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Social Work with Elders : A Biopsychosocial Approach to Assessment and Intervention,9780321049476
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Social Work with Elders : A Biopsychosocial Approach to Assessment and Intervention

by
Edition:
1st
ISBN13:

9780321049476

ISBN10:
0321049470
Format:
Paperback
Pub. Date:
1/1/2002
Publisher(s):
Allyn & Bacon
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Summary

Social Work with Elders is intended to provide a comprehensive overview of the process of providing social and mental health services to the elderly. This book covers the basics of biopsychosocial changes associated with the aging process through the assessment of strengths and challenges to the design and execution of problem-solving interventions. Social Work with Elders is intended to cover topics as basic as encouraging elders to exercise to the complex process of differential assessment and diagnosis of depression, dementia, or delirium. The topics covered throughout the book are relevant to practitioners working in social service agencies, nursing homes, congregate and assisted living centers, and adult day care. Unlike many other texts on gerontological social work, this text includes a more comprehensive array of topics within a single text. It provides the important human behavior in the social environment of elders and designing interventions. It includes the protocols for both traditional and nontraditional interventions, recognizing the amazing heterogenity of the aging population. In many respects, it can be considered "one stop shopping" for content on gerontological social work. Content on diversity regarding gender, race, ethnicity, and sexual orientation is integrated into each chapter as it is relevant to the topic rather than begin isolated in a separate chapter. This approach helps students to incorporate the importance of cultural sensitivity at the time an issue is being discussed rather than to do so retrospectively.

