Needs of the Elderly: A Case Study

Introduction

We live in an ageing world and Australia is not an exception. In 1901 only 4% of Australians were 65 and older, by 2016 that figure increased to 15.3% and is estimated to rise to 23% by 2041 (Australian Bureau of Statistics, 2016, Australian Human Rights Commission (AHRC), 2012). The United Nations (UN) principles of ageing, supported by the Australian Government, recognises the rights of all older persons, focusing in areas such as: independence; participation; care; self-fulfilment and dignity (Australian Association of Social Workers (AASW), 2013), but are we doing enough to protect these rights and ensuring our older Australians are not left disadvantaged? This essay looks at the case of Hank, retrenched from his ‘lifelong’ employer at the age of 62 with future employment prospects bleak. It looks at factors through the life course that effect Hank in his older years and discovers how Social Workers can respond to this demographic to assist them in continuing to fulfil a satisfying life.

Key Social, Psychological and Physical Needs

As a social worker, it is important to have an understanding of the key social, psychological and physical needs of the client plus any issues that may be present. In this way, a holistic and specific needs assessment can be made that identifies how a client situation affects his needs moving forward (Tanner & Harris,2008). Hank was retrenched from his workplace and is having difficulty finding a new job. The jobs he is experienced in are becoming unsuitable due to the onset of arthritis and without formal training, his employment prospects are bleak. There have been many studies linking unemployment with lower levels of well-being, and higher levels of distress, self-doubt and dissatisfaction (VanDerMeer,2014). Being unemployed can be detrimental to ones needs, not only because of lesser income but also due to the effects on psychological and social factors (VanDerMeer,2014). Societal norms and expectations also plays an important role in well-being, being employed helps us to feel we are conforming to those values and norms (Thompson,2016, VanDerMeer,2014). Men’s social identity is often centred around their work and although as a society we are shifting in our view of men being the sole bread winner, for Hanks cohorts, his role as financial provider gave him a sense of pride and sense of identity. Hanks friends, his social group, have remained at work, this puts added stress on Hank’s wellbeing, people who are unemployed are better able to cope when others around them are in the same situation (Clark,2003).

Human Rights and Legislation

Hank, like all Australians, have a universal right to employment regardless of factors such as culture, gender, age and disability (Ife,2012). The Australian Government, through the Australian Human Rights Commission, has agreed to uphold the UN covenants on human rights. Although there is no international covenant in the area of ageing, the Universal Declaration Of Human Rights (1948, art.23) and the International Covenant On Economic, Social And Cultural Rights (1966, p.3,art.6) states that everyone has the right to work and be paid without discrimination, and that protections should be in place against unemployment. Federal legislation in place to uphold Australian Human Rights include the Australian Human Rights Commission Act 1986 and Age Discrimination Act 1992. In Victoria, workers’ rights are protected through the Equal Opportunity Act 2010, which includes Age and Disability. Adhering to such rights gives all people a sense of human dignity, a value held by the Australian Association of Social Workers (AASW) in its code of ethics (2010). These protections should be an advantage to Hank but unfortunately, in reality age discrimination, modernisation and globalisation often make it difficult to apply.

Impact of Structural and historical Factors

Although ageing happens to us all regardless of race, culture, gender or class, these structural factors, economic and social policies, plus experiences throughout the life course, often have a significant influence on later life (Hughes & Heycox,2010). That influence, restrained by economic and social policies, has the ability to limit choices and opportunities that impact on ageing (Bengtson & DeLiema,2016). Australia’s increasing population and its effect on the dependency ratio (the portion of population who are too young or old to work by those of working age), will also have an impact on factors such as housing, medicare, Centrelink, superannuation and age care.

