Responding to an Elder Abuse
Case in the Community:
A Collaborative Approach
Maggie McNally
Senior Case Worker for the
Protection of Older People
North Tipperary / East Limerick
LIVE LONG…..
BE HEALTHY…..
Case Process
 Referral
 Assessment
 Intervention
Referral
88 year old female - Mrs. T
 Visually impaired
 Subject to multiple fractures / falls
 Lives with 92 year old husband – Dementia
 No Children – niece lives locally and
manages finances
 Private care – 1 person only

Referral Continued…
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Recent fall, Hospital admission (surgery)
Required Rehabilitative services prior to going
home - Discharge Co-ordinator arranged a period
of rehab in Nursing Home
Opposition from niece
Questions previously regarding falls by hospital
staff; no referral made however given nieces
demeanour/response a referral was forwarded by
Discharge Co-ordinator to Service for Protection of
Older People
What next – Assessment
Referrer- Background information /
concerns
 Meeting with Mrs. T at Hospital
 Contact with G.P / PHN
 Meeting with Mr. T at Home
 Contact with niece
 Contact with private carer
 Ongoing contact with Mr. and Mrs. T.

What next?
Safety Assessment
 Risks identified
 Other professionals contacted – O.T,
Home Help Service, Home Care Package,
Alzheimer Society – Home Support/Day
Care Centre, NCBI
 Case Conference

Safety Assessment
Is the older person in immediate danger?
 What steps can be taken to increase
safety?
 Prevent social isolation
 Decrease Caregiver stress
 Manage medical issues

Case Conference
The purpose of a case conference
is to bring together all the relevant people
involved in the care/future care of the older
person in order to:
Exchange information
 Determine the degree of risk
 To formulate a plan to protect the service user
 To make arrangements for the monitoring and
the review of the case

Case Conference
To clarify the roles and responsibilities of the
various professionals involved
 To nominate a key worker
 To establish a care plan to work with the
perpetrator if he/she is also a person who is
vulnerable
 To arrange for any other appropriate follow up

Professionals / Agencies
Involved….
Discharge Coordinator – Hospital
 Registrar / Consultant – Hospital
 Nursing Home Rehabilitation Unit
 G.P
 PHN
 Alzheimer Society
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(Day Centre / Home Support)
Social Worker – NCBI
Professionals / Agencies
Involved….
Occupational Therapist
 Physiotherapist
 Home Help Service /Home Care Package/
Private Care
 Counselling Service
 Social Welfare Department
 Senior Case Worker for Protection of
Older People

Intervention
Ongoing Home Visits - monitoring
 Assessment concluded that home environment
was safe
 Private care supplemented with
Homehelp/Home Care Package/Alzheimer
Soc.
 Counselling for Mrs. T
 Support from NCBI
 O.T aids for house / Mr. and Mrs. T

Intervention cont’d
Physio – Rehab Unit
 Social welfare – pension
 Rehab Unit – Discharge plan
 Day Centre – Alzheimer Society – Mr. T
 Meals on Wheels
 Pendant Alarm – