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There Is No Excuse For Elder Abuse

by Susanne Stadler | March 30th, 2014 | Our Relations | Please Comment

You could not think of a better advocate for elder abuse than Mary Twomey, astute, articulate and funny. Yes, we did laugh at our last forum on elder abuse. Mary, who co-leads the Institute of Excellence on Elder Abuse at UC Irvine and also founded the Ageless Alliance United Against Elder Abuse packed the essence of elder abuse in a rap song.

90% of elder abuse is perpetrated by family members. 1 in 10 Americans over 60 are the victim of abuse (people with dementia are not part of this number). Elder abuse comes in the form of physical, emotional, financial and sexual abuse as well as neglect and self neglect. Few people know what to do about it when they see it. Many don’t see it.  Knowing about it helps.

Mary demonstrated that nearly everything can be linked to elder abuse. The location and design of the home for example can contribute to isolation or force some people into institutions.  The lack in dementia training for the general public – most of us will be caregiver to somebody with dementia, is nonexistent. Many family relationships have a long term abuse history and the balance can tilt when an older person becomes vulnerable. A person has about 150 personal care attendants through a life time.  About 44 million Americans are caregivers to family or friends. The potential for abuse happens when relationships are unequal.

Mary raps, “There is no excuse for elder abuse” but understands the complex web of family relationship where the abuser and abused can switch roles when one of them becomes a vulnerable elder and understands that  releasing the pressure on care givers through support, training and simply by providing a place  for sharing experiences is crucial in preventing elder abuse.

The other side of elder abuse is the quite delicate balance between an older person’s right to self determination and the recognition of their vulnerability together with a society’s responsibility to help. Accepting help is voluntary, nobody can be forced.

How to prevent it?  Bring up the topic of aging wherever people come together, such as in faith communities and invite people to share experiences. Prevent isolation among seniors. Create a 24/7 hotline for caregivers. Train people in understanding dementia (1 in 2 people with dementia experience some form of abuse by others). Strengthen the voluntary ombudsmen program in nursing homes. Create a federal budget for Adult Protective Services. Include this question in every medical screening “Are you afraid of anyone in your family?” (part of the Hwaleck-Sengstock Elder Abuse Screen).

How to spot it? Go to The Red Flags and realize how we all tend to relegate some of these signs to the realm of “private matters”.

How to report it? Call 1-800-677-1116 (National ElderCare Locator).

 

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Caring For Children And Parents

by Susanne Stadler | February 2nd, 2014 | Our Relations | Please Comment

Sheila Malkind, who in her 70’s, runs the Legacy Film Festival on Aging in San Francisco,  presented at the last AHWGO salon in January a selection of films from the festival. One of them, ‘The Sandwich Generation’by Julie Winkour initiated a very interesting exchange and discussion among attendees, that differed from how film reviews talked about the movie.

The film chronicles the life of Julie’s family with her 83 old father who has dementia, until his death  about two years after they move in together.  Julie and her husband and two young kids move from San Francisco to New Jersey to take care of him. The film shows the everyday challenges and stress of caring for her father and kids in a very candid and unedited way.

This is what reviews say about the documentary:

-“ It is a story of love, family dynamics and the immeasurable sacrifice of those who are caught in the middle.”

-“ In The Sandwich Generation, they have created an honest, intimate account of their own shifting — and challenging — responsibilities, as well as some of their unexpected joys.”

-“ Ed and I really thought we knew what we were doing,” Julie Winokur says early on in The Sandwich Generation, an eloquent and sometimes brutally honest documentary that she and her husband, Ed Kashi, made while caring for her 83-year-old father. “We really felt like ‘experts.”

This is what was said at AHWGO:

-The family took on too much without seeking expert advice.  

-The family had no training for taking care of Herbie which was stressful not only for them but also for him. 

-The movie is an account solely from the point of view of Julie, her husband and kids, Herbie’s view is not present.

Two moments in the movie stood out for most of us. One was when Herbie and his caregiver went by themselves to the father’s vacation home on Fire Island. One literally felt how much more at ease Herbie was in his own environment, by himself. The other was when the film maker’s husband lost patience with his father in law when he refused to return ‘home’.

Nearly 47% of adults in their 40s and 50s have a parent age 65 or older and are either raising a young child (age18 or older). And about one-in-seven middle-aged adults (15%) is providing financial support to both and aging parent and a child (Pew Research).  Family care giving that extends both to children and parents is a reality.

The reversal of roles from child to caregiver, from parent to dependent is obviously an intricate process. Some of us do it long distance, some of us move, in some cases parents move. Both children and parents need help with this process. There are resources, like Family Caregiver Alliances but of course there are not always easy to find and also, we are so used to making it all work. If we just try hard enough we should be able to solve it. Not true.

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Health, Aging and Propaganda in the Helping Professions

by Susanne Stadler | January 13th, 2014 | Our Selves | Please Comment

10 points from Professor Eileen Gambrill’s talk and ensuing discussion at the recent AHWGO salon.

1. Decisions about our health are emotional decisions. Unless one is an expert in the field one does not know what information is missing and what questions to ask as health decisions are getting increasingly complex.

2. We want to be healthy, normal. What we consider healthy and normal changes over time. How we define what is healthy and normal determines how we get treated if we ‘deviate’. 

3. There is a tendency to medicalize problems in living. What once for example was called sin, then crime, is now called mental illness. What once was a difficult child, is now a child with Attention Deficit Disorder.

4. How we name conditions influences the treatment for it by society and potential  “cures”. The power of naming is essential. 

5. Treatment options are often misrepresented. We are given information on treatment options that might not be transparent or even misleading (benefits of treatments are often presented as more impressive relative risk rather than absolute risk reductions, see http://www.patient.co.uk/health/Risks-of-Disease-Absolute-and-Relative.htm).

6. From kick backs to doctors to improperly promoting drugs to older adult with dementia, big money is at play in an ever growing pharmaceutical market and incentivizes wrong doing despite the recent crack downs on companies that disregard F.D.A. regulations (such as the recent Johnson and Johnson settlement for Risperdal). Especially the aging wave of baby boomer market means a growing market with mental and chronic health issues.

7. What is considered mental illness is largely defined by the Diagnostic and Statistical Manual of Mental Disorders.

8. The UK Database about Uncertainties of the Effects of Treatments (Duet) www.library.nhs.uk/duets/ publishes treatment uncertainties from patients, carers, clinicians, and from research recommendations, covering a wide variety of health problems.

9. The Cochrane Collaboration critically reviews published and unpublished medical literature http://www.cochrane.org/cochrane-reviews.

10. www.criticalthinking.org. We all need it!

What is next? Personal monitoring and measuring, dna testing and a focus on brain research. It seems that we have an increasing influence on our health decisions but also are increasingly subject to propaganda and big money influences.

propaganda

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