



nFormation of Older Persons Association with all available and necessary facilities.
nGerontological topics should be included in national education system and all level of syllabuses (primary to advanced level)
nCreating job opportunities in this service sector (all hospitals, clinics and medical centres)
nNational monitoring and evaluation cell for measuring progress and outcome
nCreating District-wise information cell and counselling and advocacy centres
nGovernment should come forward for the well-being of older persons in all respects.
Moreover, in many countries, there have been a flourishing development in research and evidence based ‘good practice’ guidance. The good practice guidelines for health and social care practice in dementia care (NICE/SCIE, 2006) highlight for example, the importance of holistic and person centred assessment practice, proactive approaches in responding to behaviour which is perceived as challenging; and comprehensive training to enable practitioners to deliver person centred care.
Dissemination of research which promotes the active participation of older people continues to develop the knowledge base on what older men and women value about services, the ways in which they are delivered and outcomes that are important to older participants.
Paradoxically, despite an apparently flourishing policy agenda, which increasingly articulates a notion of ‘good practice,’ major challenges exist in the current provision and delivery of social and health care services. These challenges reflect a dichotomy between on the one hand, an imperative to operate within a managerialist agenda and on the other, develop preventative and proactive, user focused and user led services. This certainly creates a difficult set of tensions manifested in terms of managing tightening eligibility criteria, responding to externally derived performance criteria and persistent reorganisations against a stated aspiration to provide good quality services for older people.
The consequences include that fewer people receive any form of services. Moreover, the emphases on responding to only those in greatest need, stymies attempts to develop any comprehensive response to the preventative agenda. Informal carers are also managing the consequences of reduced levels of provision.
This has raised a number of critical issues on the aged people, which require urgent discussion and debate. First, it is clear that social workers working with older people are managing increasingly complex workloads most of the times. If the preventative measures are to be taken seriously, then this will add to the demands for a skilled workforce with appropriate gerontological knowledge, skills and attitudes and values.
Assessment and intervention for older people with complex needs can create the experience of a negative or inadequate response to a person’s need. Moreover, such approaches can serve to reinforce negative assumptions about what older people need. Besides, in an environment where inter-agency collaboration is commonplace, social workers need to know and be confident about the knowledge, skills and values they bring to the table. There is, finally, a need to re-examine the knowledge and skill base in respect to working with older people.
For example, should the gerontological research and knowledge base be utilised to inform practice?
More or less, it is already proved that there is a major challenge facing social workers with older people caring process. Not only qualified social workers are disenchanted, social work students, previously committed to working with older people turned off’ by their experience on placement: social work with older people is ever more driven by ‘process’ with many complex tasks previously undertaken by qualified social workers being carried out by social care staff.
The advent of the new specialised social welfare degree of the Institute of Social Welfare and Research having with its emphasis on the application of research and the integration of knowledge, skills, values and practice offered the potential for the development of a more theoretical, evidence based, knowledge driven social work with older people along the lines of that pursued in other areas such as social work with children and young people or mental health social work. However this degree is a generic qualification and the extent to which ‘gerontological’ social work is addressed in those academic institutions that do not already have an interest in gerontology is questionable. Disappointingly, in the new post-qualification framework social work with older people is not regarded as a specialist subject area but is subsumed within ‘social work with adult,’ alongside younger adults, physical and sensory impairment, learning difficulties, chronic and/or terminal illness, drug dependency and people who may be HIV positive or have Aids. Again, the extent to which training in gerontological, rather than process-led training will be developed is open to debate as a whole.
Most of the social workers increasingly work alongside other professionals in multi-disciplinary settings or even across sectors, and this is particularly the case in social work with older people. To the contrary, in order to best advocate with, and for, older people social workers should be encouraged and supported in all respects to develop an identity that is located in specialist as well as generalist knowledge, shared values and anti-ageist practice and both traditional skills and those honed towards gerontological social work.
It is seen that, in the current climate, there has been a loss of both identity and confidence in social work with older people. Social workers have become resigned to their lot. We think it is time to ‘fight back’ to find ways of raising morale and restoring confidence amongst social workers working with older people and at the same time provide the highly skilled, multi-agency workforce that is necessary in order to ensure that those older people who make use of services are both included and best served.
It should be obligatory to start recognising the complexity of the work and the gerontological profession that are regularly pursued by social workers who work alongside older people and their families,caregivers and the way in which this mirrors many of the debates currently being addressed within the social gerontological community.
Constraints relating to gerontological activities such as service user involvement, identity, gender, ethnicity, disability, life-course transitions, family relationships and conflicts, loss and bereavement, management of autonomy in the face of change quality of life, as well as those relating to the management of crises resulting from ill-health, abuse and neglect. In addition, social workers support and enable carers, many of whom are also older people. Such complex work needs a sound evidence base of ‘good practice’ which is not just about ‘process,’ nor generalist social skills but should be rooted in specialist knowledge, skills and values and which enables social workers to uphold the rights of older people, better negotiate eligibility criteria and argue for resources.
It is viewed that such an evidence base already exists within the welter of social gerontological research but that it is not consistently being accessed by hard-pressed practitioners. Given the lack of specialist training in gerontological social work identified earlier, we would go further and argue that many social workers are not even aware of its existence.
Specialised Masters degree programme in Gerontology and Geriatric Welfare of Dhaka University (Institute of Social Welfare & Research) really inspire the students to gain new knowledge, skill, views, outlook and insight on the activities of ensuring overall well-being in the work practice. So, these batches of students can play a very pivotal role in combating the awful situation in the forthcoming future and could solve many socio-gerontological problems by exerting valuable knowledge and skills in the development of gerontological processes, approaches, services, policies, techniques and practices (both family, group and individual level) towards the betterment of the older people of Bangladesh. Needless to say that research and gerontological debates, symposiums, seminar and establish training programmes for the gerontological activists who can put effective contribution in the fulfilment of well-being of the older people in the years to come.