Human beings grow across various age groups. Each age group faces diverse social, economic, political, and health issues affecting their lives. Older persons belong to a population comprising of elder members of the society in global communities. At their advanced age, elder persons face various clinical and healthcare issues. National Association of Social Workers (NASW) asserts elder persons face bio-psychosocial issues. People grow and develop with age attributing to the various changes they experience in relation to diverging social, physical, mental, and cognitive capabilities. These changes mainly affect elder persons adversely due to increased barriers, challenges, and inabilities. Adverse effects are attributed to restrictions and constraints in relation to financial resources in order to facilitate access to comprehensive, high-quality, and affordable healthcare services (NASW, 2010).
This dissertation will therefore focus on the following issues. Foremost, it will highlight the various challenges elder persons face in society. More importantly, it will discuss social issues elders go through. These issues further cause other related issues including clinical diminishing qualities of life among elderly persons. Employed trained, qualified, and experienced social workers and caregivers seek to improve qualities of life among older persons. However, social workers and agencies face various risks and protective factors while administering healthcare and clinical intervention strategies applicable to older persons. Thus, the dissertation will also discuss the risks and protective factors in relation to clinical evidence-based interventions administered among older persons. The clinical evidence-based interventions will address therapeutic, diagnostic, and cognitive measures. They will address social and health needs among older members of society.
Social Issues Older Persons Face in the Society
Older persons face several social challenges. Some challenges need clinical and social interventions from social workers, caregivers, or agencies while others need attention from family members. Older persons suffer from emergency and specific health threats either from man-made or natural causes. These needs are specific, unique, and diverse from children, youths, and able persons in the society. More so, they suffer from restricted mobility coupled with increased vulnerability to abuse, neglect, and exploitation. This can be attributed to weak muscles, insufficient strengths, poor eyesight, hearing capabilities, and vulnerability to cold and heat. These issues overwhelm them in developing coping mechanisms. During war, fights, and struggles, older persons lack strength and muscle power to seek refuge and safety from dangers and harm. More so, they lack abilities to provide food, shelter, water, and various basic needs without help from other members of the family and community (McDonough & Davitt, 2011).
There are various emergency food distribution programs. They are tasked with providing food to vulnerable members of the community including women and children living in poverty. They fail to recognize older persons also belong to this group with specific dietary needs in relation to the number of proteins and micronutrients required. More so, they need to consume food particles that can be easily digested to provide them with the strength to undertake simple basic movements. These programs should therefore target older persons as they lack financial and physical abilities. Foremost, they are unable to purchase the expensive food ratios due to financial constraints. Secondly, those lucky to afford the purchases lack the physical strength to carry them from the store to the household. Consequently, they are challenged in preparing them in the comfort of their homes. Thus, they face a dilemma of either eating from restaurants or risking their lives trying to prepare a meal using highly dangerous cooking appliances due to financial constraints (Brian, Jean, Charlotte & Kirsten, 2005).
The majority of older persons can account for losing several members of the family including their parents, sisters, brothers, and even children. Fatalities especially in a family setting are painful disasters. It affects people differently in relation to emotional and mental stabilities. Thus, older persons are vulnerable to feeling isolated, depressed, neglected, and discriminated against especially after losing several loving members of the family. This is mainly witnessed among older persons living alone in their family homes as widows or widowers. They lack physical, emotional, mental, and cognitive abilities to cope with the losses. Thus, they are vulnerable to suffering from depression (Imbody, 2011).
Older persons who retired from their official duties lack sufficient and regular sources of income. Although some receive pensions, the rest survive without a regular source of livelihood as they are often excluded from undertaking cash for work duties and responsibilities. They are denied opportunities to work due to weak physical aspects and health complications facilitating younger persons to undertake more employment chances. This further affects their abilities in accessing and affording healthcare services. They lack financial resources to access and afford healthcare services tasked with improving qualities of life among citizens (Brian, Jean, Charlotte & Kirsten, 2005).
Evidently, older persons have different, diverse, and extensive social issues affecting their healthcare needs. These needs should be addressed to improve and enhance qualities of life among older persons. They need walking sticks to facilitate their daily movements. More so, they need hearing aids and prescribed glasses to improve and enhance their hearing and eyesight respectively. Consequently, they also need prescribed medication to treat various illnesses among older persons such as chronic and heart diseases as well as diabetes, stroke, rheumatism, dementia, and respiratory challenges. Thus, when older persons are denied employment opportunities their vulnerable lives are further exposed to inadequate resources sufficient to purchase basic needs including medicine and affordable healthcare programs (Brian, Jean, Charlotte & Kirsten, 2005).
