Volume 4, Number 6 - June 2009
In This Issue: Elder Abuse Awareness
World Elder Abuse Awareness Day is June 15, and this issue of the CSWE Gero-Ed Center's Aging Times focuses on this troubling and prevalent problem.
Elder Abuse
Georgia J. Anetzberger, Cleveland State University
Anetzberger argues that social workers are uniquely positioned to intervene in cases involving elder abuse, which may affect up to 10% of older Americans.
Self-Neglect in Older Adults
Sarah McKay, MSW Student, Cleveland State University
McKay reflects on her first brush with hoarding, a type of self-neglect that calls for social work intervention.
Resources on Elder Abuse
National Center on Elder Abuse
This collection of resources from the Administration on Aging includes information on World Elder Abuse Awareness Day on June 15.
Role Play Vignettes: Self-Determination, Elder Abuse, and Kinship Care, Class Exercise (MS Word)
Spirit of Aging Rising (SOAR) Elder Abuse, Teaching Modules (Word doc)
CSWE Gero-Ed Center Updates
Torres-Gil to Kick-Off 2009 Gero-Ed Track
CSWE's 2009 APM will feature Fernando Torres-Gil, an expert on the Gero-Ed Track's theme of social justice and aging.
EWA Plans Day of Advocacy: Participate in a June 23 Call-In Day!
The Eldercare Workforce Alliance will visit Capitol Hill and organize a concurrent call-in day on June 23 to address the nation’s worsening eldercare crisis.
Update Your Curricula With MAC's Resource Reviews
These free, user-friendly tools can augment substance use, health, and mental health curricula with resources on gerontology.
Hokenstad Receives Educator of the Year Award From OAGE
M.C. "Terry" Hokenstad, Jr accepted the award at the 33rd OAGE Annual Conference & Meeting in March 2009.
Elder Abuse
By Georgia J. Anetzberger
Elder abuse represents the infliction of harm or threat of harm upon an older adult by a caregiver or trusted other, or the failure of a caregiver to protect an older adult or satisfy her or his basic needs (National Research Council, 2003). The National Center on Elder Abuse (2009) recognizes six forms: physical abuse, sexual abuse, emotional or psychological abuse, neglect, abandonment, and financial or material exploitation. It also acknowledges self-neglect, but distinguishes this from types of elder abuse where there is a perpetrator. Elder abuse is believed to affect 1-10% of older Americans. Although mandatory elder abuse reporting laws exist in nearly all states, it is estimated that as few as 1 in 14 situations are reported to authorities (Lachs & Pillemer, 2004). Almost two-thirds of elder abuse reports involve family members as perpetrators (usually adult children or spouses), and over half represent self-neglect and neglect as forms (Teaster, Dugar, Mendiondo, & Otto, 2005).
Social workers have led efforts to understand and address elder abuse for over 50 years. They spearheaded the development of “protective care,” as adult protective services (APS) were first called, during the 1950s and early 1960s. They conducted the first research on elder abuse during the late 1970s, noting the complexity and intervention difficulties associated with this problem. Today the majority of APS workers are social workers, and APS remains the only nationwide program dedicated to elder abuse intervention.
Social workers are ideally situated to identify and report elder abuse. They are among the professional disciplines most likely to be named as mandatory reporters in state laws. They also are in the top tier of actual reporters (Teaster, et al., 2005). As geriatric case managers and service providers, social workers frequently are in the homes of older adult clients and able to observe conditions that reflect or contribute to elder abuse. As members of interdisciplinary clinical teams in hospitals or residential care facilities, they generally coordinate activities for reporting suspected elder abuse situations to authorities.
Likewise, social workers play important roles in multiple systems involved in elder abuse prevention and treatment. Within the Older Americans Act Aging Network, they help heighten public awareness and provide professional education on the problem. They also offer supportive services that reduce the vulnerability of older adults to elder abuse. Within the justice system, social workers often provide victim assistance or guardianship services. Within health care, they may offer counseling or conduct support groups to deal with the psychosocial effects of elder abuse.
