The effect of a family-based intervention with a cognitive-behavioral approach on elder abuse

ABSTRACT

Elder abuse may become a health issue in developing countries, including Iran. The purpose of this investigation was to study the effectiveness of Family-Based Cognitive-Behavioral Social Work (FBCBSW) in reducing elder abuse. In a randomized clinical trial in Iran, 27 elders participated in intervention and control groups. The intervention groups received a five-session FBCBSW intervention and completed the Domestic-Elder-Abuse-Questionnaire (DEAQ), which evaluates elder abuse at baseline and follow-ups. Repeated measures of analysis of variance (ANOVA) and the Wilcoxon test were used to analyze the data. The repeated measures ANOVA revealed that FBCBSW was successful in reducing elder abuse. The Wilcoxon test indicated that emotional neglect, care neglect, financial neglect, curtailment of personal autonomy, psychological abuse, and financial abuse significantly decreased over time, but there was no statistically significant difference in physical abuse before and after the intervention. The findings from this study suggest that FBCBSW is a promising approach to reducing elder abuse and warrants further study with larger samples.     

A New Genre of Social Protection Policy for Older People: A Critical Analysis of Legislative Development in Nepal

This commentary critically discusses recent legislation promulgated in Nepal to safeguard older people's rights and promote their well-being. Using a human-rights–based framework, the legislation is analyzed for its strengths and weaknesses. Emphasis has also been placed on discussing various aspects overlooked by the legislation, such as changing family structure, relations, and social values; the impact of employment structure and migration; and, importantly, maintaining a desired balance between the roles of the state and of the family in providing social security, support, and care to older people. Efforts have been made to reflect the promulgated law in light of the contemporary developments taking place globally, particularly in regions of Asia. Areas for future policy work are also identified in order to make legislation more inclusive and effective.     

Gender and Pensions: An Analysis of Factors Affecting Women's Private Pension Scheme Membership in the United Kingdom

There has been considerable debate about the future sustainability of pension provision and, in particular, the precarious position of many female pensioners. The reasons for women's lower participation rates in private pensions than men's require greater investigation. Using the General Lifestyle Survey (GLF) 2008, this article examines the impact of various characteristics on the likelihood of contributing to a private pension, such as educational attainments, income, occupational group, full-time/part-time status, and whether an individual has any dependent children. It shows that these characteristics play an important role in access to private pensions. Finally, it suggests that strategies to alleviate disadvantages must take into account the complex circumstances that individuals experience throughout the life course, which result in gendered pension provision.     

The Needs of Elders in Public Housing: Policy Considerations in the Era of Mixed-Income Redevelopment

A number of studies have followed the changes in the lives of public housing residents forced to relocate because of redevelopment. From 2002 to 2007, researchers followed the residents of a public housing development from the first year when residents learned of the pending demolition through 4 years of resettlement. Elder residents dispersed throughout the city provide insights into what life is like for low-income seniors leaving their homes and entering as strangers into new neighborhoods. The article concludes with recommendations for rethinking aging in place for poor elders.     

Efficacy of Work-Based Training for Direct Care Workers in Assisted Living

This article reports on the efficacy of a work-based learning program for direct care workers in assisted living. The program goal was to improve skills and facilitate career development. The training program had positive impacts at both individual and organizational levels. Survey data found that workers felt more competent and self-confident about their abilities to work with residents. Furthermore, increasing satisfaction with the training program over time led to greater job satisfaction and a desire for additional education. Organizations have better outcomes when workers are well trained, feel empowered, and are satisfied with their work. Policy implications for assisted living settings and meeting the growing demand for a competent direct care workforce are discussed.     

Competing Values in Serving Older and Vulnerable Adults: Adult Protective Services,Mandated Reporting,and Domestic Violence Programs

State mandatory reporting statutes may directly or indirectly list domestic violence programs as among those that are mandated reporters of cases of suspected abuse, neglect, or exploitation of older individuals and those with disabilities. Domestic violence programs, however, may not consider themselves to be mandated reporters, because the responsibility of reporting abuse may be contrary to their programmatic philosophy. In the Commonwealth of Virginia, the potential conflict between domestic violence programs and Adult Protective Services about the issue of mandated reporting has created tension between these organizations as each entity continues interpreting the issues and policies of mandated reporting through its own lens. The authors draw out some of the reasons for the conflict as well as make recommendations for improving relationships between the two organizations, which will ultimately benefit vulnerable adults who are experiencing abuse.     

Elder Abuse and Barriers to Help Seeking in Chennai,India: A Qualitative Study

This qualitative study attempts to understand why older persons abused by their family members in India do not seek help. In-depth interviews over three visits were conducted with six adults aged 65 years and above who had been physically abused by their sons/daughters-in-law. The interviews were transcribed and themes identified using a thematic analysis method. The barriers preventing a person from seeking help were service-related (accessibility, lack of trust); religious (Karma); family (deleterious effects on family, family members’ responses to help seeking); and individual (socioeconomic dependency, self-blame). The unique findings that surfaced were fear of losing one's identity by losing one's family, attributing abuse to past sins, and concern over not attaining salvation if one's sons did not perform funeral rites. The authors propose a checklist to explore and assess the barriers to seeking help. Recommendations for geroprofessionals in overcoming barriers include implementing outreach programs and changing the misconceptions regarding Karma.     

A National Comparison of Spousal Abuse in Mid- and Old Age

This exploratory study addresses whether there are similar or different risks and protective factors associated with spousal abuse among mid-age adults (persons aged 45–59) and old-age adults (persons aged 60 and over). The risk and protective factors of abuse are compared across these two age groups and situated within a life course framework. Cross-sectional data from the 1999 and 2004 General Social Surveys are merged to address the research questions. Overall, it was found that there are as many differences as there are similarities in risk/protective factors connected to individual, relationship, and community environments. The findings are discussed in terms of program development and future research.     

Diffusion of the Property Tax Work-Off Program for Senior Homeowners in Massachusetts

Property tax work-off programs (TWOPs) provide senior homeowners with relief from some of their property tax obligations in exchange for services provided to local governments. These programs are offered by some county and municipal governments at their own discretion in a number of states. Through a qualitative study comparing municipalities in Massachusetts that participate in the program with similar communities that do not participate, the authors sought to learn the reasons for both participation and nonparticipation. They interviewed local officials in eight participating and six nonparticipating communities. Mohr's theory for adoption and Roger's theory for diffusion are used for the conceptual framework of the study. Local leaderships' motivation, financial or political resources and obstacles, senior homeowners' awareness, communication between communities, and perceived benefits of the program were the major factors in adoption and diffusion of TWOPs in Massachusetts.     

An Examination of the Adult Day Services Industry Using the Resource Dependence Model within a Values Context

The adult day services (ADS) industry continues to grow and develop in providing care to larger numbers of older adults and their caregivers. Despite the growth in the number of programs and the changes in the way services are delivered, a systematic examination of the development of the ADS industry from a policy perspective has not been published since the mid-1990s. This article provides an analysis of the development of the ADS industry using the resource dependence model within a values-based context to determine whether public reimbursement opportunities are congruent with the needs of older adults and caregivers. Potential directions for the future development of the industry are presented through analysis of the collaborations of adult day providers with the providers of other services for older adults and the effort by public and private funders to connect quality outcomes and resources.