Is social work in the UK ageist?

Published by Professional Social Work magazine, 9 February 2023

As social workers we think we practise in a non-ageist way, but there is evidence to suggest otherwise.

A review by the Centre for Policy on Ageing in 2019 found that social care services for older people are typically more concerned with physical needs and issues of safety than with enabling participation or inclusion. Assessment is critical, and social workers, it suggests, expect less of older adults, especially the less able they are. Their abilities and strengths and what they themselves want are discounted and devalued.

A blog posted on the Department for Health and Social Care's ‘Social Work with Adults’ website in January 2020 posed the question ‘Is ‘Compassionate Ageism’ the Curse Within Social Work and Care?’  Author Mervyn Eastman, of Independent Age, defined ‘compassionate ageism’ as the belief that older adults are needy and deserve special policies to help them. He suggested this has led to the ‘othering’ of older adults and responses which "can re-enforce paternalistic and patronising social care services".

Eastman says we risk demeaning and disempowering those we are tasked to help. "As a consequence, we risk celebrating the tangible results of our compassion with little thought to their short and long-term outcomes for individual recipients."

The outcomes of our ‘benevolent patronage’ can so often be pernicious and at worst lead to negative and damaging outcomes. A frail older person may be admitted to a care home because we see it as the safest thing to do, even when this is the last thing she or he wants.

Most older adults needing social care want to retain their independence as much as possible, and want to be in control of their lives, and less oppressive forms of compassionate ageism support this. Social work with older people needs to enable them to achieve what they want this rather than imposing standard, potentially disabling, solutions.

In 2014, The College of Social Work supported an initiative which made the case for the specialist nature of social work with older people to be recognised and developed.

Social Work with Older People: A Vision for the Future concluded that social work with older people has become "profoundly marginalised in practice and is at risk of disappearing altogether as a specialist area of social work". The marginalisation of social work with older people, it says, is part of the more general discounting or othering of older people, or ageism.

And yet, ageism in society has been downplayed, according to the Centre for Ageing Better, which gave a presentation in May 2022 to a parliamentary Adult Social Care Committee arguing change is needed.

So what could or should this mean in terms of social work practice?

Firstly, it means valuing social work with older adults and understanding there are lessons to be learned for social work in general. We all have a vested interest in getting it right, for our older kin and ultimately ourselves, if we one day need social care.

Secondly, there needs to be more of a focus in social work training on social work practice with older adults. This requires social work educators to develop their knowledge of the social construction of old age and the way old age in this country is experienced.

Thirdly, it will mean recognising the particular knowledge, skills and capabilities working with older adults requires. This will need further development of theories, methods and practice approaches, drawing on relevant knowledge areas and using evidence of what works to inform practice.

And, importantly, it requires Social Work England and BASW to encourage and take a lead in the development of social work practice with older adults.

Ageism can indeed be seen in the downplaying of older people’s needs, the assumptions that are made about work with them, the lower priority given to professional training for work with them and the fact that very little is published in the social work media regarding practice with older adults.

Many social workers are anti-ageist in their practice, challenging stereotypes of older people and old age and doing what they can to empower older people. But many more do not see there is a problem, and the profession appears to have the same view.

David Hearnden is a social worker who carries out continuing health care assessments