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If Hank turns 63 in 2017, he was born in 1954, the baby boom generation. The year of birth is not only important in determining Hanks generational cohorts and possible life course experiences, but also in determining his eligibility for services such as the aged pension and superannuation release. The baby boomers were so called due to the raise in babies born during and post world-war II – 1943 -1964 (Tolbize,2008). According to Tolbize (2008, p.2), it was an era of “prosperity and optimism and bolstered by the sense that they are a special generation capable of changing the world, have equated work with self-worth, contribution and personal fulfillment.” Generalising on the typical situation of this generation, Hank and his cohorts would have had a strong sense of work and sacrifice. They believed in loyalty to one employer with success being gained through step-by-step promotion, of paying their dues (Tolbize,2008). Hank was born in the pre-globalisation era where people could more easily get a job without the need for a university or formal trade education (Phillipson,2009). Hank chose to follow the path of his father, leave school at 16 and start work as a machine operator. He expected, just as his father did, to be in his job for the rest of his working life. However, the recent globalisation of the Australian economy and technological advances, are often reflected in retrenchment of lower skilled workers like Hank and the creation of structural unemployment – where unemployment results from shifts in the economy and by factors such as technological advances, making lower-skilled jobs obsolete (Business Council of Australia (BCA),2004, Klehe et.al,2012). Government measures are normally in place to provide assistance in the form of retraining in such situations. For example, when industries such as the car manufacturing, the government purposed other needed industries for retraining – such as, ironically, aged care. For older workers, such as Hank, the offer is often refused. Hank’s self-devaluing attitude based on the ageist stereotype of “you can’t teach an old dog new tricks” is often a barrier to changes in one’s employment sector.

Based on his year of birth, Hank will be eligible for the aged pension at age 66. Since April 1909, when Australia commenced the Invalid and Old Age Pensions Act 1908 for people aged 65, Australia’s retirement, pension and superannuation policies have become an important factor in the ageing experience. Since then, Australia has made changes to encourage Australians to be more self-sufficient in their retirement, therefore removing the burden of financial assistance from the government. 1915, saw the Income Tax Assessment Act 1915 allowing employers to make contributions on behalf of its employees for superannuation. In 1972 only 32% of Australians where covered by superannuation. In the 80’s, the Federal government established policies around superannuation and taxation, this, plus the introduction of superannuation contribution by employers, increased the number of employees covered by Superannuation in 1990 to 64%. In 1992 the superannuation guarantee was implemented, employers were required to contribute to their employees superannuation fund. The amount of contribution progressively increased from 3% to 9% in 2002. In July 2017, the qualifying age for the age pension will increase by 6months every two years until it reaches 67 years of age in 2024 (Parliament of Australia,2010). The impact of government policy in Hanks situation means, that although he will not be eligible for the aged pension until 66, he is eligible to access his superannuation (Australian Department of Human Services (DHS),2017). The Department of Human Services through Centrelink is responsible for income support such as newstart, however in Hanks case, it is unclear if he is eligible for newstart based on his wife’s full-time income. Victorian Skills Gateway, which is part of the Victorian Government Department Education and Training (DET) offices help with retraining and job search (DET,2017).

Knowing the importance of older workers in the workforce, the government restart program offers incentives for employers to hire people over 50 (DET,2017). They are also looking at reforming structural barriers such as worker’s compensation, income protection and professional licensing – all factors that affect employability of older workers. This is with the hope, that by removing these barriers, will remove negative perceptions of employing older workers (AHRC,2012).

Theories of Ageing

In the last few decades there has seen the development of many theories on ageing that allow us a better understanding of an older person’s world. As a social worker, we can draw upon theories to gain clarity in understanding aspects of the human condition (Tanner & Harris,2008, Hughes & Heycox,2010). Theory can also enable us to find appropriate approaches to dealing with clients based on their specific needs and situations (Tanner & Harris,2008).

