Working With Older Adults in Integrated Health Care: Social Workers’ Perspective

Abstract

Objective: Older adults are a rapidly growing segment of the global population; a paucity of research exists on social workers supporting this vulnerable group in integrated health care that focuses on both physical and behavioral health. To fill the gap, this study explored social workers’ perspectives of working with older adults in integrated healthcare settings. Methods: Using qualitative methods, a constant comparison data analysis approach was conducted to identify themes. Results: Themes included: (1) working with and highlighting the unique needs of older adults in integrated health, (2) identifying skills needed for working as a social worker within integrated healthcare settings, (3) supporting patient families, and (4) needing to make decisions on behalf of patients. Discussion: Study findings demonstrate social workers as key members of interdisciplinary team as well as highlight the unique needs, skills, and challenges for working with older adults in integrated healthcare settings.

Keywords

loneliness chronic illness aging interdisciplinary end-of-life loss ethics

What this paper adds

Provides insight into the roles and perspectives of social workers who serve older adults in integrated healthcare settings.

Highlights specific skills and knowledge required to successfully work with older adults in integrated health care.

Identifies challenges of supporting patient families and upholding ethics that are relevant in assisting older adults in integrated health care.

Applications of study findings

With a growing older adult population, the perspectives social workers provided in this paper can help social workers gain a general understanding of working with this vulnerable population.

The specific skills, knowledge, and challenges highlighted in this paper can better prepare social workers entering into integrated health care to work with older adults.

The demonstration of the important role social workers serve may motivate healthcare agencies to consider adopting an integrated healthcare model.

Introduction

As of 2019, there were 54.1 million adults 65 or older in the United States, up from 40.3 million in 2010 (United States Census Bureau, 2020). By 2060 this number is predicted to increase twofold to 98 million (Demiris et al., 2020). The National Association of Social Workers (NASW) noted one of the key challenges facing older adults is access to quality health care, including physical, behavioral, and mental health services (2016). Due in part to the passing of the Affordable Care Act in 2010, the United States healthcare system is shifting to a more integrated model of care to address patient social and psychological needs in addition to the more traditional physical needs (Mattison et al., 2017) with the goal to yield best outcomes with the most acceptable and effective approaches (Goniewicz et al, 2021). The model is expanding (1) collaboration across disciplines; (2) services such as case management; (3) referral linkages; and (4) acknowledgment of health determinants such as social functioning, housing, and education. The expansion makes social workers integral in many traditionally medically focused settings including hospitals and outpatient clinics, home health, long-term care facilities, rehabilitation programs, and more (NASW, 2016).

Despite the rise in integrated healthcare services and the recognized value of social workers in such settings, there is limited research documenting the perspective of social workers who are engaging with older adults. Keefe et al. (2009) examined the need and value of social workers within healthcare settings but did so from the perspective of doctors and nurses. Similarly, Donelan et al. (2019) examined data on care management programs in primary care settings for older adults, yet only physicians and nurse practitioners were surveyed despite programs that included social workers. Even in studies where social work perspectives were examined, such as that conducted by Fraser et al. (2018), the focus was on the overall value of social workers within an integrated setting, but does not address the unique experiences of working with older adults. Given the prevalence of older adults in the healthcare system and the crucial roles social workers serve, this study seeks to fill the gap in the literature.

Background

Older Adult Needs and Challenges

Older adults face a number of physical, social, and emotional challenges. An estimated 80% of older adults are living with at least one chronic illness (National Council on Aging [NCOA], 2021) and 77% are living with a minimum of two chronic health conditions (Demiris et al., 2020). As a result of multiple physical health challenges, older adults are at risk of polypharmacy, commonly defined as use of five or more prescription drugs (Golchin et al., 2015). Use of multiple medications can create adverse reactions, which are often compounded due to biological changes associated with aging (Diggins, 2019).

Mental health conditions also commonly develop in older adults due to a combination of biological processes occurring as part of aging, as well as social and environmental changes experienced in older adulthood (Hirst, Lane, & Stares, 2013). According to Falk and Taylor-Schiller (2019), approximately 20% of older adults in the United States are living with at least one mental health condition, including depression, anxiety, schizophrenia, and post-traumatic stress disorder. Loneliness has also been shown to impact mental health outcomes. Blazer (2020) found 50% of older adults who experience loneliness also suffer from depression. Further evidence suggests that loneliness can change physiological processes such as decreasing sleep and increasing inflammation, both of which can lead to declines in cognition and emotional regulation (Blazer, 2020).

