Report: Social isolation and low self-esteem linked to elder abuse, say case workers
Preventing social isolation and helping older people to develop the own emotional resources will help prevent abuse and support older people who have experienced abuse, according to a new report.
The National Centre for the Protection of Older People at University College Dublin and the Health Service Executive (HSE) announced the report findings on Thursday, 26 April 2012.
The report examined the experiences of senior case workers who manage cases of elder abuse.
Senior case workers are part of the service infrastructure established by the HSE in 2007 for dealing with elder abuse. The senior case workers investigate allegations of elder abuse and work with older people, their families and carers to resolve cases of abuse within the framework of existing policy and legislation. Eighteen senior case workers were interviewed about their experiences in managing cases of elder abuse.
The study findings show that elder abuse can present as a complex phenomenon taking many forms, including financial, psychological and neglect of the older person, and the boundaries between the various forms of abuse can be fluid.
With this complexity, elder abuse can be difficult to recognise, detect and manage. Among the challenges for senior case workers in managing cases of elder abuse is the need to reconcile the autonomy and self-determination of their clients with issues of capacity, risk and vulnerability. This requires good assessment and interpersonal skills and it requires making ethical judgements.
Senior case workers referred to the critical importance of effective interagency relationships, the need for negotiation of role boundaries and responsibilities in relation to elder abuse and the role of awareness raising and training among health and social care professionals to ensure effective management of elder abuse.
Many advocated a team-based approach to the protection of vulnerable adults and the management of cases of elder abuse. They also identified a need for standardised procedures, greater consistency across the service regarding best-practice guidelines, procedures for case referral and documentation, and the maintenance of case statistics.
A number of recommendations arise from the study findings. Recommendations for the practice of assessing risk and preventing elder abuse include the need to consider targeted interventions to promote older peoples self-esteem and enhance their own psychological resources, to continue to examine the social networks of older people as part of risk assessment, and to consider efforts to secure a supportive social network for older people as part of elder abuse case management.
Among recommendations for case management approaches include the need to promote a multi-disciplinary approach and interagency working and to consider ways to formalise existing inter-professional communications and effective interagency and multi-disciplinary working. Senior case workers can be supported in their role by having clear guidelines that give direction to case management practice, but also take account of the need for flexibility and the retention of existing informal procedures that are effective in helping them in their practice.
Speaking at the report launch, Mr Paschal Moynihan, Specialist, Services for Older People, HSE West said: The acknowledgement of elder abuse as an issue is relatively recent, as are the responses. The HSEs elder abuse service is still in its infancy and this study, along with others that the HSE and the National Centre for the Protection of Older People at UCD has initiated, will assist in enhancing our response in meeting the complex challenges posed by cases of abuse of older people.
Professor Gerard Fealy, Director of the National Centre for the Protection of Older People at UCD, said that this report provides important evidence of the everyday experiences of those directly involved in assessing and managing cases of elder abuse in Ireland, and will contribute to the growing body of research into elder abuse in Ireland that is informing national policy in this area.