Week 12: Elder Abuse

Question 1

what is elder abuse?

Answer 1

single or repeated act, or lack of appropriate action occurring within any relationship where this is expectation of TRUST, which causes harm or distress to older person.

Question 2

“elder abuse” is specifically about TRUST relationships and does not generally include: ?

Answer 2

self neglect or abuse by strangers

Question 3

financial elder abuse?

Answer 3

• illegal or improper use of person’s property or finances by another person with whom they have a relationship implying trust
• most common and fastest growing
• overwhelmingly about children believing they are entitled to money. e.g trying ot become power of attorney.

Question 4

physical abuse?

Answer 4

infliction of physical pain or injury or physical coercion

Question 5

emotional abuse or psychological abuse?

Answer 5

infliction of mental anguish, involving actions that cause fear of violence, isolation or deprivation, and feelings of shame, indignity or powerlessness.

Question 6

neglect?

Answer 6

failure of carer to provide necessities of life to person for whom they are caring. can be intentional or unintentional.

Question 7

sexual abuse?

Answer 7

sexual abusive or exploitative behaviour.

Question 8

biggest risk factor for elder abuse?

Answer 8

• having an adult child.

Question 9

is gender a big factor when i comes to abuse?

Answer 9

not necessarily, a gendered view of violence and abuse becomes blurred when the abuse occurs in older populations
- women and men were split evenly as perpetrators of violence

Question 10

what is another factor towards elder abuse other than gender?

Answer 10

ageism

- older peoples’ place in society and entitlement, rights to make decisions

Question 11

key risk factors:

Answer 11

• dependency
• medical/ psychological conditions
• carer stress
• family conflict
• social isolation
• addictive behaviours
• greed and opportunism

Question 12

risk factors: dependency

Answer 12

example: adult children being dependent on getting a carer’s payment because the elder parent lives with them (housing and income is evidence of dependency)

Question 13

risk factors: medical/psychological

Answer 13

example: dementia

- easier to abuse someone who has a lack of capacity and is forgetful/frail

Question 14

risk factors: carer stress

Answer 14

SW needs to be understanding and consider the supports in place. some physical signs of carer stress.

Question 15

risk factors: family conflict

Answer 15

example: adult children disagree about decisions made on elder parent

Question 16

risk factors: addictive behaviours

Answer 16

example: gambling

Question 17

risk factors: greed and opportunism

Answer 17

example: “i do it because i can”

Question 18

capacity and abuse: substitute decision making and risk of abuse?

Answer 18

• substitute decisions maker may have authority under EPOA to make financial and housing decisions - opportunity for financial abuse or neglect

Question 19

capacity and abuse: carers and risk of abuse?

Answer 19

• carers may not have authority via EPOA but may assume authority by access to bank details or moving in with older people

Question 20

capacity and abuse: this form of abuse is strongly linked to?

Answer 20

adult children who believe their use of assets is reasonable (prospective inheritance)

Question 21

empowerment approach to conceptualising elder abuse:

Answer 21

• older people competent to make informed decisions (unless documented otherwise)
• support should empower elder to take action without influence
• elder’s needs and desire first, right to self-determination, and supported in choices

Question 22

family caregiver causal factors for abuse:

Answer 22

• mainly adult-child/parent care relationships
• initially seen as caregiver burden and stress arising from dependence of the elder on the adult.
• later research now suggests it is the dependence of the adult child on the elder (esp. when adult child has mental illness - that underpins the abuse **)

Question 23

main cause of abuse for family caregiver -elder abuse

Answer 23

the dependency of the care giver (adult child) on the elder (care receiver) , especially if the care giver has a mental illness

Question 24

family violence perspective causal factors for elder abuse:

Answer 24

• intergenerational violence
• DV theories see abuse as arising from unequal power relationships
• usually involves mix of physical and emotional abuse

Question 25

sense of entitlement to assets elder abuse causal factors:

Answer 25

• more form is financial abuse but can be linked to emotional abuse and neglect
• distinct from other forms of abuse
• may be linked to reduced capacity for decision making

Question 26

SW steps in dealing with potential elder abuse (financial) where there is an EPOA in place.

Answer 26

1. talk to the elder, find out more info about situation, what does the elder think about it? permission to talk to their adult child?
   - may be an obligation to report if i work in a care facility
   - get advice from my supervisor or ring the ADA (aged and disability advocated australia).

Question 27

best ways for SW to show an understanding of older people when intervening effectively in elder abuse

Answer 27

• understand older people are not homogeneous in what they want to happen and in their capacity and willingness to engage in making changes

Question 28

SW working at a range of levels when intervening effectively in elder abuse

Answer 28

• macro level of ageism and attitudes
• meso level of service system development/ reform
• micro level of individuals and families

Question 29

intervening effectively in elder abuse: outcomes

Answer 29

• be clear about outcomes sought and who defines them

Question 30

list of interventions with individuals and families:

Answer 30

• watch and wait
• info. options and support
• direct interventions to modify risk
• case management, support services, advocacy
• counselling, group therapy, mediation, conflict resolution

Question 31

responses/interventions: watch and wait

Answer 31

• open up conversations, sometimes people stop what they are doing because they know they are being watched.

Question 32

responses/interventions: information, options and support:

Answer 32

• being able to assist with supports within the home, respite for carers, legal avenues available

Question 33

responses/interventions: direct interventions to modify risk:

Answer 33

• people coming into the home (professionals visiting e.g nurses) SW can organise these things.
• putting supports and interventions in to lessen isolation and observe them.

Question 34

responses/interventions: counselling

Answer 34

counselling is rare in this situation

Question 35

interventions may include:

Answer 35

• crisis responses
• community support services
• respite care
• counselling
• assisting/ intervening w/ perpetrator (financial/addiction help)
• alternative accommodation
• legal interventions (last resort)

Question 36

ensure that older people gain

Answer 36

their objectives are far as possible

Question 37

to help the older person be more in control of their lives, try to

Answer 37

reduce power inequalities

Question 38

consider working with

Answer 38

family members, rather than seeing them as abusers

Question 39

why introduce more people into the situation?

Answer 39

• abuse is often linked to isolation or collusion between those providing care (direct intervention to modify risk)

Question 40

what is a ‘good assessment’

Answer 40

• do no harm
• good assessment of what the older person wants as far as possible
• what risks they are and not prepared to take

Question 41

remediate impacts on

Answer 41

assets/housing/older person relationships etc.

Question 42

evidence for counselling

Answer 42

• motivates clients to make changes for themselves for a safer environment and greater autonomy

Question 43

social work combined with what shows more reduced risk than one alone

Answer 43

• legal service

Question 44

negative outcomes of interventions

Answer 44

• escalate family conflict
• loss important relationships (further social isolation)
• no long-term change, fear of re-abuse
• financial hardship from loss
• stress and anxiety for elder
• disempowerment

Question 45

things to consider when intervening

Answer 45

• the older person: capacity and willingness to consider options, resources
• context of abuse and alleged abuser (level of risk, urgency, safety)
• family context
• complexity (work across systems)
• protective vs empowerment responses
• working with impact of abuse and loss
• cultural context
• geographic and service system context
• who reports

Question 46

services available when SW need advice

Answer 46

• office of public guardian
• QCAT queensland civil and administration tribunal
• elder abuse prevention unit EAPU: referral pathways, minding the money
• seniors legal and support service (SLASS)
• aged care quality and compliance with dept. health
• ADA Aged and disability advocacy