The aspect of social work practice I feel most difficult to perform is the gerontological social work. This paper would firstly describe the context of social work practice with old people. After that, I would exam the reasons preventing me from effectively conducting helping process by evaluating my attitudes, emotions and experiences as well as by reviewing professional literature on social work practice with old people. In the end, I will shape a personal plan on how to address this weakness in the future.
There is a universal folk saying that everyone wishes to live a good long life, but no one wishes for old age. Although in virtually every helping process attempt, social workers bring their own emotional or cognitive influences to intervention, I feel especially difficult to perform in the interventions dealing with older adults.
With the development of medical and health care and with the baby boomer generation’s entering into their old years, the aging of population in the twenty-first century has become increasingly concerned by more and more people. In responding to the drastic transformation of social institutions such as elderly social service and health-care system, the social work practice with old people turns out into one of the most popular social work aspect today.
Apart from the well-known nursing homes and hospital, there are other settings for gerontological social work as well. Geriatric care management, community social service agencies, adult day health care, legal services¼Œhome health-care agencies , macro settings for gerontological social workers and community planning also play their active roles in serving the older adult in a variety of ways.
The gerontologiacal social work, which needs high level of self-awareness, commitment and professional skills, is somehow a complex mission for us to carry. Many social workers admit that social work practice with old people is both challenged and exciting for the reason that, at one hand, it reminds of feelings about death, aging of our family and one’s own attitudes toward helping the disadvantaged and vulnerable old adults; on the other hand, it also presents joys and delightful pictures and makes us think more about ourselves.
Root of difficulty
Review own personal factors
Among all the factors that influence my ability to perform this particular area, the subtle effects of my social and personal massages and the counter-transference feelings of old people would be matters of cardinal significance. Furthermore, I also affected by my characteristics and cognition to certain kind of old people.
Stereotypes. When I was a child I always heard people saying that old people are vulnerable and need help, and older adults are less valuable as human beings because they have to rely on their children. At home, I was asked to behave properly and not offend grandparents; otherwise I would get scolds and punishment. While at school, I was required to help older people for that they have trouble getting around. These stereotypes toward elderly are usually negative for me and imply an attitude or unintentional message that old people are hard to take care of, stubborn, old-fashioned and unpleasant.
Consequently, I always feel that I cannot handle the relationship with older people well and they will not like me. I feel uncomfortable in front of many of my eldership because I do not know how to keep conversations going with my poor eloquence and interpersonal skills. Even though I understand ageism is a destructive social justification when I grow older, I still cannot change the comments I once made on aging and I am a little bit afraid of old people to some extent.
Personal emotion factors. I am by nature a sentimental and emotional person from an early age. My grandma passed away when I was in primary school. She left me even before seeing my admission into university and engagement with my fiancé. I always think that if she could see these, she would be very pleased and also, I would be the most delight person in the world. She always lived a difficult life when she was young and did not enjoy much in her late years. Sometimes all my family members would feel guilty for missing the chance to treat her well before she left us.
As a consequence, when facing the dying older people, especially female elderly suffered from chronic disease or cancer, I inevitably feel urgent to ‘save’ them and so scared to face the truth that they will eventually die someday. I doubt myself about what I can do for them and I am so scared that they will leave me before I can do anything right or helpful. In fact, that is one of the most difficult challenges in social work practice for me.
Real understanding of old people. As a social worker, I appreciate that getting old does not inevitably mean the loss of intelligence, memory and cognitive functioning. I also understand that developing a level of understanding is necessary from a social worker standpoint, and it helps me to anticipate client needs and perform an ongoing self-critique in order to improve and grow my helping process. However, many times I feel I am not able to truly understand them and consider things from their perspective of views as I never experienced true aging. Many decisions I made somehow reflect my own perception of the situation such as to decide whether an old adult should stay in own home or hospital, or to conclude that an older person is showing poor judgment about financial decisions. Furthermore, it would be even harder to perform my role as a social worker when a balance between the opinions of the older adult himself, his family and the social worker need to be achieved. This obstacle prevents me from behaving more successfully at building a sustainable relationship with elderly clients and I simply do the work and move on.
When everything needs more time and patience. With the tight time schedule and many objectives to be accomplish, sometimes a social worker needs to be in a hurry to push on the intervention process. And some other times even if I have explained many times, it is still necessary to have extended periods describing complicated appointments to older clients. I always tend to speed it up although in that case, in order to attain my goal I should slow down to give them more time to think about the process. Lack of patience would be another problem preventing me from effectively working with elderly or even almost every aspect of social work practice.
Reviewing the professional literature
Many social workers admit that, even though both meaningful and satisfactory, working with elderly people can need a high level of self-awareness and self-discipline. The truth that everyone must eventually face the developmental stage of aging and death for themselves and their families may contribute to the anxiety and complexity of the helping process, as social work practice in the aspects of domestic violence or drug abuse may not personally affect worker. This can impact workers with older clients on both a conscious and subconscious level.
