Geriatric Advocacy Competencies Scott Wright Rachel Peloquin Jessica

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

+ Elderly Client Empowerment n Emphasize n Discuss Autonomy, Meaning, and Ability the realities of Ageism n Empower client to overcome internalized Ageism

+ Client Advocacy (microlevel) n. Barriers to individual development: n Physical Ability: chronic pain, transport n Cognitive Ability: degenerative diseases, memory issues n Mental Health: highest rate of suicide & least likely to seek counseling n Spiritual Concerns: death anxiety & issues of meaning/purpose n Counselor n 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 + n Part psychoeducational: n Navigate specialized resources n i. e. Adult Community Center Programs/Activities, Medicare & Medicaid, community transportation services n Part Collaborative: n Develop list of individualized barriers specific with client (brainstorm) n i. e. feelings of isolation, diagnosed with a medical condition, loss of license n Part n Creative: Create specialized plan and discuss how to implement n 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 n Causes n Malnutrition n Depression and dementing illnesses n Age-related changes n Inadequate support system n Attributes n Problems in social relatedness n Physical/cognitive dysfunction n Feelings of exclusion, shame, helplessness and worthlessness n Loneliness n Giving up

+ Community Collaboration n What will help? n Reminiscing n Create opportunities for elderly to share their stories and become socially involved n School mentoring program n Support groups at churches with others in their demographic n Day Care n To improve social interaction and increase activity n 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 n Art therapy, exercise, nutritious meals

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

Systems Advocacy Definition: n. Attempting to change systems such as policies , rules or laws of government, organization or agency to facilitate client’s development or meet their needs n. Working on how existing systems can be made more “older person friendly”

Example: Quality of Life Partnership n. Multi-agency signposting scheme - enable elderly to access preventive services n. Provide opportunities for frontline staff to learn from each other n. Older Person’s Accommodation Strategy - a theme on housing information and advice

+ Public Information n A public information counselor must advocate for the elderly on a macro-level • Educate the public about ageism • Be aware of stereotyping & microaggressions n 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 n More likely to go to a religious figure rather than a professional therapist n May avoid the topic due to stigma that is more prevalent within their cohort

+ Public Info. – Adverse Drug Effects n Oliver et al. (2009) found an increasing amount of emergency room visits due to adverse drug reactions in the elderly (65 years+) n There is a need to increase the availability of information to the public about drug interactions and polypharmacy among the elderly n. A better way of educating the elderly themselves and those who may live with them is important n 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 Problems n. Abuse n. Financial n. Physical n. Sexual n. Research Funding n. Dementia n. Nutrition n. Innovative Care Models n. Seeking a better experience and lower costs

+ ALLIES n AARP (American Association of Retired Persons) n ELDERADVOCACYBLOG. COM n HEALTH INFORMATION COUNSELING AND ADVOCACY GROUP n AMERICAN HEALTH CARE ASSOCIATION n INNOVATIVECAREMODELS. COM n LONG TERM CARE OMBUDSMAN

+ Questions?

+ References n Baldridge, D. (2004). Double jeopardy: Advocating for Indian elders. Generations, 28, 75– 78. American Society on Aging. Retrieved from http: //generations. metapress. com/index/ 925742 r 572481706. pdf n Cohen, E. S. (1990). The elderly mystique: Impediment to advocacy and empowerment. Generations: Journal Of The American Society On Aging, 14(Suppl), 13 -16. n 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 n 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. ) n 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 n 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. n 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