Week 12: Elder Abuse Flashcards
what is elder abuse?
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.
“elder abuse” is specifically about TRUST relationships and does not generally include: ?
self neglect or abuse by strangers
financial elder abuse?
- 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.
physical abuse?
infliction of physical pain or injury or physical coercion
emotional abuse or psychological abuse?
infliction of mental anguish, involving actions that cause fear of violence, isolation or deprivation, and feelings of shame, indignity or powerlessness.
neglect?
failure of carer to provide necessities of life to person for whom they are caring. can be intentional or unintentional.
sexual abuse?
sexual abusive or exploitative behaviour.
biggest risk factor for elder abuse?
- having an adult child.
is gender a big factor when i comes to abuse?
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
what is another factor towards elder abuse other than gender?
ageism
- older peoples’ place in society and entitlement, rights to make decisions
key risk factors:
- dependency
- medical/ psychological conditions
- carer stress
- family conflict
- social isolation
- addictive behaviours
- greed and opportunism
risk factors: dependency
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)
risk factors: medical/psychological
example: dementia
- easier to abuse someone who has a lack of capacity and is forgetful/frail
risk factors: carer stress
SW needs to be understanding and consider the supports in place. some physical signs of carer stress.
risk factors: family conflict
example: adult children disagree about decisions made on elder parent
risk factors: addictive behaviours
example: gambling
risk factors: greed and opportunism
example: “i do it because i can”
capacity and abuse: substitute decision making and risk of abuse?
- substitute decisions maker may have authority under EPOA to make financial and housing decisions - opportunity for financial abuse or neglect
capacity and abuse: carers and risk of abuse?
- carers may not have authority via EPOA but may assume authority by access to bank details or moving in with older people
capacity and abuse: this form of abuse is strongly linked to?
adult children who believe their use of assets is reasonable (prospective inheritance)
empowerment approach to conceptualising elder abuse:
- 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
family caregiver causal factors for abuse:
- 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 **)
main cause of abuse for family caregiver -elder abuse
the dependency of the care giver (adult child) on the elder (care receiver) , especially if the care giver has a mental illness
family violence perspective causal factors for elder abuse:
- intergenerational violence
- DV theories see abuse as arising from unequal power relationships
- usually involves mix of physical and emotional abuse
sense of entitlement to assets elder abuse causal factors:
- 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
SW steps in dealing with potential elder abuse (financial) where there is an EPOA in place.
- 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).
best ways for SW to show an understanding of older people when intervening effectively in elder abuse
- understand older people are not homogeneous in what they want to happen and in their capacity and willingness to engage in making changes
SW working at a range of levels when intervening effectively in elder abuse
- macro level of ageism and attitudes
- meso level of service system development/ reform
- micro level of individuals and families
intervening effectively in elder abuse: outcomes
- be clear about outcomes sought and who defines them
list of interventions with individuals and families:
- watch and wait
- info. options and support
- direct interventions to modify risk
- case management, support services, advocacy
- counselling, group therapy, mediation, conflict resolution
responses/interventions: watch and wait
- open up conversations, sometimes people stop what they are doing because they know they are being watched.
responses/interventions: information, options and support:
- being able to assist with supports within the home, respite for carers, legal avenues available
responses/interventions: direct interventions to modify risk:
- 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.
responses/interventions: counselling
counselling is rare in this situation
interventions may include:
- crisis responses
- community support services
- respite care
- counselling
- assisting/ intervening w/ perpetrator (financial/addiction help)
- alternative accommodation
- legal interventions (last resort)
ensure that older people gain
their objectives are far as possible
to help the older person be more in control of their lives, try to
reduce power inequalities
consider working with
family members, rather than seeing them as abusers
why introduce more people into the situation?
- abuse is often linked to isolation or collusion between those providing care (direct intervention to modify risk)
what is a ‘good assessment’
- do no harm
- good assessment of what the older person wants as far as possible
- what risks they are and not prepared to take
remediate impacts on
assets/housing/older person relationships etc.
evidence for counselling
- motivates clients to make changes for themselves for a safer environment and greater autonomy
social work combined with what shows more reduced risk than one alone
- legal service
negative outcomes of interventions
- 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
things to consider when intervening
- 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
services available when SW need advice
- 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
