ORIGINAL PAPERThe Meaning of ‘‘Place’’ to Older Adults.docx

ORIGINAL PAPER
The Meaning of ‘‘Place’’ to Older Adults
Jeanne Sokolec1
Published online: 16 July 2015
� Springer Science+Business Media New York 2015
Abstract Social workers are well-equipped to work with
older adults and their families. The life course perspective
provides a framework for seeing older adulthood as a stage
of life in the continuum of life as well as a stage with its
own characteristics and tasks. All the roles within social
work practice can be adapted to this population. In addi-
tion, social workers working with older adults and their
families must be cognizant of the specific issues that are
associated with aging and older adulthood. The issue of
loss on many levels is a frequent topic. One area of loss
that is not frequently addressed is the loss associated with

where one lives. The word place can have several mean-
ings. One meaning has to do with where one lives. The
second meaning of loss is about one’s status and role—
place-in-society. For older adults both meanings become
important issues as they and their families navigate the
decisions that have to be made. While residence is based on
the level of independence and competence of the older
adult, the issue of place-as-status is a constant frustration
for older adults. Issues of leaving one’s place and losing
status in the eyes of others evoke a myriad of feelings
depending on the particular older adult. But given that as
one ages there are naturally some physical and mental
acuity losses, every older adult is subject to feelings of
sadness, depression, hopelessness, and even anger. These
feelings are natural responses to loss. Among the roles of
social workers working with older adults is one of helping
a mourning process move to a healthy acceptance of one’s
aging and planning rather than devolving into major

depression.
Keywords Older adults � Aging � Ageing issues � Social
worker role
Introduction
The literature on older adulthood consistently reports that
there is a shortage of professionals to work with the older
adult population (Hartford Foundation 2011; National
Association of State Mental Health Program Directors
2014; Eldercare Alliance Network 2015). Among these
professionals are social workers and especially those who
provide services on a direct practice basis. Social workers
are educated about the tasks and issues of the life stages
across the life course. Until more recently older adulthood
was treated as the end stage where individuals reflected on
their lives while waiting to die. Similar to other life phases,
older adults are not a homogenous group in many factors.
One of these factors is their state of health. It is unrealistic
to think that older adults will not have a variety of ailments
but the nature and severity of these ailments are dependent

on a host of factors and experiences earlier in their lives or
acquired as they age. Thanks to the few geriatric social
workers and researchers we now know that there is much
more happening during older adulthood than was thought
about previously. Recognizing the variation in functioning
of older adults, social workers are not only working with
diminished older adults but older adults who are healthier
and more active. These clients in turn may, according to
Ruffin and Kaye (2006), bring higher expectations for their
lives to the counseling relationship (p. 529).
& Jeanne Sokolec
[email protected]
1 School of Social Work, Loyola University Chicago, Chicago,
IL 60611, USA
123
Clin Soc Work J (2016) 44:160–169
DOI 10.1007/s10615-015-0545-2
http://orcid.org/0000-0002-0295-6650
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0545-2&domain=pdf

http://crossmark.crossref.org/dialog/?doi=10.1007/s10615-015-
0545-2&domain=pdf
One major concern for older adults and their families is
where they are going to live as they age. Some older adults
will not have options about their residence because of the
resources they do not have or the level of care that is
needed. However, there are an increasing number of older
adults who have both the resources and the health to make
choices about both how and where they want to live.
Housing as an issue is not a new problem that social
workers address with their clients. For older adults housing
issues are more than about addresses. Along with the
physical structure of housing are emotional issues related
to the particular address. Borrowing from other authors,
Gonyea (2006) stated this very well saying that:
…housing is about much more than a physical space
or structure. Rather, a home serves multiple functions
and has a deeper meaning. A home offers individuals
a safe haven and protection from the intrusion of the

outside world. One’s home and neighborhood are a
crucial piece of one’s self-identity and evoke a sense
of belonging. For many older adults, a home is a
highly cherished symbol of their independence and
dignity (p. 559).
Geriatric social workers are cognizant of the many
issues older adults have in order to provide the best practice
for their clients. Housing is an example of a common issue
for older adults that involves social work interventions at
micro, mezzo and macro levels. At the micro, direct level,
social workers may be directly involved in locating hous-
ing options and facilitating transitions. As the direct prac-
titioners social workers have to encourage the client to
address whatever underlying feelings the older adult has
about their future. Given their knowledge about the older
adult life stage and the varying needs of older adults, social
workers can be instrumental at the mezzo level in helping
older adult facilities to have appropriate programs. Policies

and programs are behind in terms of the increasing num-
bers of older adults needing policies to provide resources
and programs to provide services. Social workers in macro
roles are a key source of knowledge to policymakers and
the departments that implement policy.
In the literature about older adulthood, and even in
public policies, the terms ‘‘aging-in-place, healthy aging
and active aging’’ (World Health Organization 2002; White
Conference on Aging 2015) have become the organizing
principles for thinking about the lives of older adults.
A Policy Brief from the 2015 White House Conference on
Aging committee has stated:
Healthy aging means more than just managing and
preventing disease and chronic conditions. It also
means continuing to live a productive, meaningful
life by having the option to stay in one’s home,
remain engaged in the community, and maintain
social well-being. Older adults may require other

services and supports, including social and commu-
nity services, and age-friendly communities, in order
to maximize their independence.
Aging-in-place is generally is meant to promote older
adults continuing to live in their own homes, or at least in
the community, as opposed to some type of care center. A
central component for aging in place is the concept of
choice, which is allowing the older adult to determine their
own living arrangements (Australian Psychological Society
Ltd 1999). Sijuwade (2009) has framed aging as:
…occurring in a societal context, ranging from the
micro scale of the family to the macro scale of the
society. This context includes the attitudes, stereo-
types and age norms, which determine age appro-
priate behavior for the aged (social-image). Further,
the aged have an image of themselves (self-image)
and an image of how they feel, the ‘others’ in the
society perceive them (image of social image). The

societal attitudes shape the social behavior towards
the aged. The interactions of the aged in the social
environment result in the self-image of the aged
being reinforced by the social image (p. 1).
The World Health Organization has defined healthy
aging as ‘‘… the process of optimizing opportunities for
health, participation and security in order to enhance
quality of life as people age. It applies to both individuals
and population groups’’ (WHO 2002, p. 11). In this defi-
nition active is not merely physical moving or working but
the more holistic conceptualization of participation. The
Minnesota Department of Health (n.d.) defined healthy
aging as:
… the development and maintenance of optimal
mental, social and physical well-being and function
in older adults. This is most likely to be achieved
when communities are safe, promote health and well-
being, and use health services and community pro-
grams to prevent or minimize disease (p. ii).

