An Ethical Dilemma in Elder Abuse

Abstract

While most elder abuse is perpetrated by family members, some may be performed by strangers. When the elderly victim reaches out to the social agency but then refuses services, an ethical dilemma is created for the social worker. Conflicts arise among social work values and the ethical principles of autonomy and paternalism, beneficence, and nonmaleficence. A model of ethical justification is applied that explains the possible decisions in this case. The actual resolution of the dilemma is accomplished through a social work practice principle.     

Psychological Abuse in Young Couples: Risk Factors

ABSTRACT

In a study conducted at a major university in Spain, 648 university students between the ages of 17 and 23 years were assessed to identify the manifestations of psychological abuse prior to the consolidation of marital status (e.g., matrimony, start of cohabitation). To evaluate psychological abuse in the students’ intimate relationships, the authors created a Questionnaire on Psychological Abuse. Results show coercive patterns of interaction in the students’ dating relationships. Significant differences were found between men and women, with behavioral factors such as hostility, blaming, and abusive insistence. Future research is suggested that would permit changes in attitude and behavior to be introduced into dating relations.     

Nursing Home Social Services Directors and Elder Abuse Staff Training

In a nationally representative study of 1,071 nursing home social services directors 80% of social services departments provided resident rights training and 60–70% were involved in abuse training. Departments headed by recent grads and in chain nursing homes or in the northeast were more likely to be involved in training. Seventy-two percent of social services directors were able to provide one-on-one training about reporting suspected abuse; education and licensure were related to ability to train.     

Causes and Contexts of Domestic Violence: Tales of Help‐Seeking Married Women in Sylhet,Bangladesh

Domestic violence (DV) against married women is widely prevalent across Bangladesh and this merits nuanced attention. Multifarious factors are believed to perpetuate DV in different socioeconomic contexts within the country. This study aimed to understand the causes and contexts of DV in the Sylhet region (a distinct sub‐culture that carries Sylheti identity). This was a qualitative study based on the experiences of 42 victims of DV who sought help from two social welfare organizations, namely ‘Women Support Program (WSP)’ and ‘Bangladesh Legal Aid and Services Trust (BLAST)’, both located in Sylhet. Using in‐depth interviews, we tried to interact with the victims to retrieve the causes and contexts of DV in Sylhet. Findings revealed that a number of factors led to DV. These causal and contextual factors for DV were dowry practice, illiteracy, cultural approval of wife beating, women's silence, polygyny, socioeconomic dependency of the wife, conflicts related to extra‐ and premarital affairs, poverty, stigmatization, and drug addiction of the husband. The study concluded that all these factors could be brought under the umbrella of age‐old patriarchal cultural values that continue to create the contexts where DV takes place unabated.     

Domestic violence and child abuse: developing social work practice

This paper takes as its starting point the report produced by the Social Services Inspectorate (1995), entitled Domestic Violence and Social Care , which seeks to alert social workers to the links between domestic violence and child abuse and urges the profession to respond more effectively to these two interconnected forms of violence. Having examined the research findings which provide evidence for these links, the theoretical and service delivery contexts in which these two forms of violence have been studied and conceptualized by the social work profession, both in the United Kingdom and in the United States, are identified. Studies of the social work response to domestic violence are discussed and some of the difficulties experienced by social workers in responding effectively to the needs of families where both forms of violence are experienced are considered. In particular, the issues of 'invisible' men and 'trapped' women and children are explored. It is argued that effective social work intervention which challenges these stereotypes will require additional resources and the article concludes with a consideration of whether the Messages from Research report might herald a shift in the approach to child protection that would promote the allocation of resources to this area of work.     

Chapter 7 Sexual Abuse of Older Women Living in Nursing Homes

Abstract

Aggregated data from APS case files of sexually abused older women between the agesof70 and 89living in nursing homes were collected over a five-year period, yielding a total of 50 substantiated cases. The most common types of sexual abuse involved instances of sexualized kissing and fondling and unwelcome sexual interest in the women's body. All alleged perpetrators were male; they typically were 70 years of age and older and residents in the nursing home. In only three cases was the alleged offender prosecuted in court and only one of these cases was the offender convicted. Implications of these data for future practice and research are discussed.     

