This chapter enhances the understanding of the multifaceted challenges that individuals, especially older adults, seeking housing with a criminal background face. It reviews the ways in which individuals, especially older adults, can be vulnerable in terms of safety and security in their housing settings. Older adults may be particularly concerned about security and safety at home because their homes have been shown to be places where they can be victimized, either by telephone scams, door-to-door solicitation, bullying in age-congregate settings, and witnessing other crimes occurring in their residences. The chapter discusses ways in which forensic practitioners can support vulnerable populations, including older adults. It also discusses the complexities of affordable and safe housing using case examples and descriptions focusing on the older adult population. The chapter provides further recommendations on other areas of assessment and intervention that forensic social workers can conduct.
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- Go to chapter: Special Populations: Medication Use in Children and Adolescents, Older Adults, and Women and Pregnancy
Special Populations: Medication Use in Children and Adolescents, Older Adults, and Women and Pregnancy
This chapter focuses on the unique characteristics presented by three special populations that frequently receive psychotropic medications–children and adolescents, older adults, and women who are pregnant or plan to become pregnant. It is intended to sensitize social work practitioners to the unique considerations frequently encountered with these populations and to highlight the importance of combining medication therapy with counseling when addressing the mental health needs of these special populations. The chapter also provides a sampling of some Diagnostic and Statistical Manual for Mental Disorders (5th ed.; DSM-5) diagnoses frequently identified in children and highlights the medications commonly used to treat the mental disorders. Assessing and determining the medications to use to assist children and adolescents suffering from a mental disorder is never easy. Two conditions that present a particular challenge for prescribers and other members of the collaborative team are attention deficit hyperactivity disorder (ADHD) and conduct-related disorders.
This chapter focuses on using humanistic sandtray as a structured play therapy intervention with clients aged 9 years and older. Humanistic sandtray therapy is a type of play therapy that can be used with clients of many ages, from preadolescents to older adults. This approach to sandtray emphasizes the primacy of the therapeutic relationship and views the relationship as the curative factor in therapy. In sandtray, therapists and clients benefit from the symbolic nature of the experience because it increases safety and provides clients with a metaphorical and indirect mode of expression. The chapter illustrates the case example to help clients go deeper into their inner experiencing and awareness so that they might move in the direction of becoming a more fully functioning person. Fully functioning people are moving in the direction of increasingly trusting their inner experiencing and becoming open to a wide range of emotions.
This chapter begins with a description of multiple systematic reviews and meta analyses of problem-solving therapy (
PST) interventions. The number of studies evaluating PSThas increased over the past decade, so more reviews has been conducted. The chapter discusses PSTfor various mental and physical health problems and depression. Following this it also discusses PSTin primary care and among older adults. It briefly describes PSTfor diabetes self-management and control; vision-impaired adults and social problem-solving therapy in school settings. The chapter describes PSTas a transdiagnostic approach. It briefs the listing of PSTinvestigations and supports the characterization of this approach as a transdiagnostic intervention. The chapter also demonstrates its flexibility of applications. Finally, it highlights certain aspects of the recent outcome literature featuring various clinical problems (e.g., health and behavioral health disorders), populations (e.g., older adults, children, ethnic minorities), and modes of delivery (e.g., telehealth).
This chapter reviews the basic concepts related to the delivery of social work services and the many roles of the social worker in restorative and long-term care (
LTC) settings. The efforts of the health care social worker generally involve assisting patients/clients/consumers and their families in these transitional LTCand restorative settings. According to the National Association of Social Workers, health care social workers in these types of facilities should follow practice standards in administration, advocacy, clinical practice, consultation, and education and follow personnel practices such as staying in compliance with governmental regulations as well as the professional code of ethics. The activities performed in LTCsettings and restorative care services can cross a spectrum of care. This chapter focuses mainly on the needs of older adults in these settings; however, other populations such as children, adolescents, and persons with disabilities may also receive these services.
