What do you think of when you hear the
phrase ‘aged person’?
What is an ‘aged person’?
What do they look like?
Where do they live?
When I searched for some ‘clip art’ for these
PowerPoint slides using the search terms ‘old
people’ and ‘elderly’ – the images below were
the ones to pop up.
Which stereotypes about ageing do you think
most of them represent?
What do you think these images convey about
Ageing and disease should not be equated
(Hammond & Jilek 2003, cited by Wiles 2005, p.167)
Less than 25% of elderly people (75+) have a
disability requiring outside assistance
(McCallum & Geiselhart 1996, cited by Wiles 2005, p.167)
Age does increase vulnerability
to a range of health problems
though difficulties are not
‘Older people do not require social work
because of their age but because of disability,
lifestyle and loss issues as they age. Social
work responses can be as diverse as the older
population itself. Social workers play pivotal
roles in the provision of a range of social,
health, housing and financial services, and in
assisting older people in adjusting to the
transitions and losses of older age. The work
of our profession is an important component
of government, commercial and not-for-
profit programs for older people’
(Naughton & Schofield 2013, p. 207).
Traditional settings for human services
work with elderly people
• Community health centres/ aged care
assessment teams (ACAT)
• Nursing homes & hostels
• Community care agencies
Background – aged care policy and
1901 – Federation – agreement on need for national support
system for aged people
1909 – payment of age pension commenced
The old age pension ‘more than any other factor… defined old age in early 20th
century Australia. In taking the pension an old person entered into an implicit
contract to retire from the workforce’ (Davison, 1993, cited by Wiles 2005, p. 164).
Increased federal government funding for
expansion in number of nursing home beds
Aged care conceptualised as a medical problem
and residential care as the standard response
Some community / domiciliary
support services (e.g. ‘Meals On
1975 – Henderson Inquiry into Poverty – aged
people as the single largest group at risk of
Increased emphasis on community care
1982 – McLeay report – indicated the aged people were
often in residential care for accommodation/social
reasons rather than medical / health reasons. Argued
community care to be a more humane and cost effective
New ideology emerges – independence, community
care, reduced institutional care – ideals still influential
1985 – Home and Community Care (HACC) program
- Increasing proportion of aged people in Australian
- Increased awareness of aged care issues and consideration
in social policy, more social work research and practice
Go to the Australian Institute of Health and Welfare
website for an overview of changing demographics in
ABS – Population projections, Australia, 2002-2101
Increase in the number and proportion of people aged over
- Falling fertility
- Increasing life expectancy
- Effect of the baby boomer generation moving through older age
This trend will grow over the coming decades, to such an extent, that
- Number of people aged over 65 years will increase from the current
2.5 million to around 7.2 million by 2051
- Proportion of people aged over 65 years will grow from the current
13%, to one quarter of the population by 2051
- Proportion of people over 85 years will grow from the current 1.4% to
approximately 6% by 2051
- Proportion of the population aged between 15 - 64 years (labour
force age) will fall from the current 67%, to around 59% by 2051
‘The ageing experience may be considered with according to a range of
variables influencing the quality of life of the aged, including
socioeconomic class, gender, disability, ethnicity, diversity, and living in
rural regions. In terms of social class, there is little doubt that
inequalities experienced over the life cycle continue or even intensify
into old age’
(Wiles 2005, p.166)
- Women out-live men – world-wide trend
- Much social policy based on men’s experiences of
ageing, paid employment, parenthood, etc.
- Recognition of gender aspect of ageing often
In 2011, 36% of Australia's older people were
not born in Australia (ABS 2011)
Emergence of ethno-specific
services & culturally
appropriate practice guidelines
Psychosocial needs of aged people
Economic- housing, income, etc
Health – nutrition, exercise, health services
Social – staying connected with wider society, family, friends,
meaning in life
Emotional – meaning in life, loss & grief issues, respect
Cultural – lifelong learning, hobbies, communication, ethno-
Environmental – transport, accessibility, safe & secure housing
Policy reform in aged care service
Go to this ABC online site and view the video of this story.
Have a look at the latest aged care policy initiatives in Australia at the
Department of Social Services website –
Policy directions and issues in aged care in
1. Encourage self-funded retirement
2. Continued marketisation of aged care – user-
pays, community care a cheaper & preferred option
3. Health promotion for healthy ageing
4. Promotion of positive ageing
Theoretical perspectives on ageing (1)
Disengagement (1950s) - detachment from paid work and
community / public life in preparation for death, segregation into
‘old people’s homes’ - e.g. Cumming & Henry 1961.
Activity theory (1960s -70s) – successful adjustment to ageing,
continuing activities, health promotion & prevention, positive
productive retirement, increased community care – e.g.
