Person-centred approaches to social work with older people: Aspirations and contradictions
Lawrence et al. (2009) report that in internationally developed countries there have been moves to provide care in the community, with the majority of people aged over sixty-five increasingly living on their own or with family rather than in institutional care. Social workers can potentially make a significant contribution to the work of inter-professional teams seeking to assess and meet the needs of older people. This chapter considers the role of the social worker in relation to person-centred approaches to the assessment of need and to the planning of care, within the general current health and social care policy context emphasizing choice and independence. This policy direction appears to be in tune with what older people want. Tanner (2009: 108) suggests that a central concern for older people is the ability to ‘keep going’ by sustaining their perception and experience of independence. This may be achieved by maintaining the aspects which preserve their experiences of quality of life in the face of the various difficulties they may encounter. Tanner’s review of research literature on older peoples’ perceptions of quality of life reveals that this is often related to a number of recurring themes, including the significance of social relationships, social role and activities, health, a positive psychological outlook, home and neighbourhood, financial circumstances and independence. She reports that overall older people value low-level support which enables them to continue living in the community in their own homes, to be able to get out and maintain their social networks and to feel safe in their neighbourhoods. Holloway and Lymbery (2007) also acknowledge that older people have these aspirations regarding maintaining their quality of life, noting:
The global trend towards community and home-based solutions seem to be generally what people want, delivered in ways which are flexible enough to allow them to shape their own package of care. The emphasis on making the service user central to the process of determining needs and appropriate services of care is a key theme in twenty-first century health and social care systems.