Social Work Practice with Hispanic Elders

Dana Adams

Gerardo Cantu is a master's level social worker at The Family Center. Gerardo's current position with The Family Center, he is Class Facilitator and Case Manager. The Family Center offers individual and family care to elderly clients and their families in a warm and supportive atmosphere. The Family Center's professional team completes a thorough comprehensive assessments to help determine problem areas along with care plans to serve as an ongoing monitoring tool. The Family Center involves and engages the client in the care plan process as it serves as the basis of ongoing communication between the family, client, and Case Manager.

Mr. Cantu works with families who are caring for older relatives and has a vital role in a part of a multidisciplinary team that manages the total scope of the needs of elder clients. Mr. Cantu has worked with The Family Center for eleven years, but is new in his role of Case Manager for elderly clients. This population is newly served at The Center and has only been in operation for six months. Mr. Cantu currently manages Twelve cases and completes bi-monthly, in-home visits with clients and their families. During home visits, Mr. Cantu provides informal counseling and social support by listening, understanding, networking, empowering, and encouraging.

During his internship for his Master of Social Work degree, Mr. Cantu worked at a local health department where he learned the logistics of working with elderly Hispanic clients and this role in his internship created a road map for his current position with The Family Center. Mr. Cantu is bilingual in English and Spanish, and assisted employed case managers with providing ancillary interpretation services to Hispanic clients. Through community outreach, he learned to enroll clients for medical insurance through the health insurance marketplace, assisted with providing patient assistance for filling out applications for Medicaid, food stamps, WIC, and free medications for low income patients.

As a Class Facilitator and Case Manager with The Family Center, Mr. Cantu conducts home visits, assessments, patient intakes, creates patient care plans based on the client's medical, psychological, and social needs. He also leads a monthly support group for caregivers, educating them on physical, emotional and financial strain of caring for their loved ones and teaching them how to balance their responsibilities at home and work. In the present moment, Mr. Cantu states he is pleased with the program and feels The Family Center is serving the needs of families in the local area who need assistance and support with caring for their loved ones.

Writer asked Mr. Cantu about the importance of networking within the agency and if he faced any challenges obtaining needed services for his clients. Mr. Cantu explained how networking involves a vast number of agencies working together to enhance well-being and how it takes a variety of agencies to network together to help individuals achieve their goals. Some agencies The Family Center network with for food, medical, financial, day care, and Hispanic services assistance is The United Methodist Church, Area Agency on Aging, Mobile County Health Department, Catholic Social Services, and The Guadalupe Center. The main challenge Mr. Cantu faces is providing adequate transportation services to the clients due to there being a high demand for services in the area. Mr. Cantu assists with transporting clients to scheduled appointments.

Applying critical thinking, motivational, and listening skills and empowerment within the context of his professional social work practice and The Family Center, Mr. Cantu understands the value base of the profession and its ethical standards and principles. He states that he always utilizes practice without discrimination and with respect, knowledge, and skills related to clients' age, class, color, culture, disability, ethnicity, family structure, gender, marital status, national origin, race religion, sex, and sexual orientation. As stated by Mr. Cantu, he has dedicated his life to helping others and his two prayers are: Use me and Thank you.

Mr. Cantu uses communications skills differentially across diverse populations and communities and seeks necessary organizational change if needed. "Developing a trusting relationship with my clients enables me to serve as a liaison between them, the community and social service agencies to facilitate access to services and help improve cultural competence and the quality of service delivery" (G. Cantu, personal communication, February 1, 2017).  Reflective use of theoretical approaches and knowledge bases underlies his practice with attention to the life course perspective. Evaluating his social work practice and practicing in ways that are culturally and gender appropriate with low income persons and with those who have experienced social and economic injustice is essential in his role at the agency.

When asked about his most memorable case, his response was of a client who thought he was her grandson and how she would cook for him during the visit and would not allow him to leave until he finished his plate. He said that he would have to beg her to leave the home sometimes because she would try to make him go to bed and rest. When asked if there were any instances of him having difficulty leaving the home, he explained how one day he had wait until the client's grandson come to the home so that she could see both together to realize that he was not who she thought he was. Mr. Cantu mentioned that it took 2 hours for the grandson to come to the home. Mr. Cantu expressed that he would not have done anything different because his last intention is to upset his clients, but to reassure them.

This writer asked Mr. Cantu about culturally sensitive assessments used by the agency used on the elderly Hispanic clients is the Bruininks Motor Ability Test for adults (B-MAT) because the test helps develop an assessment to support service users, families, and clinicians in determining the level of independence with their activities of daily living, support the intervention process and monitor the client's progress (Kesler, Lynn, Sullivan, & Thompson, 2011).

Family plays an important role when caring for the aging and much attention needs to be given to micro, mezzo and macro systems impacting the client system. Intervention are used within the individual, family, group, organization and community levels. With generalist social work practice, client system assessment is an ongoing social work skill used with all intervention levels and throughout the client intervention process (Hays, 2008).

