Social Workers' Perceptions Regarding Legal Intervention for Older Adults without Significant Cognitive Decline Who Are Abused by Their Adult Child.

Social workers aiding older adults facing abuse from their adult child confront an ethical dilemma: whether to honor autonomy or prevent harm. The study explores how social workers perceive legal intervention against the older adult's will. Twenty-one aging-specialized social workers took part in semi-structured interviews using a vignette. The analysis was conducted inductively, guided by content analysis principles. Two main themes emerged, focusing on the disadvantages and benefits of legal intervention. The findings underscore that combining teleological and deontological considerations could form a foundation for developing decision-making tools to aid social workers in navigating this dilemma effectively.

"Let me touch him": Perceptions and experiences of family caregivers of nursing home residents during the COVID-19 outbreak in Israel.

Older adults in nursing homes were particularly vulnerable to COVID-19 morbidity and mortality worldwide. Due to the COVID-19 pandemic, visitations in nursing homes were restricted. The present study examined the perceptions and experiences of family caregivers of nursing home residents during the COVID-19 crisis in Israel and their coping strategies. Online focus group interviews were held with 16 family caregivers of nursing home residents. Three main categories were identified through Grounded Theory techniques: (a) Anger and decreased trust in nursing homes; (b) Perception of the residents as victims of the nursing home policy; (c) Coping strategies at different levels. The outbreak redefined family caregivers' understanding of their role. Practical implications include making the voice of the family caregivers heard, identifying effective coping strategies, and creating a dialogue between family caregivers, nursing home managements, and staff.

"They just did what they usually do": Mistreatment, abuse, and neglect in nursing homes from the perspective of Ministry of Health auditing teams.

The aim of this article was to examine how Ministry of Health auditing teams experience quality of care, mistreatment, abuse, and neglect in nursing homes in Israel. The research included four in-depth focus groups consisting of 19 multidisciplinary auditors. The qualitative analysis was encoded in stages with repeated comparisons between individual participants and within groups and led to three main themes: (1) Failure in addressing basic, personal, and social needs of residents in nursing homes; (2) Mistreatment manifested in violation of residents' privacy and human dignity, neglect, and physical harm; (3) Abuse, including psychological, financial, and physical abuse. The findings can be explained by the characteristics of nursing homes as total institutions, as well as perceptions of ageism and de-humanization of the residents. In addition, the findings highlight the importance of the auditing role in monitoring the nursing homes' quality of care and the safety of the residents.

"You Killed the Hospital, They Have No Place Left": The Experience of Nursing Home Multidisciplinary Staff in Israel during the COVID-19 Pandemic.

The purpose of the present study is to examine how multidisciplinary staffs experienced and coped with the COVID-19 pandemic crisis in nursing homes. The research included six in-depth online focus groups consisting of 21 multidisciplinary staff members from 14 Israeli nursing homes. The qualitative analysis was encoded in stages with repeated comparisons between individual participants and within groups and led to four main themes: (a) Multidisciplinary staff perceptions of nursing home management's performance in relation to them, which was experienced as insufficient appreciation and feelings of abandonment among the non-medical staff; (b) Multidisciplinary staff perceptions of the Ministry of Health's performance, which was experienced as chaotic and disconnected albeit supportive on the personal level; (c)The nursing home multidisciplinary staff experience during the COVID-19 pandemic, in terms of perceived stress and burnout, as well as development of a routine; (d) The multidisciplinary staff's coping strategies, which included commitment to work despite risk, redefinition of their role, and staff insights about the need to take responsibility for their role and not rely on outside help. The findings indicate the importance of relationships that promote support and mutual communication between multidisciplinary staff, and both nursing home management and Ministry of Health.KEY POINTS Nursing home multidisciplinary staff experienced disconnection from and abandonment by nursing home management and Ministry of Health during the Covid-19 pandemic.Nursing home multidisciplinary staff experienced stress and burnout but also developed a routine.Despite intensified negative emotional feelings, multidisciplinary staff also underwent processes of redefining their role and gaining greater independence.Findings indicate the importance of creating a climate that facilitates mutual sharing, listening and learning.

