The historical perspectives on social work incorporate the idea that it could simply be reduced to common sense of experienced mothers, but the modern understanding of social work moves it far beyond this narrow interpretation. Nowadays, “social workers constantly try to make a positive difference to service users’ lives and support community members in a variety of ways” (Stepney & Ford, 2000, p.xiii). In this process, a balanced combination of theory and practice is required, while practice standards used to protect the individuals in society and enhance social justice are based on the solid body of theoretical perspectives, frameworks and principles. The practical aspect of social work (which is literally the focus of this field) must be underpinned by the sound knowledge base, i.e. theoretical foundations, relevant values and skills which maintain the high standard in provision of these services and prevent the social worker from conflicts with other agencies, laws and institutions. Facing numerous situations, social workers have to understand the extent to which their personal aspects of values effect their professional inclinations. Given importance of values and skills application to the practice of social work, particularly, in Mrs. Yoshinaga’s case, the present essay will address the values and skills relevant for this specific case and analyze theoretical underpinnings of social work practice in this case. Identifying the appropriate theories applied to this case, one will be able to clarify the direction of social work and use necessary skills to preserve the relevant values.
In British social work, manners of theory application and attitudes towards different theoretical models of social work underwent numerous changes in the course of the twentieth century. All these theories were concerned with what kind of knowledge should be used in identifying and solving social issues. Particularly, the considerable input of sociological knowledge and non-discriminatory ideas into social work practice should be emphasised and applied in practice.
As Vass and Harrison (2004, p.14) note, “an understanding of poverty, crime, mental illness, deviance, substance abuse, racism and violence has been facilitated by the input of sociological theories into social work's knowledge base”. Thereby, the social workers should have and be able to apply this knowledge in practice in order to relieve social issues faced by their clients.
As stated by the BASW (2014, p.7), “the social work profession draws on theories of human development and behaviour and social systems to analyse complex situations and to facilitate individual, organisational, social and cultural changes”.
Experts in the field of social work are determined to promote positive social change and address issues in human relationships while empowering service users themselves to enhance their life and well-being (Nygren & Blom, 2001, p. 370). This specialized field of training is rests upon the inherent respect for human dignity and is realised through the support of the human right to participation, self-determination, and making choices concerning their life. Service users, as in the case of Mrs. Yoshinaga, should be viewed as equal, which provides grounds for implementing a nondiscriminatory solution.
For instance, an individual cannot be isolated from a social, cultural, family and natural perspectives within which they exist, and this context is to be taken into account when constructing practice. In addition, human rights conventions and frameworks are also a fundamental source of knowledge that helps challenge negative ageism in modern culture.
Professionals are concerned with the improvement of the welfare and needs of service users and clients. Sufficient knowledge and a proper grasp of these skills, values, and experience are imperative to work successfully with service users and their carers. This case requires specific skills, values, and legal regulations for both the client and her caregivers to improve her welfare, health status and understanding of dementia as her age-related condition.
The values employed in solving cases are dependent on the type of case and the approach used in the intervention. Prinsloo (2014, p.445) lists the key values which are to be integrated in social work practice with service users of different demographic characteristics: “acceptance, unconditional positive regard, respect, equity, self-determination, a non-judgemental approach/attitude, as well as the practice of concepts such as confidentiality and objectivity”.
In other words, the value system used in social work practice incorporates values aimed at elimination of discrimination and differential treatment, even though social work often presupposes working with social groups which are marginalized in this way or another. In the case study of Mrs. Yoshinaga, a skilled worker may be prompted to use values and responses that do not discriminate against her as a service user and an equal individual.
Furthermore, the key values listed in the ethical code of the British Association of Social Workers (2014) include human rights, social justice and professional integrity, which means that the social worker should balance enhancement of the client’s wellbeing, non-discriminatory treatment, challenging unjust policies, considering all judgments carefully and recognising the client’s right to self-determination (HASW, 2014, pp.8-10). In fact, all these values are to be applied in the present case study.
A social worker is expected to gain consent from the service users and work toward protecting the interests of the client while keeping in mind the principle of confidentiality. Furthermore, the professional should work within his/her competence and maintain professional boundaries and be accountable for the possible outcomes of the decision made by the clients with his or her assistance. Moreover, following the principle of challenging discriminative policies and practices, the social worker should be ready to instruct potential caregivers of Mrs. Yoshinaga about the need to apply non-discriminative and respectful strategies in care.
This is extremely important both for residential and home care, for caregivers often tend to treat elderly patients with neglect or ageist prejudice, underestimating their needs and abilities. Yet, the woman’s dignity, strengths, and abilities should not be downplayed.
Considering that the social work discipline is underpinned by certain necessary skills, values, and theoretical approaches, it becomes imperative to employ the most appropriate skill set in the case (Gray & Webb, 2013, p. 67). For instance, in the present case study, a thorough analysis needs to be conducted to evaluate and compare appropriate theories and approaches that can be employed in tackling the issue.
While the category of orienting theories underpinning social work practices encloses knowledge borrowed from different field including biology, sociology and psychology, there is a need to seek out and consider theories which orient the decision-making process.
The theory that might orient the social worker in the attitude towards the needs of the service user is the developmental perspective, for it outlines the key changes occurring in late adulthood as the concluding stage of development and also explains the needs and concerns of the individual on this stage.
Ageing is a sensitive process tied to cognitive and physical changes as well as to changes in the individual’s patterns of social interaction. In this respect, the activity theory developed by Robert Havighurst in the early 1960s emerges in the discourse as the theory defining the humanistic standards of ageing. According to this theory, elderly people experience disengagement from society and are likely to age successfully and maintain the decent quality of life as long as they stay socially active and engaged in various types of social activities (Schulz, 2006, p.9). Emile and colleagues (2014, p.199) summarise findings of the rather ample research on the topic, stating that engagement in various types of activity in elderly adults is associated with successful ageing and life satisfaction. At the same time, the authors support the activity theory of ageing with the evidence of better mental and physical health in the elderly as a result of active lifestyle, participation in social activities and internalization of positive attitudes towards ageing. Here, it should be added that the more positive attitudes towards ageing are held by the elderly, the higher levels of physical and mental health are observed in this group (Emile et al., 2014, p.199). Based on the aforementioned findings, the social worker could refer to the principle of protection of dignity and self-worth and consider an option of counseling for the discussed service users – Mrs. Yoshinaga and also her children – in order to improve their attitudes towards ageing. For Mrs. Yoshinaga, this aspect of social work could be especially helpful in light of the theoretical framework mentioned above.
However, the limitation of the activity theory which emerges in the discussed case and should be taken into account by the social worker is the fact that there are not always sufficient opportunities for the elderly to stay engaged is social activity and physical activity in particular. Mrs. Yoshinaga has issues with mobility due to her injury and this raises the risk of isolation. Thereby, the social worker should consider this limitation in encouraging and designing social activity plans for the woman so that she could stay connected and active despite her physical issues.
For the elderly woman in the case study, withdrawal from social life has been aggravated by the loss of her closest social relation, her husband, and distancing on the side of her children. In seeking solution for the problem – either placing Mrs. Yoshinaga in residential care or letting her live at home – the social worker would consider the aforementioned theoretical perspective and mind the service user’s unique needs in the given developmental period.
Another theory underpinning social work in relation to older adults is, of course, ageism: “Within western cultures, old age is considered a 'problem' and as such ageism becomes evident” (Hanson, 2014, p.225). Kite and Wagner in their overview state that ageism in relation to older adults is largely represented by the combination of three factors: feelings towards older people, stereotypes held in relation to them and their age, and behaviors displayed by society towards them, i.e. commonly differential treatment (Kite & Wagner, 2004, p.131).
In the modern popular culture and society as a whole, people hold negative sentiments about the elderly: the old are regarded as frail with little or no contribution towards the economy, while youth is regarded as a ‘gold’ standard. Old age is also associated with mental retardation, lower intellectual capability, physical decline and decline in memory. As such, elderly people are viewed as incapable of making their decisions independently, while young people often develop attitudes of avoidance towards their elderly relatives and acquaintances.
Declining health and cognitive abilities are perceived as an inevitable part of getting old in popular culture and, therefore, when a senior person complains of being sick, he/she is usually ignored or given sub-standard treatment. Given high relevance of this theoretical approach, the social worker should always keep in mind people’s propensity to ageism in treatment of older adults, for this theory turns out to be important in identifying the key negative dispositions which might affect the outcome of the social work.
Dementia cases require one to be knowledgeable and experienced and have empirical background regarding the disease. Social science knowledge originates from a variety of sources. A social worker is expected to be well-informed and aware of The Social Care Act 2014, Equalities Act, Human Rights Act 1998 as well as global, national and local policies regarding dementia and the elderly. Also, there is the need for practical knowledge derived from empirical research, reflective learning, experience, intuition, and natural knowledge. Also, a social worker will require theoretical knowledge that drives practice accumulated through various disciplines and models of intervention.
Additionally, professionals are required to update their knowledge and skills continually remain abreast with the relevant social conditions and trends: in the case at hand, it is, of course, the tendency of ageism which has been burdening elderly population recently. Evaluating this skill, one could note that this field of research has been rather popular in the recent years, and the new findings in psychological research could be informative for the social worker in the process of strategy development. At the same time, in any case involving human beings, a social worker should be able to manage risk and inform clients when things get out of hand.
Such conducts will enable one to maintain a trustworthy relationship between the clients and the social worker. In this context, a social worker should be in a position to address Mrs. Yoshinaga’s concerns and those of her children without being discriminative and be aware of the possible risks for the service user in case the issue is not resolved (for instance, if Mrs. Yoshinaga is taken to residential care and is disregarded by her children).
Old age is greeted with stereotypical receptions which have led to the tendency of mistreating this group of individuals or treating them negatively (Hanson, 2014, p.225). Just like sexism and racism, ageism has been internalised by senior citizens themselves leading to lowered self-esteem and self-despise among this group of persons. At the same time, “in the last decade health organizations have emphasised self-esteem as a central component of mental health” (Ferreira et al., 2013, p.7).
In light of this, the anti-discriminatory and anti-oppressive values in social work are instituted to help promote social justice and offer non-discriminative services to all service users (Nygren & Blom, 2001, p. 380). These values are relevant as they assist in challenging traditional beliefs that have led to isolation and discrimination of the elderly from the mainstream society. At the same time, deploying anti-discriminative values is critical for preventing Mrs. Yoshinaga’s mental health from further decline.
The scope of the discipline encompasses many defining skills and values across the practice profession. The need to establish clear directions when working with patients with dementia is based on legal and ethical guidelines. Social work is grounded in human rights and equality. The primary role of the discipline is fair distribution of resources and services among service users. Individuals with nervous system disorders are entitled to live just like other persons, and humanist perspectives should be foundations of social work practice. Professionals working with this group of persons are tasked to protect this right without administering high or lower dosage of drugs which would result in harm to human life.
Joe and Sally dismiss their mother’s idea of going home thus defying her right for freedom and independency in decisions. The role of a professional in this context could be to use proper legal and ethical guidelines to help both Sally and Joe understand the importance of respecting human rights. This means that that the social worker should resort to the relevant human rights frameworks and ethical principles as well as to skilled communication in order to assist Mrs. Yoshinaga’s children in making a right decision rather than to make this decision for them.
At the same time, the social worker should not forget the value of human safety and biological aspects of developing dementia in encouraging the decision concerning Mrs. Yoshinaga’s future. While the woman finds it difficult to take care of herself in daily life, the children might be offered an option of involving a qualified caregiver for their mother.
Communication is important in the delivery of social services, skills such as speech, listening, body language, and encouragement are also crucial for this case. A skilled worker should be able to create a conducive atmosphere that will encourage the client to talk by being through listening attentively guiding them through the session.
Additionally, the client should be motivated to continue talking by the social worker’s nodding the head, maintaining eye contact, allowing the client to speak, and speaking in an encouraging tone. More important, a skilled worker should demonstrate that he/she remembers what the client is talking about by clarifying points.
Communication is an important skill that creates trust and promotes transparency among the involved parties. In Mrs. Yoshinaga’s case, excellent communication skills will enable the client to establish trust and open up more regarding her feelings and concerns. On the other hand, communication might be even more salient in relation to the woman’s children, for – in modern society – they are perceived as more adequate and capable of sober decisions than their elderly mother.
Professional behaviors and actions are guided by a professional code of ethics which govern a social worker on what is right and wrong in the provision of services when dealing with individual clients to enhance an individual’s welfare and health (Gray & Webb, 2013, p. 69). Ethical issues may arise in case if a skilled social worker concerned with the welfare and rights of the individual turns out to develop a solution contrary to the expectations of the client, though the client’s health condition might be salient in decision-making. For example, Mrs. Yoshinaga is anxious to go home, but her mobility and memory are deteriorating, placing her at risk if she has to live in isolation. Such ethical issues require a mastery of social work ethics and standards.
Apart from the theoretical perspectives applied to Mrs. Yoshinaga’s case, the social work method to be used is definitely the problem-solving method: its primary strength for such social work tasks is that it presupposes instructing services users on how to make a good decision rather than defining the solution on the side of the social worker, i.e. it positions the clients in the stance of active agency rather than deals with them as with passive objects.
Sally and Joe should also be advised to visit their mother more frequently at her home as this can contribute to her healing. Moreover, given the activity theory approach, frequent visits are likely to enhance the woman’s social involvement and allow her to be engaged in communications and leisure activities which might prevent further deterioration of her mind.
Self-awareness is a valuable skill in Mrs. Yoshinaga’s case. Professionals just like other people are born and brought up in the current popular culture which is full of prejudice and negative stereotypes about old age. Therefore, it is rare for humanitarian officers to escape the judgments about the elderly and ageist, oppressive, and discriminatory stance – these perceptions often pass to professional activity by inertia.
Thus, a constant critical reflection will be a significant tool in dealing with social issues such as with the elderly. Professional workers are required to check oneself constantly in action and reflect on the course of action so that anti-ageist values are observed. A skilled worker should be aware of personal values and judgments that could result in discrimination and differentiate between personal values and general values enclosed in social work practice.
Counseling skills are a requirement to provide quality services to the senior citizens in the society. Mrs. Yoshinaga needs to be counseled regarding her condition to enable her to make the right decisions and help her cope with her condition. Empathy, non-judgmental attitude, understanding, and warmth are necessary skills for a conducive environment that will enable Mrs. Yoshinaga to express herself without being judged. Sally and Joe should also be counseled to obtain more information regarding their mother’s condition from them. This service will enable them to appreciate the importance of family support for their mother’s health and welfare (Nygren & Blom, 2011, p. 387).
Individuals with nervous disorders face some issues that range from lack of independence in one’s life, privacy issues, isolation, discrimination, and diseases. Dementia is on the rise in the modern society, while statistical data indicate that dementia and its related symptoms are more prevalent among the elderly as in the case study. The need for specialised services among caregivers is a necessity as this group is faced with an array of difficulties in their care role. Mrs. Yoshinaga’s case is one such example that requires specialized intervention to improve her health and welfare without neglecting her right for participation and avoiding discriminative treatment. It could be concluded that the main task of the social worker in the present case study is to apply theoretical knowledge (especially, theories of ageing and development) to the problem-solving method of social work with careful consideration of values and ethical principles. At the same time, the social worker is expected to demonstrate self-awareness, profound knowledge of developmental and behavior theories, and accountability for both risks and outcomes of the decisions made with his or her help. Even more, treatment of the elderly is a very sensitive issue where stereotypes are difficult to outcome, which makes the observation of non-discriminative norms literally the most important facet of social work practice in the given case.
References
Emile, M, Chalabaev, A, Stephan, Y, Corrion, K, & d'Arripe-Longueville, F 2014, 'Aging stereotypes and active lifestyle: Personal correlates of stereotype internalization and relationships with level of physical activity among older adults', Psychology of Sport & Exercise, vol. 15, no. 2, pp. 198-204 7p. Available from: 10.1016/j.psychsport.2013.11.002. [27 June 2016].
Ferreira, J, Teixeira, A, Massart, A, & Filaire2, E 2013, 'Assessing Self-Esteem and Perceived Physical Competence in Elderly Using the Physical Self-Perception Profile', European Journal Of Adapted Physical Activity, 6, 2, pp. 7-18, SPORTDiscus with Full Text, EBSCOhost, viewed 27 June 2016.
Hanson, RM 2014, ''Is elderly care affected by nurse attitudes?' A systematic review', British Journal Of Nursing, 23, 4, pp. 225-229 5p, CINAHL Complete, EBSCOhost, viewed 27 June 2016.
Gray M, & Webb, SA 2013, Social Work Theories and Methods, 2nd edition. Sage. [Online] Available at https://www.academia.edu/2541988/Social_Work_Theories_and_Methods_-_2nd_Edition [Accessed June 25, 2016]
Kane, M, & Cook, L 2013, Dementia 2013: The Hidden Voice of Loneliness. Alzheimer’s Society. [Online] Available at https://www.alzheimers.org.uk/site/scripts/download_info.php?fileID=1677 [Accessed June, 25, 2016]
Kite, ME, & Wagner, LS 2004, ‘Attitudes toward Older Adults’, in Nelson, TD (ed.) Ageism: Stereotyping and Prejudice against Older Persons. Cambridge, US: A Bradford Book, 2004. ProQuest ebrary. Web. 25 June 2016.
Nygren, L, & Blom, B 2001, ‘Analysis of short reflective narratives: a method for the study of knowledge in social workers’ actions’, Qualitative Research, 1(3), pp. 369-384.
Prinsloo, RC 2014, 'Social Work Values and Principles: Students' Experiences in intervention with Children and Youths in Detention', Journal Of Social Work Practice, 28, 4, pp. 445-460, OmniFile Full Text Select (H.W. Wilson), EBSCOhost, viewed 25 June 2016.
Schulz, R. (2006). The Encyclopedia of Aging: Fourth Edition. Springer Publishing Company.
Stepney, P, & Ford, D (eds.) 2012, Social Work Models, Methods and Theories: A Framework for Practice. Russell House Publishing.
The British Association of Social Workers [BASW] 2014, The Code of Ethics for Social Work. [Online] Available at http://cdn.basw.co.uk/upload/basw_95243-9.pdf [Accessed June 25, 2016]
Vass, AA, & Harrison, B (eds.) 2004, Social Work Competences: Core Knowledge, Values and Skills. London, GB: SAGE Publications Ltd.