- Go to chapter: Trauma-Informed Care and Adverse Childhood Experiences with Older Adults in Nursing Facilities
Social workers in nursing homes are asked to include questions about trauma when gathering information from residents at the time of admission. Questions about the person’s past life can include a long list of likely traumatic events, e.g., living through a hurricane, and individual episodes of trauma, e.g., rape. For some older adults, trauma can be found in their childhood experiences, having a family member with a mental health or substance use disorder, violence in the community, poverty, and systemic discrimination. The effects of childhood abuse can be life-long and can include the need for resolution at the end of life. Older adults who have had adverse childhood experiences and/or childhood sexual abuse who have protective factors have an improved outcome in navigating symptoms and risks such as poor physical and/or mental health and suicidality when they have greater self-acceptance and higher extraversion. This chapter discusses the effects of these experiences on older adults, protective factors that help residents who are affected, and helpful interventions for social workers and the facility care team.
The frequency of pain and pain undertreatment in older persons has been increasingly brought to the forefront of the care of older adults in long-term care settings. Pain is a subjective experience and there are no specific tests to objectively measure it. Older adults who may be not able to communicate effectively about their pain are of particular importance to caregivers in long-term care settings. Older adults with untreated chronic pain also become less likely to engage in independent activities; their activities become more narrow and debility increases. The social worker can provide education to families about the physiological changes that occur in older adults that contribute to the absorption of medications, as well as comorbidities such as multiple diagnoses, chronic disease presence, and polypharmacy. In addition, the social worker can contribute to greater understanding of the need for pain management to avoid losses in physical function (ambulation), self-care, mental acuity, and socialization.
The importance of diagnosing depression and providing subsequent treatment to nursing home residents has been acknowledged and supported by the Centers for Medicare & Medicaid. The Mood section of the Minimum Data Set (
MDS) 3.0 includes the Patient Health Questionnaire, Nine Questions ( PHQ-9), in order to help identify depression. Depression is also associated with other chronic diagnoses such as Alzheimer’s disease, Parkinson’s disease, cancer, and arthritis. Substance use is often seen in the nursing home as a co-morbidity of depression for older adults. Depression and the diagnosis of depressed mood is a significant concern for social workers in long-term care. The social worker should be familiar with key signs and symptoms of depression, as well as the current modes of intervention, drug treatment, and psychotherapy.
This book provides a tool kit for helping professions responding to vulnerable populations and preparing populations prior to a disaster. Some populations are more vulnerable to the effects of a disaster than others, making it more difficult for them to prepare, evacuate, shelter, respond, and recover in the event of a disaster or emergency. Considering the needs of these groups requires special knowledge essential to preparedness, response, and recovery planning. In circumstances where there is mass evacuation, such as during Hurricanes Katrina and Sandy, there is always frequent media coverage of large-scale evacuations, including evacuation of medical facilities and nursing homes. Those with chronic medical conditions and older adults are two of the many categories worthy of consideration. Vulnerable populations also include pregnant women, prisoners, the homeless, those with functional mental health issues or addiction issues, those with transportation issues, persons in poverty, minorities, persons who are obese, and those who have special supervision needs. Socioeconomic status (SES) has recently been recognized as a significant vulnerability factor. Evacuation can also be an issue for those of a lower SES due to limited financial resources. Dealing with persons with substance abuse and dependency is one of the most neglected areas in the literature involving empirical evidence and guidelines for appropriate response in a disaster. Developing appropriate guidelines and interventions presents a thorny set of problems for both addicted individuals and emergency responders. A final consideration is the role of pets in disaster recovery. Those who engage in disaster preparedness and response with vulnerable populations should be aware of the characteristics that make those populations vulnerable and make special considerations during planning, response, and recovery. The book highlights some of those characteristics, providing responders with necessary guidelines to assess and intervene with those who are especially vulnerable.
- Go to article: Improving Social Work Student Competence in Practice With Older Adults Affected by Substance Misuse: Spotlight on the Bronx
Improving Social Work Student Competence in Practice With Older Adults Affected by Substance Misuse: Spotlight on the Bronx
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.Source: