Effective Social Work with Older People
This report is part of the review of the role of the social worker commissioned by the Scottish Executive to inform the work of the 21st Century Social Work Review group. Their prime focus is the role of the social worker across different service systems and national contexts.
CHAPTER ONE INTRODUCTION
Aims and objectives of this review
1.1 As part of the 21 st Century Review of Social Work, The Scottish Executive asked the Social Work Research Centre at the University of Stirling to review the evidence base for effective social work with older people. The aim was to explore 'what works' in terms of effective practice by qualified social workers and what leads to quality outcomes for older people and their carers. This review will sit alongside similar papers commissioned by the Scottish Executive on work with offenders (McNeil et al 2005) and work with children and families (Walker 2005).
1.2 The specific objectives agreed for this piece of work are as follows:
- to identify effective and desirable outcomes for older people, including outcomes desired and defined by older people themselves
- to identify the distinctive skills required by social workers in order to achieve desirable and effective outcomes
- to draw out and discuss the implications for future policy and practice in this field
Scope
1.3 This review will cover:
- older people who have dementia, physical/sensory impairment, mental illness and /or complex health needs
- outcomes in a variety of domains, including promotion and maintenance of independence, assessing and managing risk, assessing and managing vulnerability, personal care and work with families
- outcomes in the range of settings in which older people live, for example, care homes, with family, and at home alone
Structure of this paper
1.4 Chapter 2 considers different understandings of effectiveness, including the views of older people themselves. It examines evidence about aspects of effectiveness in social work with this service user group. Chapter 3 looks at aspects of the wider context in which social work with older people takes place, while the following chapter discusses demographic trends and older people's needs for social work support. Chapter 5 contains a detailed discussion of effective social work with older people, including practitioners' statutory duties, their role in protection and risk management, and the ways in which different settings can impact on work with older people in key areas such as loss, change and grief.
1.5 The final chapter draws out the implications for the 21 st Century Social Work Review, making reference to its interim report, for example, considering how the various social work roles identified in that report - such as counsellor, advocate and assessor - might apply to social work with older people.
Methods
1.6 The main task carried out by the project team was a review of various key texts and recent research reports primarily from the UK. The team combines extensive experience in research in community care for older people with significant practice and management experience of services for older people: it is hoped that this balance is reflected in the paper.
1.7 The review draws on the recently published Older People and Community Care - a review of recent research (MacDonald 2004), also commissioned by the Scottish Executive. While there is a considerable amount of research and publications about the needs of older people, the impact of demographic change and social policy developments, rather less work has been conducted on evaluation of 'what works' and what is valued by older people themselves, still less on the effectiveness of what social workers do. Consequently, the findings and conclusions of the work presented here were discussed in a small, informal consultation exercise with a number of very experienced and skilled social workers and social work managers, to facilitate as comprehensive a review as possible.
Limitations
1.8 We were asked to present our review as a formal research report (using the standard Scottish Executive research report template). This paper is not, however, the result of systematic research nor is it a comprehensive literature review, neither of which were possible within the short timescale available of about six weeks. However, the findings are presented in a style which we hope will be helpful and accessible to the 21 st Century Review group.
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