Table of Contents

Preface xvii
The Context of Social Work Practice with Elders
1(25)
Aging in the Twenty-Frist Century
1(1)
Diversity within the Elderly Population
1(1)
The Focus of This Chapter
2(1)
The Demography of Aging
2(5)
The Growth of the Older Population
2(1)
Life Expectancy and Marital Status
3(1)
Living Arrangements
4(1)
Poverty
5(1)
Employment
6(1)
Health Status and Disability
6(1)
The Life Course Perspective on Aging
7(3)
The Life Course as Stages in Development
7(1)
The Life Course as a Fluid Process
8(1)
Life Stage Variations within Old Age
8(1)
The Importance of Birth Cohort
9(1)
Settings for Gerontological Social Work
10(7)
Social Service Agencies
10(1)
Home Health Care Agencies
11(1)
Congregate Living Centers
11(1)
Adult Day Health Care
12(1)
Assisted-Living Centers and Continuum of Care Facilities
13(1)
Hospitals
14(2)
Nursing Homes
16(1)
Personal and Professional Issues in Work with Elders
17(5)
Ageism
17(1)
Countertransference
18(1)
Death Anxiety
18(1)
Devaluation of Gerontological Social Work as a Career Choice
19(1)
The Independence/Dependence Struggle
20(1)
Self-Awareness and Supervision
21(1)
Summary
22(1)
Check Out These Websites!
23(1)
References
24(2)
Biological Changes and the Physical Well-Being of Elders
26(34)
Why Does the Body Age?
26(3)
Genetic Programming
27(1)
Cross-Links and Free Radicals
27(1)
Deterioration of the Immune System
28(1)
Biological Changes That Accompany Aging
29(11)
Skin, Hair, and Nails
29(1)
The Neurological System
30(2)
The Cardiovascular System
32(1)
The Musculoskeletal System
33(2)
The Gastrointestinal System
35(1)
The Respiratory System
35(1)
The Urinary Tract System
36(1)
The Endocrine and Reproductive Systems
37(1)
The Sensory System
38(2)
Implications of Age-Related Biological Changes for Social Work Practice with Elders
40(3)
Elder's Physical Health as a Social Barometer
42(1)
Private Functions Become Public Business
42(1)
Environmental Adaptation Is Necessary
42(1)
Incontinence
43(4)
The Prevalence of Incontinence
43(1)
Types of Incontinence
44(2)
Treatment of Urinary Incontinence
46(1)
HIV/AIDS and Elders
47(5)
Why Elders May Be More Vulnerable to Contracting HIV / AIDS
48(1)
The Biological Vulnerability of Elders to HIV / AIDS
49(1)
HIV / AIDS among Elders of Color
50(1)
Implications for Social Work Practice
51(1)
The MacArthur Study and ``Successful'' Physical Aging
52(3)
The Influence of Diet
53(1)
Exercise and Physical Activity
54(1)
Summary
55(1)
Check Out These Websites!
56(1)
References
57(3)
Psychosocial Adjustments to Aging
60(19)
Psychological Changes That Accompany Aging
61(6)
Intelligence
61(2)
Personality
63(2)
Memory
65(2)
Learning
67(1)
Social Theories of Aging
67(5)
Role Theory
68(1)
Activity Theory
69(1)
Disengagement Theory
69(1)
Continuity Theory
70(1)
Social Constructionism
71(1)
Feminist and Political Economy Theories of Aging
72(1)
The MacArthur Study and ``Successful'' Psychosocial Aging
72(2)
Cognitive and Intellectual Functioning
73(1)
The Significance of Social Support
73(1)
Implications of Psychosocial Changes for Social Work Practice with Elders
74(2)
Provide Opportunities but Respect Choice
74(1)
Everything Takes More Time
75(1)
Psychosocial Health Is Often Contingent on Physical Health
75(1)
Social Isolation Can Be Deadly for Elders
75(1)
Change Is Always Possible
76(1)
Summary
76(1)
Check Out These Websites!
77(1)
References
77(2)
Conducting a Biopsychosocial Assessment
79(26)
What Is an Assessment?
79(1)
What Is the Purpose of a Biopsychosocial Assessment?
80(2)
Evaluation of Strengths and Obstacles
80(1)
Identification of Ways to Support and Maintain Existing Functioning
81(1)
Identification of Interventions That Restore Lost Functioning
81(1)
Identification of Supports to Replace Lost Functioning
82(1)
Special Considerations in Assessing Elders
82(3)
The Balance between Independence and Dependence
82(1)
Origin of the Request for Assessment
83(1)
The Heterogeneity of the Elder Population
83(1)
Respecting Personal Privacy
84(1)
Conditions for Conducting an Assessment
85(2)
The Physical Environment
85(1)
Optimum Functioning
86(1)
Explaining the Purpose of the Assessment
86(1)
The Issue of Confidentiality
86(1)
Components of a Comprehensive Assessment
87(15)
Basic Demographic Information
87(1)
Physical Health
88(3)
Psychological Functioning
91(3)
Emotional Well-Being
94(3)
Social Functioning
97(1)
Competence in the Activities of Daily Living
98(2)
Financial Resources
100(1)
Environmental Issues
100(2)
Professional Intuition
102(1)
Using Collaterals to Gather Additional Information
102(1)
Summary
102(1)
Check Out These Websites!
103(1)
References
104(1)
Differential Assessment and Diagnosis of Cognitive and Emotional Problems in Elders
105(33)
Differential Assessment and Diagnosis
105(1)
Depression in Elders
106(7)
Risk Factors for Depression in Elders
106(3)
The Relationship between Race, Ethnicity, Socioeconomic Class, and Depression
109(2)
Diagnosing Depressing in Elders
111(2)
Dementia
113(7)
Alzheimer's Disease
113(2)
