Traditionally the social work role with older people has had low status, has been allocated to the less qualified, and focused on allocating resources in the form of domiciliary support hours, day care or a place in a care home. The current personalisation agenda in the United Kingdom that focuses on self-directed support challenges this tradition, and with the extension to older people of the rights-based approach from the disability movement, there are different requirements of the social work practitioner. This chimes well with the approach argued in Critical Issues in Social Work with Older People, based on the principles of critical gerontological social work and reflecting the acknowledged expertise in this area of the authors, Mo Ray, Miriam Bernard and Judith Phillips.
The authors endorse the definition of critical gerontology framed by Phillipson and Walker, namely a commitment not just to understand the social construction of ageing but also to change it. They highlight the need to recognise the strengths and resource of older people, the diversity of their biographies and their potential for achievement. Challenging ageism and discrimination and promoting intergenerational justice should be at the heart of social work with older people. This volume in the ‘Reshaping Social Work Series’ seeks to develop the knowledge base for reflective practice, and is an excellent exposition of how such a critical gerontological framework can be applied. Illustrated throughout by extracts from Margaret Forster's Have the Men Had Enough? (Reference Forster1989), which add immeasurably to the accessibility of the text, it is primarily addressed at those on qualifying social work programmes and at practitioners wishing to update. Helpful summaries head each chapter, while critical reflection is provoked under the heading ‘stop and think’.
Two initial chapters explore the traditional separation between gerontology and social work and the more recent emergence of the arguments for a critical gerontological social work. The implementation of the approach is then explored in five key areas: risk; the support of older people with dementia; end-of-life care and palliative support; transitions, including those around loss and bereavement and on moving into a care home; and informal care-giving. The increasing profile for dementia with the release of the National Dementia Strategy in England highlights the need for a positive practice approach that focuses not on the deficits of the diagnosis but on the promotion of wellbeing and of a quality life. Likewise, for end-of-life care much current practice is discriminatory and poorly managed, with many experiencing unnecessary disruption in the last days or hours of life. The authors propose a reconceptualisation of the end-of-life, developing practice concerned with care and wellbeing in line with the traditions of a person-centred focus. Particular skills are highlighted: active listening, developing relationships with people at a time of anxiety, encouraging communication in others, and promoting rights through effective advocacy. The strengths of the approach are discussed in respect of three key challenges: post-traumatic stress, depression, and mistreatment of older people. Finally, a closing chapter maps how the approach presented in the volume should be promoted and developed through a range of channels.
Social Work with Older People, from the Learning Matters Series, is directed particularly at student social workers, explicitly citing the benchmark statements and the National Occupational Standards for the profession. The volume is described as ‘interactive’, focused on ‘developing skills of reflection and analysis about, in and on practice’ and takes an ‘action-oriented approach’, speaking to the reader in the second person and liberally threaded with practice activities, case studies and, refreshingly, summaries of contemporary research. The authors highlight five core areas of knowledge for social work: human growth and development; assessment, planning, intervention and review; law; communicating with people; and working inter-professionally. Against this backcloth, the first three chapters address respectively three generic areas: values and ethics; the impact of the cultural, economic and social context; and the legal, policy and political frameworks. Two chapters then focus specifically on support for individuals with mental ill-health or learning disabilities and, a topic often notable for its omission, for older people with sensory and physical impairments. Finally, two areas at the heart of practice with older people are highlighted in chapters on ‘vulnerability, abuse, risk and rights’ and on ‘partnership working’.
Although Karin Crawford and Janet Walker do not explicitly argue for the critical gerontological framework favoured by the authors of the first book, it is nonetheless implicit if less developed, with a similar focus on empowering and enabling older people. They are encouraging students to reflect on the position of older people in society and to address issues of ageism, inequality and oppression. They are directing them to the cultural, social and economic contexts which often contradict the aspirations for a ‘good life’. My only reservation with the activity reflection approach would be the need for some peer discussion and external commentary to ensure that responses are appropriate: some tricky scenarios are presented. The need to include a range of core material can occasionally appear a little disjointed and it is essential that students recognise the connecting links. Inevitably in the rapidly changing policy context there is little reference to the latest developments triggered by personalisation and self-directed support, for example the debate about whether older people will embrace individual budgets with the enthusiasm of other groups. This will have to await the third edition.
Both these volumes give a refreshing and positive priority to the practice of social work with older people. They are written in a clear and engaging style and, whether through the case studies in the second volume or the telling extracts from Margaret Forster in the first, draw the reader, in this case the student, directly into the tensions and dilemmas that they are likely to encounter. They should perhaps be considered as successive texts, Social Work with Older People offering the essential overview for the student at an introductory stage, while Critical Issues in Social Work with Older People refines the discussion further, elaborating the strength of a critical perspective.