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Annual Annotated Bibliography of Elder Abuse and Neglect Publications
July 2004 - June 2005
Protecting Vulnerable Adults from Abuse
Nursing & Residential Care; Vol. 7 (2), 56-61; February 2005.
This overview was written to assist nurses and residential care professionals in identifying and addressing vulnerable adult abuse and neglect. The authors point out that in addition to staff abuse of care recipients, resident to resident abuse, abuse by visitors, and abuse of staff are other forms of mistreatment that may be encountered. Aspects of institutionalized care, including the depersonalization of residents, are considered as part of the context in which abuse may occur and be perpetuated. Indicators of positive care environments are also outlined, and include practices that reflect respect for the client's privacy and dignity, client involvement in care planning, and client engagement in community activities. Organizations should have clearly established protocols to follow regarding abuse and neglect issues. All care workers are encouraged to report concerns to their managers. (U.K.)
Wei, G. & Herbers, J.
Reporting Elder Abuse: A Medical, Legal, and Ethical Overview
Journal of the American Medical Women's Association; Vol. 59 (4), 248-254; Fall 2004.
This overview is intended for physicians and other health care professionals. Barriers to the
identification and reporting of elder mistreatment are addressed. Shame, denial and fear on the part of patients may inhibit detection, while limited awareness and time constraints may prevent physicians from observing signs and symptoms of elder abuse and neglect. A summary of
mandatory reporting legislation throughout the U.S. is provided, and several key aspects of state to state variations are highlighted. Such differences concern which practitioners are identified as mandatory reporters, whether adult protective services (APS) statutes cover only community-dwelling elders, and which individuals are considered vulnerable, among other issues. Commonalities are also highlighted, and include themes such as the provision of immunity from liability for all who report in good faith, and the need to report "suspected" abuse, not only substantiated abuse. Guidelines for appropriate clinical management are also offered.
Elder Mistreatment: Self-Learning Module
MedSurg Nursing; Vol. 14 (2), 133-138; April 2005.
This self-learning module is part of a series developed by the Geriatric Resource Nurses at the
University of Virginia. The objectives of the module are to allow participants to define and explain the dynamics of elder abuse and neglect, and to understand the clinician's responsibility regarding assessment, intervention and reporting of suspected mistreatment. Two case studies are presented (one inpatient and one outpatient) that allow health care professionals to explore the practical aspects of this process. Virginia state laws regarding mandatory reporting are presented.
Whyte, S., Jacoby, R. & Hope, T.
Testing Doctors' Ability to Assess Patients' Competence
International Journal of Law and Psychiatry; Vol. 27 (3), 291-298; 2004.
This article describes the process of developing a test of physicians' ability to assess competence for decision-making regarding health and treatment related matters. The instrument was designed to be practical, affordable and simple to administer, while reflecting typical clinical situations. It contained multiple choice, short-answer questions based upon general knowledge as well as case scenarios presented via video tape and in text. In order to determine retest reliability, a sample of 150 participants were stratified into the following groups: 36 percent took the test and then were retested within 14-28 days; 20 percent sat for the test and then later participated in a simulated assessment of a patient, which was evaluated by a qualified expert; and 44 percent took the test only once. Results were mixed; there was a weak relationship between participants' test scores and their seniority; and while most scores of the test/retest group were not significantly changed, eight participants scores worsened substantially while one improved. Researchers point out that even the experts had only "fair" agreement with each other. It is unclear if the relatively low correlations were reflective of the instrument's defects, or related to the consensus that there is no accepted way of measuring the accuracy of competence assessment. (U.K.)
Wright, B., for the AARP Public Policy Institute
An Overview of Assisted Living: 2004 (Issue Brief)
AARP Public Policy Institute, Washington, D.C.; October 2004.
As quoted from the introduction: "...This issue brief summarizes the findings of some of the major multi-residence, multi-state studies on assisted living in the United States and Examines their implications for state policymakers and consumers of long-term supportive services. The issue brief begins with a description of the philosophy of assisted living and a discussion of the definition of assisted living. Next it examines four topics: the characteristics of residents and services provided; the degree to which assisted living residences carry out the assisted living philosophy; the costs and affordability of assisted living; and quality and consumer protection. The paper then reviews current efforts to promote affordability and quality in assisted living, explores future demand for assisted living, and presents conclusions with implications for relevant public policy. A limitation of the available research is that the units of analysis vary, as each study defines assisted living somewhat differently and some studies include a broader range of residential housing settings. Currently, the National Center for Health Statistics is attempting to create a uniform classification system, or typology, for long-term care residences. This typology may improve the sampling methodologies of future studies and facilitate cross-state comparisons..." (Note: This issue brief is available online at: http://research.aarp.org/il/ib72_al.pdf .)
