T HE U NIVERSITY OF N ORTH C AROLINA AT C HAPEL H ILL
S CHOOL OF S OCIAL W ORK
C
OURSE
N
UMBER
: SOWO
C
D
OURSE
AY AND
T
T
ITLE
IME
:
:
Older Adults: Theory and Practice
Monday, 5:30 to 8:30pm
I
NSTRUCTOR
:
Denisé Dews, MSW
Office: Tate, Turner, Kuralt Building, 335A
Phone: 919-962-6439
O
FFICE
H
OURS
:
Monday, 3pm to 5pm (by appointment)
C
OURSE
D
ESCRIPTION
: This course fosters understanding of normal aging, illness, and common challenges associated with aging, and also practice skills to treat older adults and their families.
C OURSE O BJECTIVES :
Upon completion of the course, students will demonstrate knowledge of:
1.
Ethical values and discipline-based theories (e.g., biology, psychology, sociology) to understand the aging process;
2.
Issues of prevention as well as common diseases and functional disorders of older adults;
3.
A strengths-based conceptual framework to view older people as resources and contributing members of society;
4.
The relationship between gerontological theory and practice with older adults;
5.
The continuum of care represented in the aging service network;
6.
How matters such as gender, race, ethnicity, culture, poverty, education, sexual orientation, and rural residence relate to aging and their relevance for assessment, treatment, and case management; and
7.
Theories of cause and theories of change related to the development, assessment, and treatment of five common challenges relevant to older adults: anxiety, depression, cognitive impairment, caregiver stress, and end-of-life.
8.
Evidence-based practice models for working with older adults and their families on problems related to anxiety, depression, cognitive impairment, caregiver stress, and end-of-life care.
Also upon completion of the course, students will demonstrate skills in:
1.
Assessment of older adults;
2.
Collaboration with the families of older adults;
3. Individual, family, and group treatment with older adults;
4. Case management with older adults and their families related to case, program, and system
management; and
5. Assessment, treatment, and case management for anxiety, depression, cognitive impairment, caregiver stress, and end-of-life.
E XPANDED D ESCRIPTION :
This course presents knowledge and theories from biological, psychological, sociological, and other disciplines to understand normal aging, illness, and common challenges associated with aging. This information is used to frame and inform practice and develop skills to treat older adults and their families in the context of individual and family treatment, group work, and case management; students also obtain knowledge and develop skills

related to assessment and care for anxiety, depression, cognitive impairment, caregiver stress, and end-of-life.
R
EQUIRED
T
EXTS
:
Hooyman, N.R. & Kiyak, A.H. (2011).
Social gerontology: A multi-disciplinary perspective
(9 th
Ed.). Boston, MA: Allyn & Bacon.
R
EQUIRED
R
EADINGS
:
Please refer to the Course Outline for a list of required readings. Most of these articles will be available on the Blackboard course site.
R
ECOMMENDED
T
EXTS
:
McInnis-Dittrich, K. (2005).
Social work with elders. A biopsychosocial approach to assessment and intervention
(2 nd Ed.). Boston, MA: Allyn & Bacon.
Williamson, G.M., Shaffer, D.R., & Parmelee, P.A. (2000).
Physical iIllness and depression in older adults: A handbook of theory, research, and practice.
Kluwer Academic/lenum
Publishers, New York.
R
ELATED
R
EADINGS
:
Numerous optional readings exist for students who wish to learn more about the topics under discussion. Students should ask the instructor to suggest readings of interest.
T
EACHING
M
ETHODS
: This course consists of presentations and case-based skills practice.
Students are expected to come to class prepared to discuss the required readings. Further, a supportive learning environment, reflecting the values of the social work profession, is expected.
This environment is fostered by listening to the ideas and views of others, appreciating a point of view that is different from one’s own, and linking experience to readings and assignments.
C
LASS
A
SSIGNMENTS
: Three assignments must be completed. They are described below, along with their proporationate value. Additional information will be provided in advance of their completion. In addition to these assignments, students will receive credit for class participation
1.
Attendance & Class Participation (10%). Attendance, punctuality, constructive contributions to class discussions, and active participation in small group tasks determine this grade. A number of in-class participation projects will be assigned throughout the semester. Projects are designed to encourage participation, critical thinking, and the practical application of course content. See Addendum A for an example of an in-class project.
2.
Quizzes (30%). There will be 17 quizzes available, one for each chapter in the the text. Each quiz is worth two points. Students are required to complete 15 of the quizzes. Students may earn bonus points for completing additional quizzes. Quizzes will be taken online using
Blackboard. Each quiz will be available for a two week window. Students needing assistance navigating Blackboard are encouraged to have a 1:1 session with the professor before Quiz 3 is due.
Due date: various dates – see Course Outline in this syllabus.
2