Integrated Health Care

Primary care physicians were found to be the most frequently sought resource for mental health care amongst older adults (Reynolds et al., 2020). But the traditional healthcare system, with siloed care for individual health concerns and a lack of coordination amongst providers, is often unprepared and creates barriers to caring for older adults with multiple comorbidities (Banerjee, 2015; Demiris et al., 2020). Integrated healthcare models aim to eliminate many of these barriers, while also holistically addressing the bio-psycho-social concerns of patients. Consequently, this model has become has become a more popular means to provide streamlined and effective care to patients (Mattison et al., 2017). Integrated care can be particularly beneficial for older adults managing chronic conditions (Hoge et al., 2015) and difficult social factors by making behavioral health care accessible (Hoge et al., 2015). The model has been shown to improve patient safety and quality of care (Keefe et al., 2009), increase patient and provider satisfaction, aid in patient mental health (Held et al., 2017), and lead to cost savings (Craig et al., 2015).

Programs of All-Inclusive Care (PACE) Programs

One such example of an evidence-based integrated care model is the Programs of All-Inclusive Care for the Elderly (PACE), which is operated through the Centers for Medicare and Medicaid and is currently available in 30 states (National PACE Association, 2022). The model is comprised of an interdisciplinary team of 11 different professions, including physicians, therapy services (such as physical and occupational therapy), and social workers (National Pace Association, 2022). PACE programs address physical and mental health needs, with conditions including vascular disease, diabetes, heart disease, dementia, and major depressive, bipolar, and paranoid disorders among the most common needs addressed (National Pace Association, 2022). Studies have shown that participants enrolled in PACE programs have positive outcomes including reduced hospitalizations, reduced rates of functional decline, and improved quality-of-life scores (e.g., Cortes & Sullivan-Marx, 2016).

Social Work with Older Adults

As integrated healthcare systems seek to address physical and mental health concerns in a single setting, social workers are uniquely positioned to assist older adults by ensuring that their psychosocial needs are met (Joosten, 2014). Fraser et al. (2018) identified behavioral healthcare services and care management as two of the overarching categories in which social workers provide services within integrated settings. Positive quality-of-life measures were noted for older adults who received social work services as part of their care in 28 of 40 studies evaluated by Rizzo and Rowe (2006). When working with older adults in the behavioral health realm, social workers can address concerns including loneliness, anxiety, and depression, which are well documented as being common challenges facing older adults (Blazer, 2020; Falk & Taylor-Schiller, 2019). When acting as care managers, social workers can make referrals and help connect older adult clients with a variety of resources, including transportation, senior centers, and meal programs, such as Meals on Wheels, long-term care facilities, and Medicare insurance information (Joosten, 2014).

Existing literature demonstrates the benefits of an integrated approach to care, the mental and physical health challenges facing many older adults, and the roles which social workers serve in addressing many of the care needs for this population. Making behavioral health care available through integrated healthcare settings decreases barriers for older adults (Hoge et al., 2015) and increases linkages to other needed services and supports (Fraser et al., 2018). However, there is limited literature in the area of understanding the experiences and perspectives of social workers employed in integrated healthcare settings who support older adults, and this study fills that gap. Even within literature that details the success of integrated PACE programs, no research was identified that specifically examines and attempts to understand the role the social worker serves within the interdisciplinary team.

Methods

The study sought to answer the following research question: What are the perspectives of social workers working with older adults in integrated healthcare settings? Given the exploratory nature of the research question, qualitative methods were used. The study was approved by a university institutional review board (IRB).

Sampling

Purposive sampling was utilized to identify 37 social workers to be part of the study. Participants qualified if they (1) held a social work degree; (2) had a minimum of 2 years of work experience in integrated health care; and (3) worked with older adults. Educational background of participants included 1 Bachelor of Social Work, 33 Masters of Social Work, and 2 PhD. Among the 37 participants, years of experience ranged from 2 to 35. All participants worked with patients across the life span that includes older adults. Participants identified their racial background as African American (2), Asian American (4), European American (16), Latinx American (11), and Multiracial (4). The vast majority of participants (32) identified as female. Participants represented a multitude of different integrated healthcare settings in which social workers are present including acute medical hospitals, psychiatric hospitals or psychiatric units within hospitals, outreach programs for individuals experiencing homelessness, hospice programs, adult day care centers, mental health clinics, home health, Veterans Affairs clinics, skilled nursing facilities, and city Departments of Health.