They face obstacles to access and affording psychological, behavioral, physical, and cognitive healthcare. These issues, inabilities, and barriers can be attributed to older persons lacking economic resources and security. Thus, they also face barriers to paying for quality shelter. This positions them in vulnerable situations where they can face abuse and exploitation (Brian, Jean, Charlotte & Kirsten, 2005).
Combining the social, economic and healthcare barriers can interfere with their social skills ensuring they undertake fewer roles and active engagements in society. A combination of these challenges renders older persons as burdens to global communities. Families, therefore, have to ensure they provide for their physical, financial, emotional, practical, and physical needs in order to show love, care, and support for older family members. Some families prefer hiring other members or friends to care for and support older persons at a reduced fee. This is however unfair because they lack skills, knowledge, qualifications, and experience in associating and caring for older persons. Thus, roles and responsibilities undertaken by qualified social workers and caregivers are often underappreciated. However, most families prefer employing qualified social workers to care for older members of the family (James, Janet & Jane, 2007).
Duties Offered by Social Workers and Agencies
A social worker is an individual possessing a degree in social work from an institution providing higher education. Social workers should be accredited and licensed by Council on Social Work Education at appropriate jurisdiction levels. This awards them with opportunities to undertake professional roles in order to cater to special needs among the elderly. They have the abilities and qualifications to recognize that older persons have undergone a continued growth rate in relation to their physical appearances. Thus, older persons contribute either little or nothing to family upkeep and societal needs. Thus, they are susceptible to neglect, abuse, and mistreatment. Qualified social workers, therefore, strive to show love, care, support, encouragement and award them with advanced meanings of life in order to elongate their life spans through therapeutic clinical interventions (NASW, 2010).
Family members and friends hired to care for older persons at either no or reduced fees hardly pay attention to their mental and cognitive needs. Instead, they concentrate on social and physical requirements. They ensure they bathe, feed, and offer them appropriate medication without necessarily spending time with them to find out what they need, desire or want. As people grow, their social and physical needs change. Thus, they need a social worker and caregiver with qualifications dedicated to catering to their daily and diversely changing needs. This improves their healthcare, social relations, emotional stability, and ultimately the quality of life. More so, qualified and experienced social workers and caregivers assist in improving relations between elder persons and the rest of the family members thus, providing cognitive clinical interventions (James, Janet & Jane, 2007).
Social Worker and Clinical Evidence-Based Therapeutic, Cognitive and Diagnostic Interventions:
Social workers undertake their roles and responsibilities derived from guiding values and ideologies. Social workers are trained to promote various social standards among older persons. Foremost, they ought to apply and adhere to ethics and values contained in a code of ethics guiding social workers. They should make ethical and valuable decisions and policies in their day-to-day activities caring for elderly persons. Thus, the code of ethics and values ensures the well-being of elder persons is enhanced while meeting their basic needs. Social workers ought to provide services to meet social justice and promote self-dignity, respect, and worth among older persons. Thus, they should engage and maintain relations with older persons to facilitate the identification of their needs. This further facilitates social workers identifying clinical interventions applicable to promote, achieve, and strengthen well-being among older persons and their relations with family members (NASW, 2010).
Professional social workers have the skills, powers, and integrity to undertake responsibilities aligned to judicial, cultural, and social interests. Thus, they should be competent and consistent in providing assistance, love, support, and care to older persons without conflicting with their interests. Evidence-based clinical interventions are strategic programs incorporated in federal registries, accounted in peer-reviewed journals and documents. They are documented to evaluate and analyze their effectiveness with support from other informational sources and experts (USDHHS, 2009).
Evidence-based clinical programs are formulated to target physical, emotional, healthcare, and mental needs to solve issues and challenges affecting qualities of life among older persons. They utilize preventive measures and approaches to intervene and reduce adverse effects through a comprehensive community plan. Thus, they are prepared by relying on adequate evidence chosen from a variety of interventions. The United States Department of Health and Human Services and community planners such as Substance Abuse and Mental Health Services Administrations and Strategic Prevention Framework identified and selected evidence-based clinical interventions. They were aligned to social needs among older persons aimed at addressing issues affecting them in order to seek reductive and preventive measures (USDHHS, 2009).
Clinical interventions were therefore based on establishing and improving resilient recovery. In order for the interventions to be implemented, SAMHSA and SPF ensured the programs are accountable, effective, and efficient to address social workers’ and agencies’ capacities in relation to care and health services offered to older persons. Thus, they strive to offer aids and resources both physical and financial to facilitate social workers, caregivers and agencies prevent, reduce and solve challenges and issues facing older persons. They offer training, technical help, and financial strengths to social agencies and programs with policies and practices aligned to improving qualities of life among older persons through social workers (USDHHS, 2009).