Taken together these concepts become the framework
for Aging Friendly Cities or the newer phrase used by the
World Health Organization: Age Friendly World (WHO
2014). In strength-based, empowerment based practices the
social worker will as much as possible honor client self-
determination and encourage the older adult to advocate for
themselves by at least stating their preferences. One fear in
promoting client self-determination is that the client will
not choose wisely. Social workers constantly deal with this
dilemma and employ strategies of full disclosure of risks
and benefits of the client’s choices, as well as help the
Clin Soc Work J (2016) 44:160–169 161
123
client through a process of decision making process. Any
work with clients is predicated on assessment of the client,
their history as well as their current functioning. Social
workers are well-versed in biopsychosocial assessment.

Geriatrically trained social workers will understand that in
addition to a general assessment the assessment should also
inquire about issues pertinent to older adulthood such as
loss. Loss is an issue for every person; however as one ages
the number of losses one has increases with the deaths of
spouses and partners, other relatives as well as friends. A
common sentiment of those in their late nineties is that all
their friends and even children have passed away. Along
with loss then is a feeling of loneliness which if not
addressed can lead to loss of enthusiasm and even
depression in the sense of giving-up.
Spirituality is a topic that has gained importance in
social work since for many clients spirituality, however
defined, is a source of comfort and strength. On the other
hand, some older adults may feel anger at their current
predicament and diminish their previously held beliefs. In
either case, these issues should be part of any assessment.
One other area that needs to be explicitly addressed is that

of risk. NASW in its Standards for Family Caregivers
(2010) lists a variety of risks that need assessment from the
ability of caregivers to adequately understand the older
adult’s situation and provide appropriate care to risk of
abuse and neglect of the older adult. Including the category
of risk there is the recognition that older adults are not
immune from having or developing substance abuse and
alcohol problems.
Anthropologist Margaret Clark in the mid-1960’s, based
on her research, reframed aging ‘‘as a situated phe-
nomenon—an iterative, socially embedded process that
requires adaptation to specific sociocultural contexts’’
(Perkinson and Solimeo 2014, p. 102). The notion that
there is a sociocultural context to aging is not surprising to
social workers and reminds us that any approach to aging
has to be seen in the particular culture in which it is
occurring. It also supports the premise that within a mul-
ticultural setting like the United States, there may be dif-

ferent views of what older adulthood should look like from
the environment to the individual.
The Meaning of Place
The word place can have several meanings. One meaning
has to do with where one lives. Tuedio (2002) has asked,
‘‘What is the connection of home to personal identity,
growth, and development (p.1) ? The other meaning is a
‘‘state of mind’’ (Tuedio 2002, p.1) including concern
about one’s status and role—‘‘place in society.’’ For older
adults both meanings become important issues as they and
their families navigate the realm of older adulthood.
Place attachment is a term that is often found in the
environmental psychology literature. In its simplest terms,
‘‘place attachment is an emotional bond between people
and their environment’’ (Anton and Lawrence 2014,
p. 451). Studies on place attachment have found that the
positive effects of this type of attachment include physical,
emotional and social phenomena (Anton and Lawrence

2014). Within place attachment there is the dimension of
place identity. Proshansky et al. (1983) described this
identity ‘‘as a substructure of self-identity consisting of
memories, ideas, feelings, attitudes, values, preferences,
meanings, and conceptions of behavior and experience that
occur in places that satisfy an individual’s biological,
psychological, social, and cultural needs’’ (p. 59). While
this concept is not specific only to older adults, it does have
particular significance for this group given the current
emphasis on aging-in-place.
As people are continuing to age, we are learning that
they are not a homogenous group, nor is there a constant
predictable pattern. In the best of worlds there would be a
robust continuum of care with adequate resources. Real-
istically however, like children, older adults may not
always be able to make an informed choice and what they
would want, which is most often to stay in their own home,
may not be appropriate. While residence is based on the

level of independence and competence of the older adult,
the issue of place as status is a constant frustration for
older adults, especially those who remain healthy and
independent well into their 80’s and 90’s. This means that
when talking about the meaning of place that there will be
different concerns depending on individual older adult. For
example, for the older adult who has to move into a level of
care away from their home and community, place as living
space may be the main concern. Three in ten Americans 40
or older would rather not think about getting older at all,
and when prompted to think about it, a majority worry
about losing their independence (Tompson et al. 2013,
p. 2). Chen’s study (2001) interviewed older adults about
how they felt about being old. The participants related their
capability to do things as meaning they were not old. One
widow stated: ‘‘Age is just a number. I don’t like the
number because people usually view the age in a negative
way’’ (What Aging Means section, Para. 1). For the older

adult these are psychological issues that come from the
core of their identity. Undoubtedly risk and resilience
factors play an underlying role in the older adult’s attitude
and coping skills. For practitioners these are issues that
have to be discussed in order to develop an integrated care
plan.
Complicating the ageing-in place discussion is the
growth of retirement communities where people can move
162 Clin Soc Work J (2016) 44:160–169
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in as early as age 55. These communities differ in the levels
of care they provide. Some communities only may have
independent living; others may have independent living
and some assisted care options; and others may offer a full
continuum of care from independent living to nursing care
with specialty floors for those residents who have demen-
tia. At the independent living stage these communities

make themselves attractive to potential residents by
offering a range of options from dining choices, social
activities, field trips, and various classes. Anecdotally older
adults who select a retirement community like the sense of
community which perhaps was no longer available in the
previous residence as well as a sense of being cared for
even if they were living as independent persons. Ideally
these facilities have social workers on staff for both
assessment purposes and the on-going monitoring of the
residents’ mental health. A major consideration in the place
issue is cost. Many of these communities require an
entrance fee which could be up to several hundred thou-
sand dollars plus monthly assessments. The costs can make
it prohibitive for those without monetary resources who
would, if they could, select a retirement community option.
It is important to note this is an area where social work
knowledge about housing needs can be translated into
advocacy at the state and federal levels.

Ageism and Status
Unlike other cultures in the world, older adulthood in the
United States has not traditionally been a revered stage of
life as a societal norm. Milton Fisk (2002) has used the
word ‘‘superfluous’’ to describe what has happened to
certain groups of workers throughout our economic history.
Synonyms for superfluous include not required, redundant,
unnecessary, or non-essential which are terms we generally
associate with things, not people. These terms could be
equally applied to the views of older adults. The proportion
of older people who are employed is an important factor
that is related to perceptions of the social status of older
people in less modern societies (Vauclair et al. 2014).
A number of factors create this age divide. Increasingly
younger people in the United States are more mobile in
comparison to other generations so that adult children and
their parents are often living in different cities. Until 1976
working persons who were 65 years old could be made to

retire regardless of their health status and quality level of
their work. The United States is seen as having a focus on
the younger generation and it is only recently that there has
been advertising that has included older adult actors
speaking directly to older adults about a specific product.
The term ageism is now regularly included in the list of
isms in our society meaning that there are prejudicial
feelings or actions based on beliefs about the limitations of
abilities due to age. Institutional ageism manifests in the
policies that do not address the needs of older adults or
treats older adults with demeaning attitudes and disem-
powerment (Grant 2010).
Status is a societal issue in terms of how older adults are
viewed by younger generations. Ridgeway defined status as
an ‘‘… an inherently multi-level form of inequality in that it
involves hierarchies of esteem and influence between
individual actors as well as hierarchies of social esteem
between groups in society’’ (2014, p. 5). This status issue is
embedded in the concept of ageism. Stereotypes about older

people suggest extremes, ranging from the incompetent fool
to the compassionate and wise elder (Carstensen and Hartel
2006, p. 22) and Nelson reminded us that until the invention
of the printing press, older adults were respected as the
‘‘sole repository of knowledge’’ (2011, p. 38). Status dif-
ferentials affect both the receiver of the status designation in
terms of their behavior as well as the one who bestows or
reduces the status of the other in terms of their attention to
the other person. Also, as Ridgeway reminded us, this
occurs at both micro and macro levels. At the micro level it
occurs when older adults are not invited to participate in
community activities and at the macro level when policy
agendas do not include concern about older adult issues.
Status as one variable can be confounded by other variables
such as gender, race, ethnicity, and/or economic resources.
Differential treatment in healthcare based on gender, race
and socio-economic status is well documented in the
healthcare disparities literature (Centers for Disease Control

and Prevention 2014). For example, older men who have
retired from businesses may receive higher status than an
older woman who has never worked. While not phrased as a
status issue by older adults, practitioners have to help their
clients deal with the hurt feelings of being discounted by
others as having nothing of value to add to society.
Bell and Menec (2015) have looked at the relationship
between independence and social exclusion. They pointed
out that individual independence is seen as a core value in
American culture that operates on at least two levels. Not
only is it a value that individuals wish to have, but inde-
pendence is also an expectation made of capable adults.
While there are reasons for individuals not being inde-
pendent persons, they can be seen as not operating within
the mainstream and can then be excluded. Given this cul-
tural norm and the consequences of not meeting the norm,
it is not surprising that older adults hold on dearly to their
independence even when it can be detrimental to their

well-being. The ‘‘fear of dependency and anxiety’’ (p. NP9)
that is created can also lessen one’s self-esteem. The fear of
dependency can also lead to older adults putting on a ‘‘false
face’’ of competence, refusing assistance and opportunities
that can be helpful to them as well as not participating in
Clin Soc Work J (2016) 44:160–169 163
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social activities ‘‘that are for old people’’ (p. NP12). One
finding of Bell and Menec’s study (2015) indicated that
social exclusion of older adults occurs at both the personal
level through self-exclusion as well as at the community
level through lack of policies, resources and supports
which in part reflect the effect of current perceptions of
older adults (p. NP 16). They concluded that along with
any structural changes that are made, there also needs to be
a cultural change ‘‘with a reimaging of aging and old age’’
(NP 18).

The LGBTQ (Lesbian, Gay, Bi-Sexual, Transgender,
Queer) community of older adults provides many examples
of differential treatment that have historical, social and
political aspects often beginning when the individual first
made their orientation known to others. The SAGE Foun-
dation—Services, Advocacy for Gay, Lesbian, Bisexual
and Transgender Elders—has summarized the various
issues within the realm of social isolation:
The primary risk factors for social isolation affect
LGBT older adults in unique and disproportionate
ways. LGBT elders are more likely to live alone and
with thinner support networks. Additionally, the
research shows that LGBT elders face higher dis-
ability rates, struggle with economic insecurity and
higher poverty rates, and many deal with mental
health concerns that come from having survived a
lifetime of discrimination. Location-related barriers,
coupled with stigma and discrimination, can make it

difficult for LGBT older people in many parts of the
country to find the LGBT-friendly community sup-
ports they need to age successfully and avoid social
isolation (Social Isolation 2015).
The issues of economic insecurity and poverty are in
part directly related to the issue of same-sex marriage and
the rights that come with marriage. For example, marriage
allows one partner to obtain social security benefits from
the spouse at a certain age or when a spouse dies. One
important value of social security benefits has traditionally
been seen as preventing older adults from falling into
complete poverty. Also related to social isolation for the
LGBTQ community is the issue of affirming services
within the Aging Network under the Older Americans Act.
Given the variation in attitudes towards same-sex relations
across states, it could be hypothesized that since aging
services are provided by state offices and agencies, atti-
tudes among these organizations may reflect their particu-

