Among the clinical concepts of significance with respect to older client populations is the notion that there are specific tasks associated with aging (Burlingame, 1999). As individuals age, they must come to terms with such issues as (eventually) declining health and physical prowess, coping with retirement and financial changes, maintenance of satisfactory living arrangements, loss of independence and of significant others, efficient use of medical, social and emotional supports, revised relationships, and so forth. Each of these tasks must be addressed successfully in different ways as the individual ages and, most significantly, as physical health status changes. Simultaneously, as Levy (2001) noted, older individuals are often victimized by ageism, which can also challenge a personÆs sense of autonomy and well-being and lead to lowered self-esteem and a negative self-concept.
In working with older clients at gateway, I often encountered this issue at the micro, mezzo and macro levels; for example, one client expressed concern with the fact that she was often ignored by her adult children when decisions regarding her care needed to be made (the micro level), while another expressed frustration because of the way that she was treated by her physicians and other caregivers (the mezzo or social level).
Interventions included role-playing with these clients to assist them in becoming more assertive regarding their own needs and concerns.
A second clinical concept stressed in the course was that older individuals, because they are more likely to be socially isolated, are vulnerable to depression and other disorders of affect and mood (Burlingame, 1999; Zarit & Zarit, 2000). In treating depressed older individuals, it is important to support their autonomy and to recognize that many of the reasons advanced for depression or disturbances of mood are legitimate. Among the treatment goals for one elderly depressed male w...