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Geriatric Advocacy Competencies

Geriatric Advocacy Competencies. Scott Wright, Rachel Peloquin, Jessica Stewart, Wan- hsuan Lin, Emily Morgan, & Peter Williams. Elderly Client Empowerment. Emphasize Autonomy, Meaning, and Ability Discuss the realities of Ageism Empower client to overcome internalized Ageism.

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Geriatric Advocacy Competencies

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  1. Geriatric Advocacy Competencies Scott Wright, Rachel Peloquin, Jessica Stewart, Wan-hsuan Lin, Emily Morgan, & Peter Williams

  2. Elderly Client Empowerment • Emphasize Autonomy, Meaning, and Ability • Discuss the realities of Ageism • Empower client to overcome internalized Ageism

  3. Client Advocacy (microlevel) • Barriersto individual development: • Physical Ability: chronic pain, transport • Cognitive 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).

  4. 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.

  5. 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

  6. 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

  7. Community Collaboration • Validation Therapy • Acknowledging the person’s feelings as valid to restore dignity • Restore self-worth, reduce stress and justify living • Work with health care agencies and eldercare programs to educate them and train them to use validation therapy in their programs • Family system

  8. 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”

  9. 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

  10. 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

  11. 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

  12. Social and Political Advocacy

  13. Types of Problems • Abuse • Financial • Physical • Sexual • Research Funding • Dementia • Nutrition • Innovative Care Models • Seeking a better experience and lower costs

  14. 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

  15. Questions?

  16. 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

  17. 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

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