PERCEPTION OF SENIOR CENTERS BY THE BLACK ELDERLY

This study explored the impact of the neighborhood senior center on the black elderly by determining their perception of senior centers. Three groups of black elderly were interviewed: attenders of a neighborhood senior center (n = 46), non-attenders in the same community (n = 33), and non-attenders in a comparable community without a neighborhood senior center (n = 27). A 29-item interview schedule was conducted that determined awareness of senior center activities and services. Significant differences were found among the three groups with the attenders and non-attenders in the same community having the highest level of awareness of senior center activities and services. Age, sex and marital status were not found to influence perception of senior centers. The findings suggest that the neighborhood senior center needs to be further examined as a model for serving minority elderly.     

SERVING FAMILIES OF THE INSTITUTIONALIZED AGED

No abstract available for this article.     

Key decisions in child protection services in cases of domestic violence: maintaining services and out‐of‐home placement

This paper looks at the response of the child protection services (CPS) system in cases where exposure to domestic violence occurs alone or together with abuse or neglect, focusing on the factors involved in decisions to maintain the case open for ongoing services or remove children from the home. The study is based on an analysis of clinical and administrative data from the files on children reported to a CPS agency in Montreal, Canada. A total of 1 071 substantiated reports were documented, including 337 cases of co‐occurrence (32%). Analysis of the data shows that domestic violence does not by itself constitute a factor liable to lead to more intrusive intervention. The CPS response appears to be influenced more by the existence of other forms of maltreatment and risk factors. Additionally, while domestic violence may be associated with more severe individual and family problems, it does not influence the decision to keep the case open because the child still need services. The lack of any connection between domestic violence and this decision is a cause for concern, as results indicate that such families need help. Knowing how to respond to their needs therefore remains a major challenge.     

Exploring approaches to child welfare in contexts of domestic violence and abuse: Family group conferences

This article sets out to explore service provision for families affected by domestic violence and abuse. For most families where there are child protection concerns, there are possibilities for intervention from child welfare agencies and domestic abuse services, but these have been criticised as having distinct and disconnected practice cultures and orientation. Recognising this divergence, in this paper, we advocate for safeguarding children affected by domestic violence and abuse using the family group conference (FGC) model. This offers possibilities for a coherent response that integrates both child‐ and women‐centred concerns in a holistic approach to family safety and well‐being. Furthermore, it is well documented that safeguarding work involves professionally‐led decision‐making that is pre‐occupied with the management of risk. FGCs, however, promote a partnership approach that engages families in a more democratic decision‐making process. As such, FGCs offer families the opportunity to develop their own safety and support plans for the protection and care of children recognising the family's inherent strengths.     

History repeating: child protection responses to domestic violence

Statutory child protection has a long and contested history in domestic violence intervention where children are involved. The inadequacy of the response has been raised by researchers, women and their advocates for more than 20 years. In fact, Linda Gordon, in her classic analysis of the files of charitable agencies from 1880 to 1960, showed that violent men were ignored, women whose own lives were in danger were judged as inadequate when they failed to protect their children and ‘child rescue’ was frequently seen as the solution to protecting vulnerable children. The same issues continue to be raised today. The repetitive pattern points to the structured nature of the problem which goes beyond the intentions and practice of individual workers. A policy response and a cultural change is needed, which tackles not only the ‘age old’ but also some of the newer permutations of intervention in this area. This paper will explore aspects of this structured pattern and then draw from international research and projects which are grappling with positive changes to child protection intervention in this area.     

Examining Engagement of Men in a Domestic Abuse Program from Three Perspectives: An Exploratory Multimethod Study

This study addresses the limited knowledge in the field on how men initially engage in domestic abuse treatment. Interviews were conducted with a subsample of the men (n = 8), all of the facilitators (n = 4), and an engagement instrument was completed by facilitators on the full sample (N = 95). Facilitator scores confirmed men's engagement in group and that it increased over time. A majority of men and facilitators identified “learning things” as most important in the engagement process. Key elements of group process men described included the importance of learning from each other's stories, and all facilitators observed the support exchanged between the men. Research and group work implications are discussed.     

