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Social work practitioners are strongly encouraged to make use of existing research. Knowledge gathered through research efforts offers practitioners many advantages. For example, research builds knowledge to a greater degree than unsubstantiated expertise, and research builds knowledge through processes that are both self-corrective and cumulative. Therefore, reviewing the literature often reveals appropriate solutions to practice quandaries. A study of the stresses experienced by widowers, for instance, might prove helpful as a basis for developing a widowers counseling model. Nevertheless, practitioners should be educated and informed consumers of research. Although the problem of loosely used terms and concepts in research may be specified in all areas of social work, this article illustrates the problem through citations from the field of gerontological practice. For example, indexes for measuring such concepts as well-being, caregiver burden, and risk of institutionalization abound (Cantor, 1977; Doherty, 1976; Fillenbaum & Smyer, 1981; Grauer & Birnbom, 1975; Kosberg, Cairl, & Keller, 1990; Lawton, 1977). Many of these measurement tools examine a person's ability to perform activities of daily living (ADLs). In his study of various correlates of disability among elderly people, Manton (1989) coded disability intensity into five levels based on a client's limitation in activities of daily living. However, there is no one accepted definition for the term "activities of daily living," and Manton did not provide his own. The example provides one illustration of the use of social concepts as if they were part of a professional lexicon when in fact they are loosely conceptualized. The activities encompassed by the terms "activities of daily living" and "instrumental activities of daily living" (IADLs) are not consistent. For instance, Kane and Kane (1981) listed 13 activities of daily living, whereas Stephens and Christianson (1986) listed six. Kerson and Kerson (1985) defined ADLs as "specific activities encountered during the normal daily routine--bed, eating, hygiene, dressing, utilities, communication, locomotion, toileting" (p. 301). Kaye and Kirwin (1989), using area agency on aging client assessment forms, listed seven ADLs. Activities such as shopping, cooking, cleaning, and laundry are generally considered instrumental activities of daily living (Doty, 1986), but again the list varies according to author. Kerson and Kerson (1985) included IADLs with ADLs, and the area agencies in the Kaye and Kirwin (1989) study included 11 specified activities under "self-sufficiency." In addition, many current studies depend on the caregiver's subjective response to questions regarding a client's ability to perform ADLs or IADLs (Conrad, Hanrahan, & Hughes, 1990; Edelman & Hughes, 1990). Responses provided by caregivers may not correlate with those provided by case managers. Subjective responses are often skewed. For example, Campbell (1976), in discussing the subjective measurement of well-being, suggested there is not necessarily a high correlation between "an individual's sense of well-being and the objective circumstances of his or her life" (p. 118). The probable validity of Campbell's assertion may be important in deciding from whose perspective a dependent adult's well-being should be viewed. The subjective sense of well-being of an individual can be viewed as primarily a cognitive process related to what one aspires to, expects, or feels one deserves. A similar argument can be fashioned for the term "needs assistance" when examining ADL needs among the disabled elderly population. We should also ask what the term "needs assistance" really means. There is, at present, a rather standard dichotomized (yes or no) assessment question used by researchers and by case managers in completing client assessment forms. These forms are the basis for preparing client care plans. … |