Protecting Who from What, and Why, and How?: A Proposal for an Integrative Approach to Adult Protective Proceedings
Elder Law Journal; Vol. 12; 2004.
In this article, the author examines the current adult protective proceedings regarding guardianship and civil commitment in order to maximize their therapeutic potential while safeguarding the rights of the individual. She provides an historical overview of the development of both guardianship and civil commitment laws, then examines the similarities among both fields of law, (including the resultant deprivation of the autonomy of protected individuals, the potential to be harmful to protected individuals, and evidence that due process is typically insufficient in both areas). Existing statutes are evaluated using the framework of therapeutic jurisprudence in order to determine which aspects of both bodies of law could be integrated to enhance the rights of the protected individual. She argues that these elements should be integrated into a unified adult protective proceeding. Such a proceeding would allow for a state appointed person to act on behalf of the protected individual, would provide counsel, focus on treatment as the outcome, allow for speedy hearings, and allow for temporary placement for medical treatment with ongoing monitoring to determine if/when the intervention is no longer necessary. In addition, it would emphasize the decision-making and functional capacity of the affected individual, allow for the participation of family members, reduce the stigma associated with civil commitment, and engender an integration of gerontology and psychiatry. The article concludes with a draft statute that demonstrates this integrative approach.
Wu, K. & Watson, D.
Hoarding and its Relation to Obsessive-Compulsive Disorder
Behaviour Research and Thearapy; Vol. 43, 897-921; 2005.
In light of the recent trend to consider hoarding a manifestation of obsessive-compulsive disorder (OCD), the authors of this article consider whether hoarding should be viewed as a basic symptom of the disorder. Two studies were designed to examine strength of correlation between hoarding and classic OCD symptoms such as checking, rituals, etc. Hoarding related only moderately to these symptoms, and OCD patients were distinguished from non-patients by the classic symptoms, but not by hoarding. The results do not support a specific OCD-hoarding relation.
Zink, T. & Putnam, F.
Intimate Partner Violence Research in the Health Care Setting
Journal of Interpersonal Violence; Vol. 20 (4), 365-372; April 2005.
Given the physical and mental health complications and tremendous cost in health care dollars
associated with intimate partner violence (IPV), practitioners in clinical settings have been
encouraged to conduct routine screenings. Thus far, there has been a lack of evidence generated
regarding the benefits and effectiveness of routine screenings. This article describes the barriers to developing and conducting evidence-based research on such interventions in clinical settings. The authors suggest that randomized controlled trials (RCT) may not be a realistic standard for IPV research in these settings. Realistic standards and explicit outcomes and process measures are necessary to advance the field of study. (Note: This article is not specific to elder abuse.)
IV. Books and Manuals
169. and 170. M106-198 and M107-99
Albright, A., Brandl, B., Rozwadowski, J. & Wall, M., for the National Clearinghouse on Abuse in Later Life, a Project of the Wisconsin Coalition Against Domestic Violence/WCADV, and AARP National Legal Training Project
Building a Coalition to Address Domestic Abuse in Later Life (Planning and Training Guide, and Participant Manual)
National Clearinghouse on Abuse in Later Life, a Project of the Wisconsin Coalition Against
Domestic Violence/WCADV; Madison; WI; revised 2004.