lar state’s attitudes regardless of non-discrimination
policies.
Older immigrants are another group who in addition to
having the usual concerns of getting older may have more
difficulties because of language, cultural customs, docu-
mentation, and monetary resources. How the older
immigrant came to live in the United States is an important
question in a cultural assessment. Immigrants coming to
the United States by choice may have very different feel-
ings and expectations than older immigrants who are
refuges, forced to leave their country of origin. In addition,
the timing of when in their lifetime the older immigrant
came to the United States is important in terms of accessing
public resources. Immigrants from other countries may
have different expectations for the involvement of their
children as caregivers than their more Americanized chil-
dren feel. The social work profession in general needs to
build a workforce that is bilingual in the many languages

that are present in the U.S. today.
Issues of leaving one’s place and losing status in the
eyes of others evoke a myriad of feelings depending on the
particular older adult. But given that as one ages there are
naturally some physical and mental acuity losses, every
older adult is subject to feelings of sadness, depression,
hopelessness, and even anger. These feelings are natural
responses to loss. The role of the practitioner is one of
helping a mourning process move to a healthy acceptance
of one’s aging and planning rather than devolving into
major depression.
Place and Status as Locational Issues
While it seems natural to separate place as physical space
from place as status, there is a third conceptualization
which is to frame both physical space and status as a lo-
cational issue in which the two concepts are intertwined.
For example, older adults will reject or resent leaving their
homes because the home represents the narrative story of

the older adult’s life. At least when remaining in the family
home in the same community the older adult can maintain
a sense of integrity and status. Tueido (2002) quoted Iris
Marion Young’s view of homemaking:
Creative preservation is the practice of ‘‘renewing’’
our investment in the meaning of things. Though it
functions in support of our ‘‘longing’’ for a ‘‘settled,
safe, affirmative, and bounded identity,’’ creative
preservation also serves to inspire a dynamic culti-
vation of identity, which in turn contributes to pro-
moting an affirmative yet ‘‘fluid and shifting’’ context
for living. Activities of preservation give some
enclosing fabric to this ever-changing subject by
knitting together today and yesterday, integrating
new events and relationships into the narrative of a
life, the biography of a person, a family, and a people
(p. 4.).
Place and identity are inextricably bound to one another.

The two are co-produced as people come to identify with
164 Clin Soc Work J (2016) 44:160–169
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where they live, shape it, however modestly, and are in turn
shaped by their environments, creating distinctive ‘‘envi-
ronmental autobiographies’’ that are the narratives we hold
from the memories of those spaces and places that shaped
us (Gieseking and Mangold 2014).
Becoming Marginalized
In many cases older adults are put into the position of being a
marginalized group. Hohler (2010) described the usage of the
word marginalization by saying that since the 1960’s, the
word has been used as a sociological term referring to
research on people and groups of peoplewho are driven to the
edge of a given society. Hohler went on to say that: ‘‘The
conceptmarginalization implicitly assumes that there are two
parts, the ‘‘marginalizer’’ and the ‘‘marginalized’’ (Hohler

2010, p. 5).’ When talking about older adults we can ask
‘‘Who is the one that ismarginalizing?’’ Certainly individuals
can marginalize other individuals and likewise entire groups
can be marginalized by other groups. Marginalization in
general is problematic because it prevents individuals and
groups from participating fully in the society in which they
live.Marginalization can lead to self-deprecation, loss of self-
efficacy and for some deep depression with poor coping
skills. In addition, the stress which can ensue is applicable to
both individual older adults as well as older adults as a group.
Meyer (2003) reported that ‘‘stress discourse has been con-
cerned with external events or conditions that are taxing to
individuals and exceed their capacity to endure, therefore
having potential to induce mental or somatic illness (p. 675.)
In the case of older adults, the external events or conditions
are related to the place of older adults in society.
On the societal level marginalization prevents members
of the marginalized group from obtaining the resources

necessary for their everyday living. More recently however
there has developed the belief that society in general loses
from marginalizing certain groups because once
marginalized, the group no longer is a resource for the
community or society. Iris Marion Young (1990) referred
to marginalization as the ‘‘…most dangerous form of
oppression. A whole category of people is expelled from
the useful participation in social life and thus potentially
subjected to severe material deprivation and even exter-
mination’’ (p. 53). Marginalization raises the issue of how
an individual or a group responds to being marginalized.
Like all psychological phenomena, responses will vary by
individuals as well as by subgroups of the larger
marginalized group. For example, Sokolec and Dentato
(2014) reported that older adults who are LGBTQ are
finding that their sexual orientation status can make it
difficult to access a full range of housing options in
response to changing status in health and capacity.

For all older adults, at one end of the continuum the
response can be an increased sense of loss of status and
hopelessness. However, at the other end of the continuum
the response may reflect resilience in the face of adversity.
Marginalized groups often develop ‘‘compensatory strate-
gies’’ (Carstensen and Hartel 2006) to cope with the neg-
ative perceptions of others outside the group.
The Nexus of Locational Space and Status
Where one is going to live in older adulthood has become
an increasingly more urgent question as people are living
longer especially through scientific and medical advances.
Older adults do not succumb to many illnesses as early as
they did in previous years when newer treatment options
were not available. So the question of locational space is
no longer a one-time decision—i.e., from one’s own home
to a nursing home—but rather a process during which an
older adult may move through levels of care from their own
home in the community to a senior-living building, to

assisted living and sheltered care, and finally to full nursing
care. At least in the early stages of this process, each move
can be perceived as a loss to the older adult that is a signal
of their decline. So the locational movement becomes not
just about changing the brick and mortar of where one lives
but rather the meaning of the locational move especially
when there are no clear signs of the necessity. This
becomes very evident when it is suggested that an older
adult couple leave their home and move into a senior living
arrangement where they will still be living independently
often in a newer space than their own home and even
within the same community as they have lived previously.
The older adult’s reaction to this suggestion, especially if
they—and their partner—are still considered to be healthy
is often one of disgust in having to live with other ‘‘old
people.’’ One area that has not been studied regarding the
attitudes of older adults towards senior living arrangements
such as assisted living is the effect of media reporting about

