"Lisa Nerenberg provides the first comprehensive look at elder abuse prevention trends and strategies. Drawing from existing models and examining salient factors, she outlines approaches to intervention that consider victims and perpetrators and engage communities and service systems. She also offers meaningful response to the many challenges endemic to elder abuse work. As a result, Lisa gives hope to the field.
"Beginning as a grassroots advocate a quarter century ago in San Francisco, Lisa developed and tested many viable elder abuse prevention programs herself through the local elder abuse network before exploring best practices elsewhere. This unique evolution and perspective gives her the depth and breadth of understanding needed to write a book like this, able to resonate equally with adult protective service workers struggling to manage caseloads of vulnerable elders, law enforcement personnel trying to prosecute abusers, and academics searching for effective responses to the problem."-- --Georgia J. Anetzberger, PhD, ACSW Assistant Professor of Health Care Administration at Cleveland State University and Editor of the Journal of Elder Abuse & Neglect
Recipient of the Legal Assistance for Seniors' "Leading the Fight for Seniors' Rights" annual award for 2007!
Drawing from over twenty years of experience helping communities improve their response to elder abuse, Lisa Nerenberg describes what agencies, communities, tribes, states, and national organizations are doing to prevent abuse, treat its effects, and ensure justice. She further explores what remains to be done and offers a plan for the future. In doing so, she addresses the broader challenges of fortifying the long-term care, protective service, and legal systems to meet the new and imminent demands of a burgeoning elderly population. In short, the book is about making communities safer places to grow old.
Ms. Nerenberg begins by exploring trends that have shaped or defined practice in the field of elder abuse prevention including the Supreme Court's Olmstead decision; a shift in focus from protecting to empowering victims; an increasingly multicultural elderly population; the "globalization" of the field; and heightened understanding of the "psychology of victimization" (or why victims do what they do and perhaps more importantly, why they often don't do what professionals think they should). She further describes eight models and theories on which practice has been based ranging from the widely recognized adult protective service and domestic violence prevention models to lesser-known approaches such as the family preservation and restorative justice models. She describes specific interventions and approaches that each model has contributed, their benefits and limitations, what is known about their impact, and factors that dictate what responses are appropriate to specific settings and situations.
In addition to describing techniques used by individual practitioners, the author outlines strategies and services that agencies, communities, states, tribes, courts, and national organizations have designed, which include elder forensics centers, elder courts, family justice centers, elder shelters, "hybrid" multidisciplinary teams, fraud prevention programs, support groups, restorative justice programs, and culturally specific outreach campaigns. She details progressive public policy initiatives, which range from statutes that provide for the mandatory reporting of deaths in nursing homes, to efforts to improve the collection and distribution of restitution, to laws that address the role of undue influence in elder abuse.
Is for practitioners, researchers, advocates, and program developers in the fields of aging, Adult Protective Services, dementia care, mental health, legal assistance, victim-witness assistance, domestic violence, law enforcement, and others
Helps readers understand and appreciate the rich, if sometimes discordant, patchwork of theory and practice that defines the field of elder abuse prevention
Offers specific examples of how agencies, coalitions, courts, communities, tribes, and states can improve their response to elder abuse in an easy to navigate format
Draws from the experiences and "practice wisdom" of elder law attorneys, social workers, support group facilitators, counselors, and health care professionals
Promotes interdisciplinary collaboration and coordination
Preface Acknowledgments I. EIGHT TRENDS SHAPING PRACTICE
Increasingly Frail Elders are Living at Home
Shifting Paradigms: From Protection to Empowerment
Heightened Understanding of Victims
The Circle Widens: The Burgeoning Abuse Prevention Network
The Changing Role of APS
The "Criminalization" of Elder Abuse
Focus on Forensics
Going Global: International Initiatives to Prevent Elder Abuse
II. DEFINING ELDER ABUSE: THE CONTROVERSIES Controversies in Defining Elder Abuse
The Disability Requirement
The "Special Relationship" Requirement
Intentionality
Focusing on Conduct or Its Impact
Frequency and Severity
What the Experts Say Challenges in Defining Specific Forms of Abuse
Financial Abuse
Physical Abuse
Sexual Abuse
Emotional Abuse
Neglect
Self-Neglect Abandonment
III. SERVICE MODELS FROM WHICH WE HAVE DRAWN The Adult Protective Services Model The Domestic Violence Prevention Model The Public Health Model The Victim Advocacy Model The Restorative Justice Model Neutralization Theory The Family Caregiver Support Model The Family Preservation Model
IV. FACTORS INFLUENCING INTERVENTION NEEDS Victim Considerations Perpetrator Considerations Urgency of the Situation Ethical Considerations Cultural Factors Affecting Service Needs
V. PREVENTING AND TREATING ELDER ABUSE Assessing Victims' Service Needs Services and Interventions for Victims
Maintaining Independence
Resolving Crises
Emergency Services
Ensuring Victim Safety
Hearing, Empowerment, and Support
Preserving, Protecting, and Recovering Assets
Ensuring Justice
Interventions for Perpetrators and Those at Risk for Abusing
Counseling for Perpetrators
Domestic Violence Treatment
Programs for Caregivers
VI. WHAT AGENCIES, THE JUSTICE SYSTEM, AND COMMUNITIES CAN DO What Agencies Can Do General Agency-Specific Practices
APS Programs
Domestic Violence Programs
Health Care Facilities
Providers of Home Health Care
Legal Service Providers
Dementia Care Programs
What the Justice System Can Do What Communities Can Do What Community Institutions Can Do
VII. WHAT STATES AND TRIBES ARE DOING What States are Doing
Ensuring that Professionals Report and Respond Appropriately
Ensuring Justice
Ensuring a Comprehensive, Coordinated Service Response
Protecting Elders with Diminished Capacity and Those at Risk for Undue Influence
Special Challenges
What Tribes are Doing
Improving Coordination