Data Collection

Semi-structured interviews were conducted face-to-face by graduate students at a location preferred by participants such as their place of work. All questions were answered and informed consent were obtained prior to data collection. Interviewees used a script and pre-constructed list of questions approved by the IRB to guide interviews and to maintain consistency across interviews. The semi-structured list of interview questions included open-ended questions exploring several distinct aspects of social work in an integrated healthcare setting and allowed for researchers to ask follow-up and clarifying questions of interviewee responses. Interviews took about 45 minutes to an hour and were audio recorded and transcribed by graduate students. Any identifiable information participants may have provided was disguised in order to maintain participant confidentiality. The lead researcher reviewed all audio recordings and transcriptions.

Data Analysis

Data analysis followed the constant comparative method by Lincoln and Guba (1985). Each transcript was read individually and coded. Following coding, individual units of standalone data were identified. Each unit was then sorted into the identified categories and then each category was reviewed to ensure unit placement was appropriate. Finally, categories were then merged or divided to allow for identification of the themes. The themes were used to establish the narrative within the data, which is discussed within the results section. Two rounds of manual data analysis were conducted, and a methodological log was kept in order to ensure consistency. Data analysis followed the guidance of Creswell (2007). Thematic analysis was conducted utilizing qualitative software, NVivo. Prior to utilization of NVivo, interview transcripts were read in depth to gain an initial understanding of the data.

Methodological Rigor

In order to provide transparency and credibility and to minimize bias, Creswell (2007) encouraged employment of two distinct strategies in qualitative research. The first strategy utilized was member checking in which the data collected were reviewed with participants. This strategy allowed for participants to correct their experiences and validate the data collected (Rodwell, 1998). No corrections were made to the data collected. Methodological journaling was utilized as the secondary strategy by recording and tracking all decisions made throughout the project (Rodwell, 1998). This strategy helped with consistency and transparency of the research process.

Results

This study sought to examine the experiences of social workers engaging with older adults within integrated healthcare settings. Themes emerged from the data including (1) working with and highlighting the unique needs of older adults, (2) identifying skills needed for working as a social worker in integrated healthcare settings, (3) supporting patient families, and (4) decision making for patients. See description of coding tree in Figure 1.

Figure 1.

Description of coding tree.

Working With and Highlighting Needs of Older Adults in Integrated Healthcare Settings

Participants shared positive feelings about their experiences in integrated health care by using words such as “empowerment (Participant 2),” “positive changes (Participant 22),” and “love (Participant 12).” Participants also talked about their ability to offer quality care and noted the value in the holistic approach to care. Several participants spoke to the richness of lived experiences older adults often share. Participant 30 mentioned appreciation for the stories of their patients: “Some are great historians, they offer life experiences, wisdom… It is about disproving stereotypes and getting to know a lot of wonderful people.”

In addition to positive experiences, some participants also noted challenges that included communication amongst the interdisciplinary team, working with patients who demonstrated a lack of motivation, and availability of additional community resources to aid patients. Another challenge social workers encountered included navigating transference or counter-transference concerns specifically relating to working with older adults, with one Participant 32 stating:

A lot of times, I see patients who remind me of my parents (we’re getting into countertransference issues) and that throws me off a little bit.

One participant noted how countertransference is not just limited to social workers but can also be experienced by members of the interdisciplinary team:

The social worker can help to provide support to the medical professionals on the team when they’re experiencing something that’s really just a difficult thing or a difficult diagnosis that they are giving a patient. Maybe it's something that the doctor or the nurse is having countertransference about and we’re able to provide that support and let them know and give them a little bit of insight on what they’re experiencing (Participant 6).

When working with older adults, participants addressed topics such as bio-psycho-social concerns specific to later stages of life, such as working with individuals who are living with various chronic health conditions, preparing for, or coping with, losses associated with aging, and preparing patients and their families for end-of-life experiences. Participants acknowledged the unique life stressors that require attention with Participant 23 emphasizing:

In geriatrics, there are specific health conditions and concerns that affect the individual’s life biologically, emotionally, socially, spiritually, psychologically, etc. To be knowledgeable in these medical issues and how they interact with every aspect of a person’s life takes time to master, so to speak.

