Challenges of Depression and Suicidal Ideation Associated With Aging With HIV/AIDS: Implications for Social Work

As the number of older adults with HIV/AIDS increases, new challenges are emerging that threaten their ability to age with this disease. Threats of particular concern are depression and suicidal ideation. Studies show that those aging with HIV/AIDS have a number of stressors that tax their coping mechanisms, increasing vulnerability to depression and suicidal ideation. These stressors can be categorized into three areas. First, there are psychosocial stressors that can contribute to depression. Second, there are health and biochemical stressors that can contribute to depression, as well as compromise cognitive abilities needed to adapt to such stressors. Third, cognitive stressors may create predispositions to depression. In particular, certain cognitive abilities needed to cope with depression and suicidal ideation may be compromised by aging with HIV/AIDS. A model of these stressors is provided for didactic purposes, as well as to suggest implications for social work practice and research.     

How Social Workers Demonstrate Respect for Elderly Clients

Although respect is a crucial aspect of social work practice, few studies have examined how social workers convey their respect for elderly clients. This study explored the various forms of respect demonstrated by social workers when they were with older clients. Fifty social workers serving elderly clients were surveyed by a questionnaire with closed- and open-ended questions. Based on data on ways the social workers respected their elderly clients, the study identified 7 forms most frequently practiced and considered most important. They are linguistic respect, care respect, acquiescent respect, salutatory respect, presentational respect, spatial respect, and consultative respect. The key expressions of these forms are introduced in quantitative data and a narrative form. These findings provide insight as to how social workers exhibit respect for elderly clients in their practice. The results of this exploration may be useful in developing a more comprehensive typology of the forms signifying respect for elderly clients.     

Compassion Fatigue and the Adult Protective Services Social Worker

Compassion fatigue is a relatively new term that describes the symptoms that are experienced by social workers and other helping professionals who work with clients experiencing trauma. This article defines the concept of compassion fatigue and relates compassion fatigue to Adult Protective Services (APS) social workers. It is proposed that APS social workers may be susceptible to the deleterious effects of compassion fatigue due to the nature of their work and environment. Suggestions for avoidance of compassion fatigue are also discussed, including self-care strategies and the need for continuing education regarding this phenomenon.     

Climate change in Alaska: Social workers’ attitudes,beliefs, and experiences

The average temperature in Alaska and the North American Arctic has risen at twice the rate of the global average due to climate change, causing changes to the natural environment that affect the physical, social, and emotional well‐being of people and communities. Social workers must be prepared to respond. Using a non‐probability, convenience sample, this study surveyed 159 social workers in Alaska to assess their attitudes and their perceptions of the effects of climate change on their clients and constituents. Results indicate that social workers in Alaska believe that climate change is happening, that human activities are responsible, and that it is a large threat to people in Alaska. Over 75% believe that climate change is dangerous for their clients now or will be dangerous in 10 years. Social workers report that in the past year their clients or constituents have experienced multiple climate change‐related problems with community infrastructure, health, and mental health.     

The Influence of Client Age on Clinical Judgements of Male and Female Social Workers

Social workers were presented with a clinical vignette in which client age was systematically varied. There were no differences in ratings of older and younger clients on prognosis or pathnology. The older client was not seen as less ideal or more organically impaired, and treatment recommendations did not differ. However, female social workers attached significantly less importance to psychodynamic issues for the older client than the younger.     

Using Community-Based Participatory Research Strategies in Age-Friendly Communities to Solve Mobility Challenges

ABSTRACT

The number of older adults is steadily increasing in the United States and across the globe. Aging is linked to an increased risk of disability. Disabilities that limit one or more major life activities such as seeing, hearing, walking, and motor skills impact a person’s ability to drive a car. Low utilization of alternative transportation by older adults and people with disabilities may put them at risk for social isolation. Social isolation is associated with a variety of negative health outcomes. While communities are challenged to create available, acceptable, accessible, adaptable and affordable mobility options, there are widely held, inaccurate biases around older adults’ abilities to contribute to the development and improvement of alternative transportation options. Gerontological social workers are well-positioned to address this bias. This paper presents a case study of a large metropolitan county in the Midwest where community-based participatory research (CBPR) strategies were used to engage older residents to support the development of alternative transportation options supporting the tenets of environmental justice.     

Client Perspectives in a General Practice Attachment

Summary In this study, 50 clients of social workers in an attachmentscheme were interviewed and their views compared with the assessmentsmade by the social workers. The results were very favourablefor the attachment; the clients were well satisfied with theservice given and the majority of clients felt that they hadbeen helped, especially with their emotional problems. However,there was much disagreement between the social worker's assessmentand that made by the client, especially regarding the type andnumber of problems helped.     

