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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

Geriatric Advocacy Competencies

Scott Wright, Rachel Peloquin, Jessica Stewart,

Wan-hsuan Lin, Emily Morgan, & Peter Williams

elderly client empowerment
Elderly Client Empowerment
  • Emphasize Autonomy, Meaning, and Ability
  • Discuss the realities of Ageism
  • Empower client to overcome internalized Ageism
client advocacy microlevel
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).
counselor competencies
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
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 collaboration1
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 collaboration2
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
systems advocacy
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
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
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
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
types of problems
Types of Problems
  • Abuse
    • Financial
    • Physical
    • Sexual
  • Research Funding
    • Dementia
    • Nutrition
  • Innovative Care Models
    • Seeking a better experience and lower costs
allies
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
references
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
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