Overview

Social Workers with Geriatric Training and Expertise Improve the Lives of Older Adults

Social workers are unique among health care providers because they are trained to address and manage the complexities of each client’s situation, taking into account how physical, psychological, and socioeconomic factors interact in ways that can impact all aspects of a person’s life and health.

Social workers receive education and training in theories of human development and behavior and in understanding social, economic, and cultural institutions. Social workers who work with older adults require additional education and training in the issues of aging and the complex needs of older adults. Many older adults require not only health care but also a range of supportive social services to be able to remain in the community. It is the role of geriatric social workers to make sure older adults live their remaining years with the dignity and respect they deserve.

“The complexity of psychological, social, biological, economic, and practical needs of older adults brings into play the wonderful skills of social workers,” says Julia M. Watkins, PhD, Executive Director, Council on Social Work Education. “Social workers understand the interactions of those various spheres and work with older adults to develop the best strategies to build on their strengths and lead a more satisfying quality of life.”

Geriatric social workers serve in a wide variety of settings with clients who represent the spectrum of diversity of the population as a whole. They may work in health care settings (hospitals, clinics, home health care, nursing homes, hospice), in social service agencies (community-based senior centers, adult day centers, case management organizations, caregiver agencies), or for government agencies, private elderlaw and eldercare agencies, and national, state, and city organizations.

Working with older adults and their families in these settings, social workers begin by assessing the physical, psychological, social, familial, economic, and environmental circumstances of the person. Once they understand all of these factors, they plan and implement appropriate interventions to ensure the older person has access to necessary resources (financial, health-related, and practical). They monitor the impact of these interventions, reassess the situation, and make adjustments to the plan.

Importantly, social workers recognize the need to work not just with individuals but to involve spouses, domestic partners, children, family members, and significant others in their assessments and interventions. The goal for social work services is to support the highest level of client functioning at the safest level of care. Social workers empower older adults and families to find appropriate health services (such as physician specialists, physical therapists, occupational therapists, and others), as well as social supports and financial services. Social workers facilitate family support and coordinate care delivered through professional systems. They educate older adults about disease prevention and health promotion. Social workers also provide counseling for depression, bereavement, addiction, adjustment to disabilities and dementia, and other mental health issues.

Core Members of Health Care Teams

Social workers who work in medical settings serve as essential members of health care teams. While interdisciplinary team care is helpful for everyone, it is especially critical for older adults with complex health needs, such as multiple chronic conditions. Each health care discipline brings unique skills to the team care of older adult patients, and each provides essential services that depend on one another.

Physicians have expertise in diagnosing and treating physical ailments. Nurses administer therapies and medications, monitor and assess patients, and provide comfort and support. Social workers coordinate services on behalf of clients, arrange back up and support for families, and tie together formal supports (such as respite care and health care programs) with informal sources (including family and social networks).

“The health professionals that make up a three-pronged approach to geriatric assessment and ongoing evaluation are the nurse, the physician, and the social worker,” says Charles A. Cefalu, MD, MS, Chief, Section of Geriatric Medicine, and Professor of Internal Medicine, Louisiana State University Health Sciences Center, New Orleans. He notes that a large portion of geriatric medicine is psychosocial, including providing support, counseling, and education. “Social workers do a very good job of taking care of issues that nurses and doctors do not have expertise in,” says Dr. Cefalu.

Kathleen C. Buckwalter, PhD, RN, FAAN, Sally Mathis Hartwig Professor of Gerontological Nursing Research, and Director, The University of Iowa John A. Hartford Center of Geriatric Nursing Excellence, Iowa City, values the contribution of social workers in interdisciplinary teams in which she has participated. “Social workers provide a unique assessment that enhances our understanding of older adults, their family members, and their situation,” she says. According to Patricia Archbold, DNSc, RN, Program Director, Building Academic Geriatric Nursing Capacity, “the American health care system is anything but rational, and social workers are key players in helping older adults receive needed care from a complex and disorganized system.”

In fact, when delivered well, social work services have a positive impact on medical systems by reducing hospital length of stay or avoiding readmissions. By counseling patients and family members and by coordinating care, managing transitions among health care facilities, arranging for services such as physical therapy and home health care, as well as other essential services, social workers make sure that older adult patients receive the highest quality health care, feel safe and in control of their lives, and don’t suffer needless setbacks.

Next: Escalating Need for Geriatric Social Workers ›