conditions in these facilities. PBS’s 2013 documentary
‘‘Life and Death in Assisted Living’’ could influence an
older adult, as well as their family members, on the
arrangements they decide to make. The notion that a
facility for older adults could make things worse supports
the belief that older adults do not matter.
Aging-in-place has become the mantra of both older
adults as well as those who work in the field of gerontol-
ogy. This phrase can have several meanings from older
adults staying in their own home with or without help to
remaining in a familiar community with assistance rather
than being moved to assisted living or a full nursing
facility. Those that deal of cost issues support this notion
because community care is always less expensive than
Clin Soc Work J (2016) 44:160–169 165
123
institutional are. But for the older adults the issue is not

monetary costs but rather it is about maintaining their
integrity as a human being and someone who wants—and
can—continue to be a participating member of society.
Aging-in-place when only referring to the space, in which
the older adult will live, is not sufficient to support the
concept of place as status. A corollary to remaining in
one’s community is that the older adult has opportunities
for social engagement and is granted access to civic par-
ticipation opportunities.
The notion of needing special allowance to access civic
engagement opportunities is not surprising since one effect
of marginalization is that the voices of those marginal-
ized—individually and collectively—become weaker, if
not eventually mute. This is not voice in the sense of sound,
but rather this is voice as standing which is expressed in the
acceptance of verbal and written communication of indi-
viduals and groups, as well as in the physical sense of being
present. The loss of voice does not indicate a lack of

something to say—although without practice, voices can
become weak. Rather, the loss of voice stems from not
being asked to speak or ignored when voice is offered.
Taking the view that physical space and status are
intertwined locational concerns for older adults; dealing
with these issues can define a new strategy of healthy
aging. Ideally older adults who wish can remain in the own
homes and communities with enough support so that they
remain safe. However, for any number of reasons an older
adult may have to leave their home and community, and
sometimes it is by choice. However, wherever an older
adult lives, integrity, self-efficacy, social engagement, and
other components of self-esteem and stress reduction are
still important issues that affect physical and socio-emo-
tional health. In fact, it is these components of identity that
are of most importance to older adults and often the basis
for not wanting to leave one’s physical home. Given that
some older adults choose to move into a retirement com-

munity some important research questions are: (1) What
are the demographics of this group? (2) What influenced
their decision to make this choice and leave their previous
home, and often times, their community where they lived
their earlier lives? (3) Do they maintain their former
identity in a new place or do they form a new identity given
their new location as well as new status as someone living
in a senior community? The third question speaks directly
to the question of the meaning of place.
Perhaps then the crucial element in aging in place is not
the place aspect but rather the notion of aging aspect. The
task becomes creating places that allow aging to occur in
such a way that the older adult remains a valued member of
their community regardless of where the community is
located, what the community looks like or who resides in
the community. For example, older adults often prefer to
remain in the own homes because their neighborhood
provides opportunities to engage with several generations.

Obviously this is not true for most specifically senior living
arrangements but it does not mean that programs cannot
be structured where a variety of generations interact
together.
Practice with Older Adult Clients
A paper written for a social work journal must look at the
topical issue from the point of view of the profession which
should inform both social work clinical and policy practi-
tioners. The policy perspective is important because clini-
cal issues and subsequent treatment never occur in a
vacuum, or out of the context of happenings in the society
in which the client lives. A clear example of this is the
1967 Age Discrimination in Employment policy which
prohibited using age as a reason for dismissal from a job.
The social work framework of person in environment
strengthens the concerns for policy and programs as the
basis for healthy aging. On a broader level the International
Federation of Social Workers ‘‘encourages the considera-

tion of older adults in all policies’’ (IFSW 1999, p. 60).
While all social workers are educated to address policy,
the majority of social workers working in gerontology will
see individuals, couples and/or family members of the
older adult. The traditional practice methods of social
workers such as respecting the individual, employing good
listening skills, acting empathically and reframing content,
all in the context of developing a working relationship, are
practices that older adults can relate to. The particular
intervention approach should vary with the needs of the
older adult. However, whatever the approach ‘‘clinical case
management should be considered a key intervention
approach in gerontological social work’’ (Naleppa 2006,
p. 521). Naleppa (2006) supported this statement using the
definition of case management from the National Associ-
ation of Social Workers as a:
…method of providing services whereby a profes-
sional…assesses the needs of the client and the cli-
ent’s family, when appropriate, and arranges,

coordinates, monitors, evaluates and advocates for a
package of multiple services to meet the client’s
complex needs….Case management is both micro
and macro in nature; intervention occurs at both the
client and system level (p.521).
In addition to the more traditional interventional prac-
tices, social workers in the twenty first century need to
acquire the knowledge and skills that match the needs of
their ever-changing clientele. One area that has not often
talk about in regards to working with older adults is
166 Clin Soc Work J (2016) 44:160–169
123
planning for retirement. As with so many issues there are
the practical concerns of retirement such as finances but
there are also the psychological and emotional feelings that
arise when one is considering retirement. One’s identity—
and status in the community—is often intertwined with
one’s work so to lose the work can leave a person unsure of

who he or she is in their own eyes and the eyes of others
even if one is looking forward to retirement to take up other
activities. Social workers, while leaving the financial issues
to other professionals, can address with the client their
feelings about the meaning of retirement. It is not unusual
today to have elder law attorneys or elder law clinics have
social workers and other professionals such as lawyers and
financial planners working together. Since social workers
are accustomed to working within service networks with
other professional disciplines, they can take the lead in
suggesting and organizing a systems approach to many
issues within older adulthood. The mezzo and macro skills
of advancing policies, programs and professional programs
that promote older adults’ self -advocacy, lifelong learning,
civic engagement, and equal opportunity in employment
contribute to the resources that support the goals of older
adults in all settings (Social Work and Aging, n.d.).
Respect for autonomy or client self-determination, when

