‘Being there’ for the long haul and ‘being persistent and consistent’ are also important. User-generated evidence suggests that what matters to older people are the social work skills of: advice and advocacy, negotiation with agencies and services, psycho-therapeutic support, signposting and practical guidance (Beresford, 2007). Studies by Moore et al., (2014), Albert et al., (2002), Challis et al., (2002) and Engelhardt et al., (2006) suggest that social workers’ effectiveness is based on a combination of skills, including assessment, knowledge about local resources, and the ability to provide counselling and/or ongoing support. It is strongest in relation to social work in palliative care and health care settings as noted by Moriarty and Manthorpe in their recent review of the effectiveness of social work with adults (2016). There is some evidence about the effectiveness of social work with older people. Advocating for the rights of older people to ‘take risks’ and gain access to high quality services are also key roles. In addition to those skills all social workers have, gerontological social workers should have specialist knowledge and skills including: understanding the ageing process and models of ageing appreciation of the impact of age-related health issues, losses and transitions recognition of the (often) interleaving nature of need and care in later life skills of communication with people with advanced dementia and a willingness to engage with the lived experiences of the older person (and their carer) and adopt a biographical lens on the assessment process (Ray et al., 2015). Social workers also have a ‘bigger picture’ responsibility to promote social justice for disadvantaged older people, address abuse and the causes of abuse, recognise the role of life course and age-related inequalities in creating or perpetuating ill-health, and challenge discrimination – specifically ageism. Its main focus is on understanding the physical and mental health challenges that older people may experience in context: personal, family, home, socio-political, societal and legal and cultural. Social work has a key contribution to make to improving this group of older people’s quality of life and wellbeing promoting autonomy, independence and dignity and helping to deliver personalised care. There are increasing numbers of older people (mainly very old) living with complex co-morbid conditions, such as dementia, who need support to manage daily living.
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