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Sheltering the victims of elder abuse: a new role for long-term care facilities.

T.M., a 61-year-old Hispanic widow, was living in her one-bedroom apartment in the Bronx. She had been a victim of child abuse by her father, and she was physically, verbally, and sexually abused by two husbands. She had virtually no community contact. Last year, her unemployed, drug-addicted adult son moved in with her and was physically, emotionally, and financially abusing her. He was drawing graffiti on her walls; having "friends" over regularly to buy, sell, and use drugs; and was sleeping in her bed. She felt that his behavior was her fault because she was not a good mother.

Her son was on parole for felony assault relating to a recent crime he committed against his wife and young daughter, who live in the same building. A final court order of protection required him to stay away from them. Other family members were terrified of him. T.M. had sustained multiple fractures of the arms and wrists but denied that her son caused the suspicious injuries. Domestic violence officers at the local police precinct were aware of the situation but had no legal basis to act.

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T.M. went to a local hospital and told a doctor that she was too afraid to go home. Had this happened earlier, T.M.'s options would have been to stay at a homeless shelter, have her name put on a long waiting list for other public housing, or try to get into a traditional domestic violence shelter, if suitable space was available and if she would be accepted with her many medical infirmities. Most likely, she would have returned to the violence and remained isolated and afraid. Instead, a doctor called (800) 56-SENIOR, the access point for the Harry & Jeanette Weinberg Center for Elder Abuse Prevention at the Hebrew Home at Riverdale in Riverdale, New York. There, staff determined that T.M. was an appropriate referral.

Rather than returning to the violence, T.M. was transported to the Weinberg Center, where she was given a room with a full bathroom. Over the course of the next six weeks, T.M. received medical care, social work support, and direct legal advice regarding orders of protection and housing strategies, and she was invited to participate in the numerous programs held daily at the Hebrew Home. All Weinberg Center clients are considered residents of the Hebrew Home and are encouraged to be part of the Hebrew Home community.

Police officers from the local precinct visited T.M. to discuss plans to ensure her safety upon discharge from the Weinberg Center. A daughter, who previously was too frightened to visit, came to see her mother daily after the Weinberg Center team determined the daughter was safe and helpful. The daughter provided needed additional emotional support for her mother and encouraged her to become a long-term resident of the Home, an available option.

Several weeks after her arrival, feeling stronger, in control, and at peace, T.M., as a competent adult, decided to return home, believing she could help her son. In developing a discharge and safety plan to enable T.M. to return home, the Weinberg Center team provided counseling that enabled her to recognize her situation and assess some of her important issues, legal advice in the event that she might need to initiate court protection, and medical care, which greatly improved her daily life. T.M. went home more empowered not only to self-protect, but with a new level of confidence and self-esteem. There is now hope for her to reengage in the community and not just survive day by day in fear.

Long-term care facilities have developed many unique and rewarding programs for residents, their families, and the community. As our country faces the realities of a rapid increase in the older adult population, a longer life span, and a marked increase in the cost of living, the epidemic of community-based elder abuse gives rise to the "perfect storm." Is there a way, therefore, for the long-term care facility to be used as a prevention, intervention, or shelter model?

Embracing AAHSA's Quality First Initiative, the Hebrew Home at Riverdale established the nation's first long-term care--based elder abuse prevention and intervention program. A comprehensive shelter for victims of abuse, the Harry & Jeanette Weinberg Center for Elder Abuse Prevention is a culmination of the Hebrew Home's long history of addressing the needs of neglected elders. It is the nation's only shelter designed specifically to meet the complex needs of victims of elder abuse.

The Hebrew Home recognized the need for multidisciplinary professional and governmental attention on elder abuse, and since 1996 it has partnered with New York law enforcement (Westchester County and Bronx County District Attorneys' offices), healthcare professionals, and other key service providers in the community to develop initiatives, conferences, and partnerships designed to educate, increase awareness, and provide much-needed training materials about the signs and symptoms of various forms of elder abuse.

The Weinberg Center's goals include increasing public and professional awareness of elder abuse through education and training, locating isolated and vulnerable victims who can be encouraged to accept services, and developing a safe, full-service shelter, whether for the emergent needs of victims or, when appropriate, for long-term housing and care. The Weinberg Center uses the Hebrew Home's extensive integrated service model (nursing home, home care, day care, and housing) and a multidisciplinary team complemented by a network of collaborative public, private, and governmental agencies. Building on the Hebrew Home's existing geriatric services, the Weinberg Center encompasses the panoply of services and care for victims of elder abuse. This includes:

* a residential shelter for victims with a dedicated nurse, an on-staff attorney to provide direct civil legal services, and a full-time social worker and elder abuse coordinator who is experienced with victims of abuse

* elder abuse detection, prevention, and intervention strategies for the community

* unique training and outreach programs for law enforcement and community-based individuals

* a research component to profile victims and assess the efficacy of these programs

Training also includes reaching traditional practitioners, as well as nontraditional community members who are often the only contacts for isolated older adults. For example, the Weinberg Center arranged with the Service Employees International Union Local 32BJ, the doormen and superintendent's union in New York City, to train doormen and superintendents to recognize elder abuse.

The shelter's direct costs are approximately $200 per day per client. Most of the victims are found to be eligible for Medicaid. Additional foundation support and government funding have helped support the cost of a staff attorney, social worker, and nurse. In replicating this model, law school clinics and social work students can provide these services at no cost to the facility, as can collaborating with community-based programs that offer legal support and advocacy.

The success of the Weinberg Center may be measured by the increasing number of referrals it receives. It may also be measured in terms of individual success stories of those like T.M. whose lives have improved by having a safe place to go where a team of healthcare professionals and support services are available to them. The Hebrew Home's comprehensive program offers sanctuary and a multitude of services that can serve as an easily replicable model for facilities in other communities. The Weinberg Center's team is available to provide technical assistance to other facilities wishing to replicate the program.

Together with its partners, the Weinberg Center has created an atmosphere of trust and safety within the community and helped raise awareness about elder abuse while working toward preventing it.

Daniel Reingold, MSW, JD, is the President and CEO of the Hebrew Home at Riverdale. For more information about the Harry & Jeanette Weinberg Center for Elder Abuse Prevention, phone (718) 581-1271, or visit www.hebrewhome.org. To send your comments to the author and editors, e-mail reingold1006@nursinghomesmagazine.com.

BY DANIEL REINGOLD, MSW, JD
COPYRIGHT 2006 Medquest Communications, LLC
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2006, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

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Title Annotation:NOT-FOR-PROFIT report
Author:Reingold, Daniel
Publication:Nursing Homes
Date:Oct 1, 2006
Words:1311
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