As quoted from NCADV, these publications were: "...developed to show how communities and professionals from various disciplines can learn from each other and work together to address domestic abuse in later life. However, this revised version is a result of specific recommendations from several nationally respected institutes to enhance the cultural competency of this curriculum. Both a trainer's guide and participants' manual are available. The one-day training is intended to allow various community members to discuss current strategies to deal with elder domestic violence and to begin the development of new (or the enhancement of current) strategies to assist older women. (Note: Both manuals are accessible online. The planning and training guide is at http://www.ncall.us/docs/BuildingCoalitionTrainerRev.pdf and the participant's manual is available at http://www.ncall.us/docs/BuildingCoalitionParticipantRev.pdf . Hard copies are available at through Wisconsin Coalition Against Domestic Violence/WCADV, 307 S Paterson St,
Suite 1, Madison, WI 53703 , telephone (608) 255-0539. Price: $5.00 for each. )
American Bar Association Commission on Law and Aging and The American Psychological Association
Assessment of Older Adults with Diminished Capacity : A Handbook for Lawyers
American Bar Association Commission on Law and Aging and American Psychological Association; Washington, DC; 2005
As quoted from the Web site: "... Lawyers face a growing challenge: older clients with problems in decision-making capacity. While most older adults will not have impaired capacity, some will. Obvious dementias impair decision-making capacity - but what about older adults with an early stage of dementia or with mild central nervous system damage? Such clients may have subtle decisional problems and questionable judgments troubling to a lawyer. Assessment of Older Adults with Diminished Capacity: A Handbook for Lawyers offers ideas for effective practices and makes suggestions for attorneys who wish to balance the competing goals of autonomy and protection as they confront the difficult challenges of working with older adults with diminished capacity..." The book addresses such topics as the legal standard of diminished capacity, clinical models of capacity, ethical considerations, and whether an attorney should seek the opinion of a clinician. (Note: This book is not available through CANE. It can be ordered from the ABA Commission on Law and Aging Web site at: http://www.abanet.org/aging/publications/publicationslistorder.shtml#assessments . Price: $25.00.)
Guardianships of Adults: Achieving Justice, Autonomy, and Safety
Springer Publishing Company, NY; 2005.
Using case examples to illustrate various issues, this book presents an overview of guardianship for health and social service practitioners working with adults with diminished capacities. Criteria for establishing guardianship, categories of guardians, alternatives to guardianship, the legal process of guardianship, and the roles of community practitioners and court personnel as they relate to these processes are among the topics addressed. (Note: This book is not available through CANE. Contact Springer Publishing Company, 11 West 42nd Street, New York, NY 10036. Telephone: 877- 687-7476. Web address: http://www.springerpub.com . Price: $41.95. This entry has also been included in the CANE bibliography, entitled Guardianship and other Legal Protections of Vulnerable Adults, which is posted on the NCEA Web site at: http://www.elderabusecenter.org/default.cfm?p=cane_guardianship.cfm .)
Stiegel, L. for the American Bar Association Commission on Law and Aging
Elder Abuse Fatality Review Teams A Replication Manual
American Bar Association; Washington, D.C.; 2005.
Although fatality review teams have been effective in improving the responses of the justice, health, and social services systems to child abuse and domestic violence, the concept was new to the elder abuse field. With funding from the Office of Victims of Crime of the U.S. Department of Justice, the American Bar Association Commission on Law and Aging, and its subcontractor, the National Adult Protective Services Association, developed a project to encourage the establishment of elder abuse fatality review teams (EA-FRT) and to promote the promising practices identified by the demonstration teams. As quoted from the manual, "The goal of the project was to expand the fatality review team concept to deaths resulting from or related to elder abuse in order to foster examination of and improvement in response of adult protective services, law enforcement officers, prosecutors, victim assistance providers, health care providers, and others to the growing numbers of victims of elder abuse. The goal was met through the following objectives: 1), Funding four demonstration projects and conducting other assessment activities to identify promising practices that support communities in establishing and continuing EA-FRT; 2) using the seed money as an incentive to ensure that victim services providers and other pertinent systems are involved in the four demonstration projects; 3) Developing and disseminating a replication guide and presenting workshops at relevant conferences in order to encourage communities to adopt the EA-FRT concept and the promising practices identified by the demonstration projects." The manual is based upon the experiences of teams established in Houston, Texas; Maine; Orange County, California; and Pulaski County, Arkansas. In addition, teams from Pima County, Arizona; Sacramento, San Diego, and San Francisco, California contributed significantly to this effort. (Note: The replication manual is available online at ABA Commission on Law and Aging Web site at: http://www.abanet.org/aging/fatalitymanual.pdf . A limited number of free hard copies are available for individuals who cannot download the manual online. Contact: Lori Stiegel, Associate Staff Director, Commission on Law and Aging, American Bar Association (ABA), 740 15th Street, NW, Washington, DC 20005-1009. Email: [email protected])
U.S. Department of Justice Office on Violence Against Women
A National Protocol for Sexual Assault Medical Forensic Examinations Adults/Adolescents
U.S. Department of Justice; September 2004.
This publication presents detailed guidelines for the health care and criminal justice professionals who respond to victims of sexual assault. The protocol is intended to instruct responders in the effective collection of forensic evidence necessary to prosecute sexual abuse crimes, while being sensitive to the personal and emotional needs of the victims. Topics considered include the need for a victim-centered approach to examination, issues surrounding informed consent and confidentiality, reporting, documentation, evidence integrity and collection procedures, and court appearances. One segment is dedicated to the specific needs of older victims.
