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.

Older adults experiencing cognitive decline and any of the dementias are suffering in ever increasing numbers. With the aging of the baby-boom generation, the incidence of cognitive decline and dementia will exponentially escalate over the coming years. With this coming tsunami of dementia, older adults experiencing dementia, as well as their family members and caregivers, will need the services of psychologists. Psychologists are needed to help families recognize the importance of end-of-life planning for an older adult when first diagnosed with a dementia. When an older adult understands that he or she has responsibility for and choice in the decision to abuse a psychoactive substance, there is a greater probability of successful treatment and recovery from a substance abuse problem. Psychologists are in a unique position to assess whether older abuse is occurring and, when discovered, to intervene with advocacy initiatives.

The medical model of psychopathology currently guides psychiatrists and many psychologists who are treating older adults experiencing psychological problems. Use of this model causes contradictions and distortions for the treating clinician and limits the effectiveness of treatment for older adults experiencing psychological problems. There are three areas of concern that illustrate these contradictions and distortions. The first area of concern is the fact that only two classes of psychiatric diagnoses meet the characteristics of a disease. The second area of concern is how the current use of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) continues a tradition among psychiatry, managed-care companies, and insurance companies that puts pressure on psychiatrists, psychologists, hospitals, and psychiatric rehabilitation facilities to treat in the most cost-effective and short-term manner. The third area of concern is the relationship that has occurred between psychiatry and pharmaceutical marketing forces.

Social isolation and loneliness are distinct concepts with a research history that evolved separately over many decades in the disciplines of sociology, psychology, psychiatry, and epidemiology. This chapter provides a historical overview of highlights from the research on social isolation, loneliness, and social support, and considers the implications of that research on current practice. It also explains the diversity of perspectives in the way one analyze human social engagement and allows for more personalized assessment of social needs and more targeted delivery of social programs and services. Researchers continue in their efforts to find effective interventions for social isolation and loneliness and for effective delivery of social support, and while one await further guidance, one can use the concepts and theories developed over decades to inform our practice. Awareness of the long research history will result in more targeted and effective help for individuals who need it.

Physical activity for older adults has become a central feature of our culture. Physical activity programs intended for older adults call for an understanding of the social, psychological, and physical factors that influence their receptivity and effectiveness in supporting individual well-being. This chapter is organized into three sections, each addressing older adult social integration and physical activity in specific ways that are applicable to health professionals. Section one defines key terms, presents concepts on aging, and offers evidence to enhance well-being through social integration and physical activity. Section two provides a practical approach to working with older adults through physical activity that includes benefits, guidelines, recommendations, opportunities and barriers to physical activity, and a resource guide to best practices and approaches for older adults. In section three, two cases, based on individuals the authors have worked with, provide physical activity progressions and considerations for social integration.

This chapter discusses the nature of error, the classification of error, concepts in quality management, types of error mitigation, hierarchy of interventions, and the role of culture in error prevention. Psychologists have proposed a dual system processing theory for thought. More recently, a classification system based on Reason’s error categorization, Human Factors Analysis and Classification System (HFACS), has been demonstrated to improve standardization of error classification, increase the specificity of error classification, and facilitate the development of actionable corrective plans. Readers are directed to the guidance from the American Society for Radiation Oncology (ASTRO) on this subject for a detailed treatise on the components of peer review. An effective quality management program depends on a robust understanding of error, appropriate classification of error, the application of a systems approach to problem solving, the careful choice and implementation of error mitigation strategies, and a commitment to continuous improvement.

There are positive and negative aspects of life at every age throughout the life span, and aging is no exception. This chapter presents a more balanced view of older adults’ mental health and cognitive abilities, one that moves away from the stereotypes. It focuses on mental health and cognitive abilities as people age, with a presentation of the many positive characteristics of older adults’ psychological and emotional well-being as well as difficulties some may face, such as depression and dementia. The chapter also describes how personality changes over the life span and how the creative arts can positively impact the lives of older adults. Finally, it discusses factors that can positively and negatively affect older adults’ mental and cognitive abilities. The Practical Application presented at the end of the chapter focuses on unique challenges faced by individuals currently around 80 and above due to mental health stereotypes and stigmas.

This chapter explores the impact of all manner of radiotherapy incidents, and comments on the role of reporting, methods of investigation, and the path to meaningful improvement. The impact of harmful incidents on patients is sometimes immediate and life changing. Although the physical impact of incidents on patients can be direct, immediate, and known for certain incidents, they are more commonly unknown. The psychological impact of known incidents on patients is typically profound. The airline and nuclear power industries study their incidents using a root cause analysis (RCA) technique, developed for investigating industrial accidents. An investigation of an incident is a bit like detective work, where evidence is reviewed to piece together what happens. After completing an incident investigation, the practice should consider implementing improvements. Effective implementation of incident investigation, monitoring for effectiveness, and support for staff involved in error can result in the development of a true learning organization.