CASE STUDY
Assisted living is often viewed as the best of both worlds. Residents have as much independence as they
want with the knowledge that personal care and support services are available if they need them. Assisted
living communities are designed to provide residents with assistance with basic ADLs (activities of daily
living) such as bathing, grooming, dressing, and more. Assisted living communities differ from nursing
homes in that they don’t offer complex medical services.
Mrs. Mary Jones is a resident of Sunrise Assisted Living Home. Mrs. Jones is 78 years old and is diagnosed
with stage three Alzheimer’s and suffers from dementia. She has been a resident at Sunrise Assisted Living
for approximately 3 years. She is a widow and has one son whom she hasn’t talked to in over twenty years.
Her husband died of a heart attack about 5 years ago and since then, Mrs. Jones health has declined. She
was once confined to a bed because of kidney failure but has had a major recovery in the past 6 months.
Mrs. Jones is a very quiet and observant elderly lady. She hallucinates at times and becomes vey forgetful of
new information processed. When not alert, Mrs. Jones mind, mental and physical behaviors will portray the
image of a 10 year old child. She often calls her husband name and has conversations with him as if he was
present in her room. Nursing staff works very well with Mrs. Jones and respects her space and decisions
that she implies on a day to day basis. Passing judgment on Mrs. Jones ideations is strictly prevented. She
has a special nurse whom she calls “Darling” that works with her from 3pm-11pm six days a week. When
she is not present, Mrs. Jones literally states she do not want anyone taking care of her and that she will be
fine until “Darling” comes back.
CASE STUDY CONTINUED……..

“Darling” was out sick for three days and another staff member had to care for Mrs. Jones. Because the agency was
short of staff with two employees being out sick, a male staff had to care for Mrs. Jones on two of the evenings her
nurse wasn’t available. Mrs. Jones was very rude to the male nurse the first time he came in her room to take vital
signs and to bring her down to the kitchen for dinner. She began yelling “NO” and “He’s a Rapist.” The screams were
so loud and Mrs. Jones was unable to tame. Three staff members (females) had to assist in putting her in a hold to
calm her down. She plainly stated she was fine and she didn’t want the man back in her room.

A female staff member cared for her the remaining of the evening. The next day the male nurse was assigned back to
her room. However, he did not go into Mrs. Jones room until 8:30 pm during his shift because Mrs. Jones had a busy
day and was resting when his shift began. Loud screams and yelling came from Mrs. Jones approximately 8:38 pm.
When the other nurses ran to her room, they found Mrs. Jones sitting up in her bed screaming with her panties
pulled down at knee level. At this point, calming her down and restraining her was impossible. Mrs. Jones social
worker (guardian) was called immediately to come down to the facility. Because this has never happened and
everyone knew that Mrs. Jones only wanted “Darling” to care for her, no one believed her allegations. The incident
that occurred the night before was not reported to the administrator or documented. Other staff was protecting
themselves because they did not follow protocol of the agency when something like this occurs. The social worker
completed a report and got a statement from Mrs. Jones. To follow the proper protocol of an allegation against a
worker, the male nurse was suspended until the investigation was complete. Mrs. Jones allegation was that he came
into her room while the lights were off and began rubbing on her. He started up her thighs and proceeded on. She
stated she was sleep until she felt the touch of someone’s hand in places on her body that they should have not
been.
CASE STUDY CONTINUED…..

When she began to scream he put his hand over her mouth and told her to be quiet and they no one would believe
her because she was a crazy old woman who talks to herself. He rushed out of the dark room and closed the door.
She never saw his face but knew his voice from the day before of caring for her. When the social worker took a look
at the schedule for the evening, his name was included as the caretaker for the evening shift on Mrs. Jones hall. He
denies all allegations of being in Mrs. Jones room at that time the sexual contact took place.
ISSUES PRESENTED WITHIN THE CASE
1. The male worker , having sexual contact with the resident violates the retirement
facilities ethical standards and goes beyond the boundaries needed for
employees assisting patients.
2. The resident has Alzheimer's, and because of this mental disability is not fully
competent.
3. The social worker for this retirement facility has to follow a chain of command for
that organization. However, since incidents as such do not occur often the social
worker is not familiar with the chain of command.
4. Because of the patients disability, proving that the allegations of abuse actually
occurred could be challenging .
ETHICAL PRINCIPLES ASSOCIATED WITH CASE

Social Workers primary goal is to help individuals in need as well as address social issues.
 As related to this case, the goal of the social worker is to assist Mrs. Jones (the person in need) while advocating for
other elderly individuals who might be susceptible to sexual violence and are too, suffering from some form of
Alzheimer's or dementia.
 Social Workers respect the inherent dignity and worth of the person.
 Considering Mrs. Jones mental condition, the social worker still has to make sure that the clients self worth and
dignity even though tarnished, is still respected and that the client, is still a vital component in the arbitration process.
 Social Workers practice within their area they are most competent and enhance their professional expertise.
 Social workers who specialize in gerontology, would be more qualified to handle cases as the one presented,
however, in referring to the ethical principles, social workers should continually work to improve on the areas in
which they have the most experience as well as those areas that they lack experience in order to become successful
social workers.
ETHICAL STANDARDS ASSOCIATED WITH CASE
 1.01 Commitment to
Clients
 1.02 Self Determination
 1.04 Competence
 1.14 Clients who lack the
decision making capacity.
COMMITMENT TO CLIENTS
ASSESSMENT TOOLS FOR THE CLIENT
 Conflict Tactics Scale
 Brief Abuse Screen for the Elderly
 Elder Assessment Instrument
 Elder Abuse Diagnosis and intervention model - which offers a crisis intervention
model for professionals who work with older victims of abuse and involves two
stages: assessment/diagnosis and intervention, Components of the model
include a mental health assessment, Physical exam, and “Collateral contacts with
individuals who are familiar with the elder”.
SELF DETERMINATION AND COMPETENCE
CLIENTS WHO LACK DECISION MAKING
CAPACITY
REFERENCES
 Imbody, B. &Vandsburger, E. (2011). Elder abuse and neglect: Assessment tools,
interventions, and recommedations for effective service provision.Educational
Gerontology, 37(7), 634-650. Doi:10.1080/15363759.2011.577721