Theoretical perspectives on ageing (2)
Continuity theory – commonalities across the lifespan, each
person unique, ageing increasing integration of life experiences,
e.g. Atchley 1976
Life review – (Butler 1963) – normal, constructive part of ageing,
the past is evaluated and reconstructed through storytellling
- Often goes unrecognised and untreated in elderly people
- Some might be organic, some might be reactive (to situations,
- Peak in suicide rates for elderly males 75+
‘The modern emphasis on family care, typically
recognised as per of the support offered by the
family, and especially female carers, is also
acknowledged as a product
of the retreat from state
responsibility for aged care’
(Wiles 2005, p.171).
The future of social work and human services
with elderly people
- Centrality of bio-psycho-social model
- Casework and group work
- Need for advocacy on social justice principles to advocate for the
- Awareness of policy context,
program reform, political action
Core social work, welfare and human service roles in working
with older people
• Counsellor – dealing with major life transitions, losses, chronic health issues
• Information provider / referrer – complex service systems, information needed on
options and associated costs, referrals to community service agencies
• Advocate – to get the best outcomes for clients, SWs often need to negotiate with
service providers and/or take action to advocate for an older person’s rights
• Assessor – assessment of need, making judgements about the capacities of carers
and social network to support the older person, thorough knowledge of services
and resources available
• Case manager – identification of needs, establishment and monitoring of service
plan to meet older person’s requirements to live at home. Managing complex care
situations, regular review.
• Service broker – selection and purchasing of most cost effective ‘packages’ of
services to meet client requirements, identification of individual service solutions,
focus on achieving maximum purchasing power
(Naughtin & Schofield 2013).
Specific areas of practice
People with dementia
Medical aspect – understanding the physiological and behavioural changes of the
The social aspect – how dementia is experienced by the individual and their social
network in the context of their cultural and community context.
Citizenship aspect – promoting the rights of people with dementia and recognising their
contributions as citizens, people with dementia as experts in dementia.
Expected increase in numbers of people with dementia –
220,000 in 2007 to 730,000 in 2050 (Access Economics 2009).
‘Whether practising with older people in the community or an institutional
setting, social workers are likely to be involved in the assessment and support of
people with dementia and their family carers across the spectrum from pre-
diagnosis to end-of-life care’ (Naughtin & Schofield 2013, p.215).
Specific areas of practice
Palliative care – the holistic response to people with life-threatening
illnesses or conditions when there is no cure; a team approach to
fostering maximum autonomy until death.
SW and human services roles include
– Supporting the person and/or their family through loss and bereavement
– Taking a system perspective – including responding to practical issues,
emotional and spiritual issues
– Counselling related to end-of-life decisions (Naughtin & Schofield 2013).
Specific areas of practice
• Elder abuse – emerging as a significant issue requiring
assessment of risk and vulnerability.
• SW practice in risk assessment, protection planning, advocacy,
criminal justice issues, social change
• Multi-agency collaboration, team work
• Mistreatment of elderly people is
(Naughtin & Schofield 2013). 28
Watch this… from the ABC in 2013
Royal Commission into Aged Care: Quality and
Announced on Sunday 16th September 2018
It is anticipated it will cover:
• The quality of care provided to older Australians, and the extent of
• The challenge of providing care to Australians with disabilities living in
residential aged care, particularly younger people with disabilities;
• The challenge of supporting the increasing number of Australians
suffering dementia and addressing their care needs as they age;
• The future challenges and opportunities for delivering aged care
services in the context of changing demographics, including in
remote, rural and regional Australia;
• And other matters that the Royal Commission considers necessary.
Australian Human Rights Commission (2012) Respect &
choice: A human rights approach to ageing and health
COTA - Connecting Over 50s Throughout Australia:
Alzheimer’s Australia. www.alzheimers.org.au
Department of Social Services – Media Hub –
Australian Bureau of Statistics – http://www.abs.gov.au
Access Economics 2009. ‘Keeping dementia front of mind: Incidence and prevalence 2009-2050’, report
for Alzheimer’s Australia. www.alzheimers.org.au
Chenoweth, L. & McAuliffe, D. 2015. The road to social work and human service practice. French Forest,
Giles, R., Irwin, J., Lynch, D. & Waugh, F. 2010. In the field: From learning to practice. OUP.
Naughtin, G. & Schofield, V. 2013. ‘Working with older people’. In Connolly, M. & Harms, L. (eds) 2009.
Social work contexts and practice. Melbourne, OUP, chapter 14.
Wiles, D. 2005. ‘Gerontological social work’. In Alston, M. & McKinnon, J. (eds) Social work fields of
practice. Melbourne, OUP.