Similarly, other social workers also noted the need to address underlying medical issues and understand the impact of health concerns on quality of life among older adults. Specific to health impacts, social workers highlighted chronic illness, with particular focus on Alzheimer’s and other dementias. Participant 29 stated: “Some have early onset dementia and even taking away their ability to drive, that is difficult. There is an increase in the older adult population and all the emotional issues that come with that.” Other diagnoses mentioned included HIV, diabetes, congestive heart failure, and cancer.

Physical, social, and emotional losses also emerged as common experiences among older adults and participants identified this as an area that social workers must be prepared to address. Participant 29 shared how physical ailments can lead to various experiences of loss:

Someone can have a stroke, and then after that you can have depression. There might be a loss of independence, or someone is hospitalized. It’s important to address the stroke that occurred and also coping with that and what is happening…On my end it is focusing on the patient’s psychosocial needs. We have to look at how things impact the patient and maybe also the family. We are addressing the patient’s needs and also looking at the whole picture.

Further, older adults are prone to a variety of social and emotional losses that may include the death of family and/or friends or friends experiencing their own cognitive decline or change in living situations.

According to participants in this study, social workers involved in the care of older adults will also likely encounter end-of-life planning and support. Participant 17 summarized some of the activities associated with end-of-life planning that social workers should be familiar with: Doing discharge planning, coordinating family meetings to discuss end-of-life issues…providing emotional support to patient and families’ End-of-life situations can be challenging for patients and families, but social workers can serve an important role in helping to cope with the loss.

Noting the Skills Needed for Working with Older Adults

Based on their experiences, participants discussed skills that are needed for working with older adults. Familiarity with health conditions and medical terminology was a skill consistently discussed amongst participants. One social worker (Participant 16) shared:

…when I’m seeing a patient to do a psychiatric assessment…let’s say they come in and they're having hallucinations. As a medical social worker, you have to know, what are the etiologies of what we consider altered mental status or hallucinations. Do they have a tumor pressing against a portion of their brain? Are they elderly? Do they have a urinary tract infection that is causing them to have hallucinations?

Although knowledge of medical conditions is not necessary initially, participants highlighted the need to be ready to learn from the medical staff. Additionally, participants noted the need to ask questions or find answers in order to be able to both communicate with the interdisciplinary team and to also be an effective liaison between the team and patients.

Insurance is another important element of care that social workers encounter within integrated healthcare settings. In working with older adults, many patients will be covered by Medicare and Medicaid. Familiarity with these systems and being able to assist patients were expressed by several participants as being important qualities for a social worker to possess. Ensuring that specific guidelines and requirements are met in order to be eligible for specific funding sources is a key part of agency management. Participant 17 stated: “The policies Medicare has about what we have to do in order to be participating Medicare providers. And we have to be a Medicare provider because that’s our biggest source of income coming into the hospital.” Participants noted that social workers need to ensure protocols outlined by these funding providers are followed, while also ensuring that patient care does not suffer as a result of satisfying the needs of another agency.

Supporting Patient Families

When working with older adults, participants stressed that, at times, families will need to be directly involved in the patients’ care, or situations may arise where family members will want to be involved. For instance, Participant 3 stated: “Families are very worried about their family member—wanting to know, wanting to intervene.” Family involvement may also be a necessity in certain circumstances such as end-of-life care in which families may be responsible for care decisions and will become a primary point of contact for social workers. Participants noted social workers need to maintain appropriate levels of involvement by assisting families through the situations, and being a source of support. Here is an example from Participant 11:

Seeing someone that might be dying, and what family members might be going through, and how you can be there for the family members and the patient. Being comfortable with what is it that as social workers we can do to help the patient and their family members during a moment of crisis.

Fundamentally, loss is a prevalent experience when working with older adults and participants stressed that social workers must be prepared to help families cope.

Some participants relayed the positive and supportive experiences of working with family members. For instance, Participant 23 reported: “A few situations I have provided support to patients and their families throughout the journey are new life of someone in their family, new death of patient or someone in their family.” Not only can the interactions be meaningful for the social worker, but some interactions can have lasting benefits on patient families, even long after the encounter. Another participant reflected:

I’ve had family members who call me and say ‘my family member was there once with you and I remembered your name’ and they ended up asking for more resources. It’s nice that family members remember you even past the patients stay (Participant 3).

Participants also shared how family involvement can sometimes create a challenge for social workers. Instances where families don’t need to be involved but want to be involved can create a conflict for patients’ right to privacy. As an example, Participant 3 stated:

We have to respect that the patient is an adult who is entitled to make his or her own decisions therefore we cannot disclose protected health care information and we also can’t disclose some of the things that were shared during our interaction with them. It becomes frustrating for families when they cannot be involved with the patient’s care.