The first clinical intervention identified was related to preventing older persons from neglect, abuse, exploitation, and substance abuse. Experts and healthcare givers assert preventive and diagnostic measures should address various clinical and social challenges reducing the quality of life among older persons. The approaches should be effectively formulated and implemented on small and large scales to address social and clinical issues. Social issues affecting older persons include being vulnerable to abuse, dangers, and exploitation during harmful societal happenings. Public resources combined with evidence-based therapeutic, diagnostic, and cognitive interventions and strategies should formulate approaches addressing the following factors (USDHHS, 2009).
Foremost, the intervention ought to fit particular social, clinical, physical, cognitive, and emotional needs among older persons. More so, it ought to align with cultural requirements affecting, influencing standards, qualities of lives among older persons, and the community. Thus, an intervention disregarding and violating cultural laws and requirements cannot be effectively implemented. However, members of the family and community should be prepared to adopt the preventive evidence-based intervention. A comprehensive plan inclusive of federal laws and social expectations should be developed. The laws and expectations within the plan can be gathered from empirical societal studies. The plan ought to combine synergistic and complementary clinical interventions to ensure various needs among older persons are addressed (USDHHS, 2009).
The clinical evidence-based strategy utilizes medicines to provide clinical and healthcare services among older persons through social workers, caregivers, and agencies. Medicines are utilized to promote, improve and enhance healthcare among persons, communities, and populations. In relation to older persons, evidence-based medicine can be applied to reduce the occurrence of various diseases and harms from abuse. Consequently, they can be used to treat illnesses and reduce impacts interfering and diminishing qualities of life among older persons. Thus, clinical evidence-based medicines are used to treat illnesses, abuse, and gain control to improve clinical health among people (Hodge, Bonifas & Chou, 2010).
Social workers, caregivers, and agencies can apply medicines to treat various diseases affecting older persons in the community. The medicines can either prevent or treat multiple diseases including dementia, diabetes, rheumatism, stroke, and respiratory illnesses. Public financial resources can also be utilized to acquire evidence-based medicines to treat and improve mental health among older persons. Mental health is adversely affected by incidences of abuse. Elderly persons are prone to abuse from family members, friends, and community members (Hodge, Bonifas & Chou, 2010).
Cost-effective cognitive clinical evidence-based approaches ought to be acquired and applied in treating a large population of abused older persons. The government should provide sustainable support with preventive measures and medicines on large scales applicable in treating physical and mental abuse among older persons (Hodge, Bonifas & Chou, 2010). Caregivers assert nonverbal communication can impact qualities of life among elderly persons. Poor delivery of messages can be translated as abusive language. Thus, caregivers provide therapeutic interventions assisting the elderly and other members of the community to communicate comfortably with respect, care, and love (GSA, 2012).
Sometimes visual aids including diagrams and pictures are utilized to provide cognitive interventions. They are applied in describing the assistance an elderly person requires. They can also be applied in treating abuse. However, it is challenging to use a diagram in describing physical or mental abuse. Caregivers pose open-ended questions to acquire information. This can reduce levels of stress, anxiety, frustration, and uncertainty among elderly persons undergoing abuse and exploitation. Thus, discovering, treating, and preventing abuse among elderly persons requires holding comfortable conversations to inquire and acquire details and evidence. However, elderly persons should not feel disrespected or uncomfortable as they provide details and evidence in relation to abuse. Thus, the conversation ought to show love, care, support, maturity, and respect (GSA, 2012).
Scientific knowledge is utilized to formulate and implement evidence-based clinical measures and interventions as protective factors in relation to mental and behavioral clinical health. The interventions are aimed at preventing and reducing risk factors in order to improve, increase, and enhance protective factors guarding mental and behavioral health. Health care practitioners, advocates, promoters, policymakers, and researchers have been engaged in an international public debate. They seek to determine qualities and standards in relation to evidence-based interventions applied in promoting and improving overall healthcare among older persons. Their efforts are aligned in enhancing valid and internal conclusions applicable in improving qualities of life among older persons (USDHHS, 2009).
Older persons mainly suffer from clinical healthcare issues in different and diverse cultural sites, settings, and societies. Thus, clinical evidence-based interventions developed scientifically should be aligned to valid cultural standards. Random control trials (RCT) are applicable and accepted gold standards and qualities strategically tasked to improve qualities of life among older persons. RCTs involve casual impacts on individual levels in implementing highly controlled evidence-based interventions. Thus, RCTs gather evidence from schools, communities, classes, and working environments. However, they need to realize long-term relationships between applicants and receivers. The research designs should therefore include value-enhancing strategies to evaluate national legislations, policies, qualitative measures, and programs (WHO, 2004).
