What Role Do Social Workers Play in Caring for Aging Adults?

Updated

Certified Care Manager, Aging Life Care Professional, and National Master Guardian Emeritus

Social work is a unique and vital part of caring for aging adults in every setting from home to hospital. Many social workers specialize in geriatrics and gerontology to be able to better address issues related to aging. They are at the foundation of care and support as our population ages. 

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For the most part, social workers take a holistic, client-centered approach to their practice. They involve the client and family in every aspect of planning and decision making. This approach empowers older adults to take charge and improve the quality of their lives.

What is a Geriatric Social Worker?

A geriatric social worker is someone who is licensed in their state to provide social work services in a variety of settings. Many social workers specialize in areas of interest and expertise, including substance use disorders, home health, nursing homes, mental health, and chronic illnesses.

A geriatric social worker has a specific interest in working with older adults and their families. Older adults are unique in that their problems and concerns can be wide-ranging and include some of the following:

Loneliness

Social isolation and loneliness are widespread problems for older adults as they lose the ability to access friends and activities. Geriatric social workers can make recommendations for re-engaging socially. Often it is the families of an aging adult who need help identifying and making changes to their loved one’s daily activity schedule.  

Loss of independence

Geriatric social workers help older adults and their families cope with the loss of function. Over time many older adults start to become dependent on family members for day-to-day activities. Geriatric social workers make specific recommendations on how to increase physical and mental functioning, preserve current independence, and suggest changes for the future.

Grief

Grief can be a valid response to the loss of independence, a partner or spouse, and friends. Significant life changes for an aging adult include loss of employment, financial problems, and illness.

Geriatric social workers provide coping strategies to deal with grief and life changes. Unresolved grief can lead to mental health problems like depression and anxiety. Geriatric social workers are trained to recognize these symptoms and make recommendations for counseling.

Family conflict

The nature of family relationships can change over time when an aging adult needs more help and relies on family for caregiving. Conflicts arise over senior living options, disagreements about who is responsible for caregiving, and finances. Geriatric social workers can mediate these conflicts and help families reach a consensus with an aging adult.

Referral

Geriatric social workers may be working with an aging adult for a short time period depending on the setting. A geriatric social worker is skilled at making appropriate referrals that address the needs they have identified. 

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How Do You Know If an Aging Adult Is Ready to Work With a Geriatric Social Worker?

Knowing if an aging adult is ready to work with a geriatric social worker will depend on several factors. An aging adult also has to agree to work with a geriatric social worker regardless of setting or situation. If they refuse, then you may not have much recourse. But, in most situations, families and clients are grateful to have the assistance of someone who can help. 

An aging adult might be suspicious that a geriatric social worker will put them in a nursing home. Sometimes education about the role of geriatric social work will go a long way in gaining acceptance. Let’s look at some of the typical situations where you know an aging adult is ready to work with a geriatric social worker.

A crisis

A crisis refers to any unexpected event that significantly changes an aging adult’s situation. Most crises tend to result from a fall, an exacerbation of a medical illness, an accident, or diagnosis of a terminal medical condition or other disorder. Many times the result of a crisis is hospitalization. In these cases, a geriatric social worker will assist families and the aging adult with the next steps for recovery or rehabilitation. 

Mental health concerns

Depression is not a normal part of aging, but losses, loneliness, changes in living situation, and other stressors can lead to mental health concerns. If you have a loved one who shows signs of depression or anxiety, they may benefit from therapy from a geriatric social worker. 

Changes in self care

Changes in an aging adult’s ability to take care of themselves can happen gradually or suddenly. A geriatric social worker is trained to offer clients and families options for care taking into consideration finances and client desires. 

Senior living situations

Aging adults live in a variety of senior care settings, from assisted living to nursing homes. Although it is rare to have a geriatric social worker in assisted living, an aging adult may need someone to advocate for them.

Nursing homes commonly have caseworkers to help an aging adult with concerns or problems. If an aging adult lives at home or in assisted living, they have the option of contracting privately with a geriatric social worker to help. 

Where Are Geriatric Social Workers Employed?

