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Social Work With Older Adults, CourseSmart eTextbook, 3rd Edition

By Kathleen McInnis-Dittrich

Published by Pearson

Published Date: Jan 5, 2009

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Social Work with Older Adults, Third Edition, provides a comprehensive overview of the process of assessing the needs of older adults and providing social and mental health services to meet those needs.


The Third Edition of this award-winning text examines the basics of biopsychosocial changes associated with the aging process. Students are introduced to theories on the biopsychosocial functioning of older adults and are taught how to assess that functioning and plan and implement interventions from a social work perspective. The book includes content on abuse and neglect of older adults, drug and alcohol abuse and the social worker’s role in dying, bereavement, and advance directives.

Table of Contents





Chapter One:  The Context of Social Work Practice with Older Adults


Aging in the Twenty-First Century

            Diversity within the Older Adult Population

            The Focus of This Chapter


The Demography of Aging

            The Growth of the Older Population

            Life Expectancy and Marital Status

            Living Arrangements



            Health Status and Disability


The Importance of Birth Cohort


Settings for Gerontological Social Work

            Geriatric Care Management

            Community Social Service Agencies

            Home Health Care Agencies

            Adult Day Health

            Independent and Assisted Living Settings


            Nursing Homes


Developing Areas for Direct Practice

            Legal Services

            Pre-retirement Planning


Macro Settings for Gerontological Social Workers


Personal and Professional Issues in Work with Older Adults

            Ageist Personal and Social Attitudes

            The Influence of Ageism on Gerontological Social Work as a Career Choice

            Ageism and Death Anxiety


            The Independence/Dependence Struggle

            Self-Awareness and Supervision




Discussion Questions/Activities


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Chapter Two: Biological Changes and the Physical Well-Being of Older Adults


Why Does the Body Age?

            Genetic Programming

            Cross-Links and Free Radicals

            Deterioration of the Immune System


Biological Changes That Accompany Aging

            Skin, Hair and Nails

            The Neurological System

            The Cardiovascular System

            The Musculoskeletal System

            The Gastrointestinal System

            The Respiratory System

            The Urinary Track System

            The Endocrine and Reproductive Systems

            The Sensory System


Implications of Age-Related Biological Changes for Social Work Practice with Older Adults

            Older Adults’ Physical Health as a Social Barometer

            Private Functions Become Public Business

            Environmental Adaptation is Necessary



            The Prevalence of Incontinence

            Types of Incontinence

            Treatment of Urinary Incontinence


HIV/AIDS and Older Adults

            Why Older Adults May Be More Vulnerable to Contracting HIV/AIDS

            The Biological Vulnerability of Older Adults to HIV/AIDS

            HIV/AIDS among Older Adults of Color

            Implications for Social Work Practice


What Factors Promote Healthy Aging?

            The Influence of Diet

            Exercise and Physical Activity




Discussion Questions/Activities


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Chapter Three: Psychosocial Adjustments to Aging


Psychological Changes That Accompany Aging





            Older Adults and Sexuality


Social Theories of Aging

            Prescriptive Social Theories of Aging

            Descriptive Social Theories of Aging

            Gender, Race and Ethnicity, Class and the Life Course


“Successful” Psychosocial Aging

            Cognitive and Intellectual Functioning

            The Significance of Social Support


Implications of Psychosocial Changes for Social Work Practice with Older Adults

            Provide Opportunities but Respect Choice

            Everything Takes More Time

            Psychosocial Health is Often Contingent on Physical Health

            Social Isolation Can be Deadly for Older Adults

            Change is Always Possible





Discussion Questions/Activities


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Chapter 4: Conducting a Biopsychosocial Assessment


What is an Assessment?


What is the Purpose of a Biopsychosocial Asessment?

            Evaluation of Strengths and Obstacles

            Identification of Ways to Support and Maintain Existing Functioning

            Identification of Interventions That Restore Lost Functioning

            Identification of Supports to Replace Lost Functioning


Special Considerations in Assessing Older Adults

            The Balance between Independence and Dependence

            Origin of the Request for Assessment

            The Heterogeneity of the Older Adult Population

            Respecting Personal Privacy


Conditions for Conducting an Assessment

            The Physical Environment

            Optimum Functioning

            Explaining the Purpose of the Assessment

            The Issue of Confidentiality


Components of a Comprehensive Assessment

            Basic Demographic Information

            Physical Health

            Psychological Functioning

            Emotional Well-Being

            Sexual Functioning

            Social Functioning

            Competencies in the Activities of Daily Living

            Financial Resources

            Environmental Issues

            Professional Intuition

            Using Collaterals to Gather Additional Information


Example of a Comprehensive Assessment




Discussion Questions/Activities


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Chapter Five: Differential Assessment and Diagnosis of Cognitive and Emotional Problems of Older Adults


Differential Assessment and Diagnosis


Depression in Older Adults

            Risk Factors for Depression in Older Adults

            The Relationship between Race, Ethnicity, Socioeconomic Class and Depression.

