Full Description
This book has a forward-thinking orientation that reflects the reality of aging with older adults throughout the aging life course... Dr. Youdin integrates an advanced clinical social work practice with in-depth knowledge of evidence-based practice as well asd geriatric medicine, psychiatry and gerontology." -- The Lamp
Written by an expert in gerontological social work and curriculum development, this book provides a wealth of clinical information for social workers and other health care professionals who counsel older adults. It describes a strengths-based, empowerment approach to treatment that integrates theory, technique, advocacy, and social policy, and encompasses the tenets of human rights. The book's content has been tested in the classroom setting for a three-year period with advanced social work undergraduate and graduate students.
The book examines various theories of aging including a contrast between the strengths-based person-in-environment theory and the pathologically based medical model of psychological problems. It advocates truly engaging with the older client during the assessment phase, and discusses a variety of intervention modalities. The psychological construct of stigma regarding aging is examined, along with the major psychopathological problems common to older adults. The book also considers Alzheimer's disease and dementia, medical problems of older adults and co-occurring psychological problems, substance abuse, older adult sexuality, elder abuse, and the vulnerabilities of gay, lesbian, bisexual, and transgender older adults. Additionally, the book addresses mental health issues pertaining to residential settings and the aspects of death and dying that give older people concern. Extensive case studies, learning objectives, and discussion questions are featured in each chapter. The book also includes an instructor packet, PowerPoint slides, and an interactive PDF.
Key Features:
Provides a wealth of classroom-tested clinical information
Espouses a strengths-based approach to treatment that integrates theory, technique, advocacy, and social justice
Consistent with social work mandates for a human rights focus
Presents extensive case studies, learning objectives, and discussion questions in each chapter
Includes an instructors packet, PowerPoint slides, and interactive PDF
Contents
Foreword
Patricia Brownell, PhD xiii
Preface xvii
Acknowledgments xxiii
PART I: OVERVIEW OF THEORIES, ASSESSMENT TECHNIQUES,
AND TREATMENT APPROACHES TO THE OLDER ADULT CLIENT
1. Theories to Inform the Social Worker Practicing With Older Adults
3
The Need for a Unifying Gerontological Social Work Theoretical Orientation
4
Theory Circle
5
Suggested Theories to Inform the Social Worker Treating Older Adults
6
Age Stages 6
Psychological and Social Aging Theories
8
Erikson's Stages Theory 8
The Medical Model 9
Person-in-Environment Theory and Resilience: A Good Partnership 10
Person-in-Environment Theory: The Beginning 12
Perception of Control 13
The Case of Georgina
14
Summary
17
Discussion Topics
17
2. Assessing an Older Adult
19
Part 1: Environmental and Communication Challenges to Be Overcome by the
Social Worker and Older Client
20
Offi ce Assessment Setting 20
A Matter of Speaking 20
Home, Nursing Home, Assisted Care Facility, or Hospital Assessment
Setting 21
Working the Clock 21
To Take or Not Take Notes 22
Part 2: Assessment Categories
22
Gender, Age, Ethnicity, Sexual Orientation 22
Presenting Problem 23
Environmental and Demographic Information 24
Developmental History 24
Medical Status 25
Sexual Assault History 26
Sexual History 26
Substance Use 26
Psychiatric History 27
Appearance 27
Attitude 27
Motor Status 27
Speech Quality 28
Thought Process 28
Mood/Affect 28
Sleep/Appetite Status 29
Suicide Assessment 29
Rational Suicide 31
Homicidal Assessment 32
Mental Status Exam 33
Spirituality/Religion 36
Older Adult Abuse 36
Collateral Interviews 36
DSM-5
Diagnosis 36
The Case of Dr. Frank
37
Gender, Age, Ethnicity, Sexual Orientation 37
Presenting Problem 37
Environmental and Demographic Information 37
Developmental History 38
Medical Status 39
Sexual Assault History 40
Sexual History 40
Substance Use 40
Psychiatric History 40
Appearance 41
Attitude 41
Motor Status 41
Speech Quality 41
Thought Process 41
Mood/Affect 41
Sleep/Appetite Status 41
Suicide Assessment 42
Homicidal Assessment 42
Mental Status Exam 43
Sensorium 43
Spirituality/Religion 43
Older Adult Abuse 44
Collateral Interviews 44
DSM-5
Diagnosis 44
Goals for Change 44
Summary
44
Discussion Topics
45
3. Intervention Theories Informing the Clinician Treating Older Adults
47
Are Theories an Uncontaminated View of an Older Adult?
