daily Double

63. These are some characteristics of the task-based model of casework.
Potpourri $300
These are some characteristics of the task-based model of casework.

64. This term characterizes the older population in the United States.
Potpourri $400
This term characterizes the older population in the United States.

65. Potpourri $500
Hospitals, hospices, state agencies, federal agencies, mental health agencies, private practice and attorneys’ offices

66. What is the Folstein Mini Mental State Exam?
Potpourri $100-Answer
What is the Folstein Mini Mental State Exam?

67. What are dementia, delirium and depression?
Potpourri $200-Answer
What are dementia, delirium and depression?

68. Potpourri $300-Answer
What are problem-focused, collaborative, sequential, and clearly defined?

69. Potpourri $400-Answer
What is heterogeneous?

70. What are places that gerontological social workers practice.
Potpourri $500-Answer
What are places that gerontological social workers practice.

71. He was the author of the following statement:
Final Jeopardy
He was the author of the following statement:
“old age was discovered only in recent years…it certainly demanded some definition when an ever- increasing number of old people were found (found themselves) to represent a mass of elderlies rather than an elite of elders.”

72. Final Jeopardy Answer
Who is Erik Erikson?