Suchergebnisse

Public guardians are appointed by the state to meet the needs of incapacitated citizens when no other willing or responsible surrogate decision maker exists. These public administrators, who live the decisional life of another citizen, need meaningful controls and accountability because of the great private and public authority that is entrusted to them. A review of program documents, interviews with public guardians and their program supervisors, and participant observations revealed complex roles for the public guardian: service monitor, service broker, client advocate, surrogate decision maker, and relationship architect. Because of the multiplicity of roles and few controls on their actions, public guardians' accountability should first be drawn from mechanical mechanisms (for instance, thorough audits and sanctions for infractions), but a second and necessary control is the principles of public administration, which are grounded in normative values and democratic governance.

This study sought to understand the perspective of public guardianship wards (e.g., adults reduced to the legal status of a minor child), for whom public guardians, through court authority, should act as a concerned family member regarding the wards' decision making. Grounded in democratic theory, four research questions guided this investigation: How satisfied are the wards of public guardians? To what extent do wards perceive that public guardians uphold the ethical values of autonomy and dignity when working on their behalf? How are public guardians responsive to and representative of their clients? What is the nature of guardian‐ward interactions? Data from ward interviews, participant observation, case files, and agency documents were used. Qualitative analysis revealed that wards came from a variety of backgrounds, had feelings of loneliness and fear, and did not understand or were not necessarily satisfied with the efforts of their public guardians.

Public guardians are individuals appointed by the state to care for the interests of incapacitated citizens. The nature and quality of their care is examined at sites in Maryland, Delaware, Tennessee, and Virginia. In the first three states public guardianship programs have been running for at least ten years; in Virginia two pilot projects are currently underway. All sites use different service delivery models. In addition to studying case file notes, public guardians, program supervisors, and wards were observed and interviewed with regard to their background, their views on public guardianship, accountability and effectiveness, and services provided. The aim of this study is to contribute to a better qualitative understanding of how well state public guardian programs intersect intimately with individuals for whom no other responsible decision maker exists. The study concludes with recommendations regarding the roles of the public guardian in improving wards' quality of life through substitute decision making and in enhancing democratic governance to give voice to wards through their own participation in decision making and relationships with their public guardian. ; Ph. D.

Theories, Constructs, and Applications in Working with LGBT Elders in Human Services /Debra A. Harley and Pamela B. Teaster --Sexual Minority Status and Aging /Pamela B. Teaster, John T. White and Sujee Kim --Family Relationships of Older LGBT Adults /Katherine R. Allen and Karen A. Roberto --Deconstructing Multiple Oppressions Among LGBT Older Adults /Tracy Robinson-Wood and Amanda Weber --The Intersection of Identities of LGBT Elders : Race, Age, Sexuality, and Care Network /Melanie D. Otis and Debra A. Harley --African-American and Black LGBT Elders /Debra A. Harley --American Indian, Alaska Native, and Canadian Aboriginal Two-Spirit/LGBT Elderly /Debra A. Harley and Reginald J. Alston --Asian American and Native Pacific Islander LGBT Elders /Debra A. Harley --European LGBT Elders /Melanie D. Otis --Hispanic/Latino LGBT Elders /Debra A. Harley --Elder LGBT Veterans and Service Members /Thomas W. Miller --LGBT Elders and the Criminal Justice System /Tina Maschi, Jo Rees, Eileen Klein and Ron Levine --Immigrant LGBT Elders /Amanda E. Sokan and Tracy Davis --Understanding Transgender Elders /Loree Cook-Daniels --Bisexuality: An Invisible Community Among LGBT Elders /William E. Burleson --An Overview of Aging and Mistreatment of LGBT Elders /Amanda E. Sokan and Pamela B. Teaster --Mistreatment and Victimization of LGBT Elders /Pamela B. Teaster and Amanda E. Sokan --The Prevalence of Elder Bullying and Impact on LGBT Elders /Robin P. Bonifas --Impact of Healthcare Reform on LGBT Elders /Debra A. Harley --Healthcare, Sexual Practices, and Cultural Competence with LGBT Elders /Tracy Davis and Amanda E. Sokan --LGBT Elders in Nursing Homes, Long-Term Care Facilities, and Residential Communities /John T. White and Tracey L. Gendron --End-of-Life Issues for LGBT Elders /David Godfrey --Mental Health Counseling of LGBT Elders /Tracey L. Gendron, Terrie Pendleton and John T. White --Substance Use Disorders Intervention with LGBT Elders /Debra A. Harley and Michael T. Hancock --LBGT Elders in Rural Settings, Small Towns, and Frontier Regions /Debra A. Harley --Law Enforcement and Public Safety of LGBT Elders /Randy Thomas --The Role of Religious and Faith Communities in Addressing the Needs of LGBT Elders /Debra A. Harley --No Money, No Work, and You're Old /Brian McNaught --LGBT Intersection of Age and Sexual Identity in the Workplace /Debra A. Harley and Pamela B. Teaster --Isolation, Socialization, Recreation, and Inclusion of LGBT Elders /Debra A. Harley, Linda Gassaway and Lisa Dunkley --Counseling LGBT Elders /Steven D. Johnson and Anthony Fluty Jr. --Advocacy and Community Needs Assessment /Robert Espinoza --Disabilities and Chronic Illness Among LGBT Elders: Responses of Medicine, Public Health, Rehabilitation, and Social Work /Debra A. Harley --Ethical Standards and Practices in Human Services and Health Care for LGBT Elders /Pamela B. Teaster and Amanda E. Sokan --Trends, Implications, and Future Directions for Policy, Practice, and Research on LGBT Elders /Pamela B. Teaster and Debra A. Harley --Implications of DOMA and the Supreme Court Ruling on Same-Sex Marriage for Spousal Benefits /Debra A. Harley and Pamela B. Teaster.