One of the pioneer theories on ageing, which draw popularity in the 60’s through to the mid-seventies is disengagement theory. Disengagement theory, as proposed by Cummings and Henry (1961) states that ageing involves the gradual and inevitable withdrawal of a person from interacting with society. It supposes that this inevitable withdrawal is mutually beneficial, as it sees the transfer of power from the old members of society to the young. According to this theory, to successfully age means a reduction in activity levels and interactions until all activities cease in preparation for death (Hughes & Heycox,2010). This enables the young a greater opportunity to become more active in contributing to society, thereby keeping society in balance (Victor,2005). Although Hank did not voluntarily leave the workforce, according to this theory, his retrenchment has set off his path to disengagement. We see this through his discouragement with not finding another job and therefore dropping out of the job search and isolating himself from his friends. Proponents of this theory, would see this as natural progression for Hank – Hank is on natural course leading to the remainder of his life. The problem with this theory in its original form however, is that it doesn’t consider social processes and structures that are in place, that may hinder a person such as Hanks ability to engage (Hall & Scragg,2012). Critics of this theory say it feeds into the negative stereotypes of ageing, making it seem acceptable and normal for older people to disengage and therefore preventing them from creating circumstances that increase engagement and quality of life (Bengtson & DeLiema, 2016). One of its strengths however, is that the development of this theory opened the door to further research, resulting in a clearer view of natural ageing (Bengtson & DeLiema,2016). Havighurst’s (1963) activity theory and Atchley’s (1989) continuity theory were both in response to disengagement theory (Carstensen,1991). Another such modification to disengagement theory was by Streib & Schneider (1971), who concluded that disengagement from one sphere of life, does not mean withdrawal from all spheres (Streib & Schneider,1971), this made available the idea of new social roles for the aged. As a social worker, applying Streibs version of disengagement – “activity within disengagement” to the case of Hank, Streib emphasis the need for a new role for the retrenched, involving activities that are not mere “busy work” but should satisfy the social-psychological needs of Hank and be recognised as valid and socially useful pursuits (Streib & Schneider,1971). Encouraging Hanks involvement in activities such as the men’s shed or volunteer organisations such as meals on wheels or hands on learning (teaching disengaged youths practical skills). These activities differentiate themselves from hobby work because they not only benefit Hank but are also of community benefit. Keeping active in such a way may also lead to renewed encouragement towards employment in other areas.

Another challenge to the disengagement perspective is the exchange theory of ageing. This theory draws upon previous works on the social-psychological theory of exchange, and addresses how a decrease in a person’s power and status is associated with ageing (Dowd,1975). Dowd presents ageing and social interaction in the image of a cost-benefit model. Dowd reasons that as we age our conduct becomes a burden to ongoing interactions with others. It takes a greater effort to maintain a level of competent contribution, this decreasing competence means those we interact with are getting less benefit in the return they give. The greater the older person is dependent on others, the more they become a burden. Therefore, an older person begins to withdrawal from social life in order to balance the equation of exchange (Lynott & Lynott,1996, Bengtson et.al,1997). For Hank, the loss of his job has given him a perceived loss of identity, status and power, not only amongst his social circle – as Hanks close friends are still employed, but also within his family. Hank took pride in being the financial support giver for the family but this has been taken away from him, and his wife Jane has had to step up into full-time work. Hank feels he has nothing to offer the workforce or his social circles and therefore has begun to disengage. He is no longer applying for jobs and has withdrawn from contact with people outside his immediate family. The strength of this theory is its power of explanation into the relationship between the costs and rewards within a relationship. It helps us to understand that when we give something to a relationship – whether that be employment, friendship, marriage, that to maintain that relationship, we expect something in return (Bengtson et.al,1997). For Hank, this explains his feeling of discouragement, he wants to give but does not feel he has anything to contribute to a work relationship due to his lack of education and decline in physical health — this is also affecting his social network, and family relationship, as he is no longer contributing to the finances. Although this theory is good at explaining relationships on a cost/benefit model, it does not take into account the complexity of relationships and a person’s ability to compromise and adapt. It places people in a selfish light – willing to give up a relationship if the costs outweigh the benefits. It also doesn’t take into account cultural aspects of a relationship and reciprocity of past care or the increased function of older persons assisting the young – such as childcare of a grandchild (Poole,2013, Carstensen,1991).

