Social Work with Older People

Karin Crawford, Janet Walker

• Publisher: Learning Matters
• Year: 2008
• Print ISBN: 9781844451555
• eBook ISBN: 9780857252456
• Edition: 2
• Topic: Social Sciences
• Subtopic: Social Work
• Index: Social Sciences

This second edition looks in detail at the role of the social worker who engages with older people. It enables the reader to develop the key skills required to understand the mental and physical needs of older people in society while encouraging plenty of discussion and critical, independent thought. Furthermore, this book is a source of contemporary research and offers the reader insights into government legislation and policy. It is an essential read for any student who wants to develop a distinctive focus on social work with older people.

Chapter 1

Values and ethics in
social work with older
people

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ACHIEVING A SOCIAL WORK DEGREE

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This chapter will help you to begin to meet the following National Occupational Standards:

Key Role 1: Prepare for and work with individuals, families, carers, groups and communities to assess their needs and circumstances

• Prepare for social work contact and involvement
• Work with individuals, families, carers, groups and communities to help them make informed decisions

Key Role 3: Support individuals to represent their needs, views and circumstances

• Advocate with, and on behalf of, individuals, families, carers, groups and communities

Key Role 5: Manage and be accountable with supervision and support for your own social work practice within your organisation

• Manage and be accountable for your own work

Key Role 6: Demonstrate professional competence in social work practice

• Work within agreed standards of social work practice and ensure own professional development
• Manage complex ethical issues, dilemmas and conflicts

It will also introduce you to the following academic standards as set out in the social work subject benchmark statement:

5.1.3 Values and ethics

• The moral concepts of rights, responsibility, freedom, authority and power inherent in the practice of social workers as moral and statutory agents
• Aspects of philosophical ethics relevant to the understanding and resolution of value dilemmas and conflicts in both interpersonal and professional contexts

The subject skills highlighted to demonstrate this knowledge in practice include:

• Listen actively to others, engage appropriately with the life experiences of service users, understand accurately their viewpoint and overcome personal prejudices to respond appropriately to a range of complex personal and interpersonal situations
• Involve users of social work services in ways that increase their resources, capacity and power to influence factors affecting their lives
• Consult actively with others, including service users, who hold relevant information or expertise
• Critically analyse and take account of the impact of inequality and discrimination in work with people in particular contexts and problem situations

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Introduction

This chapter will examine issues of ageism, in particular the concepts of discrimination and oppression. You will be encouraged to identify your assumptions and values, by examining your own concepts of later life. You will consider and reflect on the themes of prejudice and oppression and the implications for practice with older people.

The chapter explores issues of values and ethics in working with older people. It will examine the social differences that affect the position of older people in society, in particular exploring the issues of social class, gender and ethnic differences. This will be linked to problems of inequality and differential need faced by older people. You will then consider how these social processes can lead to marginalisation, isolation and exclusion and how such issues can impact on social work practice. This will lead to a discussion about the nature of social work services in a diverse society (with particular reference to concepts such as prejudice, interpersonal, institutional and structural discrimination, empowerment and anti-discriminatory practices).

Developing an understanding of your own starting point

In order to explore the themes of ageism and their impact on your work with older people, it is important that you have an understanding of your own views in relation to older people, both personally and professionally. Try and take an honest approach to your thoughts, attitudes and feelings.

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ACTIVITY 1.1

Think about your views and assumptions about older people. Make a list of words or phrases that describe your views about people in later adulthood. Reflect upon how these views and beliefs have been formed. Can you identify experiences in your own life that have influenced your ideas and thoughts about older people?

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Your answer will, of course, be very personal to you. As a child you may remember thinking that all adults were ‘old’, especially your parents or other people’s parents. As you get older you realise that making distinctions on the basis of age is not as simple as when you were a child: individuals are a lot more diverse, with age being only one factor that makes up the identity of that individual. The contacts and experiences that you have had with older people may have impacted on your views. Other factors such as your family’s attitudes, beliefs and cultural background, the beliefs of others such as friends, the religion in which you were brought up, the influence of the media, will all have influenced your views, assumptions, values and attitudes about older people.

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ACTIVITY 1.2

How do you think that society views older people? What barriers and opportunities exist in society for older people?

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You may have come up with a number of ideas of ways in which society views older people – for example, as those with wisdom and experience that can support and nurture the following generations. Alternatively, the other end of the continuum is that society may view older people as a burden, a drain on resources. Holding this range of attitudes and beliefs will influence the way in which society constructs barriers and opportunities. For example, as people get older they may experience difficulties in getting a job because they are perceived as being at the end of their working lives as opposed to having a positive contribution to make, e.g. in terms of experience. This can happen despite recent legislation, the Employment Equality (Age) Regulations 2006 that came into force on 1 October 2006, prohibiting age discrimination in terms of recruitment, promotion and training (DTI, 2006).

It may be useful for you to share your responses to these two exercises with a fellow student or colleague to discuss similarities and differences. The starting point for thinking about values has to be your own personal perspective. It is important that you examine and continue to re-examine and explore your assumptions, values and attitudes, in this case of older people, on a regular basis.

