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Patricia Brownell and Joanne Marlatt Otto
Adult Protective Services (APS) are empowered by states and local communities to respond to reports and cases of vulnerable adult abuse, neglect, and self-neglect. While incorporating legal, medical, and mental health services, APS programs are part of the social services delivery system and incorporate principles and practices of the social work profession.
Various models and theories of adult development exist but they are more assumptions about development than theories. The most popular age and stage theories have lost favor to contextual theories that put more emphasis on interaction with the environment. It has also become recognized that adults are a diverse group and do not follow universal stages of development. The usefulness of chronological age is also questionable as it does not tell us much about any particular person. Instead, we have to know their concerns and the events they are dealing with, and their dreams and aspirations.
This entry presents information about group settings that provide residential long-term care for older adults, focusing on nursing homes and residential care/assisted living communities. It provides an overview of both settings, and describes their scope of services, funding, and clientele. The section Issues in Residential Long-Term Care addresses issues of special relevance to social workers: dementia and other psychosocial care needs; quality of life and quality of care; access to and disparities in care; end-of-life care; family involvement; and abuse and neglect. It ends with a section on the role of the social worker in residential long-term care.
Safeguarding is an area of social work activity concerned with the care and protection of children or adults who have care and support needs and who may be at risk of abuse or neglect. This is a major concern for social workers who usually have prime responsibility for ensuring as far as possible that the vulnerable clients they work with are protected. People’s ability to keep themselves safe is partly determined by their individual circumstances, and this may change at different stages in their life, so it is important that safeguarding is always considered in relation to the wishes of the person concerned. Effective safeguarding depends on a careful consideration of the factors involved and will almost always involve a multi-agency partnership approach. This article will primarily examine the situation regarding safeguarding vulnerable adults in the United Kingdom.
Meredith Stensland, Sara Sanders, and Marla Berg-Weger
Advance care planning (ACP) is the process of determining and documenting desired wishes for the end of one’s life. Referred to by such terms as end-of-life planning, advance (health) directives, and living wills, ACP is a relatively new concept within our society, having emerged as a social, political, and ethical issue in the United States only since the 1960s. Researchers and legislators have been challenged in their efforts to examine healthcare decision-making and design appropriate policy to guide practice. This article will define ACP, provide an overview of the history and evolution of the process and the associated legal and ethical issues, and describe the process with three specific populations. In addition, it examines the role of the social work profession in working with individuals and families on planning for the end of one’s life.
Definitions of what constitutes advanced statistical analysis often differ among social-work researchers and across disciplines. In this article, the term advanced statistical analysis refers to advanced models increasingly applied to social-work research that help address important research questions. Because contemporary statistical models fully rely on the maximum likelihood (ML) estimator, this article begins with an overview of ML that serves as a foundation for understanding advanced statistical analysis. Following the overview, the article describes six categories of analytic methods that are important in confronting a broad range of issues in social-work research (that is, hierarchical linear modeling, survival analysis, structural equation modeling, propensity score analysis, missing data imputation, and other corrective methods for causal inference such as instrumental variable approach and regression discontinuity designs). These analytic methods are used to address research issues such as generating knowledge for evidence-based practices; evaluating intervention effectiveness in studies that use an experimental or quasi-experimental design; assessing clients’ problems, well-being, and outcome changes over time; and discerning the effects of policies.
Robert L. Schneider, Lori Lester, and Julia Ochieng
Social work advocacy is “the exclusive and mutual representation of a client(s) or a cause in a forum, attempting to systematically influence decision-making in an unjust or unresponsive system(s).” Advocacy was identified as a professional role as far back as 1887, and social workers consider client advocacy an ethical responsibility. Social workers are increasing the use of electronic advocacy to influence client issues and policy development. As client and societal needs evolve, universities should emphasize advocacy in their curricula, and the National Association of Social Workers should promote electoral and legislative initiatives that reflect an emphasis on social and economic injustices.
Stephen H. Gorin, Julie S. Darnell, and Heidi L. Allen
This entry describes the development and key provisions of the Patient Protection and Affordable Care Act (ACA), which instituted a major overhaul of the U.S. health system, much of which took effect in 2014. The key provisions of the ACA included an individual mandate to purchase insurance, an employer mandate to offer coverage to most workers, an expansion of Medicaid to all persons below 138 percent of the federal poverty level (FPL), minimum benefit standards, elimination of preexisting condition exclusions, and reforms to improve health-care quality and lower costs. This historic legislation has deep roots in U.S. history and represents the culmination of a century-long effort to expand health care and mental health coverage to all citizens.
Larry E. Davis, John M. Wallace Jr., and Trina R. Williams Shanks
African Americans have been a part of the nation's history for nearly four hundred years. Although their history includes the forced imposition of chattel slavery, the strict enforcement of legal segregation, and a tenuous acceptance as equal citizens, African Americans have been, and continue to be, major contributors, creators, investors, and builders of America. In this article we summarize briefly the history of African Americans, we examine racial disparities in key indicators of social, mental, and physical well-being, and we highlight persistent strengths that can be built upon and areas that provide hope for the future. The challenge for social work is to simultaneously celebrate the historical successes and ongoing contributions of African Americans to this country while also recognizing the vestiges of structural racism and fighting for greater civil rights and social and economic justice.
Fariyal Ross-Sheriff and Tamarah Moss-Knight
The number and percentage of immigrants and refugees from Africa to the United States have increased substantially since the mid-1990s. Though still a relatively small percentage of the immigrant population, immigrants from Africa encounter many challenges that are important for social work professionals to address. This entry examines two groups of immigrants from Africa: legal migrants (immigrants) and refugees. It provides information on distinctive characteristics of recent African immigrants, reasons for emigration from Africa, challenges they face in the United States, and their settlement (geographical distribution) patterns. While black Africans are the focus of this entry, the research literature does not provide clear distinctions within the group of African immigrants. The emphasis is on black African immigrants to the United States as their experience is unique in terms of their race in America and the types of stigma and discrimination they face as a result. Critical issues for social work practice are examined through a case example of Somali refugees, followed by implications for social work practice and research.