Diagnosing and Assessing Alzheimer's Disease Using Biopsychosocial Indicators
115(5)
Delirium
120(2)
Symptoms of Delirium
120(1)
Causes of Delirium
121(1)
Treatment of Delirium
122(1)
Differentiating between Depression, Dementia, and Delirium
122(6)
Anxiety Disorders
128(5)
Risk Factors for Anxiety Disorders
129(1)
Types of Anxiety Disorders
129(3)
Assessing Anxiety in Elders
132(1)
Differential Diagnosis of Anxiety
133(1)
Summary
134(1)
Check Out These Websites!
135(1)
References
136(2)
Social Work Interventions in the Socioemotional and Cognitive Problems of Elders
138(31)
Introduction
138(3)
What Happens in the Process of an Intervention?
138(1)
Empowerment as a Goal of Intervention
139(1)
Whose Goals?
140(1)
Obstacles to Intervention and Treatment with Elders
141(2)
Attitudes about Interventions
141(1)
Somatization of Emotional Conflicts
141(1)
Physical Barriers
142(1)
Cultural Barriers
142(1)
Developing a Relationship with an Elder
143(2)
Helping Elders Understand the Purpose and Process of an Intervention
143(1)
Developing Rapport
144(1)
Cognitive-Behavioral Therapy
145(6)
Elders Who Respond Best to Cognitive-Behavioral Therapy
146(1)
The Process of Cognitive-Behavioral Therapy
146(5)
Validation Therapy
151(3)
The Principles of Validation Therapy
152(1)
The Pros and Cons of the Validation Approach
153(1)
Reminiscence and Life Review
154(4)
Goals of Reminiscence
154(1)
How Effective Is Reminiscence?
155(1)
The Process of Therapeutic Reminiscence
156(2)
Life Review
158(5)
Goals of Life Review
159(1)
When Can Life Review Be Beneficial?
159(1)
The Process of Life Review
160(3)
Medical Interventions for Depression and Anxiety
163(2)
Drug Therapy
163(2)
Electroconvulsive Therapy
165(1)
Summary
165(1)
Check Out These Websites!
166(1)
References
167(2)
Alternative Interventions in the Socioemotional Problems of Elders
169(25)
Traditional and Alternative Interventions
169(1)
The Therapeutic Use of Music
170(5)
Music as Psychotherapy
171(2)
Therapeutic Music with Elders with Alzheimer's Disease
173(1)
Receptive or Passive Use of Music
174(1)
Active Participation in Making Music
174(1)
Music Combined with Other Art Forms
175(1)
Art as a Therapeutic Activity
175(4)
Art Therapy
176(1)
Art as a Therapeutic Group Activity
177(2)
Art as Recreation
179(1)
The Therapeutic Use of Drama
179(6)
Psychodrama
180(2)
The Benefits of Psychodrama
182(2)
Other Forms of Drama as Therapy
184(1)
Animal-Assisted Therapy
185(5)
The Human-Animal Bond
185(1)
Animals's Roles as Social Connections
186(1)
Types of Animal-Assisted Therapy
186(3)
Animal-Assisted Therapy and Elders with Alzheimer's Disease
189(1)
Precautions in Establishing Animal-Assisted Programs
189(1)
Summary
190(1)
Check Out These Websites!
191(1)
References
192(2)
Addictive Disorders and Suicide Prevention in Elders
194(31)
Substance Abuse and Elders
194(1)
Alcohol Use and Abuse by Elders
194(10)
Problems in Assessing Alcohol Abuse among Elders
195(2)
Early-versus Late-Onset Alcoholism
197(1)
Risk Factors Associated with Alcoholism
198(2)
Alcohol and Older Women
200(1)
Alcohol Problems in Nursing Homes
201(1)
Psychological and Medical Consequences of Alcohol Abuse
201(2)
Recognizing Alcohol Problems in Elders
203(1)
Treatment of Alcohol Problems in Elders
204(4)
Barriers to Treatment
205(1)
The Detoxification Process
206(1)
Follow-Up Treatment for Recovery
206(2)
Drug Misuse and Dependency
208(5)
The Use of Illegal Drugs
208(1)
Drug Dependency and Prescription Medications
209(1)
The Interaction of Alcohol and Prescription Medications
210(1)
Treatment for Drug Dependency
211(2)
Suicide among Elders
213(7)
Risk Factors for Suicide among Elders
214(2)
Assessing Suicidal Tendencies in Elders
216(1)
The Role of the Social Worker with High-Risk Elders
217(1)
Long-Term Treatment for Suicidal Elders
218(1)
Preventing Suicide among Elders
219(1)
Summary
220(1)
Check Out These Websites!
221(1)
References
222(3)
Group Work with Elders
225(26)
Using the Group Work Approach with Elders
225(5)
Advantages of the Group Work Approach
225(2)
The Unique Characteristics of Group Work with Elders
227(2)
When Group Work Is Not Appropriate
229(1)
Cultural Issues in Group Work
230(2)
Developing Cultural Sensitivity
230(1)
Cultural Diversity and Group Dynamics
231(1)
The Group Process
232(2)
Stages in the Group Process
232(2)
Specialized Groups for Elders
234(11)
Reality Orientation Groups
234(2)
Remotivation Groups
236(3)
Social and Recreational Groups
239(1)
Support Groups
240(2)
Therapy Groups
242(3)
Ethical Dilemmas in Group Work with Elders
245(2)
Respecting Self-Determination
245(1)
Balancing Responsibilities to the Group and the Individual
246(1)
Respecting Confidentiality
246(1)
Intervening in Group Dynamics
246(1)
Summary
247(1)
Check Out These Websites!
248(1)
References
249(2)
Spirituality and Social Work with Elders
251(24)
Spirituality and Religion in Social Work Practice
251(2)
Defining Spirituality and Religion
251(2)
The Social Work Profession's Approach-Avoidance Relationship with Spirituality
253(2)
