Professional Hope in Working with Older Adults
Koenig, Terry, Spano, Richard, Journal of Sociology & Social Welfare
Writings about hope within gerontological literature assume social workers already possess hope that they can use in their practice. The purpose of this article is to challenge this assumption and to examine ways in which social workers can sustain hope in personal life, in their agencies, and in the reform of larger social structures that impact older adults. The authors examine culture change in nursing homes as an emerging approach that can be more fully developed by applying the strengths perspective to interpersonal work with elders, agency change and broader structural change.
Keywords: hope, growth, culture change, and strengths perspective
At first glimpse, professional hope in older adults' capacities for ongoing growth and change appears pretentious and not based in reality. Although some human development models or theories describe growth and change in old age (Smith, & Freund, 2002; Atchley, 1989; Kuypers, & Bengston, 1973; Mead, 1934), many continue to describe aging as a life stage fraught with multiple health problems, an accumulation of losses (e.g., loss of friends, housing, or life partner), and decreased access to financial, social and other resources. Older adults are often not able to sustain let alone surpass current levels of growth and development (Gray, 2003; Herth, & Cutliffe, 2002; Cheavens, & Gum, 2000; Rowe, & Kahn, 1998; Farran, Wilken, & Fidler, 1995).
These negative views of older adult growth and development permeate the hope and aging literature. This literature emphasizes how professionals can instill hope in the older adult who is facing negative and difficult challenges such as a terminal or chronic illness, bereavement, and depression (Westburg, 2003; Duggleby, 2000; Forbes, 1999; Roberts, Johnson, & Keely, 1999; Tennen, & Affleck, 1999; Klausner, Clarkin, Spielman, Pupos, Abrams, & Alexopoulos, 1998; Nekolaichuk, & Bruera, 1998). Few writings address the role of hope in physically or emotionally healthy older adults (Zorn, 1997; Herth, 1993).
Consistent with negative views of older adult growth and change, virtually no gerontological writings discuss how professionals develop and sustain hope in working with older adults. In order for professionals to believe in older adults' capacities for growth and change it seems paramount to cultivate this professional hope. The purpose of this article is fourfold. First, the authors will examine ways in which hope is described in the gerontological literature as compared with the larger social sciences literature. Second, strategies are presented that gerontological social work professionals can use to develop and sustain hope in personal life and professional work. Third, the use of hope-inducing models or theories of human development are presented for use in social work curricula and in agency-based practice to help gerontological social workers develop and sustain hope. Fourth, culture change in nursing homes, often described as the enlistment of resident and direct-care staff involvement in institutional decision-making, is critiqued as an example of larger social structural reform that can develop and strengthen professional hope. Social workers are encouraged to facilitate advocacy efforts that involve multiple stakeholders (i.e., staff, residents and families) for the purpose of changing the culture in nursing homes.
Although physical capacities eventually diminish in old age, human beings are comprised of multiple and overlapping components (e.g., social, psychological and spiritual) that may contribute to enhanced growth and development in old age. For example, older adults may strengthen friendships and support, develop wisdom and increased well-being, and may enhance their capacity for self-transcendence and a sense of life meaning. Our contention is that gerontological social work professionals can have hope in older adults' capacities to grow even in the face of physical and other limitations. …