Participants stated that social workers must be able to mediate between the needs of family and of the patient and when done carefully, it can lead to beneficial outcomes for all parties involved.

Decision-Making on Behalf of Patient

Participants identified three broad areas where social workers may need to navigate making decisions on behalf of patients and the challenges that these situations can present: (1) when older adults are unable to make decisions for themselves, (2) when family may be required to make decisions for the patient, and (3) when the interdisciplinary team may need to make decisions on behalf of the patient. Participants identified how cognitive impairment or conservatorship status may result in patients being unable to make decisions on their own behalf. Participant 3 stated:

Or this patient doesn’t want care, but do they have the cognitive ability to make that decision? If they are not conserved, do we give the patient the right? These are situations that often come up and have to be looked over by a risk team.

In instances where a patient is no longer able to speak for themselves, social workers must collaborate with their interdisciplinary teams, as well as with patient families, to determine the most appropriate steps forward.

Participants noted how family involvement in decision-making can be challenging, depending on the circumstances. Participant 12 provided the following example where a family member might be overstepping:

Sometimes you have family members that want to make decisions, but the patient is alert and oriented and they can still make their own decisions. The family may want treatment, but the patient does not…They [the patient] get to make that decision.

In these instances, participants recommended social workers remember that their role is to support the patient and provide psychoeducation to families on policies and patient rights. With end-of-life situations in which patients are unable to speak for themselves, participants discussed how family members may disagree with medical recommendations. Participant 17 shared: “We’ve got people who are really at the end-of-life and the family won’t accept it.” In these instances, social workers may need to serve as brokers between the medical team and patient families, while also continuing to act in what they believe to be the best interest of the patient.

At times, the interdisciplinary team will need to make decisions on behalf of the patient, but study participants noted how consensus amongst the team may be difficult to obtain. According to Participant 22:

Physicians are trained to tell people what to do and it’s hard for them when people do not listen. We are bound to a Code that we have to follow. For example, as social workers we value and promote clients’ autonomy, physicians don’t.

Although both social workers and physicians might have patients’ best interest at heart, the professional approach to what is best for the patient might differ, which can create tension within the team. As acknowledged by participants, social workers believe in a patient’s right to self-determination, but when the medical team feels strongly that medical interventions that may go against patients’ wishes are appropriate, social workers may find themselves in challenging situations.

Discussion

As integrated models of health care become more common across the United States, the role of social workers has become more pronounced and important. Yet, there is minimal research documenting the experiences of social workers with older adults in these settings and this study fills that gap. Social workers in this study highlighted the benefits of holistic, integrated care, as well as noted positive personal experiences and patient benefits. These findings are consistent with existing literature which notes integrated care is associated with improved patient health outcomes, as well as satisfaction levels of both the patient and provider (Held et al., 2017). The findings in this study add to the literature with the perspectives and benefits from social workers’ experiences. This has important implications for organizations that may not yet have adopted integrated care models. For healthcare agencies that are uncertain of how to approach these, the Center of (2021), funded by the Substance Abuse and Mental Health Services Administration (SAMHSA), offers programming support and evidenced-based practice.

Stein (2016) warned that transitioning away from the traditional format of the doctor being the primary decision maker to an integrated model can lead to “resistance or disregard” (p.1) from some team members. Social workers should utilize their communication skills to help navigate the transition process as well as communication difficulties within the interdisciplinary team. Organizations should also foster cohesive and effective interdisciplinary teams where each member feels valued and is able to contribute. Further, as noted in this study, social workers can support other team members to navigate difficult feelings that arise as a result of working with older adults who might be experiencing chronic health concerns or approaching death.

When working with older adults in integrated healthcare settings, participants highlighted certain needs of older adults in terms of chronic conditions, coping with a variety of life losses, and preparing for end-of-life. Losses identified by study participants included physical losses associated with the natural aging process and chronic health conditions, as well as social and emotional losses, such as the loss of family and friends and ability to care for oneself. Perissinotto et al. (2019) discussed how these losses can contribute to social isolation experienced by older adults. Helping patients and families emotionally prepare for end-of-life is a role social workers in this study highlighted, whereas existing literature focuses more on tasks such as preparing an advanced directive (Joosten, 2014).

