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Older People Living Alone With Dementia

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We are having a conversation, social worker to social worker, about the older constituents and clients who we each try to help. She works in a small senior center, and I work in the district office of a New York State Senator. I believe it is those of us on the front line of senior issues in our city who see first-hand the breadth and depth of the ever-growing population of older adults who are left to their own resources to navigate the complexities of life in this large urban city. So many are suffering from some form of mental illness, most often dementia. They are only one step away from winding up in a shelter system where they do not belong. To most people, they are invisible.

Sounding frustrated, she says,”They just keep coming”. I reply, “And they are all mentally ill or in some phase of dementia, right?” “Absolutely, she replies, “either that or they are broke…or, more likely, both.”

And yet, over the past several years, with a very heavy heart, I have had to refer elderly people to our city’s shelter system.This comes only after exhausting my own resources to find them even just a bed for the night. Programs that once offered temporary emergency shelter are full. One program director told me, “Clients used to come in and stay for a few weeks or a few months until they could find permanent accommodations. Now they seem to stay forever, and we very rarely have even a single bed available.”

Add to this the fact that these are people who have no social support network. They have no children or are estranged from their children, their friends have all died; and in some cases they have physical and/or mental limitations, that keep them isolated. These constituents are not anomalies, they are part of a cohort of seniors and elderly community members who come into or call our office every day. One day a young staffer said to me, “Wow, all seniors are mentally ill”. My answer was “No, not all seniors are mentally ill, only the ones that come to see us.”

The older adult that seeks our assistance comes with a legitimate presenting problem; i.e. my landlord is harassing me, someone is coming into my apartment when I’m not home, I’m not getting my food stamps or SSI credits. It is only when I sit down to talk with the constituent, whether in person or by phone, that I very soon realize that the presenting issue is just one piece of a much larger problem. When I make the decision that the constituent’s issues are not appropriate for a legislative office, I then refer the constituent to a senior service agency. It is my hope that the agency will be able to assign her to a case worker who can holistically see the entire picture and assist her in getting the help she needs.

While we need the many extraordinary social workers who are dedicated to helping these constituents with direct service, I can’t help wondering why we are having such an influx of older adults with mental health issues. It is only when we can answer that question that an effective solution can be found…or perhaps legislation can be written…to ameliorate the situation. As a macro social worker, this is my job.

As a political social worker, Alice is deeply interested in best practices in community building and an advocate for improving services and quality of life for older adults. She developed and runs Senator Liz Krueger’s Roundtable for Boomers & Seniors.She is particularly interested in the challenges of longevity in today’s ageing society, and Alice holds an M.S.W. from Hunter College School of Social Work.

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