49
Sources of Contamination
49
Sorry, No Theory Available 49
Ageism 49
The New Ageism 50
The Incompetence Model 50
The Geriactivist Model 50
Theoretical Orientations for Treating Older Adults
51
Foundations Underlying Existential, Brief Solution, Cognitive Behavioral,
and Narrative Therapies
51
Empowerment Theory and the Strength Perspective 51
Constructivist Theory 52
Existential Theory 52
Cognitive Behavioral Theory 55
Narrative Theory 56
Reminiscence Therapy 58
Feminist Theory 58
The Case of Henriqua
59
Summary and Applications of Theoretical Orientations to Henriqua's Case
60
Henriqua Through the Optic of Existential-Phenomenological Theory 60
Henriqua Through the Optic of Cognitive Behavioral Theory 62
Henriqua Through the Optic of Narrative and Reminiscence Theory 63
Henriqua Through the Optic of Feminist Theory 64
Discussion Topics
64
4. Stigma and Older Adults
65
Examples of Optics Affected by Stigma and Their Subsequent Effects on Older
Adults
66
Ageism 67
Race/Ethnicity/Sexual Orientation 68
Gender 69
Poverty 70
Policy 71
Psychological Problems 72
Medical Illness 75
The Internet: A Tool for Fighting Stigma
76
The Case of Michael
77
Summary
79
Discussion Topics
79
PART II: SPECIALIZED PROBLEMS AND ORIENTATIONS IN
GERONTOLOGICAL SOCIAL WORK PRACTICE
5. Psychopathological Problems in Older Adults
83
The Medical Model of Psychopathology
83
Psychopathological Problems in Older Adults
85
Anorexia Tardive 86
Anxiety Disorders 86
Co-Occurring Psychological Disorders and Substance Abuse/Dependence
Disorders 87
Delusional Disorder 88
Mood Disorders 88
Personality Disorders 90
Schizophrenia 91
Suicide 91
The Case of Anthony
93
Summary
94
Discussion Topics
95
6. Alzheimer's Disease and Other Dementias
97
Mild Cognitive Impairment
97
Vascular Dementia
98
Dementia With Lewy Bodies
98
Frontal Lobe Dementia (Including Pick's Disease)
99
Korsakoff Syndrome
99
Parkinson's Disease
99
Alzheimer's Disease
99
Stage 1 100
Stage 2 100
Stage 3 100
Stage 4 100
Stage 5 101
Stage 6 101
Stage 7 101
A Basic Guide to Medicines for Alzheimer's Disease
101
Neurotransmitters 102
Therapeutic Interventions for Alzheimer's Disease Patients
104
Agitation States Common to Dementias 104
Caregiver Support Groups 105
Psychotherapeutic Interventions in Early-Stage Dementias 105
Psychoeducational Support Groups for Alzheimer's Disease Patients 105
Leisure Activities and Therapeutic Recreation 106
Cognitive Training Intervention Programs 107
Driving Retirement
107
Fall Risk With Dementia
108
Inappropriate Sexual Behaviors
108
Dementia in Imprisoned Older Adults
108
Long-Term Care for Dementia
108
The Case of Daiki
108
Summary
110
Discussion Topics
111
7. Medical Problems in Older Adults
113
Commonly Occurring Medical Problems Experienced by Older Adults
113
Arthritis 113
Cardiovascular Diseases 114
Cancers 116
Chronic Obstructive Pulmonary Disease 117
Diabetes 117
Eye Disorders 118
Hearing Disorders 119
Osteoporosis 119
Pain 120
Pressure Ulcers 121
Sleep Disorders 121
Urinary Disorders 121
Interventions for Older Adults With Chronic Illnesses and Their Families 122
The Case of Miguel
122
Summary
124
Discussion Topics
125
8. Older Adult Substance Abusers
127
Chronic Versus Situational Substance Abuse
129
Alcohol Abuse/Dependence
130
Nonalcohol Substance Use Disorders
132
Benzodiazepine Abuse/Dependence Disorders 132
Opioid/Synthetic Opioid Abuse/Dependence Disorders 133
An Existential Analysis of Older Adult Substance Abuse/Dependence
134
Motivational Interviewing
135
Cognitive Behavioral Interventions
136
Integrating Motivational Interviewing With Other Therapeutic Modalities
137
The Case of Pauline
138
Summary
139
Discussion Topics
140
9. Older Adult Sexuality
141
Men
142
Erectile Dysfunction Treatments 143
Women
143
Gay Male and Lesbian Couples
144
Heterosexual Couples
144
Sexuality and Dementia
146
Caregiver Sexual Education for Dementia Patients
146
HIV/AIDS
147
Nursing Homes
148
Older Adult Sexuality and Religion/Spirituality
149
The Case of Lim and Jun
149
Summary
150
Discussion Topics
151
10. Older Adult Abuse
153
Prevalence of Older Adult Abuse
155
Perpetrators of Older Adult Abuse
156
Assisted Living Facilities and Nursing Homes
156
Long-Term Care at Home
157
Older Adults' Perceptions as Potential Crime Victims
158
Sexual Violence
158
Disabled Older Adults
159
Older Adult Prisoner Abuse
159
Historical Programs to Address Older Adult Prisoner Abuse 159
Older Adults' Self-Abuse
160
Self-Neglect 160
Self-Harm 161
Interventions for Older Adult Abuse, Self-Neglect, and Self-Harm
162
The Case of Gloria
164
Summary
166
Discussion Topics
166
11. Gay Male, Lesbian, Bisexual, and Transgender Older Adults
167
Coming Out in Later Life
168
Older LGBT Sexuality and HIV
169
Substance Abuse
170
Older Gay Inmates
171
Clinical Intervention 171
Concerns About Health Service Delivery
172
Interventions 173
Mental Health Issues
173
Retirement and Housing
175
The Case of Sheri and Camila
176
Summary
177
Discussion Topics
178
12. Care and Residential Settings for Older Adults
179
Retirement Communities
180
Gay-Oriented Retirement Communities 181
Aging in Place
181
Adult Day Care Services
182
Continuing Care and Assisted Living
183
Housing for Aging Inmates: A New Type of Aging in Place
185
Nursing Homes
185
Goals for Improved Experiences in All Types of Care and Residential
Settings
186
The Case of Adanna
188
Summary
190
Discussion Topics
191
13. Dying and Death
193
End-of-Life Planning
193
End-of-Life Palliative Care
195
Intensive Care and Terminal Illness
198
Euthanasia
199
Place of Death
200
End-of-Life Psychotherapy
201
Grief Counseling
201
The Case of Yael
204
Summary
205
Discussion Topics
205
References 207
Index 251