Social Workers' Perceptions of Training Preparedness and Social Justice Norms on Workplace Empowerment

This study examined the relationship between (a) social workers' perceptions of preparedness to perform in their professional roles and perceived social justice behaviors at work and (b) workers' sense of workplace empowerment. A sample of 152 currently licensed social workers responded to web or mailed surveys. Respondents were more likely to perceive having workplace empowerment related to meaning in their work if they reported their social work program training prepared them for their professional roles. Perceived social justice behaviors at work were associated with workers' experiencing empowerment related to the impact they had at work. Social workers' sense of training preparedness and experiencing social justice at work can positively influence workers' perceived empowerment. Enforcing the importance of engaging in social justice with clients in social work education, both in class and in field placements, has the potential for long-lasting effects on empowerment in students' future workplaces. Agency-level management should ensure continuity in social justice activities to enhance feelings of workplace empowerment, which may help social workers connect with clients. Future research should examine elements of social work programs that promote feelings of empowerment in order to understand how the same approach can be used in models of continuing education and organizational management.     

Advance Care Planning in the Delivery of Adult Protective Services

ABSTRACT

In ensuring the safety and protection of older adults from abuse and exploitation, adult protective services (APS) workers face a variety of situations involving serious illness and end-of-life conditions. Many older adults encountered in APS will present with one or more chronic conditions that may warrant discussion of advance care planning with clients and their families. This study surveyed APS workers (n = 508) in 21 states regarding encounters with end-of-life situations and the practice of future care planning. Results revealed that three-fourths of APS workers encounter clients with serious illnesses and about two-thirds do discuss planning in advance for care. More than one-half of the respondents indicated client incapacity and refusal to address future care needs as barriers to discussing planning in advance for care. Recommendations to enhance advance care planning among APS workers are discussed.     

“Playthings of the Brain”: Phantom Visions in Charles Bonnet Syndrome

Charles Bonnet Syndrome (CBS) is a condition of the visually impaired, in which hallucinations – or, more appropriately, visions – of geometric patterns, people, and objects appear within the visual field. Most people with CBS are older adults, a function of increased likelihood of visual deterioration in later life, but the condition can occur at any age. Diagnostic criteria vary among professions, but generally includes awareness that the visions are not real, the absence of other accompanying sensory hallucinations, and the absence of dementia or other neurological condition. The mechanism by which the phenomenon occurs is not well understood, although some speculation exists that it is akin to phantom limb syndrome. Although there has recently been increasing awareness about the condition, many in the fields of medicine, optometry, and social work have not heard of it. As front-line providers for clients, it is important that social workers be well informed about the condition to alleviate anxiety our clients may have about expressing their experiences with the condition.     

Ethical Assessment of the Use of Influence in Adult Protective Services

The role of influence in social work practice has been generally understated despite its importance to the course and outcome of the clinical process. This paper examines the influence strategies used by adult protective service workers with clients who refuse the services that the workers think the clients need for their own protection. It then discusses the moral justifications provided by the workers for using influence to overcome their clients' reluctance to comply with their recommendations. Finally it suggests questions to guide an ethical assessment of the use of influence in practice.     

IX. Children referred by the schools to the Worcester child guidance clinic 1

Abstract

The level of job rewards for social workers has been correlated with the quality of service to clients. A purposive quota sample of 127 Licensed Independent Clinical Social Workers in Massachusetts employed in three settings completed the Job Role Quality Scale. Respondents found Decision Authority, Flexibility, and Impact (sense of helping others) most rewarding. Private practitioners reported a significantly higher level of reward than respondents in public and private agencies. Administrative interventions directed toward increasing job rewards and decreasing job concerns, may reduce social work staff turnover and enhance the quality of service to clients.     

Self-determination: Lessons to be Learned from Social Work Practice in India

Correspondence to Dr F. K. Ejaz Research Associate Applied Research Institute Menorah Park Center for the Aging 27100 Cedar Road, Beachwood, OH 44122 USA. Summary Self-determination is a controversial principle in social workpractice. On the one hand it is accepted as being central tosocial work and stems from the broader philosophical issuesof autonomy and respect for the individual. On the other hand,there are many doubts about its implications for practice. Thisarticle examines how the Western social work principle of self-determinationis influenced by cultural beliefs and expectations in India. Twenty-six social workers participated in a qualitative studyon the influence of culture on casework practice in Bombay,India. Open-ended questions and case studies were used to examinehow culture specific problems were handled and how workers interpretedand used some of the principles of social work practice. Social workers believed that Indian clients expected to be guidedin a therapeutic relationship. Further, clients were generallyapathetic and fatalistic about circumstances in their lives.Indian social workers came across as being maestros at bridgingeast-west differences. They subtly fulfilled social and culturalexpectations and at the same time enabled clients to assumeenough autonomy to handle their own problems.     