Geriatric social workers practice in a wide range of programs, clinics, and agencies. They are found in almost every health care setting.

  • Government agencies including Adult Protective Services and Area Agencies on Aging
  • Rehabilitation centers
  • Hospitals
  • Outpatient medical clinics
  • Assisted living and nursing homes
  • Mental health agencies both public and private
  • Stand-alone mental health practices
  • Hospice and home health companies

Educational Requirements for Geriatric Social Workers

The governing and licensing body for social work is the National Association of Social Workers (NASW). Social workers, depending on the setting where they work can have either a bachelor’s or master’s degree. Social workers adhere to a code of ethics established by the NASW.

Some social workers specialize in gerontology, but others may not. For social workers who are doing psychotherapy, a master’s degree is required and states determine eligibility requirements. Depending on education and licensing, supervised practice hours are also required. To keep their licensing current, social workers also have to earn continuing education units.

How Do Geriatric Social Workers Help With Long-Term Care and End-of-Life Planning?

Long-term care planning is critical to social work involvement. Short-term planning is a stepping stone to the long term health and well being of the client. Immediate needs such as a discharge to a rehab setting or referral to home health are part of the long term plan to return the client to the highest level of functioning possible.

The pieces to the puzzle of putting together the long term plan require a multifaceted, individualized approach. End of life planning can be difficult and emotional. Geriatric social workers are accustomed to talking with clients and families about end of life decisions and are uniquely qualified to guide these discussions. 

Assessment

The first and most critical aspect of a social worker’s job is to complete an assessment on the client. An assessment identifies needs, strengths, goals, and includes the following:

  • Function: This part of the assessment evaluates a person’s ability to perform activities of daily living like walking, dressing, cooking.
  • Medical history: This includes past and current medical issues and medications.
  • Living situation: Is the living environment safe? What accessibility modifications are needed?
  • Caregiving: Is the client receiving caregiving from family or an agency and is that enough?
  • Finances: Although geriatric social workers are not financial planners, they can assess a client’s basic financial situation. This information will guide the social worker in making recommendations for care.
  • Mental health: Does the client have mental health problems like depression or anxiety?
  • Cognitive function: Is there an indication of memory issues or other difficulties in processing information?

Advance directives and end-of-life planning

End-of-life planning is an important part of a social worker’s responsibility. If advance directives are not in place, a social worker will assist in filling out the necessary paperwork.

If a client is being referred to hospice or needs to discuss end-of-life planning, a social worker will help facilitate this. 

Identify resources

A geriatric social worker is well versed in public and private resources for an aging adult. Depending on the environment where they work, they can refer the client to services for support. Long-term care planning, and identifying the resources to support the plan, are an integral part of social work practice. 

Apply for services

Applying for services can be overwhelming for many people. A social worker can assist with the application, helping to streamline the experience, and expedite the process. 

Financial support

If finances are limited, a social worker can help the client and family identify possible avenues of financial support. This could include government, non-profit or faith-based programs.

Mental health

Some geriatric social workers are licensed in their state to provide psychotherapy. Others refer clients to mental health programs or providers that specialize in geriatrics.

These programs can include individual or group therapy. If the client is in assisted living and unable to access outpatient services, teletherapy might be an option.

Elder abuse

Elder abuse is a serious problem that affects up to 5 million seniors per year. Elder abuse includes physical, emotional, financial, and sexual abuse.

Unfortunately, incidences of elder abuse are underreported due to shame and fear. A social worker can often help encourage a client to open up about abuse and then take appropriate action to get them some help and support.

Discharge planning

If someone is in the hospital, the social worker can make recommendations for rehab that is covered by the client’s insurance. For clients in rehab, a social worker plans for discharge to home with home health or other caregiver support. 

Advocacy 

Advocacy is at the heart of social work practice. The client is front and center of any planning and decision making. Social workers are trained to look at situations in a holistic way. They help bring people and communities together to find ways to address pressing individual, group, and societal issues. 

Social workers have their client’s best interest in mind and actively involve the client in making proactive decisions to improve their quality of life.