3.
Audacious Aging (10%).
This paper will be a reflection assignment. See Addendum B for assignment specifics.
Due: September 27, 2010
4.
Class Presentation: Mental Health Problems and Challenges (25%). In small groups, students will deliver a one hour presentation on one of five common mental health problems and challenges of later life: anxiety, depression, cognitive impairment, caregiver stress, and end of life. An overview of DSM IV-R Diagnostic Criteria for the disorder and therapeutic interventions should be included, and handouts are required. See Addendum C for assignment specifics.
Due October 25, November 1 and 8.
5.
Assessment and Treatment Paper (25%). Students will be required to submit a 10-12 page paper (Note: page length does not include the title page or references) on the assessment and treatment of an individual or family described in a case vignette. Several vignettes will provided by the instructor and students will select one case description and then develop a tailored assessment and treatment. Students will be required to include a clear rationale for the approach, including the description of a guiding theoretical or therapeutic model, an overview of the evidence-base for the approach, and individual factors to consider such as client diversity, autonomy, or ethical dilemmas. See Addendum D for assignment specifics.
Due November 22.
G
RADING
S
YSTEM
: The School of Social Work operates on an evaluation system of Honors (H),
Pass (P), Low Pass (L), and Fail (F). A grade of P is considered entirely satisfactory. The grade of
Honors—which only a small percentage of students attain--signifies that the work is clearly excellent in all respects. The numerical values of these grades are:
80-93 = P
70-79 = L
≤ 69 = F
P OLICY ON I NCOMPLETES AND L ATE A SSIGNMENTS :
Professional practice and administration require attention to detail as well as timely completion of assignments. The classroom serves as an environment in which to develop professional practices such as meeting deadlines and producing high quality work. As such, class assignments are expected to be completed on time and to represent the student
’ s highest level of effort. If there are circumstances that prohibit the timely completion of an assignment, it is the responsibility of the student to contact the instructor at least
24 hours prior to the assignment due date. The instructor may grant an extension under certain extenuating circumstances, but may choose not to grant an extension.
A paper is considered late if it is handed in later than the beginning of class on the day that it is due.
The grade for late papers will be reduced 10% per day, including weekend days. Therefore, a paper that would merit a grade of 100 at the time class begins on Friday would receive a grade of 90 if submitted later that day; a grade of 81 if submitted on Saturday; a grade of 73 if submitted on
Sunday; and a grade of 66 if submitted on Monday.
A grade of Incomplete is given on rare occasions when there is sufficient reason to warrant it. It is the student’s responsibility to initiate a conversation with the instructor to request an Incomplete; the instructor has no responsibility to give an Incomplete without such a request.
3

P
OLICY ON
A
CADEMIC
D
ISHONESTY
:
It is the responsibility of every student to obey and support the enforcement of the UNC Honor Code, which prohibits lying, cheating, or stealing in actions involving academic processes of this class. All written work should contain a signed pledge stating:
“I have neither given nor received unauthorized aid in preparing this work.” In keeping with the
UNC Honor Code, if reason exists to believer that academic dishonesty has occurred, a referral will be made to the Office of the Student Attorney General for investigation and determination if further action is required.
It is the student’s responsibility to properly cite sources used in preparing written work. To avoid difficulties with plagiarism, ideas that are not one’s own must be credited, whether or not those ideas have appeared in print. Please refer to the
APA Style Guide,
The SSW
Manual,
and the SSW
Writing Guide for information on attribution of quotes, plagiarism and appropriate use of assistance in preparing assignments.
P
OLICY ON
A
CCOMMODATIONS FOR
S
TUDENTS WITH
D
ISABILITIES
:
Students with disabilities that affect their participation in the course and who wish to have special accommodations should contact the University’s Disabilities Services (disabilityservices.unc.edu) and provide documentation of their disability. Disabilities Services will notify the instructor that the student has a documented disability and may require accommodations. Students should discuss the specific accommodations they require (e.g. changes in instructional format, examination format) directly with the instructor.
P
OLICIES
O
N
T
HE
U
SE OF
E
LECTRONIC
D
EVICES IN THE
C
LASSROOM
:
Use of electronic devices for non-class related activities such as checking e-mail, surfing, IMing, blogging or playing games is prohibited
E
XPECTATIONS FOR
W
RITTEN
A
SSIGNMENTS
: Students are expected to use good academic
English; grades will be lowered for poor grammar, syntax, or spelling. Those who have difficulty writing are strongly encouraged to use online resources of the campus Writing Center
(unc.edu/depts/wcweb) and/or to seek assistance from the Diane Wyant, the School’s editor
(dwyant@email.unc.edu).
The School of Social Work faculty has adopted APA style as the preferred format for papers and publications. All written assignments for this course should be submitted in APA format . The web sites listed below provide additional information regarding APA formatting, and students are strongly encouraged to purchase the text that is listed first:

