This study found that only half of all nursing homes employed degree social workers. Even further, 61 percent of nursing homes in this study did not have a social worker with a license. Read more at Nursing Home Standards. For me it is  this is a pretty upsetting issue. When I try to critically think why this is happening in our nursing homes, I wonder, could this really all be about money? As the report suggests for-profit nursing homes are 31 percent less likely to hire a degreed social worker. Do nursing homes just want to find the cheapest way to meet the federal standards without regard for qualified employees? Or, is it that nursing home execs to do not see the necessity of Social Workers? Or perhaps both?

Let’s talk about who social workers really are. Social Workers are trained professionals with an understanding of the personal experience. Social Workers examine all aspects their clients be it  an individual, family, group or community. Each aspect is important in understanding the whole. Many social workers have training in mental health with the ability to identify depression, anxiety, risks for suicide, etc. Social workers understand how to handle a crisis, a major life transition, and family dynamics. Social Workers understand the growth of an individual, the life course. Social workers examine the physical, the emotional, and the social experience of their clients, and can identify the links between each of those aspects.

A call for standards for nursing home social workers is most definitely in order. Not only must nursing homes provide for their residents a social worker with a degree, but these social workers should be licensed. Nursing home social workers should have a case load that offers them a chance to work with each resident as much as needed, in order that all the needs of the older adults are met. This may mean that other qualified staff must also be apart of the social service department to assist the qualified social worker complete all the necessary paper work and reports needed for our overseeing government. With more qualified social workers nursing homes may see a change in their residents qualify of life, standards of living will be raised. But now the question is, will the federal regulators see this importance, and or will nursing homes see the importance themselves?

Picture courtesy of Zsuzsanna Schreck. View more of her photos at Rocketcat.blogspot

Like all social workers, Geriatric Social Workers work with not just the individual, but also the family and community at large. Often a Geriatric Social Worker’s clients may be individuals who are not necessarily “old” but are dealing with issues related to aging. It could be the middle aged overwhelmed caregiver of a 95 year old widow or the family who does not know what to do now that Dad (age 70) has a diagnosis of dementia. In order to improve the well being of an elder, often family members and community leaders are the client of the Geriatric Social Worker. In other words, the Geriatric Social Worker is charged to work with the whole system of the Older Adult client.

What Qualifications are needed for a Geriatric Social Worker? Geriatric Social Workers often have a Masters in Social Work with either a focus in their studies on aging, or/and a Licensed Social Worker or Clinical Social Work with a couple years of training working with older adult clients. Although there is not a specific license for Geriatric Social Work, the Geriatric Social Work Initiative is currently working to improve Social Work interest, understanding of aging issues, and training; particularly within the student population.

Below are some of the few places you may find a Geriatric Social Worker.

Nursing Home: Administrator; Admissions; Case Managers; Social Service Coordinator or Director; Activities Department Coordinator or Director; Counselor

Assisted Living Facility: Intake or Admissions; Case Manager; Activities Coordinator

Independent Residential Facility for 55+: Case Manager; Counseling; Social Service Director/Coordinator; Admissions Coordinator; Building Manager

Hospital: Case Manager inpatient or outpatient; Geri Psych unit,

Outpatient diagnostic or Rehabilitation Center: Case Manager; Counseling; Crisis worker; Educational Specialist; Research Coordinator.

Health Related Non-Profit: Administrator or Manager of a Program(s); Education of Public, Professionals, and/or Clients; Advocacy related work; Research related work, Case Management; Counselor.

Area Agency on Aging/Senior Center: Case Manager; Support Group Facilitator; Activities Director; Abuse Assessment.

Mental Health Agency: Case Manager; Counselor; Outreach Advocate

Caregiving For-Profit Agency: Care Manager; Marketing Coordinator; Intake Assessment

If you know of any other places you may find a Geriatric Social Worker make a comment! There are so many places you could find one!!!

Here is the post from a NASW blog – Is Hoarding a Big Deal?

After reading this post, I thought about a client I worked with a couple years ago. This women lived in an independent residential apartment building for seniors 55+. She was one of the first clients I had in my social work career. Here were my thoughts on hoarding.

{I have always been very intrigued by all that affects the older adult population. Hoarding, seems to be yet another ailment that plagues this population’s homes and lives. I agree with many of the other comments classifying hoarding as a mental health issue. I had a client in the past, that I felt, defined herself through her belongings. By losing a belonging it was as though she was losing part of her own self, her own identity. I also felt that she was able to cope through the other losses in her life; death, physical disability, etc. by hoarding more and more items. She was particularly interested in garage sale findings. How I made sense of this particular client, of course, will not fit other older adults. But, I felt this helped me understand what she was experiencing, enabling me to clinically identify the underpinnings of her compulsive hoarding.}

My question is, now what? If it is a mental health issue, how do we handle it differently? This was of categorizing the issue, of course, is apposed to a “quirk” or a style of living. Is there a drug to solve hoarding? Is there a treatment approach, similar to anxiety disorders? Can we use Cognitive Behavioral Therapy?