Ageism and Death Anxiety. In most cultures around the world, particularly the Chinese culture, people feel uncomfortable when deal with death or anything related to death. From an early age, children are asked to avoid to talking death and dying, and to replace the word death with phrases such as “passed on,” or “gone on to another world”. Therefore, the social workers dealt with older people may require more self-control and comfort on the acknowledging the real pain caused by the loss of human life of family and friends.
The anxiety of aging and dying process on one’s own work, combined with generally indisposed experiences about the proximity of death surrounding older adults, bring about some social workers’ avoiding work with the aging. According to the Hong Kong Social Workers Registration Broad’s data gathered from its members about their areas of practice, despite older adults make up about 12.8 percent of Hong Kong population, less than 6 percent of social worker identify gerontological social work as their field of practice, which compared to nearly 30 percent for mental health.
Countertransference. The reactions, real, and unreal, to a certain individual can occur irrespective of origin and can be based on one’s own past or present experiences or characteristics. Counter transference can be described as social worker’s reactions involve feelings, wishes, and unconscious defensive patterns onto the client. In the professional relationship with old people, a social worker may place negative feelings or dislikes of older persons onto the client, which restrict his willingness (no matter consciously or unconsciously) to continue investigating and result in impatience or intolerance of the aging. On the other side, old clients who evoke images from one’s past such as parents, grandparents or other elderly family members can make process even more arduous to advance as a result of ‘destructive’ sympathy and the ‘need to save an older person’.
The Independence/ dependence fight. Old people want to maintain their independence to make decisions while the social worker commits to promote self-determination and dignity of the individual. But things are not that simple. When an elderly claims for increasingly supporting service and experiences growing difficulties to maintain independence on his own, it will be confrontational to live up to the elderly expectations.
McInnis-Dittrich (2008) states ‘A worker can appreciate the desperate efforts on the part of an older adult to stay in his or her own home. Yet when an older adult is struggling with stairs or a deteriorating neighborhood, and difficulties in completing the simple activities of daily living challenge the feasibility of that effort, professional and personal dilemmas abound.’ This is a good example to understand that sustaining independence in the gerontological social work is a critical goal which has no simple good answer.
Private functions become public business. Discussing the topic such as an old woman’s bladder and bowel functions or an older man’s maintaining an erection or urinating with clients may cause awkward and uncomfortable resistance when social workers and other helping professional get involved. Therefore, sometimes it is important to be sensitive to the deeply personal nature when social workers try to acquire necessary comprehension of an older adult’s health conditions. A better understanding of interpersonal skills and psychosocial adjustment to aging would be helpful and essential.
Personal plan to address this weakness
Overcome stereotype influence
First of all, I hope that from now on I will pay more attention to those featuring active, healthy, productive, and successful older persons so that I will develop a balanced understanding about aging and elderly. Aging is not painful and debilitating. Many wise, gracious, and humorous elderly have made admirable contribution to the world and have shown remarkable strength to achieve a positive as well as enthusiastic life.
Secondly, another important thing for me is to keep the lines of communication open with older adults. If I can open my heart to communicate, they will share more with me. The stronger relationship between us will help me cope better with the stereotype challenges.
Last but not least, in my future helping process I will often ask myself: ‘does it reinforce stereotypes again?’ I should start from every thing in daily life to alter the attitude that hinders my ability to face the normal changes of aging. Make a change in attitude is not easy, but I will try my best to drive myself on the right direction.
Awareness and Introspection
Awareness of the emotional influence is the first and the essential key to solve my problem. How well do I manage my own anxiety with this client’s situations should be my first concern. I will always remind myself that do not be affected by my experience and differentiate my experience of losing a family member from the intervention my client. That will help me to distinguish between the older people’s need and my own need and, to remain focused on the clients’ need.
Furthermore, I could seek help from colleagues and supervisors as well. By discussing the situations with them, I can expose and explore my own feelings and get advices in order to effectively facilitate help process.
To truly understand elderly
Above all, I will try to get in touch more with old people to truly feel their emotional and cognitive problems, as well as to open my heart and listen to them. Maybe I can join them more in their music, art activities in communities. Aging does not necessarily mean the loss of memory and cognitive capacities, and I will try to explain the information in a variety of ways so that we can build understanding relationship.
Moreover, reading more books about the psychological problems of the elderly would be really useful to analyze their psychological changes and behavior patterns. Equipped with a better look at the findings from professional social workers, I will more effectively comprehend the aging process the distinguishing features of elderly.
Finally, I should learn from experienced social workers to get more suggestions when I feel difficult to continue. For one thing, they can improve my ways of carrying intervention by pointing out my mistakes. For another, they can