Where disengagement theory sees the withdrawal and social isolation of older people as a societal need and of mutual consent, the exchange theory of ageing shows an unequal exchange between older persons and others in society. Disengagement theorists would say the reduction in interaction is fuelled by emotional distancing, whereas exchange looks at the change in dynamics of relationships and interaction (Carstensen,1991). And whilst both theories offer an explanation as to why we decrease in social interaction as we age, both are criticised for their lack of complete empirical data (Carstensen,1991). For Hank, I can see both as factors for his discouragement and disengagement – the change in dynamics due to long term job loss has become a trigger for emotional distancing. For a social worker it is important to draw on the knowledge these and other theories gives us in offering a wider understanding of Hanks circumstance, to assist him in moving forward.

Challenges and Social Worker Response

At 62, Hank hasn’t reached what most of us would consider older age, but he is now facing a serious transition point due to the current circumstance of his job loss. Hank is looking ahead at the challenges all Australians face when growing old. Australian society has made significant achievements in the promotion of health and wellbeing of its older citizens. However, our older population still faces many challenges. Some of which include biological and psychological changes – general and mental health including dementia care. Other challenges include ageism and social isolation. Ageism can be seen here in discriminatory practices in employment or retrenchment strategies that see people like Hank lose their job or have difficulty in finding new employment (Thompson,2016). Throughout the last century, the Australian government has developed policies, such as those mentioned in previous sections, to enable people to be more self-sufficient in their older years. However, the government focus is often on the cost burden of aged care without consideration of protecting human rights, recognising contributions of older Australians and ensuring the needs of social inclusion (Ife,2012, Poole,2013). Although older people may be seen as a burden to society, they actually make substantial contribution. They volunteer an average 4.4hr more a week than working people and are often a valuable source of child-care to their grand-children (Poole,2013).

Social work can play an important role in responding to the needs of a client such as Hank by taking a holistic approach to practice. Holistic care means focusing on the whole person, physical, emotional and spiritual, as it relates to their environment. It is taking into consideration a wide range of factors that affect the client (Tanner & Harris, 2008). A social worker will consider all aspects involved in their care including, ecological and systems perspectives, legal and ethical matters, plus the biopsychosocial aspects (AASW,2013). The quality of a person’s life can be enriched by adding opportunities to thrive under any circumstances. So assisting Hank maintain his independence and to participate to the fullness of his being, is important to his wellbeing and speaks of Hank in terms of his right to dignity and self-fulfilment. As we have seen above,a social worker uses knowledge, theoretical frameworks and models to identifying the best way to approach and discover the clients, strengths, weakness, and opportunities for participation and well-being. It is also important in the case of Hank, to be up-to-date with the latest policies and procedures provided by both State and Federal government. A person-centred approach considers the client as the expert in their own life and able to decide on their own lives path (Tanner & Harris, 2008). Thus, encouraging clients within the system to take control and be empowered within their own lives. The effectiveness of this in Hank’s case, is it supports the need for collaboration and keeps at the forefront the client and his family, as people with needs and desires, who should always be in control of their own decisions.

Social workers also focus on social justice, delving into the inequalities and oppression within society based on such factors as age, gender, class, poverty, race, culture and sexual orientation to become an advocate of change (AASW,2013, Thompson,2016). They can help develop those opportunities through change in policy, social planning and community involvement (Hughes & Heycox,2010). This Contributes not only to the individual client, but to the community as a whole.

Conclusion

With Australia’s growing older population and the fast-paced technological world of modernisation and globalisation, there are many real cases like Hank’s happening every day. It is hoped that any new federal government reforms will assist in helping older Australians maintain active and productive lives, not only for the sake of individual wellbeing but also for the betterment of society. Social workers can have a role to play in policy reform by being strong voice in advocacy for change. Social Workers also have an arsenal of tools to draw upon, to help work collaboratively with the client to assist them in making decisions that have a positive influence on their lives and the lives of those around them.

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Legislation

Australian Human Rights Commission Act 1986

Age Discrimination Act 1992

Equal Opportunity Act 2010 (Vic)

Income Tax Assessment Act 1915

Invalid and Old Age Pensions Act 1908

Treaties

International Covenant on Economic, Social and Cultural Rights, 1966, (resolution 2200A), entry into force 1976

Universal Declaration of Human Rights (UDHR) 1948, (resolution 217 A), adopted 10 December 1948.