(Note: This publication is available online at http://www.ncjrs.org/pdffiles1/ovw/206554.pdf .)
Wisconsin Coalition Against Domestic Violence (WCADV), National Clearinghouse on Abuse in Later Life (NCALL)
Anticipate: Identifying Victim Strengths and Planning For Safety Concerns Training Guide
Wisconsin Coalition Against Domestic Violence (WCADV), National Clearinghouse on Abuse in Later Life (NCALL), Madison, WI; 2004.
This manual is part of an interactive training exercise designed to "enhance the safety planning skills of professionals who work with older victims and/or people with disabilities" who are living in abusive environments. It is designed for use in groups of four to eight people, with a target audience being professionals from the fields of domestic violence, sexual assault, the disability and aging networks, and adult protective services (APS). A breakdown of safety planning is provided, and includes prevention strategies, protection strategies, notification strategies, referral and services and emotional support contingencies. For victims who are leaving, the safety planning encompasses practical decisions regarding living arrangements, financial support, health decisions, legal decisions, and assistance for others affected by the victim's decision (children and grandchildren, other residents of the home, pets). The kit contains various case scenarios for safety planning exercises, in addition to handouts and tools needed to complete the training exercises. (Note: Training kits are available only through NCALL/WCADV. To order, email [email protected] or telephone 608/255-0539. Price: $40.00.)
Vierthaler, K., for the Pennsylvania Department
of Aging and the Pennsylvania Coalition Against Rape (PCAR)
Addressing Elder Sexual Abuse: Developing a Community Response
Pennsylvania Department of Aging and the Pennsylvania Coalition Against Rape (PCAR);
This multimedia curriculum is designed to promote collaboration and community partnerships in addressing elder sexual abuse. It is divided into six modules covering the topics of sexual violence, gerontology, elder sexual abuse, detection of elder sexual abuse, Pennsylvania laws applied to elder sexual abuse, and collaboration. Each module contains an outline and talking points, suggested activities to illustrate the themes identified, handouts, and other tools. The material presented includes a history of the recognition of rape as a crime of violence. There is also a brief summary of the role and function of the Pennsylvania Coalition Against Rape (PCAR) and the Pennsylvania Area Agency on Aging (AAA). The module on elder sexual abuse focuses on differences experienced by the older victim, which include increased risk for physical injury and longer recovery time. It includes information on domestic and institutionalized victimization. (Note: This training curriculum is accessible online at: http://www.aging.state.pa.us/aging/cwp/view.asp?a=541&q=252220 and also may be requested by emailing [email protected] or telephoning (717) 783-1549.)
While many of the hearings conducted by the U.S. Senate Special Commission on Aging do not directly address elder abuse and neglect, they address issues related to the physical, emotional and financial well being of older Americans. Testimony from the following hearings may be accessed online at:
Saving Dollars, Saving Lives: The Importance of Prevention in Curing Medicare?
Mandatory or Optional? The Truth About Medicaid
Keeping the Power On: Examining the Impact of Soaring Energy Costs on the Elderly
Exploring the Promise of Embryonic Stem Cell Research
HIV Over Fifty: Exploring The New Threat
Living Stronger, Earning Longer: Redefining Retirement In The 21st Century Workplace
The Role of Employer-Sponsored Retirement Plans in Increasing National Savings
Exploring the Economics of Retirement
Implementation of the Medicare Modernization Act: Delivering Prescription Drugs to Dual Eligibles
Social Security: Do We Have To Act Now?
Internet Pharmacy and Importation: Exploring Risks and Benefits
Combating The Flu: Keeping Seniors Alive
FORUM: Medicare Drug Discount Cards: Measuring The Savings
Breaking The Silver Ceiling: A New Generation Of Older Americans Redefining The New Rules Of The Workplace
A Fresh Look At Mandatory Retirements: Do They Still Make Sense?
FORUM: Protecting Older Americans Under Guardianship: Who Is Watching The Guardian?
Helping Those Who Need It Most: Low-Income Seniors And The New Medicare Law
Medical Liability In Long Term Care: Is Escalating Litigation A Threat To Quality And Access?
(To search for reference materials from previous years, please visit the CANE Web site at: http://db.rdms.udel.edu:8080/CANE . To search the CANE Bibliography Series, go to http://www.elderabusecenter.org/default.cfm?p=cane.cfm .)
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