American Psychological Association. (2009).
Publication manual of the American
Psychological Association, 6 th
Edition
. Washington, D.C.: American Psychological
Association.

Apastyle.org/elecref.html (APA style for material in electronic formats)

Owl.english.purdue.edu/handouts/research/r_apa.html (general information about
documentation using APA style)

bartleby.com/141 (electronic version of Strunk's
The Elements of Style
)
4

W
EEK
1
2
3
4
5
D
L
ATE
ABOR
D
AY
8/30/10
9/13/10
9/20/10
9/27/10
C
OURSE
O
UTLINE
T
OPIC
&
A
CTIVITIES
Introductions,
Expectations, and Review of the Course
Syllabus no class
□
R
EADINGS
Course Syllabus
& A
SSIGNMENTS DUE
Enjoy the break!
The Aging
Population
Film:
Big
Mama
Guest speakers:
Nina Browner,
MD, UNC
Neurology and
Lindsay Penny,
MSW, UNC
Neurology
Cognitive
Impairment:
Assessment and Treatment
Older Adult
Sexuality
Film:
Still
Doing It, the
Intimate Lives of Women
Over 65
□ Hooyman & Kiyak – Part One – The Field of Gerontology
– Chapters 1 & 2
□ Rosowsky, E. (2005). Ageism and professional training in aging: Who will be there to help?
Generations, 29
, 55–58.
□ Sasson, S
.
(2000). Beneficence versus respect for autonomy: An ethical dilemma in social work practice.
Journal of Gerontological Social Work, 33
(1), 5-16.
□ Quiz 1
□ Quiz 2
□ Hooyman & Kiyak – Part Two – The Biological and
Physiological Context of Social Aging – Chapters 3 & 4
□ Gorin, S. H. (2010). Healthcare reform and older adults.
Health
&
Social Work
,
35
(1), p3-6
□ Ackerman, M. L., Edwards, J. D., Ross, L. A., Ball, K. K.
Lundsman, M. (2008). Examination of cognitive and instrumental functional performance as indicators for driving cessation risk across 3 years. The Gerontologist,
48, 802-810.
□ Quiz 3
□ Quiz 4
□ In-class assignment: Biopsychosocialspiritual Assessment for Big Mama
□ Hooyman & Kiyak – Part Three – The Psychological
Context of Social Aging – Chapters 5
□ Anderson, K.A., Cimbal, A.N., & Maile, J. J. (2010).
Hairstylists’ relationships and helping behaviors with older adult clients.
Journal of Applied Gerontology, 29
(3),
371-380
□ Ayalon, L., Gum, A. M., Feliciano, L., & Areán, P. A.
(2006). Effectiveness of nonpharmacological interventions for the management of neuropsychiatric symptoms in patients with dementia: A systematic review.
Archives of Internal Medicine, 166
, 2182-2188.
□ Quiz 5
□
Audacious Aging
paper due
5