            Diagnosing Depression in Older Adults



            Alzheimer’s Disease

            Diagnosing and Assessing Alzheimer’s Disease Using Biopsychosocial Indicators

            Vascular Dementia



            Symptoms of Delirium

            Causes of Delirium

            Treatment of Delirium


Differentiating between Depression, Dementia and Delirium


Anxiety Disorders

            Risk Factors for Anxiety Disorders

            Types of Anxiety Disorders

            Assessing Anxiety Disorders in Older Adults


Differential Diagnosis of Anxiety




Discussion Questions/Activities


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Chapter Six: Social Work Interventions in the Socioemptional and Cognitive Problems of Older Adults


The Intervention Process

            What Happens in the Intervention Process?

            Empowerment as a Goal of Intervention

            Whose Goals?


Obstacles of Intervention and Treatment in Older Adults

            Attitudes about Interventions

            Somatization of Emotional Conflicts

            Physical Barriers

            Cultural Barriers


Developing a Relationship with an Older Adults

            Helping Older Adults Understand the Purpose and Process of an Intervention

            Developing Rapport


Cognitive-Behavioral Therapy

            Older Adults Who Respond Best to Cognitive-Behavioral Therapy

            The Process of Cognitive-Behavioral Therapy


Life Review

            When Can Life Review be Beneficial?

            The Process of Life Review


Validation Therapy

            The Principles of Validation Therapy

            The Pros and Cons of the Validation Approach


Advantages of the Group Work Approach

            The Group Process

            Specialized Groups for Older Adults

            Reminiscence Groups

            The Process of Therapeutic Reminiscence

            Remotivation Groups

            Social and Recreational Groups

            Support Groups




Discussion Questions/Activities


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Chapter Seven: Alternative Interventions in the Socioemotional Problems of Older Adults


Traditional and Alternative Interventions


The Benefits of Creative Arts for Older Adults


The Therapeutic Use of Music

            Music as Psychotherapy

            Therapeutic Music with Older Adults with Alzheimer’s Disease

            Receptive or Passive Use of Music

            Active Participation in Making Music

            Music Combined with Other Art Forms


Art as a Therapeutic Activity

            Art Therapy

            Art as a Therapeutic Group Activity

            Art as Recreation


Recreation as Therapy

            Examples of Recreation as Therapy


Animal-Assisted Therapy

            The Human-Animal Bond

            Animals’ Roles as Social Connections

            Types of Animal-Assisted Therapy

            Animal-Assisted Therapy with Older Adults with Alzheimer’s Disease

            Precautions in Establishing Animal-Assisted Programs




Discussion Questions/Activities


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Chapter Eight: Substance Abuse and Suicide Prevention in Older Adults


Substance Abuse and Older Adults


Alcohol Use and Abuse by Older Adults

            Early-Onset versus Late-Onset Alcoholism

            Risk Factors Associated with Alcohol Dependence

            Alcohol and Older Women

            Psychological and Medical Consequences of Problem Drinking

            Recognizing Alcohol Problems in Older Adults


Treatment of Alcohol Problems in Older Adults

            Barriers to Treatment

            Brief Treatment Approaches

            Other Treatment Approaches


Drug Misuse and Dependency

            The Use of Illegal Drugs

            Drug Dependency and Prescription Medications

            The Interaction of Alcohol and Prescription Medications

            Treatment for Drug Dependency


Suicide among Older Adults

            Risk Factors for Suicide Among Older Adults

            Assessing Suicidal Tendencies in Older Adults

            The Role of the Social Workers with High-Risk Older Adults

            Long-Term Treatment for Suicidal Older Adults

            Preventing Suicide among Older Adults




Discussion Questions/Activities


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Chapter Nine: Social Work Practice in Identifying and Preventing Abuse and Neglect of Older Adults


Growing Concern about Abuse and Neglect of Older Adults


The Incidence of Abuse and Neglect of Older Adults

            Problems in Identifying the Abuse and Neglect of Older Adults


What Constitutes Abuse or Neglect of Older Adults?

            Physical Abuse

            Emotional or Psychological Abuse

            Financial Exploitation



Risk Factors Associated with Abuse or Neglect of Older Adults

            Gender and Age

            Health Status of Older Adult

            Socioeconomic Class

            Racial and Ethnic Group Membership

            Characteristics of Abusers


Understanding the Causes of Maltreatment of Older Adults

            Social Learning Theory

            Social Exchange Theory

            Psychopathology of the Abuser


Assessment of Abuse, Neglect or Self-Neglect

            Reporting Abuse or Neglect

            Asessing an Older Adult for Abuse or Neglect


Designing Interventions to Prevent Abuse or Neglect

            Protecting against Financial Abuse or Exploitation

            Offering Supportive Counseling

            Developing Support Services

            Modifying the Environment


Abuse and Neglect in Nursing Homes


When an Older Adult Refuses Protective Services

            What is the Ethical Dilemma?

