Defying, Delaying, and Anticipating Decline of Older Adults in U.S. Residential Settings
Social work historians and scholars in related disciplines have long attempted to confront issues related to decline, challenging traditional understandings of older persons based on ambiguous and problematic categories such as dependence, disease, disability, and diversity. Historian of Medicine Charles Rosenberg critiques the marginalization of social work during the rise of the U.S. hospital system, arguing that “within each system of municipal and county care, it was difficult to make distinctions between disease and dependence, between dependence and disability” (1987: 326). Current social work researchers argue that social worker practitioners need to continue to account for diverse populations in providing services for older adults (Carasquillo & Chadiha 2007). Drawing from these scholars, our papers seek to extend their discussions by addressing three aspects particular to decline and the role of social workers: in assessment of service use, during voluntary relocation processes, and as members of medical care teams.
Ranging from the Great Depression in the United States to the recent Global Financial Crisis, panelists draw from both quantitative (longitudinal) and qualitative (narrative, ethnographic, archival) methods to explore the ways older adults defy, delay, and anticipate decline—both during and after their transitions to residential care. Beginning the panel in the setting of 1930s Detroit, the first panelist explores strategies of older adults and social workers who attempt to defy a physician’s or judge’s order of commitment from home-based assistance to residential care. Moving into the early twenty-first century, the second panelist discusses cases in which elders anticipate disease progression, concomitant with decline, by moving. Shifting from the focus on transitions themselves to a post-transition approach, additional panelists consider social and health services that effectively slow functional decline among older adults through a longitudinal study of service use in retirement communities. Our goal is to examine the intersections of health and aging related to housing decisions and human experiences. Additionally, we will critically analyze the role of social workers—past, present and future—in the midst of these challenges.