The Interplay Between Poly-Victimization and Sexual Assault in Late Life in the Context of Life Course Perspective.

The aim of this article is to explore the interplay between poly-victimization and sexual assault against women in late life (SAWLL) according to the life-course perspective. Two themes emerged from qualitative interviews with 18 experienced welfare and health care professionals who intervened in cases of SAWLL: sexual assault by a spouse co-occurring with other types of abuse within marital relationships, and sexual assault and other types of abuse by two or more perpetrators along the life course. In many cases, SAWLL is an expression of a broader experience of poly-victimization, which relates to vulnerability in old age.

Forms of sexual assault against older women in the context of acquaintance relationships: An intersectional perspective.

This study addresses forms of sexual assault against women in late life (SAWLL) from an intersectional perspective, focusing on acquaintance relationships. Qualitative research was conducted, using in-depth interviews with 18 welfare and healthcare professionals who treated sexual assault survivors. Five forms (themes) emerged, relevant to the identification of SAWLL: (1) Coercive sexual assault in the context of changes brought on by old age, (2) contempt and sexual humiliation based on ageist and sexist social constructions, (3) violation of the older women's dignity in the multigenerational context, (4) life-long incestuous relationships and sexual assault against older women and (5) erotic touching and exhibitionism in caregiving relationships. The revealed forms emphasise the vulnerability of older women who are sexually assaulted in domestic relationships by perpetrators whom they know. These forms can contribute to filling the existing gap in knowledge on SAWLL and promote the visibility of sexually assaulted older women in the justice system. In addition, they can aid law enforcement, health and welfare professionals and policymakers to advance the general understanding of SAWLL as well as improve the response to this phenomenon.

"Who Would Sexually Assault an 80-Year-Old Woman?": Barriers to Exploring and Exposing Sexual Assault Against Women in Late Life.

The phenomenon of Sexual Assault against Women in Late Life (SAWLL) has received increasing research attention in recent years. Yet, there is still only scant knowledge on it, compared with research on the sexual assault of younger women. Sexual assault is considered a sensitive topic, generally characterized by a conspiracy of silence. The aim of this article is to explore the barriers that hinder the identification and exposure of SAWLL, as reported by professionals. The research question was as follows: How do welfare and health care professionals present the motives and processes that obstruct exploring, exposing, and intervening in cases of SAWLL? A qualitative research design was used. Participants were 18 experienced welfare and health care professionals engaged in intervention with sexual assault in late life victims as well as offenders. Data were collected through in-depth, semi-structured interviews, which were later transcribed and thematically analyzed. Four themes emerged from the data analysis: (a) Leading Negative Emotions, (b) Lack of Language, (c) Implications of Cumulative and Complex Trauma, and (d) Social Exclusion. Women and professionals alike undergo complementary processes involving silence and silencing. These processes construct a "wall" of barriers, requiring professionals' sensitivity and awareness to deconstruct these barriers. Professional intervention through open discourse with the abused women can break this conspiracy of silence. We recommend that training programs for professionals intervening in cases of elder abuse and neglect will be directed along two paths: The first path should focus on professionals' competence and skills, and the second path should address the women's specific needs. These programs will include a particular module that will specifically address SAWLL. This module should comprise knowledge on typical emotional reactions to SAWLL, the use of language in creating reality, cumulative and complex trauma, and the social construction of ageism and sexism, which lead to social exclusion.

Can Physical, Psychological, and Social Vulnerabilities Predict Ageism?

Ageism can be expressed as the discrimination, social exclusion, and even abuse of older adults. The literature suggests that certain vulnerabilities could be risk factors affecting people's ageism. Based on the Social Identity Theory, the present study aimed to examine the association of physical/psychological and social vulnerabilities with ageism. The sample consisted of 200 Israelis from the general population who completed self-report questionnaires. Hierarchical regression indicated that low well-being, high post-traumatic distress, and limited social support were associated with ageism. Furthermore, the association of post-traumatic distress with ageism increased with age. The findings expand the knowledge of vulnerabilities as risk factors for ageism, perhaps reflecting its unconscious nature, and can assist in designing interventions for people interacting with older adults.

