Principles of Clinical Practice with Older Men
Kaye, Lenard W., Crittenden, Jennifer A., Journal of Sociology & Social Welfare
Older men are much less likely to be aware of community services available to them and they are less likely to utilize services generally. This underutilization is affected by tire way in which social services are organized and how practitioners function within them. Since there are greater numbers of elderly women and women utilize services more readily, practice tends to be female-centered. It is important that gender-sensitive intervention processes are established that recognize tire unique experiences and concerns of older men in order to better serve them. The uniqueness of men's experiences with such issues as loss of a spouse, retirement, caregiving, and victimization warrant particular attention by gerontological practitioners. Male-friendly interventions that take into account traditional male values will foster greater participation and better quality care for older men.
Key words: elderly men, services, interventions, participation
Setting the Context
While it may seem counterintuitive to write about the clinical needs of older men given the advantages afforded them by society over older women, it is essential to note that older men have tended to be underserved as a population and remain largely invisible to social service providers in the community (Thompson, 1994). Social service workers interact with fewer older men in their professional role. In part, this is due to the larger proportion of older women surviving into later old age. However, it is also noteworthy that older men are less likely to be aware of existing community resources and less likely to seek out such resources even if their existence were known. As Strain and Blandford (1999) found, older male caregivers were less likely than their female counterparts to be aware of community resources available to them. These kinds of service knowledge and utilization patterns are even more pronounced for older men of color who have historically experienced an additional set of barriers to accessing services that are racially derived.
Secondly, the configuration of social services is one that may not necessarily be "male friendly." For example, according to U.S. Department of Labor statistics, the social assistance industry employed 2.8 million people and of those employed in this industry approximately 86 percent were women (U.S. Department of Labor, 2003). Services are often not designed to reach out to older male clients and older men may see seeking out services as admitting personal weakness. Older men, especially older caregivers, tend to be more suspicious of government-run services (Kaye, 2002).
It is against this backdrop, that eight areas of particular concern for working with older men are considered below. It is argued that these areas, in particular, warrant special consideration by clinicians in their daily practice.
Principles of Practice with Older Men
A common theme running throughout this article pertains to the social expectations of the manner in which older men should behave with respect to their roles within communities and their own families. These expectations can help a man feel comfortable in knowing what expected behavior is and how to carry out his role. However, both developmentally normative and non-normative events occur that can contribute to men redefining themselves and the roles they fulfill. As such, practitioners who work with older men need to be cognizant of their own biases and expectations of older men. Intervention strategies need to be informed by research and augmented by the personal experiences of working with older men.
Practitioner bias affects not only whether or not services are delivered but also how effective and helpful those services may be to an older man. A female-centered intervention philosophy within the research community often extends into the service community rendering older men largely invisible and under served (Thompson, 1994). …