scholarly journals RISKS AND VULNERABILITIES AFFECTING ADVANCED CARE PLANNING FOR OLDER ADULTS INVOLVED IN ADULT PROTECTIVE SERVICES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S181-S181
Author(s):  
Joy S Ernst
Keyword(s):  
Older Adults ◽  
Qualitative Content Analysis ◽  
Functional Limitations ◽  
Family Members ◽  
Care Planning ◽  
Advanced Care Planning ◽  
Protective Services ◽  
Adult Protective Services ◽  
Difficult Conversations ◽  
Insight Into

Abstract Adult protective services (APS) workers regularly engage in advanced care planning (ACP). This qualitative content analysis of 21 APS cases sought to extend knowledge and uncover characteristics that influenced the ACP process and increased vulnerability of older adults in cases of neglect. The case narratives were examined to identify themes of vulnerability and risk related to ACP. Vulnerabilities of the older adults included multimorbidities, geriatric syndromes, and functional limitations. Risks involving caregivers included health problems and cognitive impairment. Caregivers were overwhelmed or lacked insight into the older adults’ needs. Involvement of other family members was detrimental or non-existent while some advocated for improvements where the caregiver refused assistance. Findings support the development of methods of ACP, including the facilitation of difficult conversations, that would respect the autonomy and dignity of the older adult while meeting the multiple needs of caregivers and family members.

Letter to a grandchild as a narrative tool of older adults’ biographical experience exploration

2019 ◽  
Vol 29 (1) ◽  
pp. 29-49
Author(s):  
Urszula Tokarska ◽  
Elżbieta Dryll ◽  
Anna Cierpka
Keyword(s):  
Older Adults ◽  
Life Experience ◽  
Qualitative Content Analysis ◽  
Future Research ◽  
Frequency Count ◽  
Applied Psychology ◽  
Narrative Paradigm ◽  
Female Data ◽  
Narrative Mode ◽  
Insight Into

Abstract The paper purports to present a method that allows to obtain and analyze letters written by older adults to their real or imaginary grandchildren. This enables an insight into their individual life experience. The study used a narrative paradigm. Letter texts were obtained from 128 older adults from Poland, both male and female. Data was analyzed with mixed methods combining qualitative content analysis (using inductive analytical categories described in originally created Coder Completion Sheet) with frequency count. The analysis allowed a systematic description of content (themes in wisdom legacy) and the differentiation of two major formal patterns in the letters: (1) the narrative mode (storytelling); (2) the argumentative mode (legacy without narrative examples: advice, warnings, and wishes). The outcomes demonstrate the letter technique may be recommended for future research in psychology, narrative gerontology and for used in applied psychology also.

scholarly journals Family Achievements in the Battle with Schizophrenia: :Life Experiences in a Qualitative Content Analysis Study in IRAN

2020 ◽  
Author(s):  
fatemeh darban ◽  
Roghayeh Mehdipour_Rabori ◽  
Jamileh Farokhzadian ◽  
Esmat Nouhi ◽  
Sakineh Sabzevari
Keyword(s):  
Content Analysis ◽  
Data Analysis ◽  
Personality Traits ◽  
Qualitative Content Analysis ◽  
Family Members ◽  
Psychiatric Hospitals ◽  
Analysis Data ◽  
Family Ties ◽  
Insight Into ◽  
Taking Care

Abstract Introduction: The challenges of living with and taking care of a patient with schizophrenia can lead to positive changes depending on the experiences and reactions of the families. Such changes may directly affect the family performance and the patient's recovery stage. Therefore, the aim of this study was to explain the positive experiences reported by families of patients with schizophrenia.Materials and methods: In this qualitative study of content analysis, data were collected using semi-structured and in-depth interviews with 15 family members of patients with schizophrenia who referred to one of the psychiatric hospitals in Zahedan City, Iran. Targeted sampling method was applied and data analysis was conducted using contractual content analysis proposed by Graneheim and Lundman.Results: Data analysis resulted in a theme entitled 'family achievements in the battle with schizophrenia'. This theme included four main categories of: Developing positive personality traits in family members, Strengthening family ties, Developing insight into life, and Social mobility.Conclusion: The findings provided evidences that the experience of taking care of patients with schizophrenia led to positive consequences for the families.Highlights- Caring for a patient with schizophrenia promotes personality traits in caregivers- Participating in patient care strengthens family ties- Living with schizophrenia patients developed their insight into life.- Family members of a schizophrenic patient try to reach their previous social status

scholarly journals Family Conflict and Older Chinese Americans’ Self-Efficacy in End-of-Life Care Planning: The Role of Acculturation

