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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

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As easy as ABC? Social Work Interventions in mental health & mental capacity practice with older people

  • 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

Mental health in later life
overshadowing of depression by dementia but serious
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
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
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
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

Reclaiming the past?
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’

A Abuse
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

B Better
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

C Care Homes
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

D Decisions
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)

E End of Life
concluding comments
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