On a personal level values refer to the beliefs and attitudes that individuals hold. A range of factors may influence these; for example your experience of family life may find you ‘upholding’ or ‘denying’ a particular way of thinking or acting because of the influence of your experience within your family or other forms of care you experienced as a child. An example may be that of your experience as a child of older people, for example of your grandparents. What, if any, was your grandparents’ involvement in your childhood? Do you view this involvement or non-involvement as a positive or negative experience? As a result of this experience what role do you think that grandparents should have in the lives of their grandchildren? What role do you think that grandchildren should have in the lives of their grandparents? Why?

It has become apparent that older people’s experiences of later life and younger people’s perceptions of older people are shaped by a range of processes and influences. These are interwoven with ageism, which acts as a decisive constraining factor, impacting on how later life is perceived and experienced.

(Tanner and Harris, 2008, p10–11)

Values may also be influenced by social, moral, religious or political ideology. For example, you may have had a lot of contact with your grandparents when you were a child. Your personal experience may be that this was a positive experience. You may have been further influenced by, for example, the wider views of the importance of family and family networks and the duty of families to care for their older relatives. This may be part of your cultural beliefs and your religious beliefs. It is important that you recognise and challenge your personal beliefs as these may have a profound influence on your professional value base.

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ACTIVITY 1.3

Think about the opportunities and challenges in working with older people as a social worker. What do you see as the positive benefits to you as a professional of working with older people? What do you see as some of the challenges to professionals of working with older people?

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You may have a clear view of what working with older people means to you; this may be an area of social work practice that you will choose to work in. Alternatively you may have had little contact with older people; you may feel that your strengths lie in working with younger adults or children. The following case studies are intended to support you in exploring your values and attitudes in relation to older people, particularly in reflecting on situations and their consequent dilemmas that you may experience in social work practice.

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ACTIVITY 1.4

Think about the following situations. Reflect upon how these make you feel and your thoughts about each one. Write down your thoughts and try to explain why you feel as you do. Also note down the values and beliefs that underpin or are informing your thinking.

Bashira is 82 years old; she lives alone now as she is widowed. During an assessment of her needs, Bashira states that she cannot do her own shopping because she is frightened when she goes to the local grocery shop. Many young people gather around the shops and they have shouted at her, made insulting and racist comments.

Daisy lives in a care home; she is 79 years old and has a range of care and support needs. Daisy becomes confused and disorientated at times and finds that her short-term memory is often very limited. The care staff are kind and thoughtful, but Daisy becomes frustrated when they make decisions for her saying it is ‘ for the best’. Recently a ‘clothing party’ was held at the home and Daisy wanted to buy some very bright and short nightdresses and scanty underclothing. Her keyworker suggested that this was not appropriate for someone of her age and guided her to other items she thought more suitable.

Susanna lives with her husband Tom; they are both over 70 years old and have been married very happily for 50 years. Their grown-up children live many miles away. Susanna has dementia and gradually her behaviour and the way she speaks to Tom have changed; she is verbally very aggressive and abusive. Tom is also struggling to meet her basic care needs as Susanna is wakeful at night and is dependent for all her personal care needs throughout the day. Tom is tired and he is sad. He is trying to find ways to keep his wife at home and continue caring for her. Recently he has started locking the bedroom door so that Susanna cannot get out in the night and wander. He also locks her in the bedroom when he goes shopping; he makes sure he is only away for a very short time, but knows that if Susanna is left in the whole house she may injure herself or cause damage in the home.

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Bashira’s experience is clearly very distressing for her. You will need to gain a greater understanding of Bashira’s situation and her perspective, to support you in seeking individual solutions to her experience. However, there are wider community issues here. What is the reason for so many young people on the streets? What may be the reasons behind the racist comments? In seeking to understand this you will need to gain a wider understanding of community issues. Talking to other professionals working in the community will help – the police, schools, youth services, voluntary and community groups. Working together you can consider what could be done to help this individual situation, for example, support from the community police officer by visiting Bashira to seek a specific solution, and the wider situation, for example support from schools in tackling racism through their curriculum.

In the case of Daisy the approach for the home may be ‘well meaning’. The assumption would appear to be that people who may be confused are incapable of expressing their views. The damaging effect of this is that it denies people their rights and opportunities to make choices for themselves. The staff’s approach could also be seen as intrusive and disrespectful. Daisy should be consulted as to what she wants, in this case in relation to buying clothing.

In the case of Susanna and Tom who do you perceive as the person in need of help? There are adult protection issues (these are discussed in Chapter 6 of this book). Tom’s treatment of his wife is unacceptable. The strain and pressure of caring for Susanna, as well as coming to terms with the loss of the partner he remembers, may explain Tom’s behaviour; it does not excuse it. An understanding will need to be gained of each of their situations and their perspectives on it. You and other professionals involved will need to undertake an assessment of risk and consider how to protect and support them both.

Understanding and reviewing your personal and professional base and reflecting on the impact of this on your practice are a critical part of your analysis and ...

Table of contents

• Cover
• Title
• Copyright
• Contents
• Introduction to the second edition
• 1: Values and ethics in social work with older people
• 2: The changing context of social work practice with older people
• 3: The legal, policy and political context of social work with older people
• 4: Specific areas of social work practice with older people – mental health and learning disability
• 5: Specific areas of social work practice with older people – sensory impairment and physical impairment
• 6: Vulnerability and abuse
• 7: Partnership and participation
• Conclusion
• References
• Index