Every day we’re getting older, wiser, and more knowledgeable and … closer to being able to avoid mental health difficulties. Right?
Wrong! Unfortunately as we age (and yes globally this population is growing rapidly) the risk of having ill mental health does not go away. The most common mental health illnesses, for the older population, are dementia and depression. However, with appropriate and timely support, older people and their families can be provided with an improvement to their quality of life. (CommunityCare, 2007).
Working with older adults, in their twilight years, is a privilege. Older people offer a wealth of wisdom and history, which provides a narrative to learn from. Assessing the mental health of older people requires person centred practice based on respect and empathy (CommunityCare, 2007).
When working in this sector the role of a social worker is often within a multidisciplinary team with a focus on recovery, and balancing rights with protection. This team approach meets the needs of this population through the support of a combination of disciplines such as psychiatry, nursing, occupational therapy, social work, psychologists and support workers (Abendstern, et al., 2014). Social work in this health setting can be seen as the bridge between medical and personal or community worlds. Unfortunately, there is much gatekeeping, which keeps many older adults separated from this support, and social workers in primary healthcare facilities could provide much needed support (Foster & Beddoe, 2012).
A social worker in this team requires knowledge of not only social work theory and practice, but also, knowledge of The Mental Health Act , an awareness of older people’s physical ailments and diseases and an understanding of medications for both physical and mental health and how they interact. In other words you learn a lot from being on this multidisciplinary team! The challenge is to remain focused on social work assessments and interventions and not to get distracted by a medicalised view of a person, which often focuses on diagnosis.
This is where the contribution of social workers in a MDT shines. They offer a holistic viewpoint, offering insights into more than a diagnosis. They’re able to unravel a person’s story, meet with family members, explore community resources and piece together the myriad of supports which are required. In what can be an emotional and complicated time of life, a social worker can be the glue which helps to stick all the different disciplines and services together. The strength of social work in this environment and with this population is our ecological, strengths based perspective.
A challenge and concern for social workers is the lack of knowledge and policy regarding older people’s mental health, particularly in rest homes and institutional settings. A European study concluded that a significant barrier to intervention for depression and in the early stages of dementia is a lack of coordinated care and sufficient qualified people who can implement any programmes which have been researched and designed for this population (Samele, Frew, & Urquia, 2013).
Working with older adults requires social workers to have a focus on respect and dignity, and ensuring that this vulnerable population is not abused or neglected (Irish Association of Social Workers, 2011). Therefore, to gain an understanding of a situation, it is important to be able to utilise excellent communication, coordination, and decision making and facilitation skills. Of equal importance is knowledge of elder abuse, and grief and loss (Foster & Beddoe, 2012). Our community MDTs are valuable in this mental health setting, however more access and resources are desperately required.
Abendstern, M., Tucker, S., Wilberforce, M., Jasper, R., Brand, C., & Challis, D. (2014). Social workers as members of community mental health teams. British Journal of Social Work, 1-18. Retrieved from https://www.researchgate.net/publication/268801088_Social_Workers_as_Members_of_Community_Mental_Health_Teams_for_Older_People_What_Is_the_Added_Value
CommunityCare. (2007, September 24). Assessing the mental health needs of older people. Retrieved from CommunityCare: http://www.communitycare.co.uk/2007/09/24/assessing-the-mental-health-needs-of-older-people/
Foster, S., & Beddoe, L. (2012). Social work with older adults in primary health – is it time to move our focus? Aotearoa New Zealand Social Work( 2), 37-48. Read here
Irish Association of Social Workers. (2011). The role of the social worker with older persons. Irish Association of Social Workers. Read here
Samele, C., Frew, S., & Urquia, N. (2013, October 11). European profile of prevention and promotion of mental health (EuroPoPP-MH). Retrieved May 23, 2017, from European Commission: https://ec.europa.eu/health/mental_health/publications_en