Abstract: Although reports of intimate partner violence (IPV) decrease with age, a significant number of aging women experience IPV in their relationships. The structure and culture of rural environments may inadvertently conceal violence against aging women and inhibit prevention and treatment efforts. Guided by an ecological community framework, 3 focus groups involving 24 professionals working with victims of IPV in rural Kentucky and in‐depth interviews with 10 aging rural women who had experienced IPV were conducted to examine the trajectory of, and community responses to, violence in late life. Findings revealed multiple interacting influences on IPV of aging women in rural areas including the women's families and resources, culture and locality, religion, community support, and government entities.

Chapter 1. Introduction to the Worldwide Face of Elder Abuse -- Chapter 2. Elder Abuse in Africa with a Special Focus on Nigeria -- Chapter 3. Between Treasuring and Mistreatment: Elder Abuse in the Eastern Mediterranean Region -- Chapter 4. Elder Abuse in India: Cultural Implications, Prevention Strategies, and Legislative Actions -- Chapter 5. Elder Abuse in the Context of Health Services in Mexico -- Chapter 6. Elder Abuse in the United States of America -- Chapter 7. Death by Neglect -- Chapter 8. From Protection to Safeguarding: Elder Abuse in England -- Chapter 9. The Face of Elder Abuse in Australia -- Chapter 10. A Tragic Case of Elder Abuse in Institutional Settings in Japan: What Can We Learn from this Case? -- Chapter 11. Concluding Thoughts -- Chapter 12. Elder Mistreatment, Evolving Possibilities.

This book provides a picture of the abuse of older adults, organized by World Health Region and locating the problem within an areas historic and present societal treatment of older persons. An actual and emblematic case study of the abuse of an older adult frames each chapter. Using the case study as a touchstone, each chapter guides the readers understanding of elder abuse in the region or country through the use of empirical data and research on the problem, explaining its usefulness and limitations as well as guiding frameworks utilized to address the problem. The book highlights the efforts of leading figures in each area or region who are addressing the problem, explaining existing policies and future initiatives to address the abuse of older adults. By providing a holistic and person-centered picture of the issue and problem of elder abuse, based on actual experiences as well as national and international statistics and research and politics and policy, this book is an invaluable resource for students, academics, social service practitioners, health professionals, law enforcement, and policymakers around the world.

