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About this book

This timely text highlights the importance of informed and critical practice in social work with older people. With an emphasis on reflection throughout, it argues for the need to rethink how social workers support some of the most vulnerable people in society.

The text begins with an exploration of the relationship between gerontology, the study of aging, and social work, and demonstrates that a gerontological approach has long been missing from social work practice. The central chapters consider key issues affecting older people and social work practice, such as:

• risk of poverty
• memory loss and dementia
• palliative and end of life care
• loss and bereavement
• moving into a care home

Bringing together theoretical and research insights, this agenda-setting text provides a sound base for creative practice with older people. All those looking to make a positive and discernible difference to older people will find this text rewarding reading.

Table of Contents

Chapter 1. Social work with older people: changing times, changing contexts

  • Social work with older people has undergone unprecedented change since the NHS and Community Care Act, 1990.
  • These changes have resulted in a greater emphasis on administrative processes at the expense of valued social work skills and practice knowledge.
  • There are significant tensions between policy which on the one hand seeks to manage finite resources effectively and efficiently and, on the other, aspires to provide person-centred and proactive services for older people.
  • Social work with older people has not been underpinned by the developing gerontological research base.
  • There is a gap between research and practice, which means that social workers may not be aware of, or informed about, the current gerontological and social work research base.
  • Older people have expressed dissatisfaction with administrative approaches to social work and social care, and have articulated clear aspirations for a quality social service.
Mo Ray, Miriam Bernard, Judith Phillips

Chapter 2. Developing critical gerontological social work

  • There is a need for social workers who work with older people to preserve the knowledge, skills and values that have traditionally been valued by the older people who are users of services.
  • A gerontological knowledge base will strengthen the knowledge and practice base of social work practitioners.
  • There is a clear agenda for the development of future practice in social work with older people.
  • There is an urgent need to articulate what social workers offer to older people, and the added value they can contribute to integrated or multi-disciplinary teams.
Mo Ray, Miriam Bernard, Judith Phillips

Chapter 3. Risk and older people

  • Notions of risk are used to determine eligibility for services.
  • Risk is a concept that may be used uncritically to label older people.
  • Risk is often located at an individual level, whereas in reality, older people may be at risk from a range of structural, environmental and practical factors. These wider understandings of risk may be overlooked in practice.
  • Critical practitioners have a duty to engage in a deep understanding of risk in order to enhance their interventions with older people.
Mo Ray, Miriam Bernard, Judith Phillips

Chapter 4. Social work with older people with dementia

  • There has been a considerable development of interest in research, policy and practice relating to people with dementia. Nevertheless, people with dementia remain marginalized and often do not receive the range of support, services and interventions that they need to promote and maximize their well-being.
  • Social workers have a crucial role to play in assessment, intervention and care planning with people with dementia and their carers.
  • Social workers need to have an understanding of the knowledge and skill base that would support positive practice with people with dementia.
  • Good practice means challenging the potential for practice to be reduced to bureaucratic procedures.
Mo Ray, Miriam Bernard, Judith Phillips

Chapter 5. Older people and end-of-life care

  • Despite the fact that death is most likely to occur in old age, considerable inequalities persist in the experience of death and dying for older people.
  • Older people will often die after a period of deterioration; end of life is therefore often characterized by uncertainty as to when death is likely to occur.
  • A reconceptualization of end of life and older people may help to promote positive, person-centred practices that embrace both life and living, and end of life/death.
  • The need to promote awareness of palliative approaches to end of life in a range of non-specialist settings is highlighted as a means of improving end-of-life care for older people.
Mo Ray, Miriam Bernard, Judith Phillips

Chapter 6. Transitions and continuities

  • Change and transition are features of all of our lives.
  • A number of theoretical approaches have been developed in an attempt to theorize the experience of ageing as well as illuminating how older people might cope with and manage transitions commonly associated with older age.
  • Traditional theories that seek to address the ‘problem’ of ageing have been critiqued. Other models, looking at adaptive and coping strategies, are relevant to social work practice and highlight the importance of, for example, recognizing and respecting the strengths, abilities, resources and continuities older people continue to use in coping with transition.
Mo Ray, Miriam Bernard, Judith Phillips

Chapter 7. Care-giving in diverse contexts

  • Carers are diverse and care-giving is a diverse activity. Care can be defined by its complexity.
  • Care is given as part of a relationship involving reciprocity and interdependency.
  • Care is central to all our lives and is something we all experience.
  • The relationship that carers have with the person they care for will be individual and located in their own biography and life course. Taking a life-course approach to care is essential.
  • Both carers and care recipients have rights as citizens.
  • A critical gerontological approach challenges assumptions; adopts reflexivity; values diversity; addresses power differentials; and has in its repertoire of tools mediation and negotiation skills.
Mo Ray, Miriam Bernard, Judith Phillips

Chapter 8. Developing critical gerontological practice: new challenges

  • Older people, as with any other part of the life course, may experience trauma, abuse or life events that impact on their emotional and mental well-being.
  • Social work can continue to have an important role in the recognition, assessment and support of older people experiencing emotional distress caused by trauma, abuse or other life difficulties.
  • This means ensuring that social work skills are used beyond the current emphasis on care brokerage.
  • Social workers can play an important role in the development of appropriate resources and services.
  • The current knowledge and research base in respect of the three areas discussed in this chapter is limited; they are all developing fields.
Mo Ray, Miriam Bernard, Judith Phillips

Chapter 9. Pushing the boundaries

Our motivation in writing this book came first from a strong belief in, and commitment to, the importance of social work with older people. Such a role should, we believe, offer a robust challenge to responses to older people premised on the provision of practical care regardless of the person’s presenting need. Second, we have, in the course of our teaching, research and contact with social workers, identified a number of areas of practice that seem to be especially relevant to the experience of older people, and throughout this book we have sought to examine the possibilities for social work in these areas. Finally, making the case for critical gerontological social work practice was a key aspiration for the book, especially in the light of the challenges that are apparent to the current and future social work role with older people. Despite variations in policy and practice across the four countries of the British Isles (see Chapter 1), our discussions are set in the context of what appears to be an increasingly beleaguered social work practice with older people.
Mo Ray, Miriam Bernard, Judith Phillips
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