ACSW cheat sheet

Normal aging changes: decreased renal clearance, reduced hepatic metabolism, lower total body water, and increased body fat raise drug half-life and risk of accumulation.

Elder mistreatment categories are physical, sexual, emotional/psychological, financial exploitation, neglect (self or caregiver), and abandonment.

Activities of daily living (ADLs) include bathing, dressing, toileting, transferring, continence, and eating; IADLs include finances, cooking, shopping, and medication management.

Screening tools: Mini-Cog for cognition (3-item recall plus clock draw), PHQ-9 for depression, and Timed Up and Go for fall risk.

Delirium has acute onset and fluctuating course with inattention; dementia is chronic and progressive; depression is subacute with preserved attention.

Polypharmacy is commonly defined as 5 or more concurrent medications; the Beers Criteria flag potentially inappropriate medications in older adults.

Ageism is prejudice based on age; elderspeak (simplified speech, elevated pitch) is associated with lower self-esteem and resistance to care.

Grief in older adults may be disenfranchised because losses (friends, function, role) are not socially recognized as bereavement.

Hospice eligibility under Medicare requires a prognosis of 6 months or less if the disease runs its normal course, plus election to forgo curative treatment for the terminal diagnosis.

Hospice provides an interdisciplinary team: physician, nurse, social worker, chaplain, aide, volunteer coordinator, and bereavement counselor.

Four levels of hospice care: routine home care, continuous home care, general inpatient, and respite (up to 5 consecutive days).

Palliative care is appropriate at any stage of illness and can be delivered alongside curative treatment; hospice is a subset with a prognostic limit.

Pain assessment in non-verbal patients uses observable indicators such as grimacing, guarding, and restlessness; pain is what the patient reports.

Bereavement support is required for family for at least 12 months after death under the Medicare hospice benefit.

Advance directives include living wills and durable power of attorney for healthcare; POLST/MOLST applies to seriously ill patients and travels across settings.

Total pain (Cicely Saunders) encompasses physical, psychological, social, and spiritual suffering.

Classical management functions: planning, organizing, staffing, directing, coordinating, reporting, and budgeting.

Span of control: narrower spans suit complex, high-acuity work; wider spans require standardized, predictable tasks.

Budget types: line-item (input-based), program/performance (output-based), and zero-based (every expense justified each cycle).

Continuous quality improvement uses Plan-Do-Study-Act cycles; root cause analysis follows sentinel events; failure mode and effects analysis is prospective.

Licensure is mandatory minimum competence granted by the state; certification is voluntary credentialing; accreditation is organizational review by a private body.

Strategic planning sequence: mission, environmental scan (SWOT), goals, objectives (SMART), implementation, and evaluation.

Supervision models: administrative (compliance), educational (skill), and supportive (morale); effective supervision addresses all three.

Medicare Parts: A (hospital), B (outpatient/physician), C (Medicare Advantage), D (prescription drugs); Medicaid is income/asset-tested and jointly funded.

HIPAA Privacy Rule permits disclosure for treatment, payment, and operations; psychotherapy notes require separate authorization.

Health literacy affects comprehension; teach-back method confirms understanding better than asking 'Do you have questions?'

Social determinants of health: economic stability, education, social/community context, health/healthcare access, and neighborhood/built environment.

Universal precautions treat all blood and body fluids as infectious; standard precautions apply regardless of diagnosis.

Stages of change (Prochaska): precontemplation, contemplation, preparation, action, maintenance, and relapse.

Patient self-determination includes informed consent elements: competence, voluntariness, disclosure, understanding, and consent.

Case management process: intake/screening, assessment, planning, implementation, monitoring, evaluation, and closure.

Case manager roles may include broker, advocate, coordinator, and clinician; role clarity reduces duplication and conflict.

Level of care determination compares functional need, safety, and available supports against setting-specific criteria.

Person-centered planning places the client's stated goals first; the professional's role is to inform and support, not to override.

Confidentiality limits: imminent danger to self or others, suspected abuse/neglect of children or vulnerable adults, and court order.

Care transition models (e.g., transitional care) reduce readmissions through medication reconciliation, follow-up within 7 days, and clear discharge instructions.

Documentation should be objective, timely, and defensible; subjective statements are attributed to the source.

Erikson stages: trust vs mistrust (infancy), autonomy vs shame (toddler), initiative vs guilt (preschool), industry vs inferiority (school age), identity vs role confusion (adolescence).

Piaget stages: sensorimotor (0-2), preoperational (2-7), concrete operational (7-11), formal operational (11+).

Child abuse reporting is mandatory for professionals in all U.S. states; reasonable suspicion, not proof, triggers the report.

Family systems concepts: boundaries (enmeshed to disengaged), triangulation, homeostasis, and multigenerational transmission.

Objective parenting measures include the Adult-Adolescent Parenting Inventory (AAPI) and the Child Abuse Potential Inventory (CAPI).

Attachment styles (Ainsworth): secure, anxious-ambivalent, avoidant, and disorganized.

Adolescent risk screening uses the HEADSS framework: Home, Education, Activities, Drugs, Sexuality, and Suicide/depression.

DSM-5 substance use disorder criteria form 11 items across four groupings: impaired control, social impairment, risky use, and pharmacological criteria; 2-3 mild, 4-5 moderate, 6+ severe.

Tolerance and withdrawal are not required for a diagnosis of substance use disorder.

Screening tools: AUDIT and AUDIT-C for alcohol, DAST for drugs, CAGE as a brief historical screen.

Withdrawal risks: alcohol and benzodiazepine withdrawal can be fatal; opioid withdrawal is highly unpleasant but rarely fatal.

Medication-assisted treatment: buprenorphine, methadone, and naltrexone for opioid use disorder; naltrexone, acamprosate, and disulfiram for alcohol use disorder.

Relapse is a clinical event, not a moral failure; motivational interviewing uses open questions, affirmations, reflections, and summaries (OARS).

Stages of change guide intervention matching: precontemplation calls for raising awareness, not action planning.

Co-occurring disorders require integrated treatment; treating one condition while ignoring the other worsens outcomes.