Social Work Services for the Latino Elderly: A Framework for Practice
Lisette Sosa, CSW, Doctoral Student, Fordham University Graduate School of Social Service
Based on my experience with the Latino elderly, I have been able to identify some of the salient psychosocial needs that must be addressed when providing services to this vulnerable population. Recognizing that the Latino community is a constellation of many nationalities and cultures, each with its distinct customs and beliefs, I will outline a guide that may serve as a generic blueprint for service providers assisting the elderly Latino community. This guide is focused on the primary needs of this population, and the establishment of the client-worker relationship.
The following are practice guidelines that may be used in working with Latino elderly clients:
Security and Trust: Security and trust are key factors in establishing a therapeutic relationship with all clients. However, because Latinos are not traditionally receptive to mental health assistance, the issue of building a therapeutic relationship based on trust is magnified. It would be particularly helpful for Latino seniors to be serviced by social workers that are both bilingual and bicultural in order for them to feel a sense of familiarity and safety.
As service providers, we also need to be more creative in our work with this population. All sessions need not be held inside an office setting. Discussions during a leisurely stroll at a nearby park, a home visit, or a telephone session are appropriate alternatives that would allow Latino clients to tell their own story in a less restrictive environment.
Personalismo: During the initial interview, establishing a sense of "personalismo" is vital in developing a therapeutic relationship with the Latino elder. Personalismo, is essentially, a Latino group value that emphasizes that relationship formation must be established before a task can be accomplished. Latino elders need to be asked brief, non-intrusive questions. The exploration of the presenting problem should occur in a way that allows the Latino elder to feel a strong sense of control over his/her situation. Social workers should give a Latino client the opportunity to feel safe enough to converse and comfortably describe their presenting problems.
Use of Religious Institutions & Clergy: In minority communities churches often play a vital role in honing its members' spiritual and sociopolitical levels of awareness. Within African-American, Afro-Caribbean and Latino communities, religiosity seems to diminish stressful events. As a result, ethnic groups such as Latinos, Blacks and Caribbeans will often seek assistance from the church rather than a formal agency. Therefore, service providers may have to involve a third party (i.e., pastor or nun) in the therapeutic relationship in order for an intervention to be effective.
Family Involvement: Latino clients tend to be very family-oriented, subsequently, as service providers, we should offer services that are culturally sensitive and involve the individual's informal support systems (e.g., family members and friends) and belief system (i.e., religious practices).
Empowerment: Latino elders respond well to service providers who are willing to empower them while teaching them how to navigate bureaucratic systems. Many Latino elders may experience feelings of extreme gratitude for having benefits such as Medicaid and Supplemental Social Security (SSI), making them less likely to complain about the mistreatment of the system or its workers. Many elders are afraid of losing their benefits; therefore, social workers need to reassure them that their benefits will not be taken away if they report a grievance.
Immigration / Migration History: It is crucial that service providers be sensitized to understanding the immigration experience in order to formulate effective and culturally appropriate therapeutic goals and interventions. For example, reasons for migration, feelings about leaving one's native country, family and friends, and the sociopolitical and economic conditions of the country of origin should be explored. When an individual migrates/immigrates to America and is forced to co-exist in a large and unfamiliar society, the sense of loss of control in many aspects of their lives is heightened. Immigrants may feel resistant and suspicious of a system that they do not understand and are unable to navigate; therefore, making the execution of therapeutic goals difficult. This is of particular importance when working with illegal vs. legal immigrants.
Language: The effects of language barriers should be particularly explored as it relates to the elder's, adjustment to the U.S., psychosocial well-being and household composition. Service providers must be cognizant of the fact that the majority of the Latino elderly do not speak English and they often accommodate themselves to this reality. Family members and nurses' aides do not always serve as the best translators, reinforcing further the need for bilingual social workers.
Spanish Media: Television and radio messages should be promoted to inform the elderly and their families of available services in their communities. In working with Latino elderly, we need to inquire how they learned about our agencies, so that we can improve our outreach strategies.
Social workers need to appreciate the Latino elderly population as a resilient, independent, and self-reliant group of individual willing to establish valuable working relationships with agencies that will safeguard their sense of dignity and their need for independence.