Responding to an Elder Abuse Case in the Community: A Collaborative Approach

1. Responding to an Elder Abuse Case in the Community:A Collaborative Approach Maggie McNally Senior Case Worker for the Protection of Older People North Tipperary / East Limerick

2. LIVE LONG…..

3. BE HEALTHY…..

4. Case Process • Referral • Assessment • Intervention

5. Referral • 88 year old female - Mrs. T • Visually impaired • Subject to multiple fractures / falls • Lives with 92 year old husband – Dementia • No Children – niece lives locally and manages finances • Private care – 1 person only

6. Referral Continued… • Recent fall, Hospital admission (surgery) • Required Rehabilitative services prior to going home - Discharge Co-ordinator arranged a period of rehab in Nursing Home • Opposition from niece • Questions previously regarding falls by hospital staff; no referral made however given nieces demeanour/response a referral was forwarded by Discharge Co-ordinator to Service for Protection of Older People

7. What next – Assessment • Referrer- Background information / concerns • Meeting with Mrs. T at Hospital • Contact with G.P / PHN • Meeting with Mr. T at Home • Contact with niece • Contact with private carer • Ongoing contact with Mr. and Mrs. T.

8. What next? • Safety Assessment • Risks identified • Other professionals contacted – O.T, Home Help Service, Home Care Package, Alzheimer Society – Home Support/Day Care Centre, NCBI • Case Conference

9. Safety Assessment • Is the older person in immediate danger? • What steps can be taken to increase safety? • Prevent social isolation • Decrease Caregiver stress • Manage medical issues

10. Case Conference The purpose of a case conference is to bring together all the relevant people involved in the care/future care of the older person in order to: • Exchange information • Determine the degree of risk • To formulate a plan to protect the service user • To make arrangements for the monitoring and the review of the case

11. Case Conference • To clarify the roles and responsibilities of the various professionals involved • To nominate a key worker • To establish a care plan to work with the perpetrator if he/she is also a person who is vulnerable • To arrange for any other appropriate follow up

12. Professionals / Agencies Involved…. • Discharge Coordinator – Hospital • Registrar / Consultant – Hospital • Nursing Home Rehabilitation Unit • G.P • PHN • Alzheimer Society • (Day Centre / Home Support) • Social Worker – NCBI

13. Professionals / Agencies Involved…. • Occupational Therapist • Physiotherapist • Home Help Service /Home Care Package/ Private Care • Counselling Service • Social Welfare Department • Senior Case Worker for Protection of Older People

14. Intervention • Ongoing Home Visits - monitoring • Assessment concluded that home environment was safe • Private care supplemented with Homehelp/Home Care Package/Alzheimer Soc. • Counselling for Mrs. T • Support from NCBI • O.T aids for house / Mr. and Mrs. T

15. Intervention cont’d • Physio – Rehab Unit • Social welfare – pension • Rehab Unit – Discharge plan • Day Centre – Alzheimer Society – Mr. T • Meals on Wheels • Pendant Alarm – Social Services

16. Goal of reporting is to: • Find a solution to the problem not to make situation worse • Keep the Older Person at home • Enlist resources

17. Other Possible Interventions • Referral to counselling (older person &/or abuser) • Dietary assistance • Housing assistance • Mediation service • Emergency responses for housing, food, health (crisis intervention) • Placement in Long Term Care

18. Key Points • Multiple types of Elder Abuse typically occur – Polyvictimisation • Complexities professionals confront • Collaborative efforts are necessary in responding effectively to Elder Abuse cases