            Determining Legal Competence




Discussion Questions/Activities


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Chapter Ten: Spirituality and Social Work with Older Adults


Spirituality and Religion in Social Work Practice

            Defining Spirituality and Religion


The Social work Profession’s Approach-Avoidance Relationship with Spirituality

            Early Ties to Charitable Organizations

            The Influences of Empiricism and Freud

            Social Work’s Renewed Focus on Spirituality


The Relevance of Spirituality to Social Work with Older Adults

            Naming Psychosocial Tasks as Spiritual

            The Common Ground between Social Work and Spirituality

            Themes and Contexts of Spirituality in Older Adults

            The Effect of Religion and Spirituality on Older Adults


Spirituality in the Lives of Older women and Older Adults of Color

            Women’s Religiosity and Spirituality

            Older Adults of Color


Incorporating Spirituality into Social Work Practice with Older Adults

            Precautions before Pursuing Spirituality

            Self-Awareness and Spirituality

            Learning about Religious Traditions and Practices

            Spirituality as an Element in the Assessment Process

Joint Commission on Accreditation of Healthcare Organizations (JCAHO)                                  Assessment Requirements

Spirituality and Social Work Intervention Techniques

How These Efforts Differ from Pastoral Counseling or Spiritual Direction




Discussion Questions/Activities


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Chapter Eleven: End-of-Life Care for Older Adults


End-of-Life Care as Part of Gerontological Social Work


The Process of Dying

            The Meaning of Death to Older Adults

            Physical and Psychological Manifestations of Dying

            The Needs of Dying Older Adults


The Role of the Social Worker in the Dying Process

            Providing Emotional Support

            Advocating on Behalf of the Older Adult and the Family

            Providing Information

            Self-Care for the Social Worker


Bereavement and Grief

            Manifestations of Grief

            Stage Theories of Grief

            Factors Affecting the Grieving Process

            Complicated Grief


Hospice Care

            The Philosophy of Hospice Care

            Hospice Care Services

            Accessing Support Groups


Advance Directives

            Instructional Directives

            The Durable Power of Attorney for Health Care

            The Social Worker’s Role in Advance Directives

            Barriers to Completing an Advance Directive

Ethical Dilemmas in Death and Dying

            The Allocation of Scarce Resources to Frail Older Adults

            Physician-Assisted Suicide



Discussion Questions/Activities


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Chapter Twelve: Working with Older Adults’ Support Systems: Spouses, Partners, Families and Caregivers


Older Adults; Support Systems


Spouses and Partners

            Gay and Lesbian Couples

            Changing Marital Roles


The Goals of Supportive Interventions with Older Couples

            The Context of Couples’ Work

            Helping Older Couples Manage Loss

            Creating Opportunities for Mastery and Control

            Maintaining Identify


Therapeutic Interventions with Older Couples

            Resource Mobilization

            Marital Life Review and Reminiscence

            Communication Skills Training


The Family Meeting

            Planning a Family Meeting


Grandparents Raising Grandchildren

            Challenges to Grandparents

            Challenges to Grandchildren

            Social Work Roles in Supporting Grandfamilies


Caregivers as Support Systems for Older Adults

            Gender as a Factor in Caregiving and Care Receiving

            Caregiving among Racial and Ethnic Groups


The Stresses of Caregiving

            Sources of Stress in Caregiving

            Depression among Caregivers

            Moderators of Caregiver Stress


Social Work Interventions with Caregivers

            Caregiver Support Groups

            Improving the Caregiver-Care-Receiver Relationship

            Promoting Self-Care for the Caregiver




Discussion Questions/Activities


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Chapter Thirteen: “Aging in Place”: Income Programs, Health Insurance and Support Services for Older Adults


“Aging in Place”


Income Support Programs for Older Adults

            Social Security Retirement and Survivors’ Benefits

            The Future of Social Security

            Supplemental Security Income (SSI)


Health Insurance Programs for Older Adults

Medicare: Parts A, B, and C

Medicare Part D: Prescription Drug Coverage




Support Services to Older Adults

            Support Programs Authorized by The Older Americans Act of 1965

Choices for Independence

Finding Services for Older Adults: The Eldercare Locator


Home Equity Conversion Mortgages (Reverse Mortgages)

            Accessing the Value of One’s Home

            Limitations of the Reverse Mortgage Concept


Continuing Care Retirement Communities (CCRC)


What Challenges Lie Ahead?

            Generational Differences


            Health Care in the Future

            Quality vs. Quantity of Life


Discussion Questions/Activities


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Social Work With Older Adults, CourseSmart eTextbook, 3rd Edition
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