Social isolation and loneliness

Social workers recognize the significant impact loneliness can have on the mental health of older adults. They are trained to recognize social isolation and make recommendations to alleviate loneliness.

Client strengths

Aging can be characterized by a series of losses, and transitions. Coping with these changes can be overwhelming, depressing, and confusing.  Social workers help clients build resilience and focus on their strengths.

Tips for Finding a Geriatric Social Worker

Finding a geriatric social worker depends on the setting the client is in. If your family member is in the hospital or rehab setting, a social worker will be assigned to you and you won’t have a choice. If, however, you are looking to hire a geriatric care manager (with a social work license) or psychotherapist, there are some tips to follow.

Check with your area agency on aging

Your local area agency on aging works with social workers in a variety of settings. Agencies also often have social workers on staff to help connect people to local resources. They can make recommendations of social workers in the community who specialize in geriatrics. 

Look at the aging life care association website

Many geriatric care managers are social workers. The Aging Life Care Association has a complete listing of geriatric care managers and their credentials. Geriatric care managers are not covered by insurance.

Ask your doctor

Some physicians who specialize in geriatrics may have a social worker on staff. This person helps with the transition from hospital to rehab and can make referrals to community resources. If a social worker is not on staff, the physician’s office usually has a list of social workers to refer to.

Contact your local state board of social workers

Your state board has a listing of all licensed social workers in the state. Once you have the names, you will want to do your own evaluation of their expertise and experience. Our list of questions is a good guide to finding the best person. 

What Questions Should You Ask a Geriatric Social Worker?

If you are looking for a geriatric social worker, you may have many to choose from. How do you know if someone has the experience you are looking for?

Here are some questions to ask to help you find the person best suited to your loved one’s situation.

  • What are your credentials and why did you decide to pursue geriatric social work?
  • Can you provide references from other clients?
  • What are some of your biggest accomplishments in your field?
  • What kind of clients do you find the most difficult to work with?
  • How do you handle aggression or inappropriate behavior?
  • Give an example of an ethical dilemma that you had to resolve.
  • Describe some of the community resources you are most familiar with and how they have helped your past clients.
  • How do you deal with suspected elder abuse?
  • How do you handle confidentiality?
  • What kind of supervision do you have and with whom?

Are There Any Alternatives to Working With a Geriatric Social Worker?

There are some viable and valuable alternatives to working with a geriatric social worker. Some are private pay, and others are through government or state programs. Here are a couple of ideas as alternatives to working with a geriatric social worker or in addition to working with one.

Geriatric care managers

Geriatric care managers are professionals with a wide range of skills and expertise in working with older adults. In most cases, geriatric care managers are paid for privately, but there are some cases where an employer or insurance company offers geriatric care management under specific circumstances.

Geriatric care managers have a lot of flexibility in that you can hire one to do a one-time consultation for recommendations or for ongoing care management. These types of managers typically have an excellent understanding of local resources and have close relationships with companies and programs that offer care. 

Case managers

A case manager differs from a geriatric social worker in that they don’t necessarily have specialized training in geriatrics, and their educational requirements may not be as stringent. However, due to the nature of critical and long-term care settings, case managers work with many older adults. 

Most case managers work in medical settings such as hospitals, home health, rehab or nursing homes. Their involvement is typically time-limited, but their expertise in connecting clients and families to resources is invaluable. 

Local aging resources

Your local division of Aging and Adult Services can have a wealth of information and access to programs that might help your loved one. These programs usually have tight financial and care criteria, but it is worth investigating any programs you might qualify for. Most Aging and Adult services departments have staff that are very willing to make referrals and give advice even if you don’t qualify for their services.

Social Workers and Aging

Aging can be an unpredictable and complex journey. Social workers can act as guides, advocates, and coaches during times of crisis and transition. Their expertise, compassion, and knowledge can give you and your family member the foundation you need to weather any storm.


Sources

  1. “What is Elder Abuse?” National Council on Aging. ncoa.org
  2. “Social Worker in Gerontology.” The National Association of Social Workers. socialworkers.org
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