What Can We Learn From the Past About the Future of Gerontology: Using Natural Language Processing to Examine the Field of Gerontology.

OBJECTIVES: We thematically classified all titles of eight top psychological and social gerontology journals over a period of six decades, between 1961 and February 2020. This was done in order to provide a broad overview of the main topics that interest the scientific community over time and place. METHOD: We used natural language processing in order to analyze the data. In order to capture the diverse thematic clusters covered by the journals, a cluster analysis, based on "topic detection" was conducted. RESULTS: A total of 15,566 titles were classified into 38 thematic clusters. These clusters were then compared over time and geographic location. The majority of titles fell into a relatively small number of thematic clusters and a large number of thematic clusters were hardly addressed. The most frequently addressed thematic clusters were (a) Cognitive functioning, (b) Long-term care and formal care, (c) Emotional and personality functioning, (d) health, and (e) Family and informal care. The least frequently addressed thematic clusters were (a) Volunteering, (b) Sleep, (c) Addictions, (d) Suicide, and (e) Nutrition. There was limited variability over time and place with regard to the most frequently addressed themes. DISCUSSION: Despite our focus on journals that specifically address psychological and social aspects of gerontology, the biomedicalization of the field is evident. The somewhat limited variability of themes over time and place is disconcerting as it potentially attests to slow progress and limited attention to contextual/societal variations.

Breaking the Taboo: Sexual Assault in Late Life as a Multifaceted Phenomenon-Toward an Integrative Theoretical Framework.

Sexual assault (SA) in late life has been receiving growing attention over the past two decades. It is directed primarily against older women and has been the least frequently reported form of abuse. Despite the growing awareness and body of knowledge on this phenomenon, the theoretical framework is still limited. Therefore, the aim of the present article is to suggest a theoretical conceptualization of the multifaceted phenomenon of sexual assault against women in late life (SAWLL). This conceptualization has been developed through several stages: (a) identification of three grounded fields of inquiry that are relevant to SAWLL: SA, elder mistreatment, and intimate partner violence; (b) classification of SAWLL along four paths: (1) ongoing SA in the context of lifelong IPV; (2) SA beginning in old age in the family within the community, involving spouses, family members, caregivers, dating mates, and so on; (3) ongoing SA, continuing in institutions, perpetrated by family members; and (4) SA in institutions, beginning in old age, relating to staff, residents, and family members; (c) We suggest three additional theoretical perspectives: trauma, a life-course perspective, and social constructionism, which provide further in-depth knowledge for understanding SAWLL. The combination of the three abovementioned stages composes an integrative theoretical framework, addressing SAWLL as a multifaceted phenomenon.

A Typology of Social Workers in Long-Term Care Facilities in Israel.

This article explores moral distress among long-term care facility (LTCF) social workers by examining the relationships between moral distress and environmental and personal features. Based on these features, authors identified a typology of LTCF social workers and how they handle moral distress. Such a typology can assist in the identification of social workers who are in a particular need for assistance. Overall, 216 LTCF social workers took part in the study. A two-step cluster analysis was conducted to identify a typology of LTCF social workers based on features such as ethical environment, support in workplace, mastery, and resilience. The variance of the identified clusters and their associations with moral distress were examined, and four clusters of LTCF social workers were identified. The clusters varied from each other in relation to their personal and environmental features and in relation to their experience of moral distress. The article concludes with a discussion of the importance of developing programs for LTCF social workers that provide support and enhancement of personal resources and an adequate and ethical environment for practice.

Development and content validation of a questionnaire to assess moral distress among social workers in long-term care facilities.

