Merck Manual

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Introduction to Social Issues in Older Adults


Daniel B. Kaplan

, PhD, LICSW, Adelphi University School of Social Work

Reviewed/Revised Apr 2023
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Social issues influence an older person’s risk and experience of illness as well as a health care professional's ability to deliver timely and appropriate care.

A social history helps members of the interdisciplinary team evaluate care needs and social supports. It should include questions about the following social determinants of health:

  • Family and marital or companion status

  • Living arrangements

  • Social network (number and quality of routine social contacts)

  • Work history

  • Education

  • Typical daily activities (eg, how meals are prepared, what activities add meaning to life, where problems may be occurring)

  • Need for, availability, and ability of caregivers (to help plan and/or provide care)

  • History of trauma, losses, and coping strengths

  • History of substance use and legal issues

  • Patients’ own caregiving responsibilities (which may make patients reluctant to report their own symptoms lest their symptoms or any resulting interventions interfere with their caregiving)

  • Worries or stressors in daily life

  • Environmental concerns regarding home, neighborhood, transportation, or access to goods and services

  • Financial status

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NOTE: This is the Professional Version. CONSUMERS: View Consumer Version
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