Stigma is the foundation that distorts the many social constructs affecting how social workers view older adults. Many socially constructed optics produced by stigma can bias social workers’ views of older people. It is important for a social worker to understand that race, ethnicity, and sexual orientation are social constructs that bias clinical care. Additionally, stigma associated with race, ethnicity, and sexual orientation produce psychosocial stressors that converge on older clients, which exacerbate their physical and psychological health statuses. The stigma of mental illness serves to increase the suffering of older people struggling with psychological problems while increasing the suffering of family members, loved ones, and caregivers who experience courtesy stigma. The stigma of suffering from mental illness may also prevent an older person from seeking treatment for his or her psychological problems. Older adults suffering from dementia also suffer from the negative reactions to them because of their diagnosis.
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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 book integrates an advanced clinical social work practice with in-depth knowledge of evidence-based practice as well as geriatric medicine, psychiatry and gerontology. The social worker must evaluate the status of the client’s housing, transportation, food, clothing, recreation opportunities, social supports, access to medical care, kinship and other factors considered important by the social worker or the client. Constructivist theory is a conceptual framework that is foundational to existential therapy, cognitive behavioral therapy (CBT), and narrative therapy, which are effective for older adults. Stigma associated with race, ethnicity, and sexual orientation produce psychosocial stressors that converge on older clients. The book discusses several medical conditions affecting older adults such as Alzheimer’s disease, arthritic pain, diabetes and various types of cancers. Older adults may also suffer from substance abuse-related problems, hypersexuality, and various types of abuse such as neglect. The book also highlights the problems faced by the older adult LGBT community and those suffering from HIV disease. It ends with discussions on care and residential settings for the older adults, and palliative care and euthanasia.