Ensuring Justice
Training Professionals
Meeting the Demand for Services
VIII. COMMUNITY OUTREACH Goals of Outreach The Impact of Outreach Local, State, National, Tribal, and International Campaigns
IX. RESPONDING TO CHALLENGES Defining Abuse Responding to a Multicultural Society Defining Capacity for Specific Tasks Service Needs Meeting the Challenge of "Consumer Choice" Research Challenges and Needs Professional Training Needs Challenges to Coordination and Collaboration Ethical Challenges
X. MOVING FORWARD Guiding Principles An Approach: Case Management An Agenda Appendix: Additional Resources
"Nerenberg provides the first comprehensive look at elder abuse prevention trends and strategies....She offers a meaningful response to the many challenges endemic to elder abuse work. As a result, Lisa gives hope to the field....Beginning as a grassroots advocate a quarter century ago in San Francisco. Lisa developed and tested many viable elder abuse prevention programs herself...before exploring best practices elsewhere. This unique evolution and perspective gives her the depth and breadth of understanding to write a book like this."--Georgia J. Anetzberger, PhD, ACSW, Assistant Professor of Health Care Administration at Cleveland State University, Editor of the Journal of Elder Abuse and Neglect
"Elder Abuse Prevention engages the reader from the beginning and it never loses us. In the preface the author describes the 24 year journey that brought her to this publication. That cumulative knowledge and experience ignite the pages of this book. ...... so much to share ..so much insight .... so much passion. Each chapter resonates with a richness and depth of ideas, strategies, technologies and forward looking solutions. Each chapter provides theory, practice, research, intervention and prevention as a myriad of complex elder abuse issues are described. Nothing is left out: definitions, service models, ethical tensions, cultural factors, victims and perpetrators, the justice system, communities and community institutions (financial, academic, faith) states and tribes; its all here. The book is a labor of love that comes from the heart.
"Everyone interested in responding to elder abuse will want this book; it will inform, guide and inspire the direct work of those involved in the care of older people who are mistreated and hurting. Written for many disciplines, the book should be introduced to students early in their careers as a preparation for clinical experience.
"The book concludes with the author returning to the initial themes of collaboration, inclusiveness, and open exchange. We are reminded that it is only through 'the sharing of ideas, expertise and resources' can we become change agents. We've been given the knowledge; the challenge now is to put it into practice so that our compassion and skills can be mobilized to keep older people safe , informed, healthy, and out of harm's way."--Elizabeth Podnieks, Professor at Ryerson University, Toronto, and founder, Ontario Network for the Prevention of Elder Abuse
"Lisa Nerenberg has written an instant classic on elder abuse and neglect for practitioners, researchers, program planners, policy makers, and lawmakers. This innovative and refreshing book is a major contribution from a professional who has worked in the field for over two decades. It advances the field by leaps and bounds.
"The book is engaging, comprehensive, forward-looking, and solidly based in both research and practice principles. It is easy to read because it is extremely well organized and written.... Not one to shrink from controversy, Ms. Nerenberg carefully outlines the issues involved with the never-ending struggle to define elder and neglect as well as the strengths and weaknesses of various forms of intervention and treatment.
"Throughout the book, Ms. Nerenberg uses a flexible lens, now focusing on the status and themes in the field and then examining issues in detail such as victim and abuser relationships, and the increasing understanding about levels of mental capacity. Her allegiance to and compassion for front line practitioners is a recurring thread throughout the book and she calls on researchers to base their work on practitioner perspectives. This book will have a very long shelf life and will serve to inspire us for years to come." --Mary Joy Quinn, Director of the Probate Court of San Francisco Superior County, co-author (with Susan Tomita), Elder Abuse and Neglect: Diagnosis and Intervention Strategies (Springer Publishing, 1997), and author, Guardianships of Adults: Achieving Justice, Autonomy, and Safety (Springer Publishing, 2005).
"This book showcases Lisa Nerenberg's remarkable ability to organize very complex and complicated issues and present the information in a clear and logical way that makes it understandable without over simplifying. This book has something of interest for anyone involved or interested in elder abuse--for novices it offers a comprehensive overview and introduction to key issues; for the experienced it provides the historical context, big picture perspective, and new ways of looking at issues.
--Mary Counihan, MSW, APS Manager, San Francisco Department of Aging and Adult Services
Lisa Nerenberg, MSW, MPH, is a consultant in elder abuse prevention. Previously, she directed the San Francisco Consortium for Elder Abuse Prevention at the Institute on Aging, which was one of the first elder abuse prevention programs in the country. Under her leadership, the Consortium piloted some of the country's first abuse prevention services and interventions, including a multidisciplinary team, a counseling program and support group for victims, and culturally specific outreach. She has provided training and technical assistance to local, state, and national organizations; developed comprehensive training curricula; and delivered keynote addresses, moderated panels, and made presentations at hundreds of professional forums in the United States and Canada. She has also testified before Congressional committees and served on governmental advisory committees and panels. She has authored dozens of articles, chapters, and publications on such far-ranging topics as coalition building, the role of culture and gender in elder abuse, financial abuse and the special needs of financial crime victims, daily money management, and the role of the civil and criminal justice systems in elder abuse prevention. A special area of interest is cross-disciplinary exchange among professionals in the fields of aging, criminal justice, victim-witness assistance, health and mental health, domestic violence, and adult protective services. Her website www.lisanerenberg.com and blog preventelderabuse.blogspot.com address cutting edge issues in the field today.