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 572-572
Author(s):  
Kaipeng Wang ◽  
Fei Sun ◽  
Yanqin Liu ◽  
Carson de Fries
Keyword(s):  
Older Adults ◽  
End Of Life ◽  
Family Conflict ◽  
Self Efficacy ◽  
Family Members ◽  
Chinese Americans ◽  
Care Planning ◽  
Older Chinese ◽  
Eol Care ◽  
Older Chinese Americans

Abstract Family involvement in end-of-life (EOL) care is critical to ensure older adults’ health and quality of life. Older adults’ self-efficacy in discussing EOL care plans with family members can facilitate family involvement in EOL care planning. Research shows that family relationships are associated with self-efficacy in discussing EOL care with family members among older Chinese Americans. However, the roles of family conflict and acculturation remain unknown. This study examines the association between family conflict and self-efficacy in discussing EOL care with family members and whether such an association differs by acculturation levels among older Chinese Americans. Data were collected from 207 Chinese Americans aged 65-102 in two metropolitan areas in 2017. Ordinary least squares regression was conducted to examine the association between family conflict, acculturation, and self-efficacy in discussing EOL care with family. Family conflict was negatively associated with older adults’ self-efficacy in discussing EOL care with family. More specifically, the negative association between family conflict and self-efficacy in discussing EOL care with family members was more pronounced for those with higher levels of acculturation. Findings highlighted differential effects of family conflict on self-efficacy of EOL care plan discussion for older adults with different acculturation levels. Those with higher acculturation may be more independent in their EOL care planning and aware of the possible negative effects of family conflict in their EOL care planning discussions. Acculturation needs to be considered by geriatric health providers to develop family-centered interventions in improving end-of-life care planning for this population.

scholarly journals TELLING THE STORY OF ADULT PROTECTIVE SERVICES: CALIFORNIA’S IDENTIFICATION, SERVICES, AND OUTCOMES MATRIX

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S843-S844
Author(s):  
Pi-Ju ( Liu ◽  
Zachary Hass ◽  
Kendon Conrad ◽  
Karen Conrad ◽  
Jarmin C Yeh ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Abuse ◽  
Emotional Abuse ◽  
Protective Services ◽  
Adult Protective Services ◽  
Caregiver Support ◽  
Client Engagement ◽  
Financial Abuse ◽  
Type Of Abuse ◽  
Abuse Risk

Abstract Adult Protective Services (APS) is responsible for investigating reports of abuse, exploitation, and neglect among vulnerable adults. California’s APS program investigates approximately 15% of all abuse, neglect, and exploitation reports in the country. Once abuse or neglect is substantiated, caseworkers design and implement a service plan for clients to reduce future risk; however, APS intervention effectiveness have not been extensively investigated. In partnership with San Francisco and Napa APS, risk and harm of abuse were measured by type using standardized items from the Identification, Services, and Outcomes Matrix, which is derived from the validated Elder Abuse Decision Support Short Form during case investigation (before APS interventions) and at case closure (after APS interventions). Data from 1,472 older adults’ (on average 78 years old; 57% females) served by APS during the six-month pilot demonstration showed the reduction of risk/harm in self-neglect (p<.001), neglect (p<.001), emotional abuse (p<.001), physical abuse (p=.002), and financial abuse (p<.001) after APS interventions. Effective interventions differ by type of abuse such that caregiver support (b=-.98, p<.10), emergency assistance (b=-1.14, p<.05), and client engagement (b=-1.85, p<.05) decreased self-neglect risk/harm; client engagement (b=-2.24, p<.05) decreased neglect by others risk/harm; case management services (b=-1.17, p<.05) decreased physical abuse risk/harm; and financial planning services (b=-3.99, p<.05) decreased financial abuse risk/harm. No services were identified as effective for emotional abuse. Since effective services differed by type of abuse, it is important to consider the etiology of abuse before implementing the services needed by older adults to effectively decrease harm/risk.

scholarly journals Advance Care Planning in Healthy Older Adults

2011 ◽  
Vol 9 (2) ◽  
pp. 6-14 ◽  
Author(s):  
Karen Van Leuven
Keyword(s):  
Older Adults ◽  
End Of Life ◽  
Advance Directives ◽  
Health Care Providers ◽  
Successful Aging ◽  
Care Planning ◽  
Advanced Care Planning ◽  
Care Providers ◽  
Healthy Older Adults ◽  
Medical Diagnoses

