This article questions ongoing moves towards integration into health care for social work with older people in the United Kingdom. While potentially constructing clearer pathways to support, integration risks reducing welfare provisions for a traditional low priority user group, while further extending the principles of privatisation. Integration models also understate the ideological impact of biomedical perspectives within health and social care domains, conflate roles and undermine the potential positive role of ‘holistic’ multi-agency care. Constructive social work for older people is likely to further dilute within aggressive integrated models of welfare, which will be detrimental for meeting many of the complex needs of ageing populations.