The Development of an Elder Abuse Intervention Pathway

1. The Development of an Elder Abuse Intervention Pathway Presented by : Gianna Renshaw Acting Team Leader – ACAT Social Workers Osborne Park Hospital ACAT

2. Overview of Presentation • ACAT role and guidance available for ACATs in working with elder abuse • OPH Social response to working with elder abuse • Intervention Pathway • Risk Assessment Tool • Awareness Raising of elder abuse • Issues raised during the development of an elder abuse response at OPH

3. OPH ACAT 6 multidisciplinary teams (medical, nursing, SW & OT) with direct links to: • Medical review via Memory Clinic, Falls Clinic and Parkinson’s Clinic. • In patient admission • Dietician • Physiotherapy • Equipment and Aides • Continence Advisors • RAILS – Rehabilitation Aged Intervention and Liaison Service

4. Definition of Elder Abuse ACAT: The Best Practice Manual (2004) • Physical Abuse • Psychological Abuse • Economic Abuse • Sexual Abuse • Neglect • Social Abuse

5. Guiding Principles – Elder AbuseACAT: The Best Practice Manual (2004) • Senior Citizens Rights • Information • Safety • Autonomy • Competency to make decisions • Complexity • Confidentiality • Interventions – Individuality • Respect

6. ACAT Practice – Elder AbuseACAT:Towards Best Practice (2004) • ACATs should have an active and up to date knowledge of elder abuse. This knowledge includes: • Risk factors • Indicators • Assessment and intervention strategies • Documentation for case management and • Community resource • Policies and Procedures • Attitudes and values • Safety • Peer support and supervision

7. Key issues in developing a pathway at OPH • Capacity to make decisions • Acknowledgement of abuse by the abuse • Role of different agencies based of capacity to make decisions • Getting a medical decision on capacity

8. Referral to Social Work Psychosocial Assessment Signs of Elder Abuse No Signs of Abuse Mental capacity established Treating presenting problem as required Is there doubt about the person's mental capacity? Does the person acknowledge abuse? YES NO YES Requires further investigations by medical team - organise referral Lack of mental capacity previously assessed - confirm with medical team Support for acknowledgement Advocare information provided DEVELOP A SOCIAL WORK PLAN* Can the abuse be stopped in current carer arrangements?* Provide support and counselling on changes required to stop the abuse, CARERS WA* Strengthen social support network: Day Care, CACP, HACC services, Home visitor, Carer Support Services, Residential Care* Liaison with GP * Link to longer term counselling/legal services:Older Peoples Rights Centre* Develop a safety plan: Police in the event of physical assault, DVAS for restraining order, ACHA for relocation* Guardianship/Adminstration Applications Is there someone trusted to act on behalf of the abused towards their best interests? NO YES Consult Office of the Public Advocate re: Guardianship Application Via Telephone Advisory Service Osborne Park Hospital - Elder Abuse Intervention Pathway

9. Risk Assessment

10. Elder Abuse Awareness • World Elder Abuse Awareness Day – June 15th 2008 • “What Can Your Community Do to Raise Awareness”

11. Issues raised while developing an Elder Abuse Response at OPH • Different perceptions of abuse • “Innocent abuser” • Cultural sensitivity • Blame free language • Spreading the response to the wider team

12. Gianna.renshaw@health.wa.gov.au