+Geriatric Advocacy

Competencies

Scott Wright, Rachel Peloquin, Jessica Stewart, Wan-hsuan Lin, Emily Morgan, & Peter Williams

+Elderly Client EmpowermentEmphasize Autonomy, Meaning, and Ability

Discuss the realities of Ageism

Empower client to overcome internalized Ageism

+Client Advocacy (microlevel) Barriers to individual development:

Physical Ability: chronic pain, transportCognitive Ability: degenerative diseases, memory

issues

Mental Health: highest rate of suicide & least likely to seek counseling

Spiritual Concerns: death anxiety & issues of meaning/purpose

Counselor Competency: Geriatric issues

As of 2009 only 2 graduate-level counseling programs in the USA are certified in gerocounseling in accordance with the Counsel for Accreditation of Counseling and Related Educational Programs (Foster, Kreider, & Waugh, 2009).

+ Counselor Competencies Part psychoeducational:

Navigate specialized resources i.e. Adult Community Center Programs/Activities,

Medicare & Medicaid, community transportation services

Part Collaborative: Develop list of individualized barriers specific with client

(brainstorm) i.e. feelings of isolation, diagnosed with a medical

condition, loss of license

Part Creative: Create specialized plan and discuss how to implement

i.e. Client discloses that they feel like they have no one to talk to since their spouse passed away. Together, you discuss options: continue individual therapy, enroll in group therapy (bereavement-centered), attend community center.

+Community Collaboration

Failure to Thrive (FTT) in Elderly Clients

Causes Malnutrition Depression and dementing illnesses Age-related changes Inadequate support system

Attributes Problems in social relatedness Physical/cognitive dysfunction Feelings of exclusion, shame, helplessness and

worthlessness Loneliness Giving up

+Community Collaboration What will help?

Reminiscing Create opportunities for elderly to share their

stories and become socially involved School mentoring program Support groups at churches with others in their

demographic Day Care

To improve social interaction and increase activity Work with organizations such as People Inc. and

Aurora Adult Day Services to be sure that they are reaching the population and meeting these specific needs

Art therapy, exercise, nutritious meals

+Community Collaboration

Validation TherapyAcknowledging the person’s

feelings as valid to restore dignityRestore self-worth, reduce

stress and justify livingWork with health care

agencies and eldercare programs to educate them and train them to use validation therapy in their programs

Family system

Systems Advocacy

Definition:

Attempting to change systems such as policies , rules or laws of government, organization or agency to facilitate client’s development or meet their needs

Working on how existing systems can be made more “older person friendly”

Example: Quality of Life Partnership

Multi-agency signposting scheme

- enable elderly to access preventive services

Provide opportunities for frontline staff to learn from each other

Older Person’s Accommodation Strategy

- a theme on housing information and advice

+Public Information A public information counselor must advocate

for the elderly on a macro-level• Educate the public about ageism• Be aware of stereotyping & microaggressions

The elderly experience societal oppression in

Western Cultures• Undervalued (physically and cognitively)• Underemployed• Those with disabilities have an additional minority

status• Sometimes difficult to get them to seek counseling

More likely to go to a religious figure rather than a professional therapist

May avoid the topic due to stigma that is more prevalent within their cohort

+Public Info. – Adverse Drug Effects

Oliver et al. (2009) found an increasing amount of emergency room visits due to adverse drug reactions in the elderly (65 years+)

There is a need to increase the availability of information to the public about drug interactions and polypharmacy among the elderly

A better way of educating the elderly themselves and those who may live with them is important

Awareness about what multiple doctors are prescribing at once is crucial, especially for those who are experiencing cognitive decline

+Social and Political Advocacy

+Types of ProblemsAbuse

FinancialPhysicalSexual

Research FundingDementiaNutrition

Innovative Care ModelsSeeking a better experience and lower costs

+ALLIES

AARP (American Association of Retired Persons)

ELDERADVOCACYBLOG.COM

HEALTH INFORMATION COUNSELING AND ADVOCACY

GROUP

AMERICAN HEALTH CARE ASSOCIATION

INNOVATIVECAREMODELS.COM

LONG TERM CARE OMBUDSMAN

http://www.ltcombudsman.org/ombudsman

+Questions?

+ References

Baldridge, D. (2004). Double jeopardy: Advocating for Indian elders. Generations, 28, 75–78. American Society on Aging. Retrieved from http://generations.metapress.com/index/925742r572481706.pdf

Cohen, E. S. (1990). The elderly mystique: Impediment to advocacy and empowerment. Generations: Journal Of The American Society On Aging, 14(Suppl), 13-16.

Foster, T. W., Kreider, V., & Waugh, J. (2009). Counseling students’ interest in gerocounseling: a survey study. Gerontology & geriatrics education, 30(3), 226-42. doi:10.1080/02701960903133489

Horton, C. (2009). Creating a stronger information, advice and advocacy system for older people. Retrieved from http://www.jrf.org.uk/ system/files/information-systems-for-older-people-summary.pdf

+ References (cont.)

Kimball, M. J., & Williams-Burgess, C. (1995). Failure to thrive: the silent epidemic of the elderly. Archives of psychiatric nursing, 9(2), 99-105. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/7755414

Kohler, I., & Kendall, J. (2010). Bringing dementia out of the shadows for BME elders : a report on the Ethnic Minority Dementia Advocacy Project ( EMDAP ). Dementia Advocacy Network at Advocacy Plus, 14(1), 12-16.

Olivier, P., Bertrand, L., Tubery, M., Lauque, D., Montastruc, J.-L., & Lapeyre-Mestre, M. (2009). Hospitalizations because of adverse drug reactions in elderly patients admitted through the emergency department: a prospective survey. Drugs & aging, 26(6), 475-82. doi:10.2165/00002512-200926060-00004