A practice framework to guide screening and assessment in the Australian Family Relationship Centres and Advice Line

In recent years, there has been a growing recognition of the reactive way in which policy is translated into practice on the front lines of child and family welfare organizations, particularly in how risk is assessed and responded to by staff at all levels in these organizations. Major reforms to family law in Australia and programmes set up to complement the existing Commonwealth-Funded Family Relationship Services Program provide an opportunity to rethink how staff can be provided with a systematic and research-based set of guidelines for screening and assessment. This paper examines the role of practice frameworks in general and the Australian family relationships screening and assessment practice framework in particular to demonstrate not only how this broader evidence-based approach encourages well-informed, professional and ethical practice but also how it leaves room for creativity and local, place-based responsiveness.     

Avoidance and confrontation: social work practice in relation to domestic violence and child abuse

Action on the relationship between domestic violence and child abuse has been slow to emerge in mainstream child protection agencies. This paper reports a qualitative study of child protection files. Particular attention was given to the issues for Asian families. Initially the numerous strategies which social workers and other professionals at child protection conferences used to avoid the issue of domestic violence are explored. However, there was also a small, but emerging, pattern of child abuse in the context of domestic violence being taken seriously. In each of these cases strong expectations were placed on women to separate from or remain separated from men who were violent. These expectations were backed by 'threats' or the actual accommodation of children often with little interagency support for women undertaking this difficult and dangerous task, or before women were ready to undertake this separation. Suggestions are made about aspects of the organizational context which need to change if good child protection is also to include appropriate protection and support for the child's mother.     

An Exploratory Study of Substance Abuse Among Latino Older Adults

ABSTRACT

Substance abuse among older adults is on the rise. Of particular concern is the increase in alcohol and drug use predicted among Latino elders, expected to result from an upsurge in the Latino population and concurrent growth in the number of older adults. Providing effective treatment for this group will require age-specific, culturally competent interventions. However, few studies have focused on geriatric substance abuse among Latinos. This study aims to lay the groundwork for further research by examining perceptions of the problem among treatment providers and researchers in aging and substance abuse. Implications for social work research and practice are addressed.     

Advance Care Planning in the Delivery of Adult Protective Services

ABSTRACT

In ensuring the safety and protection of older adults from abuse and exploitation, adult protective services (APS) workers face a variety of situations involving serious illness and end-of-life conditions. Many older adults encountered in APS will present with one or more chronic conditions that may warrant discussion of advance care planning with clients and their families. This study surveyed APS workers (n = 508) in 21 states regarding encounters with end-of-life situations and the practice of future care planning. Results revealed that three-fourths of APS workers encounter clients with serious illnesses and about two-thirds do discuss planning in advance for care. More than one-half of the respondents indicated client incapacity and refusal to address future care needs as barriers to discussing planning in advance for care. Recommendations to enhance advance care planning among APS workers are discussed.     

Systematizing Knowledge of User Influence – A Study of User Advisory Boards in Substance Abuse and Mental Health Services

While there is a great deal of interest in, and literature describing user influence in mental health and substance abuse services at the individual level, there are fewer studies of collective user influence at the organizational level. This article presents the findings of a study of the development of user advisory councils in regional organizations providing substance abuse services, which were part of a national implementation project in Sweden. A survey of both users and professionals involved in the local projects, in addition to interviews with key actors at the national level, were completed and analyzed with reference to the results of a literature review. The overall aim of the study was to identify obstacles and success factors related to the development of collective user influence at the programme and system levels. The results indicated that there was an overwhelmingly positive attitude towards experience‐based knowledge and the potential for developing formal, collective user influence in these organizations. Users and professionals had common viewpoints regarding the obstacles and success factors, which included: addressing power relations, establishing legitimacy, assigning resources, investing in sustainability and planning for real participation. They were also substantially in agreement as to the strategies that would be needed in the future in order to move from ideology to action. These factors form the basis for a model that might be used to support the systematic implementation of this type of organized user influence.