This article reports the secondary analysis of a qualitative study that examined the beliefs, values, lifestyles and health status of adults at least 75 years old (N=18). An unanticipated finding was that all participants who self-identified as healthy (N=14) had in place advance directives which dictated their end-of-life wishes. In contrast, participants who self-identified as fair or poor health (N=4) did not have advance directives (N=4). These "healthy" older adults also differed substantially from their counterparts in the degree in which they were socially engaged in their community and family, but varied little related to their actual medical diagnoses or health problems. The self-described healthy group approached advanced care planning as part of health promotion; they simultaneously planned for end-of-life while engaging in activities to maintain optimum health. In contrast, those who evaluated their health as fair or poor perceived advanced care planning as something to be avoided. Planning for end-of-life may be a form of ongoing engagement as it requires dialogue with health care providers, and thoughtful consideration of experiences and wishes. It may also be a manifestation of successful aging in that death is recognized as the culmination of a good life rather than something to be feared.

scholarly journals A Scoping Review of Financial Elder Exploitation Interventions

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 323-324
Author(s):  
Stephanie Skees
Keyword(s):  
Older Adults ◽  
Scoping Review ◽  
Elder Abuse ◽  
Protective Services ◽  
Adult Protective Services ◽  
Health Crisis ◽  
Financial Exploitation ◽  
Attorneys General ◽  
Universal Definition ◽  
Mature Market

Abstract Elder financial exploitation (EFE), defined by the National Center for Elder Abuse (2021) as “the misappropriation of an older person’s money or property,” is a continuing public health crisis shown to cost individuals at least $2.9 billion a year (MetLife Mature Market Institute, 2011). Many believe this impact will increase exponentially due to the effects of COVID-19. In fact, a recent study conducted by Chang & Levy (2021) found that the prevalence of elder abuse as a whole increased from 1 in 10 older adults to 1 in 5 in the past year. Although increased collaboration between state attorneys general, Adult Protective Services, and financial institutions has driven progress in the field; there is still little known regarding EFE interventions. To address this issue, this study conducts a scoping review of the EFE intervention literature. This approach was chosen over a systematic review primarily due to the lack of a universal definition of EFE, as well as the limited number of studies available delineating between EFE and elder abuse as a whole. The main findings of the review reveal that current EFE intervention practices are focused on preventing abuse before it occurs by addressing risk factors for abuse in older adults; and are largely reliant on Adult Protective Services and the legal system. This finding is significant because state policies differ in their qualifications of EFE, thus leaving many older adults vulnerable and unprotected. Further interventions that address EFE while it is occurring and alignment across governing bodies are needed.

scholarly journals PRELIMINARY FINDINGS ON FAMILY PERPETRATORS AS DESIGNATED SURROGATE DECISION MAKERS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S383-S383
Author(s):  
Cory Bolkan ◽  
Pamela Teaster ◽  
Holly Ramsey-Klawsnik ◽  
Kenneth Gerow
Keyword(s):  
Older Adults ◽  
Decision Makers ◽  
Policy Recommendations ◽  
Community Settings ◽  
Protective Services ◽  
Adult Protective Services ◽  
Surrogate Decision Makers ◽  
Surrogate Decision ◽  
Vulnerable Adults ◽  
Process Level

Abstract Vulnerable older adults needing surrogate decision makers typically rely upon others for care and are unable to advocate for themselves. The issue of EFFE perpetrated by family members designated as surrogates has become highly visible nationally, yet no reliable, empirical documentation exists on the nature or extent of exploitation by surrogate perpetrators. In collaboration with the National Adult Protective Services Association (NAPSA), we prospectively gathered APS data from six geographically diverse counties on 450 substantiated cases of abuse by POAs, representative payees, and guardians of vulnerable adults 65+ living in community settings. This presentation will highlight how family member surrogates perpetuated abuse and the outcomes on elder victims. These findings elucidate person and process-level factors (e.g., characteristics of victims, perpetrators, and their relationships) within the context of the APS system and can inform practice and policy recommendations for better prevention, detection, investigation, and intervention in these challenging cases.

scholarly journals SELF-NEGLECT OLDER ADULTS’ OUTCOMES AFTER ADULT PROTECTIVE SERVICES INTERVENTIONS

2018 ◽  
Vol 2 (suppl_1) ◽  
pp. 876-876
Author(s):  
P Liu ◽  
K Conrad ◽  
K Conrad ◽  
M Iris
Keyword(s):  
Older Adults ◽  
Protective Services ◽  
Adult Protective Services
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