The micro approach focuses on major contributions from the biological, behavioral and social sciences that are essential for understanding the person-in-environment. The mezzo-level practice is concerned with interpersonal relations that are somewhat less intimate than those associated with family life, but more personally meaningful than those that occur among organizational and institutional representative and the macro approach concentrates on development of knowledge and skills for practice in communities, organizations and other social systems. Culturally sensitive social workers should have a standard practice of not making any assumptions when working with a diverse client system. This helps creates a lens that broadens the understanding of the client situation and value is placed on being culturally sensitive as one embraces diversity in the clients who are served by social workers (Hays, 2008).

 Completing this course assignment has enlightened this writer about the impact of physical, mental and emotional aspects of aging, and the micro and macro issues of caregiving. Social work involves working with interrelated networks. The ecological theory is an approach to social work practice that addresses transactions between people and their environment (von Bonsdorff, & Ilmarinen, 2013). The person and the environment can be understood within their affiliation as they always have great impact on one another. The ecological theory is used for its ability to view the client's whole situation. The ecological theory looks at acculturation, language, and socioeconomic status. The framework, consisting of eight dimensions of treatment interventions (language, persons, metaphors, content, concepts, goals, methods, and context) can serve as a guide for developing culturally sensitive treatments and adapting existing psychosocial treatments to specific ethnic minority groups (von Bonsdorff, & Ilmarinen, 2013). The Family Systems Theory focuses on how each member relate to one another. The family is a structure of subsystems and every action/change within the subsystem affects each person. Changes are caused by both normative (predictable life cycle changes) and non-normative (crisis) stresses and the continuity theory states that the aging person try to preserve and maintain internal and external structures by using strategies to maintain continuity to deal with changes that occur during the normal aging process (von Bonsdorff, & Ilmarinen, 2013).

Aging can be a stressful and challenging situation for someone who is used to being active as they must learn to adjust to the mental, physical, emotional, and financial difficulty that is a part of aging. Social workers can help each individual manage, adjust, and cope with each of these issues. The main goal of a geriatric social worker is to make sure that the needs of the clients are being met.  According to the Administration on Aging, the number of elderly Americans over the age of 60 jumped from 378 million in 1980 to 759 million in 2010 (US Department of Health and Human Services, 2008). Administration on Aging. A Statistical Profile of Older Americans 65.  The National Institute of Aging estimates that 60,000-70,000 professionally trained social workers will be needed by 2020 to work with the older population (Cummings, Galambo, & DeCoster, 2003).  The discrepancy between the importance of providing services to Latinos, given their growing numbers, and the preparedness of social workers for serving this population is alarming (Furman, Negi, Iwamoto, Rowan, Shuckraft, & Gragg, 2009).

Utilizing and implementing multicultural sensitivity is important within the social work profession because this encourages the clinician to focus on significant factors such as ethnicity, race, and spiritual components (Payne, 2014). it is also important to learn about the clients from their perspective, maintain a positive forward-looking outlook, and allow clients to come up with their own potential solutions by looking at the successes they have already experienced (Payne, 2007) rather than focus on what has not worked, or what a practitioner feels are most beneficial. Attaining cultural competence requires social workers to engage in honest and genuine personal self-assessment and introspection coupled with the willingness to challenge and overcome the ingrained stereotypes of Latinos and other minorities that have served to dehumanizing factors and implementing new perspectives that "rehumanize" minorities (Organista, 2007). Immigration can be a major life stressor and includes issues such as health disparities and acculturation (García, 2012). These issues can affect mental health in Hispanics who find that they have limited or no access to the resources of their host culture. Realizing how immigration impacts Hispanics will enhance my service provisions. This writer would be interested in volunteering as a mental health counselor at a free clinic or other organization in the Hispanic community. Since macro practice focuses on achieving long-term change in the economic, political and social environment (Payne, 2014). This writer feels this would be a great avenue for advocacy in the Hispanic community.

References:

Cummings, S. M., Galambos, C., & DeCoster, V. A. (2003). Predictors of MSW employment in gerontological practice. Educational Gerontology, 29(4), 295-312.

Furman, R., Negi, N. J., Iwamoto, D. K., Rowan, D., Shuckraft, A., & Gragg, J. (2009, April). Retrieved February 10, 2017, from National Center for Biotechnology Information: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2861823/

García, J. (2012). Mental health care for Latino immigrants in the U.S.A. and the quest for global health equities. Psychosocial Intervention 21, (3), 305-318.

Hays, P. A. (2008). Addressing cultural complexities in practice: Assessment, diagnosis, and therapy (Vol. 10, pp. 11650-000). Washington, DC: American Psychological Association.

Kesler, K. E., Lynn, J. D., Sullivan, J. D., & Thompson, J. M. (2011). Bruininks Motor Ability Test for Adults (B-MAT): Exploring Relationships Among Motor Assessments. Brenau University.

Organista, K.C. (2007). Solving Latino psycho social and health problems: Theory, practice and populations. Hoboken, NJ.

Payne, M. (2014). Modern Social Work Theory. (4th ed.). Chicago: Lyceum

US Department of Health and Human Services. (2008). Administration on Aging. A Statistical Profile of Older Americans 65.

von Bonsdorff, M. E., & Ilmarinen, J. (2013). Continuity theory and retirement.