OBJECTIVE: Despite the significance of ethical issues faced by social workers, research on moral distress among social workers has been extremely limited. The aim of the current study is to describe the development and content validation of a unique questionnaire to measure moral distress among social workers in long-term care facilities for older adults in Israel. METHODS: The construction of the questionnaire was based on a secondary analysis of a qualitative study that addressed the moral dilemma of social workers in nursing homes in Israel. A content validation included review and evaluation by two experts, a cognitive interview with a nursing home social worker, and three focus groups of experts and the target population. RESULTS: The initial questionnaire consisted of 25 items. After the content validation process the questionnaire in its final version, consisted of 17 items and included two scales, measuring the frequency of morally loaded events and the intensity of distress that followed them. CONCLUSIONS: We believe that the questionnaire can contribute by broadening and deepening ethics discourse and research, with regard to social workers' obligation dilemmas and conflicts.

Coping with the Obligation Dilemma: Prototypes of Social Workers in the Nursing Home.

We examined the ways in which the social worker is coping with obligation dilemma in an Israeli nursing home. The research was conducted using semi-structured, in-depth interviews carried out with fifteen social workers employed in nursing homes. The interviews were analysed thematically, using constant comparisons. The three themes were concerned with the social worker's place in the nursing home, her relationship with the management and staff, and her coping with the obligation dilemma. These themes highlighted the difference between the interviewees. On the background of this difference, four prototypes of nursing home's social workers were defined: the managerial, the contented, the fighter and the frustrated. From analysing the findings, the significant place of the personal and environmental factors that influence the ways in which the social worker deals with these four themes emerges. Our findings suggest that the strengthening, empowerment and support of social workers in institutions can directly enhance the health, security, emotional well-being and quality of life of nursing home residents.

A systematic review and meta-analysis of interventions designed to prevent or stop elder maltreatment.

BACKGROUND: elder maltreatment is a major risk for older adults' mental health, quality of life, health, institutionalisation and even mortality. OBJECTIVES: to perform a systematic review and meta-analysis of interventions designed to prevent or stop elder abuse. METHODS: Studies that were posted between January 2000 and December 2014, written in English, specifically designed to prevent or stop elder maltreatment were included. RESULTS: overall, 24 studies (and four records reporting on the same participants) were kept for the systematic review and the meta-analysis. Studies were broadly grouped into three main categories: (i) interventions designed to improve the ability of professionals to detect or stop elder maltreatment (n = 2), (ii) interventions that target older adults who experience elder maltreatment (n = 3) and (iii) interventions that target caregivers who maltreat older adults (n = 19). Of the latter category, one study targeted family caregivers, five targeted psychological abuse among paid carers and the remaining studies targeted restraint use. The pooled effect of randomised controlled trials (RCTs)/cluster-RCTs that targeted restraint use was significant, supporting the effectiveness of these interventions in reducing restraint use: standardised mean difference: -0.24, 95% confidence interval = -0.38 to -0.09. INTERPRETATION: the most effective place to intervene at the present time is by directly targeting physical restraint by long-term care paid carers. Specific areas that are still lacking evidence at the present time are interventions that target (i) elder neglect, (ii) public awareness, (iii) older adults who experience maltreatment, (iv) professionals responsible for preventing maltreatment, (v) family caregivers who abuse and (vi) carers who abuse.

Running between the raindrops: the obligation dilemma of the social worker in the nursing home.

The authors examined perspectives of social workers working in nursing homes concerning their obligation to the older adult, the family, and the facility, and identified the dilemmas and difficulties that arise from these sometimes conflicting obligations. Authors conducted semistructured in-depth interviews with 15 social workers employed in nursing homes in Israel. Inter-theme consistencies and contradictions were elucidated, and descriptive and then interpretive categories were created to represent interview data. Social workers acknowl- edged their multiple, often contradictory loyalties to the older resident, the management of the institution, the staff, and the resident's family. The obligation dilemma was particularly evident in relocation decisions and suspected cases of elder abuse. The findings highlight the importance of the obligation dilemma in the work experience of social workers. Potential, implications for the care provided to older adults in nursing homes are discussed.