Case Management
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Human Services for the Older Adult 

3- An aging assistant to specialists who deal with the client. Netting and Williams (1998) did an article on the need of social workers to

 

work with primary care physicians. Specifically looking at geriatric

 

care managers in nine demonstration projects, they propose a

 

stronger relationship in social work education to working with

 

medical professionals in a harmony that would be better for the

 

patient/client. Giving the example of how nursing education is

 

structured, they suggest social work follow that model in preparing

 

students for the real world practice within the existing medical model.

 

They note that social work has been involved with health issues since

 

1900, but it still needs to improve its' relationship with medical

 

personnel. They also make an interesting statement: “We envision

 

recruiting RNs to MSW programs.” They see a future welding of the

 

two professions in a much more dynamic way than has currently

 

been accepted by either profession. But if it is more serviceable to

 

the patient/client, then gearing the education towards that end needs

 

to begin now.

 

 

      One unmet area of assistance for most older individuals is in

 

planning for person-environment fit. Many homes need to be altered

 

as the individual may decline in health as they age.  Although most

 

retirees stay in the same city after retirement, they may change 

 

housing options. Fixing up a current residence to accommodate

 

age-change needs is the most frequent option. (About 7 of every 10

 

older head of households own their home). This might include

 

placing handrails in bathrooms and changing bedrooms to main-level access. 

 

      Some retirees, especially in the early years of retirement, turn to

 

travel trailers, RVs, and other mobile residence life-styles. This may

 

be done on a group scale as "caravans" create support in traveling.

 

      Multiple-residency options also exist, with retirees having more

than one of "their own places" or living at times with relatives (usually

children). "Grandma Apartments" are a frequently chosen option.

The apartment can be freestanding or adjoining with the children's

home with a private or common entrance.

      Public housing units for older persons, with subsidized rental

 

costs, are found in most cities, even in smaller towns.

 

4- A facilitator to help bring about behavioral change, if necessary, for the benefit of the older adult. William J. Hoyer and associates, (2003), charts suicide rates by age, gender and race. From the age group 65-74 and above, white male suicide rates climb very dramatically with only a modest increase for non-white males and

 

nearly no growth in the rates from white women and non-white

 

women. By age 85, his chart suggests that nearly 60 older white men

 

commit suicide out of 100,000 people in the population. Non-white

 

men top off at about 18 / 100,000 in the 25-34 age range and are

 

only about  10 / 100,000 in the years 85+. At no time do the women

 

exceed 9 / 100,000 in successful suicides.

 

      A Case Manager should be an empower specialist who helps clients grow more independent. In Article 40: "Elder Care: Making the right choice," in "Annual Editions: Aging," (2002)  John Greenwald lists useful web sites, gives a table to help in decision making, and illustrates "Making a home senior-friendly." Some in the Private Sector have begun to see that home remodeling to influence person-environment fit for older people makes good sense and good profits.