Consequently, it is essential that social work education incorporate curriculum content to help students understand elder abuse and its possible manifestations. This includes information on signs and risk factors along with available screening tools to promote detection. The varied roles that practitioners play mean that social work education must prepare students for navigating the multiple service systems available to address elder abuse, the potential contributions of social work in each system, and effective methods for promoting communication and coordination among distinct disciplines (Anetzberger, 2005).
Georgia J. Anetzberger is assistant professor of health care administration at Cleveland State University, editor of the Journal of Elder Abuse & Neglect, and vice president of the National Committee for the Prevention of Elder Abuse. She holds a doctorate from Case Western Reserve University and has spent over thirty years addressing elder abuse as a practitioner, administrator, researcher, and educator.
References
Anetzberger, G.J. (Ed.). (2005). The Clinical Management of Elder Abuse. Binghamton, NY: The Haworth Press.
National Center on Elder Abuse. (2009). Major types of elder abuse. Retrieved May 11, 2009 from http://www.ncea.aoa.gov/ncearoot/Main_Site/FAQ/Basics/Types_Of_Abuse.aspx
National Research Council. (2003). Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press.
Lachs, M. S., & Pillemer, K. (2004). Elder abuse. The Lancet, 364, 1192-1263.
Teaster, P.B., Dugar, T.A., Mendiondo, M.S., & Otto, J.M. (2005). The 2004 Survey of State Adult Protective Services: Abuse of Adults 60 Years of Age and Older. Washington, DC: National Center on Elder Abuse.
Self-Neglect in Older Adults
By Sarah McKay
As I entered the small apartment, I was met immediately with piles of books and bags of clothes that I needed to walk sideways to fit through. The living room was surrounded by different sets of dishes and china; the couch was being used as a bed; the bath tub was filled with shoes and the shower was used to hang clothes. The toilet and sink were covered with items and neither seemed functional. Everywhere I turned, I needed to be careful not to trip over anything. There was a distinct odor of spoiled food and garbage. I left the apartment feeling as though what I had seen could not have been real.
I experienced my first hoarding case during my internship at an Office on Aging. The woman who lived in the senior living apartment was in her 80s and had a history of hoarding, along with other psychological problems. She was known for wrapping her food in napkins from the dining hall and storing it in her room; she also used the public restroom for bathing. She eventually was evicted due to the poor living conditions and moved in with a family member. The social worker who had worked with this client in the past explained that her hoarding behavior was the result of a tumultuous childhood filled with abuse. The social worker was able to assist the client in sorting through her collections and explaining the need to have a safe living environment, but eventually those hoarding habits would arise again. It fell to the social worker with whom I was working to make the necessary calls to family members and come up with a plan for the client.
This type of situation is an example of self-neglect. Self-neglect is a form of elder abuse that is three time more likely to occur than physical abuse or caregiver neglect (Pavlik et al, 2001). Self-neglect in older adults is becoming more widespread as people live longer and stay in their homes longer. Hoarding is the extreme case of self-neglect that threatens the health, safety, and dignity of older adults (Poythress et al, 2006). The private nature of hoarding poses a threat because this type of behavior can remain unseen by the general public. Social service agencies in the community that service older adults can help monitor this behavior before it becomes harmful to the client.
As a graduate student pursuing a Masters in Social Work and a concentration in Gerontology, I learned a valuable lesson from this case. The social worker with whom I was working made the necessary calls to family members and came up with a plan for the client. During this internship I learned to distinguish between situations where there is self-neglect—and therefore a need for social work intervention—and those where the behavior represents a life style decision rather than compulsive hoarding that threatens a client’s safety. In the field of gerontological social work, each client, without exception, has an extensive life history that social workers must understand and respect. My goal as a social worker is to maintain and improve the story of the clients with whom I work.