appropriate, is a client centered practice that has been
central to the profession. In general, autonomy is respected
when one is treated as an adult who can act in a responsible
manner and that ability is acknowledged and supported in
any context. Respect for autonomy as an ethical principle is
not necessarily an all-or-nothing principle. Autonomy must
take into consideration the capacity of the individual in
regards to critical decision making. This does not mean
ignoring autonomy when capacity is broadly diminished
but rather finding ways to include the client in the con-
versation to the extent that they can participate or at least
be informed of decisions that are being made in their
behalf. Client self-determination is neither an all-or-noth-
ing principle. Social workers continually evaluate clients’
wishes for appropriateness and safety. When clients are
able, social workers will help the client process their
wishes and help them understand the risks and benefits of
their choice. In addition, ‘‘…autonomy does not happen in

a vacuum but rather in a context that not only provides
resources but ensures access for all’’ (Polivka and Moody
2001). This conceptualization has implications for public
policy.
Beneficence, a term used more in medical ethics than in
social work, can be a double-edged sword. Beneficence
implies the striving to do good but can sometimes devolve
into paternalization of the client based on assumptions that
may or may not be true. Any practice situation involves
both the client and practitioner both of who bring their
values, perceptions and experiences to the relationship. The
practitioner expects that part of the work will be around the
client’s feelings about aging and the changes aging brings
to their personal, social and economic lives. The client
expects that the social worker is capable of accepting the
client’s anxiety and that they will not be judged for how
they feel. This can be said of older adults and all the
practitioners they encounter. Social workers and other

practitioners naturally come to the treatment encounter
with their own values, perceptions and experiences.
Research has found that among the perceptions and feel-
ings of practitioners there can be a conscious and/or
unconscious ageism (Troll and Schlossberg 1971). Pater-
nalistic and ageist biases by the practitioner decrease their
ability to value and practice from a strengths perspective
‘‘which focuses on what is ‘strong’ in an older adult’s
ability to rally personal and social assets to find solutions to
the problems he or she faces in the aging process’’ (Dittrich
2014, p.7).
The strength approach as applied to all clients presup-
poses the belief that individuals can change. This approach
is in direct contrast to the assumption that all the negative
things that happen to an older adult are part of the aging
process thus not treatable. A clear example of this is in the
area of depression in older adults. A pathological model
assumes that all older adults are naturally depressed and

medication, rather than treatment, is the proscribed rem-
edy. On the other hand, not all older adults are depressed
and when depression does appear at least an evaluation
needs to be done to assess whether it is related to a pre-
existing condition or is functional due to a recent loss.
Changes in individuals are often dependent on appro-
priate resources to enhance and support the changes.
Internal resources such as self-reliance, self-efficacy, pro-
ven coping skills while generally stable over time can be
assaulted from a variety of sources. However, the assault,
while resulting in bruising, may not necessarily destroy
these resources. From a strength perspective treatment
should focus on identifying previous successes and the
reclamation of these personal factors. External resources
can mediate internal and external assaults. From a social
justice framework, Charles Taylor’s ‘‘politics of equal
dignity’’ requiring ‘‘an equal basket of rights and immu-
nities’’ would resonate with social workers at all levels of

their work (1994 p. 38).
The integrated resource model looks at resources from a
three pronged perspective: ‘‘… (a) looking at resources
broadly, rather than focusing on a specific resource;
(b) viewing resource change in the face of stressful chal-
lenges as a key operating mechanism by which well-being
and health are influenced; and (c) viewing the possession of
reliable resource reservoirs as critical in promoting and
maintaining well-being and health’’ (Hobfoll 2002, p. 311).
Social work practice includes both review of a client’s
Clin Soc Work J (2016) 44:160–169 167
123
resources and when necessary, facilitating the client in
finding new resources. In fact, it could be argued that
having access to social work intervention is a resource in
itself. Additionally, from a macro perspective social
workers advocate for policies and resources that facilitate
clients’ well-being.

For many reasons older adults remain in their own
homes or live with close relatives. Caregiving to older
adults is not a new phenomenon but given the increased
longevity of older adults, there are more family members
caring for older adult members of their families than pre-
viously. Whether the caregiving is by choice or out of
necessity, there is greater appreciation for the burden of
caregiving and recognition that the caregivers may need
care for themselves. Often times the older adult and their
family members have different conceptions of what is
appropriate for the older adult. There can be differences in
opinion between the family members themselves. Social
workers as mediators can be a helpful intervention in the
family so they can come to a consensus. The strengths-
based and ecological models acknowledge others in the
client’s life as important. For older adults this creates a
‘‘dual caregiving network’’ (Crewe and Chipungu 2006,
p. 542).

Recognizing that unconscious and unaddressed biases
can affect the treatment relationship and eventual out-
comes, increasingly social workers and other helping pro-
fessionals are counseled early in their training to be aware
of their own stereotypes and biases that can affect the
treatment process. This educational tenet recognizes that
helping professionals can absorb the same stereotypes
about individuals and groups that are present in the larger
culture.
Another principle highlighted in social work education
is cultural competence in its broadest sense. Older adults
as a cultural cohort are best served with practice meth-
ods that take into account their special needs. In addi-
tion, given the multicultural nature of the United States,
this competency is equally important in working with
older adults and their families. This can be a potentially
conflictual area if the cultural aspect(s) of the client does
not fit the current societal context in which the person

lives.
As more social work students are selecting the older
adult population as their specialization they are entering the
field with more knowledge and skills to work with older
adults. Ideally they are being educated on the close rela-
tionship between clinical work and policies affecting older
adults. Terms like aging-in-place and civic engagement are
becoming the language of the specialization with a rapid
increase in textbooks about the older adult population both
for clinical and policy practices.
Conclusion
Social workers are well-suited to work with older adults
around issues of locational space and space as status
through the many roles that social workers take in behalf of
their clients. These roles span practitioner, community
organizer and advocate, mediator, educator in helping
others to learn to advocate for themselves, and, most
importantly, intersecting roles to create an integrated

