As a licensed clinical geriatric social worker and co-owner of Right at Home in Northern Virginia, Colleen Turner has a passion for helping older adults manage life well. In her private practice, Colleen provides mental health therapy for elders who have anxiety and depression. She also supervises social worker candidates as they prepare for their licensing exams. Here, Colleen addresses common questions about the field of geriatric social work.
1. What is a geriatric social worker?
A social worker is a trained professional who is able to assess individuals, families and entire holistic situations; listen to their present needs; provide alternatives or possible solutions; and then be ready to help implement those solutions as people want. A main focus of social work is self-determination, helping a person maintain their independence and right to make their own decisions as a competent adult. As a social worker, you’re looking at the micro level—you’re looking at the person physically and at their environment and what basic needs they have. You’re also looking at the person’s family to see what support systems the person has and what may be needed. And you’re looking at the macro level such as the person’s religion and culture to see what also may be presenting challenges to them.
Social workers can choose to focus on a specific field. You can be a school social worker, or you can work in geriatrics, or you can work in substance abuse. A geriatric social worker is a social worker with expertise in the field of geriatrics, or the care and health of older people.
2. When should someone consult with a geriatric social worker?
A person should consult with a geriatric social worker whenever there are physical or emotional needs, conflicts or resistance, or safety concerns that the individual or the family cannot resolve alone. Many times people work with a geriatric social worker when facing a crisis. They’re in the hospital, or they just got into a car wreck, or another crisis brings them to seek help. Actually, it can be very valuable to have a social worker as part of your care team before a crisis hits, for example, to help you write your advance directive and help make sure things are in order with end-of-life decisions.
3. Why work with a geriatric social worker in particular?
The professional geriatric social worker is going to know the geriatric population and can distinguish between normal and abnormal aging. One example of normal aging is that it takes longer to process information, and it’s harder to hold a lot of information in the brain. But that’s not to say that you have dementia. The difference is that with normal aging, the memory will come back; the information can eventually be retrieved. But with dementia or abnormal memory loss, the memory will never come back. You can’t access the information bank at all. When we see our loved ones slowing down, we think, “Oh, Mom’s getting dementia,” but it may just be slower processing speed. It can work the other way, too. We think, “Oh, it’s just normal aging,” when it’s really dementia or another cognitive condition.
A geriatric social worker is also familiar with the community resources available in the local area. For example, a geriatric social worker would be able to refer older adults for home care services when they need safety oversight or assistance with personal care.
4. Do geriatric social workers operate under professional standards?
It is important to know that there is a guiding code of ethics that is the same for every social worker and a board of social work in every state. The Social Work Code of Ethics includes respect, understanding, empathy, professionalism and the best interests of the client. Social workers take state exams that include different examples of case scenarios that require knowing and following the code of ethics to determine the right solution for each of the scenarios presented.
5. How do you find a geriatric social worker who can help?
Check with your county or city Area Agency on Aging or your state board of social workers. You can also ask your doctor or other care providers. If you use hospice services, they have their own social workers. You can call the intake line of a country social worker, as well, and ask, “Do I qualify for any services that the social worker can bring me?” A lot of county agencies provide very minimal, basic-needs services as an entry point to get the oversight of a social worker in the home. For example, with Meals on Wheels, your meals are delivered, but they also provide a social worker who does an assessment to see if there are other needs to be taken care of, as well as reassessments by a social worker to see if there has been any change. That’s the holistic picture the social worker looks at, as opposed to a silo approach.
6. How can a geriatric social worker help reduce my cost of care?
When a social worker does their assessment, they are going to look at the needs. But because the social worker is always serving the best interests of the client, the social worker will suggest the least amount of intervention at the least cost. Besides financial costs, another cost to consider is loss of independence. For example, instead of moving someone who lives alone to a care facility, maybe all they need is an alert system in their home and a designated friend/family member who can be contacted in case of a fall. When a social worker does propose a plan, it’s always good to have family buy-in, which may take some navigating on the social worker’s part when reminding everyone to keep the loved one’s best interests at heart and mind.
7. Who pays for geriatric social work services?
Most often medical providers or a skilled care agency can provide medical social work for geriatric patients and Medicare will reimburse for the cost. The Medicare funds can be divided into physical therapy, speech and language rehabilitation, and/or a medical social worker. Rarely does social work require private pay from individuals. Also, a social worker can help with the application process for Medicaid, Medicaid waiver programs or a long-term insurance policy. A social worker can discuss with a person their physical needs and financial resources and help them determine if they qualify and should apply for any of these.
8. Can a geriatric social worker help me with my advance directive?
Yes, they can. I don’t think any state requires you to have an attorney write up your advance directive, or what’s known as a medical power of attorney, which is your written statement of your wishes for medical treatment in case you can no longer communicate them. When you’re talking finances—the durable power of attorney—for that you would need an attorney, but not the advance directive.
9. What are common misconceptions about social workers?
The No. 1 misconception is that people think we can administer anything, and we can’t. We’re not RNs. We can’t take blood pressure, vitals or anything like that. We’re not trained to do that. We can’t change diapers for you. We are there to present options, not make you do anything. There can be a misconception that social workers are like police and can come in and say, “You’ve got to get out of here.” And we do that with children, but not with adults. Even adult protective services can’t order an adult out of a living situation unless the person is found to be incompetent. There are checks and balances and a lot of state oversight. A hospital social worker can’t just send somebody home. The state says, “Where’s the safe plan? Where’s documentation of the safe plan?”
10. How do I convince my loved one to accept a geriatric social worker?
When you decide to seek social work services, you can contact a social worker to arrange a home visit. Many times, the loved one will resist the initial visit and say, “We don’t need anybody out here. We don’t need that.” And a lot of times, you can tell the older adult that the county has hired this whole department of social workers who are ready to provide oversight and ensure their safety and the safety of other seniors like them, so they’re entitled to it, and they’ve paid their tax dollars for it. Then the older adult will let the social worker visit. But there is still getting past the older adult’s suspicion that the social worker is just going to make them go to a nursing home. This line of thinking is very real among older adults. So building trust with a care client is the first challenge.
With home care agencies like Right at Home, I think one of the best staff members to have is a social worker who can be the first one to help a client identify needs right now and develop a care plan that will work for the client going forward. The social worker can discuss timing for home care and how to plan for change, and can be ready with ideas now for when things change in the future.
About the Author
An award-winning journalist who has documented stories in nearly 20 countries, Beth Lueders is an author, writer and speaker who frequently reports on diverse topics, including aging and health issues for both U.S. and international corporations.