Case Management and Elder Abuse CLAIRE CHRISTINA AND

Case Management and Elder Abuse CLAIRE, CHRISTINA, AND KATRIN

Population Served What is Elder abuse? "Any knowing, intentional, or negligent act by a caregiver or any other person that causes harm or a serious risk of harm to a vulnerable adult. . may include: physical abuse, emotional abuse, sexual abuse, exploitation, neglect, and abandonment" (National Council on Aging, 2009, Issue Briefs. ) Statistics: 37. 5 million people 65+ in US (2006) 12. 4% of U. S. population Population expected to be 20% of U. S. population by 2030 (Administration on Aging, 2009, Aging Statistics).

Video Elder Abuse PSA Clip (0: 27 seconds) http: //www. youtube. com/watch? v=g. WYJt. C 5 ab. VY&feature=rel ated

Clinical Management of Elder Abuse 5 Steps • Detection • Assessment • Planning • Intervention • Follow-up

Detection • • Purpose Difference between "known" and "suspected" incidents Future risk-of-abuse factors More than 80% of states have mandatory reporting laws by professionals identified as social workers, physicians, law enforcement officers, psychologists and nurses Signs of Elder Abuse - General and Specific • Frequent arguments or tension between the caregiver and the elderly person • Changes in personality or behavior in the elder Barriers to detection for clinicians and victims

Assessment The three levels (Summers, 2009, p. 72): Micro- personal attributes Meso- immediate surroundings Macro- larger systems The reason for a more thorough assessment is to evaluate the person and situation of victim and perpetrator in order to determine: need for assistance, immediacy of need, available resources to assist, and to identify priorities. (Anetzberger, 2005, p. 31)

Planning Purpose Approaches used to address elder abuse 2 Goals for Planning Elder Abuse Intervention in Clinical Management 1. Preserving victim autonomy 2. Promoting victim safety To be successful: • Ability and willingness of the victim & perpetrator to accept assistance • Quality of the interventions resources

Intervention Application of services, laws, and clinical procedures What are the specific needs of this elder? What is the primary purpose of this intervention? What kind of Model of Intervention will be used? What different levels of prevention are involved? Consider the time duration of the intervention? What services are there for the perpetrator? (Anetzberger, 2005, "Clinical Management, " pp. 33 -34)

Follow-Up Purpose (Anetzberger, 2005, p. 37): -To evaluate intervention effectiveness -Reassessment of need - Situation monitoring to prevent abuse reoccurrence

Laws and Policies that affect services Older Americans Act, 1965/2006 It is the "duty and responsibility of the governments of the United States to assist our older people to secure equal opportunity to the full and free enjoyment of [the. . . ] free exercise of individual initiative in planning and managing their own lives, full participation in the planning and operation of community based services and programs provided for their benefit, and protection against abuse, neglect, and exploitation" (Administration of Aging, n. d. , Unofficial Compilation of the Older Americans Act). Administration on Aging (AOA) Vulnerable Elder Rights programs: § Prevention of Elder Abuse, Neglect, and Exploitation Program § National Center on Elder Abuse (NCEA)

Laws and Policies, continued Elder Justice Act, S. 795, Currently introduced in Senate - Would provide a federal funding stream to APS - Assure that Dept. of Health and Human Services identifies an office to provide coordination and technical assistance for APS systems H. R. 448, Passed House in 2009 Washington State: Vulnerable Adult Protection Act RCW 74. 34

How are services funded? Federal Funding of US Administration on Aging APS - Funding from DSHS’s Aging and Disability Services Administration Current economic status of Washington state • As a human services professional, stay current on agencies' financial status o Who has funding? Who does not?

Clinicians' Responsibility - Awareness of the issues - Difficulties with detecting and reporting - Courage Emotions and sensations of elder abuse - sense of smell, sight, hearing, the mind • The Clinician's Perspective • difficulties with detecting and reporting -courage • The Victim's Perspective • • effects of elder abuse: physical, behavioral, psychological, and social Increased levels of depression

Local Resources Page Adult Protective Services (APS) Visiting the Hotline section of the National Center on Elder Abuse website Visiting the Eldercare Locator website or calling 1 -800 -6771116. Aging and Disability Services Administration (DSHS) 1. Senior Information and Assistance 2. Home and Community Services 3. Family Caregiver Support Program 4. Area Agency on Aging

How to report Elder abuse What if I suspect abuse, neglect, or exploitation? http: //www. aoa. gov/Ao. ARoot/Ao. A_Programs/Elder_Rights/EA_Prevention/What. To. Do. aspx 2007: Reports to APS in Washington: 13, 551 Substantiated cases: 1, 463 Source: DSHS, 2007

References Administration on Aging. (n. d. ) Unofficial Compilation of the Older Americans Act of 1965. Retrieved May 24, 2009 from http: //www. aoa. gov/Ao. ARoot/Ao. A_Programs/OAA/oaa_full. asp#_Toc 153957785 Administration on Aging. (2009, March 24). Aging Statistics. Retrieved May 23, 2009 from http: //www. aoa. gov/Ao. ARoot/Aging_Statistics/index. aspx Anetzberger, G. J. (2005). Clinical management of elder abuse: General considerations. Clinical Gerontologist, 28(1/2), 27 -41. Anetzberger, G. J. (2005). The reality of elder abuse. Clinical Gerontologist, 28(1/2), p. 1 -25. Help. Guide. Org. (2009). Understand, prevent and resolve life's challenges. Elder Abuse. Retrieved May 24, 2009 from http: //www. helpguide. org/mental/elder_abuse_physical_emotional_sexual_neglect. htm National Center on Elder Abuse. (2009, May 19). What we do. Retrieved on May 23, 2009 from http: //www. ncea. aoa. gov/NCEAroot/Main_Site/About/What_We_Do. aspx National Council on Aging. (2009, April). Issue Briefs: Elder Justice Act. Retrieved May 24, 2009 from http: //ncoa. org/content. cfm? section. ID=336&detail=2119 Summers, N. (2009) Case management practice: Skills for the human services. Belmont, CA: Brooks/Cole. Washington State Department of Social and Health Services. (2007). Adult Protective Services (APS), January 1 – December 31, 2007: Reports of abuse, neglect, self-Neglect, exploitation of the person, financial exploitation or abandonment. Retrieved May 28, 2009 from http: //www. adsa. dshs. wa. gov/APS/