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Clinical Gerontological Social Work Practice

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Clinical Gerontological Social Work Practice

SKU# 9780826129895

Author: Robert Youdin PhD, LCSW

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This book has a forward-thinking orientation that reflects the reality of aging with older adults throughout the aging life course... Dr. Youdin integrates an advanced clinical social work practice with in-depth knowledge of evidence-based practice as well asd geriatric medicine, psychiatry and gerontology." -- The Lamp

Written by an expert in gerontological social work and curriculum development, this book provides a wealth of clinical information for social workers and other health care professionals who counsel older adults. It describes a strengths-based, empowerment approach to treatment that integrates theory, technique, advocacy, and social policy, and encompasses the tenets of human rights. The book's content has been tested in the classroom setting for a three-year period with advanced social work undergraduate and graduate students.

The book examines various theories of aging including a contrast between the strengths-based person-in-environment theory and the pathologically based medical model of psychological problems. It advocates truly engaging with the older client during the assessment phase, and discusses a variety of intervention modalities. The psychological construct of stigma regarding aging is examined, along with the major psychopathological problems common to older adults. The book also considers Alzheimer's disease and dementia, medical problems of older adults and co-occurring psychological problems, substance abuse, older adult sexuality, elder abuse, and the vulnerabilities of gay, lesbian, bisexual, and transgender older adults. Additionally, the book addresses mental health issues pertaining to residential settings and the aspects of death and dying that give older people concern. Extensive case studies, learning objectives, and discussion questions are featured in each chapter. The book also includes an instructor packet, PowerPoint slides, and an interactive PDF.

Key Features:

  • Provides a wealth of classroom-tested clinical information
  • Espouses a strengths-based approach to treatment that integrates theory, technique, advocacy, and social justice
  • Consistent with social work mandates for a human rights focus
  • Presents extensive case studies, learning objectives, and discussion questions in each chapter
  • Includes an instructors packet, PowerPoint slides, and interactive PDF

Product Details 

  • Publication Date May 13, 2014
  • Page Count 288
  • Product Form Paperback / softback
  • ISBN 13 9780826129895
  • EISBN 9780826129925