framework. Concern for place in both of its meanings can
become an organizing principle for work with older adults
since in discussing the concept of space, a myriad of
themes can emerge from grieving losses to finding an inner
resilience in spite of existing stereotypes. Finally, it should
not only be academic researchers who conduct research
around the issues raised in this paper. Social work practi-
tioners hold a great deal of information from their clients’
stories which can be turned into research questions.
Equally important as conducting the research, results from
any studies need to be communicated to those working in
the various aspects of ageing so that places and programs
can become affirming for their older adult constituents.
Compliance with Ethical Standards
Conflict of Interest The author declares she has no conflict of
interest.
Human and Animal Rights This article does not contain
any studies with human participants or animals performed by
the

author.
Informed Consent This article does not contain any studies with
human participants.
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Clinical Social Work Journal is a copyright of Springer, 2016.
All Rights Reserved.
The Meaning of ‘‘Place’’ to Older
AdultsAbstractIntroductionThe Meaning of PlaceAgeism and
StatusPlace and Status as Locational IssuesBecoming
MarginalizedThe Nexus of Locational Space and StatusPractice
with Older Adult ClientsConclusionReferences
1
Copyright © 2015 McGraw-Hill Education. All rights reserved.
No reproduction or distribution without the prior written
consent of McGraw-Hill Education.
Chapter 5
The
Communication
Process
5-2
Communication
between a sender and a receiver

age
- Language
5-3
A Model of the Communication Process
5-4
Basic Model of Communication
Source
• Person or organization that has information to share
with another person or group of people
Encoding
• Putting thoughts, ideas, or information into a symbolic
form
Message
• Contains the information or meaning the source hopes
to convey
5-5
Graphic
• Pictures

• Drawings
• Charts
Verbal
• Spoken
Word
• Written
Word
• Song
Lyrics
Musical
• Arrange-
ment
• Instrum-
entation
• Voices
Animation
• Action/
Motion
• Pace/
Speed
• Shape/
Form

Verbal Graphic Musical
There are many forms of message encoding
Encoding
5-6
nnel: Facilitates communication between sender
and receiver
-personal channel or mass media
receiver
- Direct communication between two
or more persons
-of-mouth (WOM): Informal communication among
consumers about products and services
-of-mouth
discussion
2
5-7
Personal
Channels

Personal
Channels
Communications Channels
Nonpersonal
Channels
Personal
Selling
Word of
Mouth/Mouse
Print
Media
Broadcast
Media
5-8
-relevant
messages with the help of individual consumers
ividual sender or receiver characteristics

of consumers who will be used to start spreading the
message
5-9
whom the sender shares
thoughts or information
thought
experience
attitudes, and values a person brings to the
communication situation
5-10
process

sender and receiver don’t overlap
eactions after seeing,
hearing, or reading the message
communicated back to the sender
5-11
Methods of Obtaining Feedback in the
Response Hierarchy
5-12
Implications of the Traditional
Hierarchy Models
Delineate the steps involved in taking potential
purchasers from unawareness of a product to
readiness to purchase it
buyer is in

effectiveness
3
5-13
Evaluating Traditional Response
Hierarchy Models
about the particular product or brand
brand
ehavioral stage
5-14
Implications of the Alternative
Response Models

marketers might pursue in different situations
owing
differentiation
service
5-15
The Social Consumer Decision Journey
5-16
Cognitive Response Approach
Cognitive responses
• Thoughts that occur to individuals while reading, viewing,
and/or
hearing a communication
Counterarguments
• Thoughts the recipient has that are opposed to the position
taken in the message
• Relate negatively to message acceptance
Support arguments

• Thoughts that affirm the claims made in the message
• Relate positively to message acceptance
5-17
Cognitive Response Approach
Source derogations
• Negative thoughts about the spokesperson or organization
making the
claims
• Leads to a lower message acceptance
Source bolsters
• Positive thoughts about the spokesperson or organization
making the
claims
Ad execution-related thoughts
• Affect attitudes toward the advertisement as well as the brand
Attitude toward the ad
• Represents the receivers feelings of favorability or
unfavorability toward the
ad
5-18
Elaboration Likelihood Model (ELM)

process and respond to persuasive messages
process
that occurs in response to a persuasive message
4
5-19
Counterarguments Support arguments
Source derogation Source bolstering
Thoughts about
the ad itself
Thoughts about
the ad itself
Source bolsteringSource derogation

Support argumentsCounterarguments
Affect attitude
toward the ad
Cognitive Response Categories
Product/Message Thoughts
Source-Oriented Thoughts
Ad Execution Thoughts
5-20
Focuses on the way consumers respond to persuasive
messages, based on the amount and nature of elaboration
or processing of information
Peripheral route –
ability and
motivation to process
a message is low;
receiver focuses more
on peripheral cues
than on message
content
Central route –
ability and
motivation to process

a message is high and
close attention is paid
to message content
Routes to Attitude Change
5-21
motivation to process a message is high and close
attention is paid to message content
motivation to process a message is low
message content
5-22
Implications of the ELM
implications for marketing communications

- Sales presentation should
contain arguments that are difficult to refute
- Peripheral cues are more
important than detailed message arguments
route to persuasion
1
Copyright © 2015 McGraw-Hill Education. All rights reserved.
No reproduction or distribution without the prior written
consent of McGraw-Hill Education.
Chapter 6
Source,
Message, and
Channel
Factors
6-2
Persuasion Matrix
Helps marketers see how each controllable
element interacts with the consumer’s
response process
6-3

Decisions Evaluated with the Persuasion Matrix
Receiver/
comprehension
Can the receiver
comprehend the
ad?
Channel/
presentation
Which media will
increase
presentation?
Message/
yielding
What type of
message will
create favorable
attitudes or
feelings?
Source/
attention

Who will be
effective in
getting
consumers’
attention?
6-4
Source
message
- Delivers a message and/or endorses
a product or service
- Draws attention to and enhances
the appearance of an ad
6-5
Skill
Knowledge
Expertise
Unbiased
Trustworthy