Cover -- Title -- Copyright -- Contents -- Contributors -- Preface -- Acknowledgments -- Share Long-Term Care in an Aging Society: Theory and Practice -- Part I: The Context of Long-Term Care -- Chapter 1: The Long-Term Care Continuum in an Aging Society -- Chapter Overview -- Learning Objectives -- Key Terms -- Introduction -- The Demographic Context of Contemporary Long-Term Care -- Long-Term Care Populations -- Informal Care: Families, Friends, and Acquaintances -- Formal Care: The Rise of Service Systems, the Aging Network, and Corporate Care -- Relocation and the Emergence of Residential Alternatives -- Revisiting the Long-Term Care Continuum -- The Social Context of Contemporary Long-Term Care -- Widening Horizons -- Challenges of Long-Term Care -- Discussion Questions -- References -- Chapter 2: History of Long-Term Care -- Chapter Overview -- Learning Objectives -- Key Terms -- Introduction -- Colonial and Early 19th-Century Practices -- Religious Reform and Long-Term Care -- Old-Age Homes -- The Myth of Almshouse Residency -- The Attack on the Almshouse -- Pensions, Social Security, and Long-Term Care -- Expansion of the Nursing Home Industry -- Discussion Questions -- Additional Resources -- References -- Part II: Community-Based Long-Term Care -- Chapter 3: The Role of Family in Community-Based Long-Term Care -- Chapter Overview -- Learning Objectives -- Key Terms -- Introduction -- The Experience of Giving and Receiving Care -- Impact of Caregiving -- Interventions for Family Caregivers -- Public Policies Pertaining to Family Caregivers -- Summary -- Food for Thought -- Discussion Questions -- Additional Resources -- References -- Chapter 4: Family Involvement in Residential Long-Term Care -- Chapter Overview -- Learning Objectives -- Key Terms -- Introduction -- The Caregiving Career and Residential Care Placement.

The objective of this study was to assess the prevalence of residents who are incapacitated and have no surrogate decision maker, known as the "unbefriended" in Alberta long-term care (LTC) homes. Using cross-sectional online survey methods, data were collected from 123 staff (i.e., directors of care/nursing, administrators) from Alberta LTC homes. Information was collected on survey respondents' demographic characteristics, number of unbefriended residents, and on organizational characteristics. The overall prevalence of unbefriended residents in LTC homes was 4.14% in Alberta ( SD = 6.28%, range: 0%-34.6%). Homes with the highest prevalence (nearly 15%) of unbefriended residents had >135 beds and were public not-for-profit and located in large urban centers. Fifty-three percent of unbefriended residents were male. The highest prevalence of unbefriended residents lived in homes located in large urban centers and public not-for-profit operators. Population level and LTC home level prevalence data are needed to assess the scope of unmet needs.

AbstractObjectivesThis study examined challenges experienced by long-term care staff in caring for unbefriended residents who are incapacitated and alone. These residents often are estranged from or have no living family or live geographically distant from them and require a public guardian as their surrogate decision-maker. To date, research on unbefriended older adults has focused on those living in acute care and community settings. Little is known about those living in long-term care homes.MethodWe conducted semi-structured interviews with 39 long-term care staff (e.g., registered nurses, care aides, social workers) and 3 public guardians. Staff were sampled from seven long-term care homes in Alberta, Canada. We analyzed interview transcripts using content analysis and then using the theoretical framework of complex adaptive systems.ResultsLong-term care staff experience challenges unique to unbefriended residents. Guardians' responsibilities did not fulfill unbefriended residents' needs, such as shopping for personal items or accompanying residents to appointments. Consequently, the guardians rely on long-term care staff, particularly care aides, to provide increased levels of care and support. These additional responsibilities, and organizational messages dissuading staff from providing preferential care, diminish quality of work life for staff.DiscussionLong-term care homes are complex adaptive systems. Within these systems, we found organizational barriers for long-term care staff providing care to unbefriended residents. These barriers may be modifiable and could improve the quality of care for unbefriended residents and quality of life of staff. Implications for practice include adjusting public guardian scope of work, improving team communication, and compensating staff for additional care.