Sarah McKay is an MSW student at the Cleveland State University School of Social Work. She holds a BA from John Carroll University in Sociology with a Concentration in Gerontology. In 2005, Sarah was awarded the Susan Friedland Gerontology Award for dedication in field work on aging studies. Sarah will be interning at the Louis Stokes V.A. Medical Center in Cleveland in their geriatric assessment unit.
References
Pavlik, V.N., Hyman, D.J., Festa, N.A., & Dyer, C.B. (2001). Quantifying the Problem Of Abuse and Neglect in Adults-Analysis of a Statewide Database. Journal of the American Geriatrics Society, 49, 45-49.
Poythress, E.L., Burnett, J., Pickens, S., & Dyer, C.B. (2006). Severe Self Neglect: An Epidemiological and Historical Perspective. Journal of Elder Abuse & Neglect 18, 5-12.
Torres-Gil to Kick-Off 2009 Gero-Ed Track
Social justice and aging will take center stage when Fernando M. Torres-Gil kicks off the 2009 Gero-Ed Track at the Council on Social Work Education (CSWE) Annual Program Meeting (APM) in November.
Torres-Gil is the director at the University of California, Los Angeles Center for Policy Research, associate dean of academic affairs, and a social welfare and public policy professor. He served as the first assistant secretary for aging at the U.S. Department of Health and Human Services under the Clinton Administration. At the Kick-Off Event on Saturday, November 7, he will speak to the theme of “Aging and Social Justice: Honoring the Past and Preparing for the Future.”
Registration is now open for CSWE’s 2009 APM, which will host the third annual Gero-Ed Kick-Off Event and related programming such as the Hot-Topic Panel and Rosen Panel for Best Practices in Gerontological Infusion. Early bird registration rates end Friday, September 18.
EWA Plans Day of Advocacy: Participate in a June 23 Call-In Day!
The CSWE Gero-Ed Center is a member of the national Eldercare Workforce Alliance (EWA) whose mission is to address our nation’s worsening eldercare crisis by building a caring and competent eldercare workforce. Several important bills have been unveiled by members of Congress that would affect the social work workforce. The Alliance will conduct visits to Capitol Hill on June 23, 2009 to advocate for these efforts.
EWA and the CSWE Gero-Ed Center invite you to participate in a Call-in Day that will be held on June 23, 2009, concurrently with EWA’s day on the Hill. Your participation will help maximize the impact of this advocacy effort. More information will be distributed in the next two weeks, including core messages and talking points. You will also receive access to a congressional call-in system that will help connect you to your Representatives on the Energy and Commerce; Ways and Means; and Education and Labor Committees.
Your help is needed! Information will be posted on the Gero-Ed Center home page in the next week. For more information on the overall efforts of the Alliance visit the EWA Press Room.
Update Your Curricula With MAC's Resource Reviews
Are your students informed in the areas of substance use detection, schizophrenia, palliative care and other issues affecting older adults? Future social workers must be equipped to manage the unique circumstances facing our aging population. The Master’s Advanced Curriculum (MAC) Project recently expanded the evidence-based Resource Reviews on substance use, mental health, and health care. These free tools provide faculty with an innovative way to infuse gerontology into advanced level courses. Access the user-friendly Resource Reviews today!
Hokenstad Receives Educator of the Year Award From OAGE
M.C. "Terry" Hokenstad, Jr received the 2009 Educator of the Year Award from the Ohio Association of Gerontology and Education (OAGE).
The 2009 Educator of the Year Award was presented at the 33rd OAGE Annual Conference & Meeting, attended by 300 educators in March. The award is given to an Ohioan "who has significantly advanced gerontological education and fostered greater understanding about aging or the issues and concerns of older people."
Hokenstad is the Ralph S. and Dorothy P. Schmitt Professor at the Mandel School of Applied Social Sciences, Case Western Reserve University, in Cleveland, Ohio.