scholarly journals THE INTERSECTION OF ETHICS AND VULNERABLE ELDERS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S238-S238
Author(s):  
Pamela B Teaster ◽  
Georgia Anetzberger
Keyword(s):  
Older Adults ◽  
Social Services ◽  
Ethical Issues ◽  
Elder Abuse ◽  
Cognitive Status ◽  
Ethical Challenges ◽  
Community Based ◽  
Conducting Research ◽  
Definition Of ◽  
Community Based Services

Abstract Researchers, practitioners and policymakers are daily confronted with multiple and competing situations regarding vulnerable older adults and the complex issues that they face in all aspects of their lives. Challenges can arise in the provision of social services, dispensing justice, conducting research, or addressing legal issues. The purpose of this symposium is to discuss dilemmas that vulnerable older adults and concerned others face by elucidating current and future challenges facing this population, particularly in the realms of compromised health (cognitive impairment); effective status (gender); care arrangements (home and community-based services); and abuse, neglect, and exploitation. Teaster and Anetzberger discuss relevant ethical theories and principles as well as a definition of vulnerability. Santos and Nichols-Hadeed report on ethical issues embedded in vulnerable elders’ cognitive status. Bowland and Halaas highlight the intersection of ethics, gender and vulnerable elders. Niles-Yokum and Beaumaster discuss the nexus of ethics and the provision of home and community based services for vulnerable older adults. Heisler considers vulnerabilities of older adults and ethical challenges when addressing elder abuse. Throughout the papers, we weave the ethical principles of autonomy, beneficence, nonmaleficence, and justice.

scholarly journals ELDER ABUSE AMID THE OPIOID EPIDEMIC: APS CASES IN RURAL AMERICA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S763-S763
Author(s):  
Pamela B Teaster ◽  
Karen A Roberto ◽  
Jyoti Savla
Keyword(s):  
Older Adults ◽  
Elder Abuse ◽  
Standard Errors ◽  
Opioid Misuse ◽  
Rural America ◽  
Opioid Use ◽  
Care Needs ◽  
Community Based ◽  
Community Based Services ◽  
Physical Care

Abstract Older adults are hidden victims of the opioid crises, suffering abuse at the hands of those who seek resources to support their addiction. Using APS data from 2015-2017 provided by the Kentucky Department for Community-Based Services, we used a logistic regression model with robust standard errors to examine whether substantiated cases of elder abuse were associated with opioid misuse by perpetrators. Overall, 9% of the 462 substantiated cases over the three-year period involved perpetrators were substance users. The percentage of these cases rose from 5% in 2015 to 13% in 2016 before dropping to 7% of elder abuse cases in 2017. Opioid use was most prevalent among perpetrators of financial abuse of older adults with cognitive and/or physical care needs. The current study offers a first look at empirical linkages between opioid misuse and elder abuse and revealed consistencies across cases that call for further investigation.

scholarly journals IT’S ACTUALLY WORSE THAN IT LOOKS: IDENTIFYING ABUSE-RELATED INJURIES AMONG APS CLIENTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S575-S575
Author(s):  
Jeanine Yonashiro-Cho ◽  
Zach Gassoumis ◽  
Kathleen Wilber ◽  
Diana Homeier
Keyword(s):  
Older Adults ◽  
Social Services ◽  
Injury Severity ◽  
Service Providers ◽  
Elder Abuse ◽  
Accidental Injury ◽  
Community Based ◽  
Physically Abused ◽  
Tests Of Association ◽  
Matched Comparison

Abstract While recent work has described elder abuse injuries seen in medical contexts, most abuse determinations are made by community-based health and social services practitioners in the field. Little is known about the types of injuries present among victims who do not seek medical care. The purpose of this study was to identify and describe injuries more likely to occur through abuse, rather than accidental injury, among older adults seen in non-medical settings. An observational, matched-comparison group design was used to compare findings among physically abused APS clients (n=61) with those from non-abused older adults (n=104) seeking usual-care in a Geriatrics clinic. Forensic nurse examiners conducted full-body examinations of subjects and collected data on injury diagnoses, locations, and characteristics. Descriptive statistics and bivariate tests of association were used to analyze differences in injury presentation between groups. Though 21.8% of APS clients had no observable injuries upon examination, as a group, they were more likely than non-abused elders to be injured (p<0.05) and had more injuries present (p<0.01). Abuse victims were also more likely to have at least one upper extremity abrasion (p<0.05) or a diagnosis of ecchymosis (p<0.01), swelling (p<0.05) or tenderness (p<0.05) in the head, neck, or maxillofacial region. Because physical abuse may not result in injury to victims, screening protocols are needed to improve abuse detection. The presence of injuries among older adults at-risk for abuse warrant further evaluation or queries from medical and social service providers, regardless of injury severity.

