Professional Decision Making on Elder Abuse: Systematic Narrative Review

Social work and health care professionals internationally are recognizing the need to understand and respond to the abuse of older people. Policy and guidance have identified processes but definitions of key concepts remain problematic, and the literature suggests that practitioners and agencies have little insight or guidance for decision making. Nine bibliographic databases were searched for studies on professional decision making regarding abuse of older people. Relevant studies retrieved were appraised for quality using explicit criteria. The findings of the 19 articles meeting the inclusion criteria were synthesised using a structured narrative approach. Common themes identified were abuse factors, situational factors, and broader contextual factors. Abuse factors relating to risk levels and client vulnerability were central; age, gender, and health status were considered as key indicators of vulnerability. The opinion of adult protection workers about the potential effectiveness of their intervention was a factor in deciding about responding to alleged or suspected abuse. Professionals struggled with complex ethical dilemmas created by elder abuse, particularly when the victim did not want an investigation. Making objective judgements was difficult when faced with complex family and contextual factors. A structured approach to narrative synthesis of a diverse range of studies retrieved through an explicit search and inclusion process provided a useful summary of key issues for practice and identified gaps in the research literature.     

Screening for Elder Abuse in Hospitalized Older Adults With Dementia

When older adults with dementia are hospitalized for psychiatric treatment, which elder abuse screen to use is questionable. This article reviews screens to identify desirable characteristics. For clinician completion, the Elder Assessment Instrument and the Brief Abuse Screens for the Elderly are recommended. For the older adult, the brief Hwalek-Sengstock Elder Abuse Screening Test is suitable. The Modified Conflict Tactics Scale, which can be used by both the older adult and the nonprofessional caregiver, has many of the recommended characteristics. Research is necessary in the application of these screens within hospitals to detect elder abuse within this specialized population.     

Book review

Human Behavior in the Social Environment: Interweaving the Inner and Outer Worlds By Esther Urdang, Ph.D.     

What Is “Elder Abuse”? Voices From the Margin: The Views of Underrepresented Canadian Older Adults

We know relatively little about the definitions and perceptions of elder abuse held by marginalized groups of older adults in Canada. The current study used focus group methodology to explore perceptions of elder abuse among marginalized groups such as Aboriginal persons, immigrants, refugees, and lesbians. We found both similarities and differences in perceptions of elder abuse across groups. Groups identified traditional forms of elder abuse (i.e., physical, sexual, psychological/emotional, financial abuse, and neglect) as well as less frequently identified types of abuse such as disrespect and government or systemic abuse. Groups also discussed issues related to immigrant sponsorship arrangements and abuse in nursing homes.     

Elder Abuse and Oppression: Voices of Marginalized Elders

The voices of elderly people from marginalized groups are rarely solicited, and the relationship between elder maltreatment and belonging to an oppressed group has not been adequately investigated. This article reviews the literature on oppression and elder abuse and describes findings from the secondary analysis of data from focus group discussions on elder abuse held with marginalized older adults and (quasi)professionals caring for them in two Canadian cities. Participants identified that increased vulnerability to elder abuse was related to oppression experienced as a consequence of ageism, sexism, ableism/ disability, racism, heterosexism/homophobia, classism, and various intersecting types of oppression.     

Perceived social support in Chinese parents of children with attention deficit hyperactivity disorder in a Chinese context: Implications for social work practice

This article reports the results of a Hong Kong study (no. of parents = 121) which identified perceived social support (PSS), both overall and four types of support, of Chinese parents of children with attention deficit hyperactivity disorder (ADHD) and examined the impact of PSS on the interrelationship between the ADHD symptoms and parenting stress. The parents perceived support of their primary social network as more satisfactory than professionals’. Parenting stress of the high PSS group was lower than the low PSS group’s. The PSS-overall, parenting role, and the ADHD symptoms explained a significant variance of parenting stress. The results pave the way to develop a complex social work model in helping.     

Advanced Clinical Social Work Practice: Relational Principles and Techniques,by Goldstein,E., Miehls,D., & Ringel,S.

Multicultural Human Services for AIDS Treatment and Prevention. Julio Morales and Marcia Bok (Eds.). (New York: Haworth Press, 1992)

Qualitative Studies in Social Work. Catherine Kohler Riessman (Ed.). (Thousand Oaks, CA: Sage, 1994.)

Feminist Psychoanalytic Psychotherapy. Charlotte Prozan. (Northvale, NJ and London: Jason Aronson Inc., 1994.)