As easy as ABC? Social Work Interventions in mental health & mental capacity practice with older...
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Transcript of As easy as ABC? Social Work Interventions in mental health & mental capacity practice with older...
As easy as ABC? Social Work Interventions in
mental health & mental capacity practice with older people
presentation
• Worldwide and local interests in mental health in later life
• Listening to experiences and to practitioners• Uncertainty over social work roles, practice• Huge opportunities
– Abuse
– Better
– Care Homes
– Decisions
– End of Life
Mental health in later life
• Rising interests in dementia
• What about people with MH problems that continue with ageing?
• Mental health problems facing carers
Overshadowing of depression by dementia - but serious
‘When depression hits me the last thing I want to do is to see the doctor, because it seems hard to define anything as ‘wrong’.’
UA Fanthorpe 1996
An ordinary city: Bristol
• Number of people aged 65+ likely to have dementia 4,140
• Number of people aged 65+ likely to have depression 6,000 – 9,000
Energy is gradually returning and with it increased focus and perhaps a self- confidence that it is repairing itself. My depression could be worse, my demon more angry. Yet I remain fragile and need my refuge. There is nevertheless a desire to move out of my existing victim status…Doom does not overwhelm me, but remains my back-drop every hour of the day.
M Eastman 2005
Why more interest in dementia?
• Tell me !
• Political recognition eg Dementia Strategy
• Popular culture
• Social work interest – making decisions
• Media spotlight
• Pharmaceutical and care industries
• Cure hopes
In contrast, depression
• Contagion thesis ?
• Negativism
• Moral failing
• Easy to miss
• Hard to help
• Less popular, political interest
• Fewer pressure groups
Reclaiming the past?
• Neglected of history of medical social work and psychiatric social work with ‘chronic and incurables’
• Depression and social work: a call for evidence, action, & engagement
A Abuse
• Social work role in construction
• Research around prevalence and risk factors
• Practice often around assessment and intervention
• Very little on practice of safeguarding
• Especially around ‘perpetrators’
B Better
• Upping the social work game
• Almost impossible to work out where social workers are and what they do in research
• Very little on user produced outcomes but promising area
C Care Homes
• Social work shady history – taking for a ride
• ‘Failure’ of community care
• Liberation or reclaim care homes!
• What do residents and supporters and staff want
• Some developments but need capturing
D Decisions
• Newly emerging area in which practice in later life can be key
• In assessing capacity and promoting this
• In best interests decision making
• In working with conflict and complexity
• England – renaissance through Mental Capacity Act 2005
E End of Life
• Not always predictable• Distress, stress, anger,
but work that is rewarding and skills needed
• Capitalising on hospice social work
• Social work as bridge between medical specialities, family and individual, and case managing death at home
• 'My husband wanted to die at home but the nurse convinced me that he would be better cared for in the hospice. I regret that decision now, I feel guilty, he had no choice or control at the end‘ (SCIE)
Concluding comments
• The potential for innovation is huge
• Capturing it is important
• No shame in cost-effectiveness
• Great scope for education, practice, team working, managing and leadership
• As easy as ABC