]]> http://www.geriwork.com/2008/12/hoarding-a-mental-health-isssue/feed/ 1 http://www.geriwork.com/2008/11/the-work-to-be-done/ http://www.geriwork.com/2008/11/the-work-to-be-done/#comments Mon, 17 Nov 2008 02:19:43 +0000 Jaimie http://www.geriwork.com/?p=7 When thinking of an issue to log about, I searched for a topic that I hear frequently discussed by some of the young professionals I chat with. Many of the social workers within this network, work inside the homes of older adults. The main purpose of their work is often clinically common; to increase the stability, independence, and the over well being of the client. Through empirically proven therapy approaches, these social workers attempt to diminish depression, anxiety, loneliness, addiction, grief, and other existing mental health issues affecting this population. However, quickly a barrier is recognized, one which if not knocked through with wicked cases managing skills, can stunt progress.

Case management, to some, is a proficiency, which can be performed by those with skill levels ranging from a high school degree to a Bachelor in Social Work.  Many professionals describe this talent differently, I will argue that this under-appreciated skill should not go unrecognized, as it is essential when administering a clinical framework with the older adult population.

It’s 4pm, time for your session with Mrs. Janet Rogers. Where is she? You think. She is late again. What does this mean? This type of behavior should be assessed as perhaps her lack of dedication to our work, and her inability to trust people.

This type of interpretation is more than reasonable when working with a population without the common obstacles of aging. What happened to Mrs. Rogers? Well, she attempted to clean her house for her upcoming traditional condo holiday party. Though due to her weak legs, achy back, and her inability to recognize how she is physically changing, she overworked herself as she cleaned all day. She felt pressure to clean, and failed to eat enough food to regulate her irregular blood sugar levels. Janet was worn out! She fell asleep as she waited for her ParaTranist car to arrive in order to arrive at the weekly session with you.

It seems, as my colleagues discover in their young practice, that time must be devoted to the daily needs of the client including house maintenance, food preparation, and medical issues, social activity, etc. In some agencies providing mental health services to the older adult population are be met by another division of the agency specializing in case management. Though, more frequently these issues must be understood and dealt with by the clinician.

This is the work that must be done in order for the work to be done. Perhaps as geriatric social workers we deserve a model that can offer a case management and a clinical combination specific to the commonalities of the older adult population?

Picture courtesy of Zsuzsanna Schreck. View more of her photos at Rocketcat.blogspot

The family, I will argue, is the most complex aspect of the older adult client. The family comes with a history of dynamics that has taken years to develop, and will take just as many years to completely understand. The family is very frequently in the front lines of the aging process. The family sees and feels the affects of their loved one’s aging, either through illness, grandparenthood, finances, wisdom, etc. The only preparation the family has had is what they may have seen with the older generations of the family. But each family is different due to the varying and ever changing;  social, emotional, religious, political, and relational dynamics.

As the world changes so too does the aging process. Lives last longer as healthcare advances. Internationally and domestically norms are redefined. Some groups are more excepted while others are still disenfranchised. The economy continues to flux and nothing will ever look like it did yesterday. These qualities allow for little to no preparation for the family, whose responsibility is to the well being of parents, aunts/uncles, and grandparents. People, who at one time, were viewed to be very capable to perform as societies standards are now viewed as ineffectual.

When I began writing this entry I intended to touch on the difficulty many adult children face when they are required to step-in for their parents. But, instead I have spoken in a more broad sense of the ever changing world, and the idea that the individual is only a one piece of a very large pie. Also, I have challenged theorists to approach clinical work with older adults through a more definitive, descriptive, and user friendly approach. Older adult issues and specific interaction with family and community are reasonably different from other age groups. As such, I hope that Geriatric social workers and other professionals understand and account for such differences.

Picture courtesy of Zsuzsanna Schreck. View more of her photos at Rocketcat.blogspot

1. Geriatric Care Managers (http://caremanager.org)

By providing a hub of Geriatric Care Manager listings this sites offers professionals, and those needing the services, a place to share and receive information and resources. Simply put in your state, zip code, city, what have you, and poof you have a list of Geriatric Care Managers that are either in or service your area. I have used this site many times in my short career. It was especially helpful for clients of mine that lived in rural areas, and had limited access to services. The only down side to this site, that I have seen thus far, is that it in order to be included in the listings, Care Managers must be a member of the Association of Professional Geriatric Care Managers. However, in 2006 the Association agreed that in order to become a member and thus have a listing, each applicant must hold four specific certifications including; Care Manager Certified (CMC), Certified Case Manager (CCM), Certified Advanced Social Worker in Case Management (C-ASWCM) and Certified Social Work Case Manager (C-SWCM). 

2. Geriatric Depression Scale

This is a standardized tool, that is easy to use. This tool simply helps you assess your older adult client for depression.  Keep in mind, not everyone who “fails” this is depressed, and not everyone who “passes” it is OK. This is only a general tool for assessment. Further assessment should be preformed if there is suspision of depression.

More online tools to come…stay tuned.