Pandemic Disease, Public Health, and Ethics

2019 ◽  
pp. 796-811 ◽  
Author(s):  
Maxwell Smith ◽  
Ross Upshur
Keyword(s):  
Public Health ◽  
Ethical Issues ◽  
Ethical Challenges ◽  
Pandemic Preparedness ◽  
Scarce Resources ◽  
Ethical Frameworks ◽  
Health Measures ◽  
Care Workers ◽  
The Face ◽  
Conducting Research

Infectious disease pandemics raise significant and novel ethical challenges to the organization and practice of public health. This chapter provides an overview of the salient ethical issues involved in preparing for and responding to pandemic disease, including those arising from deploying restrictive public health measures to contain and curb the spread of disease (e.g., isolation and quarantine), setting priorities for the allocation of scarce resources, health care workers’ duty to care in the face of heightened risk of infection, conducting research during pandemics, and the global governance of preventing and responding to pandemic disease. It also outlines ethical guidance from prominent ethical frameworks that have been developed to address these ethical issues and concludes by discussing some pressing challenges that must be addressed if ethical reflection is to make a meaningful difference in pandemic preparedness and response.

scholarly journals BUILDING DISASTER RESILIENCE FOR OLDER ADULTS AGING IN PLACE: THE ROLE OF COMMUNITY-BASED ORGANIZATIONS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S340-S341
Author(s):  
Claire Pendergrast ◽  
Basia Belza ◽  
Ann Bostrom ◽  
Nicole Errett
Keyword(s):  
Older Adults ◽  
Social Services ◽  
Aging In Place ◽  
Well Being ◽  
Local Context ◽  
Disaster Resilience ◽  
Community Based ◽  
Senior Centers ◽  
Community Based Organizations

Abstract Older adults are more susceptible to adverse health outcomes during and after a disaster compared with their younger counterparts. Developing community resilience, or strengthening communities to reduce the negative impacts of disasters, has the potential support older adults’ health and well-being. Community-based organizations (CBOs), such as senior centers and Villages, provide social services and programming that support aging in place and may support older adults’ resilience to disasters. This study examines CBO leadership perspectives on the role of CBOs in building disaster resilience for older adults aging in place, as well as perceived barriers and facilitators to incorporating disaster resilience activities into organizational programming. In-depth interviews were conducted with a purposive sample of staff-members of CBOs serving older adults aging in place in King County, Washington. Participants included representatives from 14 organizations that varied in size, geographic setting, organizational structure, and ethnic, linguistic, and socio-economic backgrounds of organizational members. The sample included five government-run senior centers, seven non-profit senior centers, and two Villages. Interviews were audio-recorded and transcribed verbatim. We used a combined inductive and deductive approach to code and thematically analyze the data. Results indicate that local context, leadership risk perception, collaborations, and existing services and programming influence CBOs’ willingness to engage in activities supporting disaster resilience for older adults aging in place. Findings suggest that CBOs supporting aging in place may support disaster resilience for older adults by serving as a trusted source of disaster preparedness information and tailoring disaster-related messages for an older adult audience.

Community-Based Aging Services

2020 ◽  
Author(s):  
Jan Ivery
Keyword(s):  
Older Adults ◽  
Health Status ◽  
Social Workers ◽  
Healthy Aging ◽  
Community Based ◽  
Limited Mobility ◽  
Age In Place ◽  
Increased Risk ◽  
Aging Services ◽  
Community Based Services

As individuals age, their physical community continues to be a primary entry point of intervention because of their attachment to place, social connections, and limited mobility to travel as far and as often as they would like or desire. The environment provides a context for understanding an older adult’s social interactions and the availability of and access to supportive services that reduce isolation and increased risk for reduced health status. When individuals age in place, social workers need to understand how community-based services can work with older adults in their community where they have lived for some time and have developed social networks. This knowledge will better assist social workers in their ability to effectively connect clients with appropriate resources. Unfortunately, it is not uncommon for an older adult’s environment to not reflect or adapt to their changing health status and physical mobility. Healthy aging (also referred to as age-friendly) and NORC (naturally occurring retirement communities) initiatives have emerged as examples of how to provide supportive, community-based services that will enable older adults to remain engaged in their community as they experience changes in their health status, mobility, and financial security. These community-level interventions emphasize the adaptability to an older adult’s changing lifestyle factors that influence how they navigate their community. These initiatives engage older adults in planning and implementing strategies to connect older adults with services and activities that promote aging in place. Social workers play a very important role in the provision of community-based aging services because they can serve as a bridge between older adults and the local, state, and federal level programs that may be available to them.

scholarly journals Use of Informal Support as a Predictor of Home- and Community-Based Services Utilization

2020 ◽  
Vol 76 (1) ◽  
pp. 133-140
Author(s):  
Kristen N Robinson ◽  
Heather L Menne ◽  
Raphael Gaeta
Keyword(s):  
Older Adults ◽  
Informal Caregivers ◽  
Behavioral Model ◽  
Study Data ◽  
Informal Support ◽  
Health Services Use ◽  
Community Based ◽  
Logistic Regression Models ◽  
Andersen Behavioral Model ◽  
Community Based Services

Abstract Objectives Home- and community-based services (HCBS) help older adults remain living safely in their homes by delaying or preventing the need for institutionalization. This analysis is guided by the Andersen Behavioral Model of Health Services Use to examine the association between informal support and use of HCBS. Method Health and Retirement Study data from 2011 and 2012 are used in the bivariate analyses and multivariate logistic regression models to examine differences in HCBS utilization among extremely vulnerable older adults who have informal caregivers and those who do not. Results For extremely vulnerable older adults who report difficulties with any instrumental or basic activities of daily living, use of HCBS is not strongly associated with access to informal caregivers. However, for this same population of extremely vulnerable older adults, those who live alone have roughly 3 times the odds of using any HCBS compared to those who do not live alone. Discussion Among already vulnerable older adults, this study revealed that living alone is an important enabling factor of the Andersen Behavioral Model as applied in HCBS research. Further investigation is needed to see if more resources should be allocated to senior centers and local providers to identify vulnerable older adults who live alone and may have unmet needs.

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