Early Ties to Charitable Organizations
253(1)
The Influences of Empiricism and Freud
253(1)
Social Work's Renewed Focus on Spirituality
254(1)
The Relevance of Spirituality to Social Work with Elders
255(4)
Naming Psychosocial Tasks as Spiritual
256(1)
The Common Ground between Social Work and Spirituality
256(1)
Themes of Spirituality in Elders
257(1)
Spiritual Development in Adults
257(1)
The Effect of Religion and Spirituality on Elders
258(1)
Spirituality in the Lives of Women and Elders of Color
259(4)
Women's Religiosity and Spirituality
259(1)
Elders of Color
260(3)
Incorporating Spirituality into Social Work Practice with Elders
263(8)
Precautions before Pursuing Spirituality
263(1)
Self-Awareness and Spirituality
264(1)
Learning about Religious Traditions and Practices
265(1)
Spirituality as an Element in the Assessment Process
265(4)
Spirituality and Social Work Intervention Techniques
269(2)
How These Efforts Differe from Pastoral Counseling or Spiritual Direction
271(1)
Summary
271(1)
Check Out These Websites!
272(1)
References
272(3)
Social Work Practice with Elder Abuse and Neglect
275(26)
Growing Concrn about Elder Abuse and Neglect
275(1)
The Incidence of Elder Abuse and Neglect
276(2)
Problems in Identifying Elder Abuse and Neglect
276(2)
What Constitutes Elder Abuse or Neglect?
278(3)
Physical Abuse
278(1)
Emotional or Psychological Abuse
279(1)
Financial Exploitation
279(1)
Neglect
280(1)
Risk Factors Associated with Elder Abuse and Neglect
281(3)
Gender and Age
281(1)
Health Status of the Elder
282(1)
Socioeconomic Class
282(1)
Racial and Ethnic Group Membership
283(1)
Characteristics of Abusers
283(1)
Understanding the Causes of Elder Maltreatment
284(2)
Social Learning Theory
284(1)
Social Exchange Theory
285(1)
Psychopathology of the Abuser
286(1)
Assessment of Elder Abuse, Neglect, and Self-Neglect
286(5)
Reporting Abuse or Neglect
286(1)
Assessing an Elder for Abuse or Neglect
287(4)
Designing Interventions to Prevent Abuse or Neglect
291(3)
Protecting against Financial Abuse or Exploitation
291(1)
Offering Supportive Counseling
292(1)
Developing Support Services
292(1)
Modifying the Environment
293(1)
Elder Abuse and Neglect in Nursing Homes
294(2)
When an Elder Refuses Protective Services
296(2)
What Is the Ethical Dilemma?
296(1)
Determining Legal Competence
297(1)
Summary
298(1)
Check Out These Websites!
298(1)
References
299(2)
Working with Elders' Support Systems: Spouses, Partners, Families, and Caregivers
301(26)
Elders' Support Systems
301(1)
Spouses and Partners
302(2)
Gay and Lesbian Couples
302(1)
Changing Marital Roles
303(1)
The Goals of Supportive Interventions with Older Couples
304(2)
The Context of Couples Work
304(1)
Helping Older Couples Manage Loss
305(1)
Creating Opportunities for Mastery and Control
306(1)
Maintaining Identity
306(1)
Therapeutic Interventions with Older Couples
306(4)
Resource Mobilization
306(1)
Marital Life Review and Reminiscence
307(1)
Cognitive-Behavioral Approaches
308(1)
Communication Skills Training
309(1)
The Family Meeting
310(2)
Goals of the Family Meeting
310(1)
The Content of Family Consultation Sessions
311(1)
The Role of the Facilitator
311(1)
Caregivers as Support Systems for Elders
312(3)
Gender as a Factor in Caregiving and Care Receiving
313(1)
Caregiving among Racial and Ethnic Groups
313(2)
The Stresses of Caregiving
315(3)
Sources of Stress in Caregiving
315(2)
Depression among Caregivers
317(1)
Moderators of Caregivers Stress
317(1)
Social Work Interventions with Caregivers
318(4)
Caregiver Support Groups
318(2)
Improving the Caregiver/Care-Receiver Relationship
320(1)
Promoting Self-Care for the Caregiver
321(1)
Summary
322(1)
Check Out These Websites!
323(1)
References
324(3)
Dying, Bereavement, and Advance Directives
327(32)
Death and Dying as Part of Gerontological Social Work
327(1)
The Process of Dying
328(2)
The Meaning of Death to Elders
328(1)
The Needs of Dying Elders
329(1)
The Role of the Social Worker in the Dying Process
330(3)
Providing Emotional Support
330(1)
Advocating on Behalf of the Elder and Family
331(1)
Providing Information
331(1)
Self-Care for the Social Worker
332(1)
Bereavement and Grief
333(7)
Manifestations of Grief
333(1)
Stage Theories of Grief
334(2)
Factors Affecting the Grieving Process
336(3)
Complicated Grief
339(1)
Hospice Care
340(2)
The Philosophy of Hospice Care
340(1)
Hospice Care Services
341(1)
Social Work Interventions with Bereaved Elders
342(4)
The Tasks of the Mourning Process
342(2)
Providing Information
344(1)
Accessing Support Groups
344(1)
Facilitating or Recommending Family Counseling
345(1)
Advance Directives
346(3)
Living Wills
346(2)
The Durable Power of Attorney for Health Care
348(1)
The Controversy Surrounding Advance Directives
348(1)
Ethical Dilemmas in Death and Dying
349(5)
The Allocation of Scarece Resources to Frail Elders
350(2)
Physician-Assisted Suicide
352(2)
Summary
354(1)
Check Out These Websites!
354(1)
References
355(4)
Index 359


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