6
10/4/10
7
10/11/10
8
10/18/10
9
10/25/10
10
11
11/1/10
11/8/10
Anxiety &
Depression:
Assessment and Treatment
Guest speaker:
Elizabeth
Welton, MSW,
LCSW
Private practice
□ Hooyman & Kiyak – Part Three con’t – The
Psychological Context of Social Aging – Chapters 6 & 7
□ Gellis, Z.D. & McCracken, S.G. (2008). Anxiety disorders in older adults.
In S. Diwan (Ed.), Mental
Health and Older Adults Resource Review. CSWE Gero-
Ed Center, Master's Advanced Curriculum Project.
□ Ayers, C. R., Sorrell, J. T., Thorp, S. R., & Wetherell, J.
L. (2007). Evidence-based psychological treatments for late-life anxiety. Psychology and Aging, 22, 8-22 .
□ Cummings, S. M. and Kropf, N. P. (2009). Formal and informal support for older adults with severe mental illness.
Aging and Mental Health, 13,
619-627.
□ Quiz 6
□ Quiz 7
Student prep for presentations.
We will not meet as a class on this night.
Groups are expected to meet on their own.
Caregiver
Stress:
Assessment and Treatment
Guest speaker:
Arlene D’Alli,
LCSW,
Caregiving
Film:
Complaints of a Dutiful
Daughter
Student presentations
Student presentations
Student presentations
□
□
□
□
□
□
□
□
Hooyman & Kiyak – Part Four – The Social Context of
Aging – Chapters 8 & 9
Quiz 8
Quiz 9
Hooyman & Kiyak – Part Four con’t – The Social Context of Aging – Chapter 10 & 11
Amirkhanyan, A. A., & Wolf, D. A. (2003). Caregiver stress and noncaregiver stress: Exploring the pathways of psychiatric morbidity.
Carpentier, N., & Ducharme, F. (2003). Care-giver network transformations: The need for an integrated perspective.
Quiz 10
Quiz 11
Gerontologist, 43
Ageing & Society 23
(6), 817-827.
, 507-525.
If a group wants their audience to read something in advance, please provide instructor a pdf file of the reading for posting on Blackboard presentation. one week prior to
6

12
11/15/10
13
11/22/10
14
11/29/10
15
12/6/10
End of Life:
Assessment and Treatment
Special populations
Settings of
Care, Case
Management, and Elder
Abuse
□ Hooyman & Kiyak – Part Four con’t – The Social Context of Aging – Chapter 12 & 13
□ Bern-Klug, M., Gessert, C., & Forbes, S. (2001). The need to revise assumptions about the end of life:
Implications for social work practice. Health and Social
Work, 24 (1), 38-48.
□ Steinhauser, K. E., Christakis, N. A., Clipp, E. C.,
McNeilly, M., McIntyre, L., & Tulsky, J. A. (2000).
Factors considered important at end of life by patients, family physicians, and other care providers. JAMA,
284 (19), 2476-2482.
□ Quiz 12
□ Quiz 13
□ Fredriksen-Goldsen, K. I. and Muraco, A. (2010). Aging and sexual orientation: A 25-year review of the literature
.
Research on Aging, 32
, 372 – 413.
□ Brown, T. H. (2008). Divergent pathways? Racial/ethnic differences in older women's labor force withdrawal.
The
Journals of Gerontology, 36,
122 -
□ Assessment and Treatment Paper Due
□ Quiz 14
□ Quiz 15
□ Hooyman & Kiyak – Part Five – The Societal Context of
Aging – Chapters 16 & 17
□ Fogler, S. (2009). Using conflict theory to explore the role of nursing home social workers in home- and communitybased service utilization.
Journal of Gerontological Social
Work
.
52
(8), 859 – 869.
□ Firman, J., Nathan, S., & Alwin, R. (2009). Meeting the needs of economically disadvantaged older adults: A holistic approach to economic casework.
Generations,
Journal of the American Society on Aging. 33
(3). 74-80.
□ Quiz 16
□ Quiz 17
TBD TBD
7

Addendum A
Biopsychosocialspiritual Assessment and Intervention Plan
You will be watching a video from which you will develop a biopsychosocialspiritual assessment and intervention plan. The video
Big Mama
chronicles the experience of an older widowed grandmother who is raising her young grandson. A biopsychosocialspiritual outline will be provided to help guide the format of your data collection.
Peer Feedback
Class time for peer feedback will be used to ensure that you are not only following the assignment as requested, but that your paper is also readable and professionally written. Be prepared to exchange your paper with a classmate. You will be responsible for reading your classmates assessment and plan then offer constructive feedback on the content.
This assignment has been adapted from:
8