Table of Contents 

Foreword Patricia Brownell, PhD xiii

Preface xvii

Acknowledgments xxiii



1. Theories to Inform the Social Worker Practicing With Older Adults 3

The Need for a Unifying Gerontological Social Work Theoretical Orientation 4

Theory Circle 5

Suggested Theories to Inform the Social Worker Treating Older Adults 6

Age Stages 6

Psychological and Social Aging Theories 8

Erikson’s Stages Theory 8

The Medical Model 9

Person-in-Environment Theory and Resilience: A Good Partnership 10

Person-in-Environment Theory: The Beginning 12

Perception of Control 13

The Case of Georgina 14

Summary 17

Discussion Topics 17

2. Assessing an Older Adult 19

Part 1: Environmental and Communication Challenges to Be Overcome by the

Social Worker and Older Client 20

Offi ce Assessment Setting 20

A Matter of Speaking 20

Home, Nursing Home, Assisted Care Facility, or Hospital Assessment

Setting 21

Working the Clock 21

To Take or Not Take Notes 22

Part 2: Assessment Categories 22

Gender, Age, Ethnicity, Sexual Orientation 22

Presenting Problem 23

Environmental and Demographic Information 24

Developmental History 24

Medical Status 25

Sexual Assault History 26

Sexual History 26

Substance Use 26

Psychiatric History 27

Appearance 27

Attitude 27

Motor Status 27

Speech Quality 28

Thought Process 28

Mood/Affect 28

Sleep/Appetite Status 29

Suicide Assessment 29

Rational Suicide 31

Homicidal Assessment 32

Mental Status Exam 33

Spirituality/Religion 36

Older Adult Abuse 36

Collateral Interviews 36

DSM-5 Diagnosis 36

The Case of Dr. Frank 37

Gender, Age, Ethnicity, Sexual Orientation 37

Presenting Problem 37

Environmental and Demographic Information 37

Developmental History 38

Medical Status 39

Sexual Assault History 40

Sexual History 40

Substance Use 40

Psychiatric History 40

Appearance 41

Attitude 41

Motor Status 41

Speech Quality 41

Thought Process 41

Mood/Affect 41

Sleep/Appetite Status 41

Suicide Assessment 42

Homicidal Assessment 42

Mental Status Exam 43

Sensorium 43

Spirituality/Religion 43

Older Adult Abuse 44

Collateral Interviews 44

DSM-5 Diagnosis 44

Goals for Change 44

Summary 44

Discussion Topics 45

3. Intervention Theories Informing the Clinician Treating Older Adults 47

Are Theories an Uncontaminated View of an Older Adult? 49

Sources of Contamination 49

Sorry, No Theory Available 49

Ageism 49

The New Ageism 50

The Incompetence Model 50

The Geriactivist Model 50

Theoretical Orientations for Treating Older Adults 51

Foundations Underlying Existential, Brief Solution, Cognitive Behavioral,

and Narrative Therapies 51

Empowerment Theory and the Strength Perspective 51

Constructivist Theory 52

Existential Theory 52

Cognitive Behavioral Theory 55

Narrative Theory 56

Reminiscence Therapy 58

Feminist Theory 58

The Case of Henriqua 59

Summary and Applications of Theoretical Orientations to Henriqua’s Case 60

Henriqua Through the Optic of Existential–Phenomenological Theory 60

Henriqua Through the Optic of Cognitive Behavioral Theory 62

Henriqua Through the Optic of Narrative and Reminiscence Theory 63

Henriqua Through the Optic of Feminist Theory 64

Discussion Topics 64

4. Stigma and Older Adults 65

Examples of Optics Affected by Stigma and Their Subsequent Effects on Older

Adults 66

Ageism 67

Race/Ethnicity/Sexual Orientation 68

Gender 69

Poverty 70

Policy 71

Psychological Problems 72

Medical Illness 75

The Internet: A Tool for Fighting Stigma 76

The Case of Michael 77

Summary 79

Discussion Topics 79



5. Psychopathological Problems in Older Adults 83

The Medical Model of Psychopathology 83

Psychopathological Problems in Older Adults 85

Anorexia Tardive 86

Anxiety Disorders 86

Co-Occurring Psychological Disorders and Substance Abuse/Dependence

Disorders 87

Delusional Disorder 88

Mood Disorders 88

Personality Disorders 90

Schizophrenia 91

Suicide 91

The Case of Anthony 93

Summary 94

Discussion Topics 95

6. Alzheimer’s Disease and Other Dementias 97

Mild Cognitive Impairment 97

Vascular Dementia 98

Dementia With Lewy Bodies 98

Frontal Lobe Dementia (Including Pick’s Disease) 99

Korsakoff Syndrome 99

Parkinson’s Disease 99

Alzheimer’s Disease 99

Stage 1 100

Stage 2 100

Stage 3 100

Stage 4 100

Stage 5 101

Stage 6 101

Stage 7 101

A Basic Guide to Medicines for Alzheimer’s Disease 101

Neurotransmitters 102

Therapeutic Interventions for Alzheimer’s Disease Patients 104

Agitation States Common to Dementias 104

Caregiver Support Groups 105

Psychotherapeutic Interventions in Early-Stage Dementias 105

Psychoeducational Support Groups for Alzheimer’s Disease Patients 105

Leisure Activities and Therapeutic Recreation 106

Cognitive Training Intervention Programs 107

Driving Retirement 107

Fall Risk With Dementia 108

Inappropriate Sexual Behaviors 108

Dementia in Imprisoned Older Adults 108

Long-Term Care for Dementia 108

The Case of Daiki 108

Summary 110

Discussion Topics 111

7. Medical Problems in Older Adults 113

Commonly Occurring Medical Problems Experienced by Older Adults 113

Arthritis 113

Cardiovascular Diseases 114

Cancers 116

Chronic Obstructive Pulmonary Disease 117

Diabetes 117

Eye Disorders 118

Hearing Disorders 119

Osteoporosis 119

Pain 120

Pressure Ulcers 121

Sleep Disorders 121

Urinary Disorders 121

Interventions for Older Adults With Chronic Illnesses and Their Families 122

The Case of Miguel 122

Summary 124

Discussion Topics 125

8. Older Adult Substance Abusers 127

Chronic Versus Situational Substance Abuse 129

Alcohol Abuse/Dependence 130

Nonalcohol Substance Use Disorders 132

Benzodiazepine Abuse/Dependence Disorders 132

Opioid/Synthetic Opioid Abuse/Dependence Disorders 133

An Existential Analysis of Older Adult Substance Abuse/Dependence 134

Motivational Interviewing 135

Cognitive Behavioral Interventions 136

Integrating Motivational Interviewing With Other Therapeutic Modalities 137

The Case of Pauline 138

Summary 139

Discussion Topics 140

9. Older Adult Sexuality 141

Men 142

Erectile Dysfunction Treatments 143

Women 143

Gay Male and Lesbian Couples 144

Heterosexual Couples 144

Sexuality and Dementia 146

Caregiver Sexual Education for Dementia Patients 146


Nursing Homes 148

Older Adult Sexuality and Religion/Spirituality 149

The Case of Lim and Jun 149

Summary 150

Discussion Topics 151

10. Older Adult Abuse 153

Prevalence of Older Adult Abuse 155

Perpetrators of Older Adult Abuse 156

Assisted Living Facilities and Nursing Homes 156

Long-Term Care at Home 157

Older Adults’ Perceptions as Potential Crime Victims 158

Sexual Violence 158

Disabled Older Adults 159

Older Adult Prisoner Abuse 159

Historical Programs to Address Older Adult Prisoner Abuse 159

Older Adults’ Self-Abuse 160

Self-Neglect 160

Self-Harm 161

Interventions for Older Adult Abuse, Self-Neglect, and Self-Harm 162

The Case of Gloria 164

Summary 166

Discussion Topics 166

11. Gay Male, Lesbian, Bisexual, and Transgender Older Adults 167

Coming Out in Later Life 168

Older LGBT Sexuality and HIV 169

Substance Abuse 170

Older Gay Inmates 171

Clinical Intervention 171

Concerns About Health Service Delivery 172

Interventions 173

Mental Health Issues 173

Retirement and Housing 175

The Case of Sheri and Camila 176

Summary 177

Discussion Topics 178

12. Care and Residential Settings for Older Adults 179

Retirement Communities 180

Gay-Oriented Retirement Communities 181

Aging in Place 181

Adult Day Care Services 182

Continuing Care and Assisted Living 183

Housing for Aging Inmates: A New Type of Aging in Place 185

Nursing Homes 185

Goals for Improved Experiences in All Types of Care and Residential

Settings 186

The Case of Adanna 188

Summary 190

Discussion Topics 191

13. Dying and Death 193

End-of-Life Planning 193

End-of-Life Palliative Care 195

Intensive Care and Terminal Illness 198

Euthanasia 199

Place of Death 200

End-of-Life Psychotherapy 201

Grief Counseling 201

The Case of Yael 204

Summary 205

Discussion Topics 205

References 207

Index 251