Dilemmas and Ethics: Social Work Practice in the Detection and Management of Abused Older Women and Men

Abstract

Social workers in one multi-ethnic area of UK were interviewed on the subject of elder abuse. They produced a dominant discourse that ignored issues of emancipatory practice relating to diversity and difference (gender and ethnicity) and that oversimplified the complexity of elder abuse cases. They worked in an organisational climate that provided insufficient resources to deal with cases of elder abuse once identified, and that imposed performance indicators that took no account of practical and ethical aspects of the abuse of older women and men. It was rare for a case of elder abuse to have a good outcome, and hence staff were faced with situations (defined as dilemmas) where no decision was likely to benefit the service users. Ethical practice gave way to avoidance of ethical issues and a reliance on guidelines and management aims.

Elder Abuse: Clinical, Ethical, and Legal Considerations in Social Work Practice

“…Interviews conducted by Wilson (2002) of front line social workers in the UK revealed that in cases of abuse that were reported and confirmed, the majority of clients ended up being institutionalized or dying. As a consequence of the challenges experienced by workers in their attempts to find safe resolutions for abused elders, avoidance was used as a professional strategy for some social workers (Wilson 2002).…”

“…Despite the prevalence of elder abuse, it remains a devastating, unrecognized, and untreated problem (Thompson and Priest 2005;Wilson 2002). Elder abuse can take the form of physical abuse, sexual abuse, psychological or emotional abuse, financial exploitation, abandonment, neglect or self-neglect or a combination of the various forms (National Centre on Elder Abuse 2007; WHO 2002c).…”

“…Understanding the factors which may impede a senior's rational choice is complicated and may require much critical thinking (Bergeron 2006). For example, when a client is found to not be of sound mind, special attention needs to be paid to the impact of mandatory reporting laws on the well-being (Wilson 2002), confidentiality and self-determination of that client. Healy (2003) examined responses of social workers to ethical dilemmas in her evaluation of the decisional capacity of elderly clients with cognitive impairment.…”

“…As a consequence of the challenges experienced by workers in their attempts to find safe resolutions for abused elders, avoidance was used as a professional strategy for some social workers (Wilson 2002). Another study by Bergeron (1999) which conducted interviews with APS workers found that many participants described feelings of frustration from being unable to make any impact against the perpetrators of elder abuse.…”

The experience of being protected

“…Indeed, this is their justification (ASPSA s.1). Moreover, pressures of time and resources (Ash, 2011;Wilson, 2002), difficulties in interagency working (authors and colleagues, 2009;Penhale et al, 2007), and the unhelpful and/or conflicting attitudes of some organisations to risk (Alaszewski and Alaszewski, 2002;Titterton, 2006), can weigh heavily on practitioners as they approach this difficult work.…”