Clinical evidence-based research studies reveal risk and protective factors impacting mental disorders among older persons. These factors can be social, individual or family-based, economic, and/or environmental in nature. Thus, increasing risks and reducing protective factors can predispose older persons to suffer from severe mental, emotional, physical, and clinical conditions. This further places them in vulnerable positions of developing mental disorders. The interventions should therefore strive to counteract the risks and reinforce the protective factors to disrupt, reduce and end processes attributed to mental dysfunctions and disorders (WHO, 2004).
Data on Clinical Evidence-Based Interventions
The World Health Organization provides data asserting clinical evidence-based interventions are effective and efficient to apply in caring for older persons. WHO listed risk and protective factors affecting social, economic, health, and environmental determinants on qualities of life among older persons. Risk factors included displacement, poverty, poor nutrition, isolation, unemployment, rejection, neglect, racial discrimination, inaccessibility to drugs and medication, social disadvantages, violence, delinquent abusive children, and neighborhood disorganization. The clinical evidence-based interventions comprise protective factors rendered effective and efficient. These factors include the provision of social services through participation, interpersonal interactions, and integration of ethnic minorities. More so, supportive community networks, programs, and plans empowering older persons to be tolerant and social workers responsible and committed, also enhance diagnostic and therapeutic clinical evidence-based interventions (WHO, 2004).
Older people are grouped in this category based on their age. Thus, not all older persons need social workers. However, all older persons face similar clinical, social, and healthcare issues. They suffer similar illnesses and diseases with equal needs, desires, and expectations with regard to challenges hindering them from leading high-quality lives. As a result, social workers, caregivers, and agencies are employed to prevent and reduce impacts interfering with qualities of life among older persons. Older persons desire to receive social and clinical assistance with love and care from persons and agencies with skills, qualifications, and experiences. This guarantees a social worker will strive to ensure values and ethics among older persons are respected, upheld, and upgraded (Brian, Jean, Charlotte & Kirsten, 2005).
Issues between older persons and social workers mainly arise in efforts to provide personal care. Older persons can often feel violated in relation to privacy, dignity, and respect. Clinical evidence-based interventions are developed and implemented to ensure older persons receive intensive care with love, care, respect, and human dignity. In order for social workers to address complex situations among older persons, they require to have experience to ensure they are supportive to intervention measure or approaches. Consequently, they are able to apply the clinical evidence-based interventions effectively and efficiently. This reduces risks and promotes protection with regard to the relationships maintained between older persons and social workers. Clinical evidence based interventions therefore promote self-independence, determinations, and sacrifice among older vulnerable persons through a balanced, adequate and protected relationship with social workers, caregivers and agencies.
Brian, K., Jean, G., Charlotte, M., & Kirsten, S. (2005). Effective Social Work with Older People, Scottish Executive Social Research.
Gerontological Society of America (GSA). (2012). Communicating with Older Adults: An Evidence Based Review of what Really Works, Gerontological Society of America Report.
Hodge, D., Bonifas, R., & Chou, R. (2010). Spirituality and Older Adults: Ethical Guidelines to Enhance Service Provision, Advances in Social Work, 11, 1 ‐16.
Imbody, B. (2011). Elder Abuse and Neglect Assessment Tools, Intervention and Recommendations for Effective Service Provision, Educational Gerontology, 37: 634–650.
James, B., Janet, L., & Jane, T. (2007). The Changing Roles and Tasks of Social Work, a Literature Informed Discussion Paper.
McDonough, K., & Davitt, J., (2011). It Takes a Village: Community Practice, Social Work, and Aging‐in‐Place, Journal of Gerontological Social Work, 54(1): 528–541.
National Association of Social Workers (NASW). (2010). NASW Standards for Social Work Practice with: Family Caregivers of Older Adults, National Association of Social Workers Report.
U.S. Department of Health and Human Services (USDHHS). (2009). Identifying and Selecting Evidence-Based Interventions, Revised Guidance Document for the Strategic Prevention Framework State Incentive Grant Program.
World Health Organization (WHO). (2004). Prevention of Mental Disorders: Effective Interventions and Policy Options, A Report of the World Health Organization, Department of Mental Health and Substance Abuse in collaboration with the Prevention Research Centre of the Universities of Nijmegen and Maastrich.