Addendum B
Audacious Aging
Go to http://www.livingto100.com/ (or any other life-expentency calculator). The calculator asks you 40 quick questions related to your health and family history, and takes about 10 minutes to complete. This is not
a scientific exercise.
1.
Identify the personal, lifestyle, family, medical, and nutritional factors that determined the calculated age. Are their behaviors you could change to increase the calculated age?
2.
Take your life expentency calculated age and subtract five years. Now, imagine you are this age (e.g. the calculated life expentency age is 81; 81-5=76; imagine you are 76 years old): a.
Where you are living, how long you have lived there, whether you live alone/with others, your source and mount of income, your current health, your significant relationships (e.g. close family, friends). b.
Identify personal characteristics such as gender, ethnic background, nationality, race, class, sexual orientation, and explain their influence on your life. c.
Identify at least one personal value that has changed over time in your life and describe why. d.
Reflecting back on your life, discuss any regrets and accomplishments not mentioned above.
3.
How did it feel to complete this exercise?
This paper should be approximently 3-5 typed, double-spaced pages and include thoughtful discussion of all elements listed above.
9

Addendum C
Class Presentation: Mental Health Problems and Challenges
Alone or in small groups, students will deliver a 60 minute presentation on one of five common mental health concerns or challenges of later life: anxiety, depression, cognitive impairment, caregiver stress, and end of life. The presentation will include a detailed description of the concern, an overview of the DSM IV-R Diagnostic Criteria (if warranted), and a critical review of possible treatment approaches; handouts are required.
For this assignment you will present a critical review of several practice-oriented treatment approaches design to address one of the five mental health concerns/challenges listed above. Your selected treatment approaches should be relevant to social work practice and
older adults. Feel free to be creative with your presentation format – just be sure that, whatever style you choose, you meet the objective of the assignment and clearly communicate your ideas.
The beginning of the presentation should provide the audience with an overview of your selected concern or challenge. This usually includes some background information about why the topic is pertinent for social workers working with older adults, as well as a concise definition of the issue
(which should include the DSM IV-R diagnostic criteria). Based on your area of concern, select a few (i.e., 3 or 4) intervention approaches that have been proposed to address the concern. Provide a clear description of the essential components for each treatment approach.
Give the audience your critical assessment of the treatment approaches by comparing and contrasting them with one another. You may want to consider: evidence of efficacy, ethical considerations, cost effectiveness, use with diverse or vulnerable populations, feasibility, or the theoretical assumptions on which the approaches are based. Be sure to answer this question: If you had to recommend one treatment strategy, which one would you recommend, and why?
10

Addendum D
Assessment and Treatment Paper
Students will be required to submit a 10-12 page Assessment and Treatment Paper (Note: page length does not include the title page or references). Students will select one case from the available case vignettes and develop an assessment and tailored treatment plan. The paper should include a clear rationale for the selected treatment approach, including the description of a guiding theoretical or therapeutic model, an overview of the evidence-base for the approach, and individual factors to consider such as client diversity, autonomy, or ethical dilemmas.
The assignment should follow the outline below:
Overview (1-2 pages):
Using the information provided in the case vignette, incorporate relevant course content to provide a broader perspective of the circumstances. What is known about this particular population and setting?
Psychosocial Assessment (2-3 pages): Describe your assessment of the situation. If additional information is required, what questions need to be asked/answered? The assessment should demonstrate use of the person-in-environment perspective by describing the relevant biopsychosocial-spiritual issues. Your assessment should result in a summary of the important problems, challenges, and strengths involved in the case. Be sure to prioritize which of these problems, challenges, and strengths need to be addressed first, and why.
Social Work Treatment Plan (1-3 pages): This is a general plan of action to address the concerns that you identified during the assessment. Note: the Specific Application of a Theory/Treatment
Model is a smaller component of this broader, more comprehensive plan. This section should primarily address of the concerns that are not covered in the next section.
Specific Application of a Theory/Treatment Model (4-6 pages):
In this section focus on how you would address 1 or 2 of the key problems, challenges, or strengths that you identified in the assessment section of the paper. Give a general description of the theoretical/treatment approach and then explain how you would apply it to your selected case. Your treatment approach should be sufficiently detailed so that a reader could easily replicate your approach (i.e., Specifically, what would you say and do?). If you use an approach developed by someone else, that’s fine. Just be sure to acknowledge your source, and explain how the treatment might need to be modified for your client(s) and environment, if at all. Also, be sure to provide a brief rational for why you selected this treatment approach -- and be sure to comment on its evidentiary support. You should also include a critical assessment of the approach (What are its weaknesses and limitations?).
Personal and Professional Reflections (1-2 pages): This is where you include your personal thoughts, feelings, and biases about the case -- as well as a discussion of the professional values and ethics pertinent to the case. Be sure to highlight any personal or ethical dilemmas, and comment on how you would attempt to resolve them.
Conclusion (1/2 page).
11