Through the lens of a case study, this article suggests ways to increase social work student competence in gerontology and substance abuse treatment to better meet needs of growing numbers of diverse clients in urban settings. Focusing on a client residing in the Bronx, New York, it explores how changing demographics and a lack of workforce preparedness can combine in an urban context to increase risks for older adults and reduce quality of life in late life. Aiming to reduce knowledge and service gaps, suggestions are made on how to improve social work student competence. These include interpreting client cases through a theoretical framework to deepen understanding about the intersection of advancing age and substance use and improving treatment skills.