Social Workers' Responses to Incontinence,Confusion and Mobility Impairments in Frail Elderly Clients

Social workers in home health care agencies are frequently involved in decisions concerning the independent living of their frail elderly clients. This study analyzes social workers' responses to elderly clients with three health problems that are relatively common among the elderly: urinary incontinence, confusion, and mobility impairments. Responses to clients with incontinence differ from responses to confused or mobility-impaired clients primarily in the specificity of attributions of cause of the problem and in evaluative responses toward the client. The findings are discussed in terms of the potential role of social work as an agent for change in both popular understandings of incontinence in later life and in the delivery of health care to the incontinent elderly.     

Social work practice toward enhancing competence in family planning

Competence in family planning possessing the ability to limit conception so that children are produced by choice. More attention must be directed toward family planning by social workers because of its importance in family welfare. They should help clients know that family planning might help in preventing family problems and promoting family health. The workers should determine whether their clients use or have ever used family planning, and who takes responsibility for it. Discussion of the physiology of the various methods can help alleviate many unwanted fears. The subject of family planning is also important in dealing with adolescent groups. As social work practice incorporates family planning as an integral part of its profession, it will become more effective.     

The client interview and the context

Based on analysis of 60 tape-recorded or observed interviews from a Danish social welfare office the article examines the Lipssky-like question: How and to what extent are macro structures such as social legislation and local municipal rules brought into real live existence in the meeting between case workers and clients? To what extent do the case workers show rule-conforming practice? Illustrated by several extracts, it is shown that the legislation is not a simple governing instance and that the case workers do not serve as simple tools for fulfilling decisions made as formal rules at a macro level. On the contrary, the case workers made use of those rules and official client or benefit categories that seemed helpful to them for their own professional purposes, and so did the clients in order to secure their interests. All in all, the case workers showed a considerable distance to social security office which was presented for the clients as distant and partly hostile towards the clients.     

Abortion: With Particular Reference to the Developing Role of Counselling

Summary This paper suggests that counselling is a rapidly expandingfield in which professional and para-professional workers mightcombine to produce an effective service, given appropriate selectionand training procedures. Initially these are seen as being providedby professionally qualified social workers with relevant experience.The author has used her own social work experience in abortioncounselling to exemplify the article and to discuss some ofthe existing problems for workers and clients alike.     

Reconciling Cash and Care: Home Care Charges and Benefit Checks in Social Services

Correspondence to Pete Alcock, Health and Community Studies, Sheffield Hallam University, Collegiate Cresent, Sheffield S10 2BP Summary This article contains the report of a small research projecton the development of welfare rights checks for home care clientsin social services departments. Welfare rights take-up activityhas become an important feature of provision by local authoritysocial services departments, frequently targeted on particulargroups of clients known to experience problems in claiming fullbenefit entitlement. Users of home care services are such aclient group. Take-up work with home care clients is also, however,a product of the impact of community care policy changes andof financial pressures on local authority social services. Thesehave resulted in the introduction of charges for home care servicesby many authorities, and the use of rebates from such chargesto protect low income service users. Welfare rights work hasthus become an important feature of the reconciliation of thesenew charging policies with the continued service needs of poorhome care clients. The research examined a successful take-upinitiative, linked to home care charges, in Sheffield and contrastedthis with similar activities in other authorities throughoutthe UK. The conclusion is reached that levels of non-take-upof social security benefits are particularly low amongst homecare clients and that benefit checks can secure significantadditional income for them, which may also have the indirecteffect of increasing the income to social services departmentsfrom the charges for home care services.     

Older Latina Women and HIV/AIDS: An Examination of Sexuality and Culture as they Relate to Risk and Protective Factors

Older Latina women are one of the least studied American demographic groups with regard to social, health, or sexual behavior. This could leave social workers and other geriatric professionals unprepared for dealing with HIV/AIDS in this population. Currently, older Latina women are one of the fastest growing groups of new AIDS cases. Twenty percent of all women ever diagnosed with the disease are Latina and 5.5% of Latinas infected with the virus are older. The number of diagnosed infections is increasing in older women, including Latinas, in spite of recent declines in infection rates with younger populations. There are also a potentially large number of cases that go misdiagnosed or undiagnosed.

This article also addresses risk and protective factors related to gender roles, traditional Latino family values, religion, socioeconomic factors, health, and health care, with special attention to the triple jeopardy faced by this population by virtue of being female, seniors, and minorities. The article concludes with recommendations for the development of culturally competent practices with older Latinas and the development of a research agenda to better understand their risk-related and health-seeking behavior.