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/comments-centenarians-grossly-underdiagnosed/ http://www.geriwork.com/2008/11/comments-centenarians-grossly-underdiagnosed/#comments Mon, 24 Nov 2008 15:40:50 +0000 Jaimie http://www.geriwork.com/?p=8 THE ARTICLE:

ScienceDaily (Nov. 24, 2008)  For many of the elderly, the golden years are anything but. Faced with health problems, financial issues and the death of a spouse or loved one, many adults 65 years and older suffer from depression. While research is emerging to help this group understand and treat the problem, another group – centenarians – has been left largely in the dark.

“Centenarians are still rare, and depression hasn’t been studied thoroughly in this group,” said Adam Davey, a developmental psychologist in the College of Health Professions at Temple University. “We’ve found that it’s a very under diagnosed condition among people over 100 years old, yet it’s one of the most easily treated forms of mental illness.”

…more than 60,000 people in the U.S. are 100 years old or over, and as baby boomers start to hit their 100-year mark, that number is expected to more than quadruple to 274,000. …a group of researchers have been studying this group more and more to learn about successful late-life aging…..Based on responses … by a sample of 244 centenarians, … more than 25 percent showed clinically relevant levels of depressive symptoms, yet only 8 percent reported having a current diagnosis of depression.

Davey notes that … a number of factors, including poor nutritional status, urinary incontinence, limited physical activity and past history of anxiety. “People who suffer from depression tend to have a high risk of mortality, so it’s puzzling to see higher numbers among the oldest old,” he said….researchers found that centenarians living in a community setting were found to have higher levels of depression than their younger counterparts. …it is important for doctors, nurses and even family members to focus on the larger picture to ensure a better quality of life.

“Caregivers often focus on the physical part of health,” he said. “Or, when they look at they mental health of older adults, they focus more on dementia. But depression is important to consider too – it’s not just something that younger people suffer from.”…

To read the complete article go to http://www.sciencedaily.com/releases/2008/11/081124080810.htm

MY COMMENTS:

When I came across this article I was oddly pleased. I was happy to see that the scientific community is taking interest in the oldest old, a population that is commonly forgotten. We talk so much about baby boomers, and forget that there are plenty of older adults here and now that need assistance with issues associated with aging. As this article is suggesting, more focus is needed on the oldest old for mental health issues that are appearing to be more prevalent then once thought.

Many times, I think, the underdiagnosis of depression occurs in not only those 100 years of age, but from 75 up. At this point, the older adult is experiencing a lot of changes physically, which is affecting them socially and functionally. They may be losing sight of their independence as they suffer physically, emotionally, and socially. The medical community comes in contact with this population more than any other. They should be able to pick up on signs of depression, right? I feel that the reason this is not the case, is the stigma faced by this population. The medical community may look at them, and think, “Well, their old, and in pain, why wouldn’t they be sad.” Ok, maybe, but this snap judgment of the sad, old age folks cannot be a part of the very vital medical evaluation these patients need.

Let’s take our time and view our clients as not an old person who has every reason to be sad, but as a person who may be severely affected by their mood changes. These changes may very well be connected to their current experiences as they age, though depressed should not be viewed as a normal part of aging.

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