Banerjee (2015) expressed how traditional healthcare systems within the United States are underprepared for the care that older adults with multiple comorbidities require. This further supports the need for the integration of health care that includes adding social workers on interdisciplinary teams to address socio-emotional needs that arise in conjunction with physical health ailments. The needs of older adults identified in the present study help social workers entering into integrated healthcare be better prepared for their roles. In preparation to better assist older adults, social workers may want to gain experience or seek training in bereavement and loss. Participants in this study also discussed the importance of having familiarity with policies such as Medicare and Medicaid, and an understanding of medical terminology. Joosten (2014) found that 66% older adults receiving home-based health and mental health services utilized Medicare services and 20% utilized Medicaid services, supporting the notion that social workers must be familiar with these programs. Participants in the present study also noted that many agencies receive funding from Centers for Medicare and Medicaid Services (CMS), which have begun to recognize the need for care management services, particularly to treat chronic illnesses. Consequently, social workers in settings where care management is offered need to be familiar with the various policies, procedures, and requirements associated with CMS funding. Regarding medical terminology, study participants recognized it is beyond their scope of practice to diagnose medical conditions, but noted familiarity with common conditions, their symptoms, and related terminology is a useful skill in integrated health care. This finding has important implications for social work practice as existing literature is limited in the discussion of the importance of this skill set. Understanding medical terminology allows social workers to interact and engage with the interdisciplinary team in a more meaningful way and being able to identify possible conditions that can mimic behavioral health conditions is a helpful skill.

It is inevitable that when working with older adults, social workers will also engage with family members in various capacities as they are the primary source of support and caregiving for older adults (Hoge et al., 2015). As part of their training, social workers learned to engage with family systems (Keefe et al., 2009) and view families as sources of potential support. Hoge et al. (2015) identified benefits as well as need for greater involvement and supportive services for families providing care of older adults, which is consistent with recommendations from social workers in this study. Participants in this study discussed how family involvement can be challenging, and that a continual balance needs to be found between protecting patient confidentiality and ensuring the patients desires are adhered to, while also being a source of support and information for family members. Section 1.07 of the NASW Code of Ethics (2017) outlines the confidentiality and privacy expectations for social workers. Social workers should ensure familiarity with the code of ethics and various policies in preparation for questions from family members and working with their teams.

Limitations and Conclusion

The study limitations and future research needs should be noted. This study was exploratory and was not intended to be generalizable. The exploratory nature and the variation of the settings represented in this study limited in-depth analysis of comparing important characteristics such as interdisciplinary training and years of service to social work perceptions. Future research should focus on specific types of settings and examine how various characteristics affect social work perceptions. Additionally, with the incorporation of social workers in integrated healthcare settings, studies on the transition from traditional nonmedical and medical settings would be useful. Another limitation of this study is that the perspective of older adult care is limited to social workers. A follow-up study can focus on older adult experiences with social workers in integrated health care. While mentioned by participants in this study, further research on issues of transference and countertransference amongst social workers working with older adults in integrated healthcare settings would be interesting. Yet another limitation of this study is selection bias due to recruitment of social workers from the research team’s own networks. Despite the limitations, this study fills the gap in the literature by noting the value of social workers in addressing the unique needs of older adults. Social workers are key members of interdisciplinary teams within integrated healthcare settings, yet their experiences with older adults are not well explored in the literature. This study provides insight into the various environments in which social workers provide services, the physical and behavioral health stressors facing older adults and the ways in which social workers can address these needs, and the dynamics of working on an interdisciplinary team. This study offers insight into the specific roles and experiences of social workers in integrated healthcare settings with older adults, providing first-hand accounts of skills, strengths, challenges, and limitations that social workers within integrated healthcare settings face. This insight can contribute to social workers being more informed and prepared to work with older adults in integrated health care settings.

Supplemental Material

sj-pdf-1-jag-10.1177_07334648221105266 – Supplemental Material for Working With Older Adults in Integrated Health Care: Social Workers’ Perspective

Supplemental Material, sj-pdf-1-jag-10.1177_07334648221105266 for Working With Older Adults in Integrated Health Care: Social Workers’ Perspective by Suzie S. Weng and Jessica Valenzuela in Journal of Applied Gerontology

Footnotes

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Research ethics

The study was approved by the California State University, Long Beach IRB #1219980 with written informed consent from all participants.

ORCID iD

Suzie S. Weng

Supplemental Material

Supplemental material for this article is available online.

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