Another challenge is the fact that it is common for the clients to be afflicted with different kinds of diseases and disabilities: physically, mentally, or emotionally. This paper aims to give an in-depth discussion of the challenges involved in working with the elderly, and how the clients' identity issues affect their relationship dynamics with the worker.
First, let us explore the clients' perspectives and situations from the beginning of things - as they enter the residential home for the elderly. Some have existing and financially capable relatives by they themselves choose to stay in a residential facility so as not to burden their family members with their needs. It could due to reasons of pride, or perhaps a deeply ingrained sense of independence that spurs them to instead opt for professional and paid help. It could be a defense against possible future rejection and the hurt that would succumb from it. Others would have preferred to stay with their children and/or grandchildren, as is in most cases in Asian countries for example, but the family members are either too poor, too disgusted at the prospect of being solely responsible of taking care of an elderly person, or too concerned with having their own lifestyles cramped.
Many times the older persons in these cases are admitted to residential homes despite wanting to stay with their families or remain in their own homes. They perhaps just weren't given a choice. The majority of the elderly have been placed in residential homes because of a physical or mental disability and/or because they do not have anyone around to take care of them anymore. These factors, one way or another, have a crucial impact on the clients' psychological state and invariably affect their responsiveness and cooperation during the course of case management. As each and every human being has unique identities and personalities, the dynamics of an elderly person and his or her identity is profoundly affected.
"Community care policyreflects contradictory aspirations (simultaneously) promoting research efficiency and cost effectiveness while advocating a process of needs-led assessment, which provides time for individuals to make their own decisions." (Wistow, 1995, p227-240). In no way and nowhere are these tensions more apparent than when "older people, and particularly frail and vulnerable older people, are considered." (Nolan et al, 2001, p11). Measuring the quality of what is truly a priority to these individuals is incredibly important: their own sake, their careers and their families.
Social justice is an indefinite core value to the mission of social work altogether. "Older people are among the most vulnerable populations for whom social workers are called on to advocate," (Larkin, 2004).
The elderly population (considered to be around 65 and older), reached 28 million in 1984. This number equalled 11.9% of the population or approximately one out of every eight Americans. "By the year 2000 individuals 65 and older are expected to 13% of the