Objective
Unbiased
Trustworthy
Expertise
Skill
Knowledge
Source Credibility
Source
Information
6-6
Source Credibility
or experience
information
Internalization: Adopting the opinion of a credible
communicator and the belief that information from

this source is accurate
2
6-7
Source Credibility
ople
- and low-credibility sources are equally
effective when arguing for a position opposing their
own best interest
increases with the passage of time
6-8
Source Attractiveness
similarity, familiarity, and likability

type of relationship with the source
behavior
6-9
receptivity
6-10
Resemblance

between the
source and
recipient of the
message
Similarity
Knowledge of the
source through
repeated or
prolonged
exposure
Familiarity
Affection for the
source resulting
from physical
appearance,
behavior, or other
personal traits
LikeabilitySimilarity Familiarity

6-11
Trust
Risk
Familiarity
Likability
Choosing a Celebrity Endorser
Factors
Match
w/audience
Match w/product
Image
Cost/ROI
6-12
Top Celebrity Endorsers

3
6-13
The celebrity’s behavior may pose
a risk to the company
The target audience may not be
receptive to celebrity endorsers
The celebrity may be overexposed,
reducing his or her credibility
The celebrity may overshadow
the product being endorsed
The target audience may not be
receptive to celebrity endorsers
The celebrity may be overexposed,
reducing his or her credibility
The celebrity may overshadow
the product being endorsed

Risks of Using Celebrities
6-14
Meaning Movement and
the Endorsement Process
6-15
Source Power
e is capable of administering rewards and
punishments to the receiver
and scrutiny
persuasive influence and acquiesces to his or her
position
favorable reaction or to avoid
punishment
6-16
Perceived control
Perceived concern

Perceived scrutiny
Perceived control
Perceived concern
Source Power
Source Power
6-17
Message Factors
• Order of presentation
• Conclusion drawing
• Message sidedness
• Refutation
• Verbal versus visual messages
Message
structure
• Comparative advertising
• Fear appeals
• Humor appeals
Message appeals
6-18

Message Structure
- Strongest arguments should
be presented early or late in the message but never
in the middle
effective
persuasive
4
6-19
Message Structure
- Messages with explicit
conclusions are more easily understood and

effective in influencing attitudes
e or topic
6-20
Message Structure
-sided message: Mentions only positive
attributes or benefits, effective if target audience:
-sided message: Presents both good and bad
points, effective when the target audience:
6-21
Message Structure

sides of an issue and then refutes the opposing
viewpoint
- When verbal
information is:
immediate and delayed recall
increase recall
6-22
Recall and Presentation Order
R
e
c
a
ll
Beginning Middle End
6-23
Fear
Appeals
Comparative
Ads

Fear
Appeals
Comparative
Ads
Message Appeal Options
Humor
Appeals
• May stress
physical danger or
threats to health
• May identify social
threats:
disapproval or
rejection
• May backfire if the
level of threat is
too high
• May be especially
useful for new
brands
• Often used for
brands with small

market share
• Frequently use in
political
advertising
• They can attract
and hold attention
• They are often the
best remembered
• They put the
consumer in a
positive mood
6-24
Message Appeals
naming competitors in an ad and comparing one or
more attributes
threat and arouse individuals to take steps to
remove the threat

-confident and prefers to cope with dangers
5
6-25
Message Appeals
- States that ads using
fear appeals should give the target audience
information on the:
6-26
Figure 6.5 - Relationship between Fear
Levels and Message Acceptance
6-27
Message Appeals

- Humorous ads:
toward the product
the message
when seen or heard repeatedly
6-28
Humor Appeals Advantages and
Disadvantages
Advantages
• Aid with awareness and
attention
• Aid name and simple copy
registration
• Aid retention
• Aid persuasion to switch
brands

• Create a positive mood
that enhances persuasion
Disadvantages
• Harm recall and
comprehension
• Harm complex copy
registration
• Do not aid persuasion in
general
• Do not aid source
credibility
• Not very effective in
bringing about sales
6-29
Channel Factors
- Information
received from personal channels is more persuasive
than that received from the mass media
-paced - Readers process the ad at their own rate and

study it as long as they desire
- Transmission rate is controlled by the
medium
6-30
Self-Paced
Media
Self-Paced
Media
Self versus External Paced Media
• Newspapers
• Magazines
• Direct Mail
• Internet
• Radio
• Television
Externally Paced
Media
vs.

6
6-31
Channel Factors
s of context and environment
on a message
message
he
broadcast environment
Web Exercise 3
Focus Text – Chapters 5 & 6
In this exercise, you will identify elements of the
communication process and then analyze the source, message,
and channel factors for Toyota’s Sienna campaign. First, watch
the “Swagger Wagon” video for the Toyota Sienna, which you
can view at
https://www.youtube.com/watch?v=pUG3Z8Hxa5I

(If clicking the link above doesn't work, please copy and paste
the URL in a new browser window instead)
This music video is based off a campaign of Sienna
commercials that became viral sensations. After watching the
video and exploring this site, visit the following websites for
additional components of the campaign:
https://www.facebook.com/sienna
http://www.toyota.com/sienna/#!/Welcome
Successful completion of the following questions will require
you to integrate information from the Chapter 5 and 6 readings.
Please provide your answers to the following questions in the
Web Exercise submission area within this folder.
1. Who is the source for the Sienna “Swagger Wagon” ad? Who
are the receivers and audience of this campaign?
2. Source attractiveness encompasses similarity, familiarity, and
likability. How persuasive do you think this campaign is to its
receivers, based on these characteristics?
3. What is the meaning that the company is trying to convey in
the Sienna campaign?
4. What appeal is being used in this campaign? Why do you
think Toyota chose this type of appeal?
5. How can feedback for this entire Sienna campaign be
collected, and how would it determine effectiveness of the
campaign?

ORIGINAL PAPERThe Meaning of ‘‘Place’’ to Older Adults.docx

ORIGINAL PAPERThe Meaning of ‘‘Place’’ to Older Adults.docx

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ORIGINAL PAPERThe Meaning of ‘‘Place’’ to Older Adults.docx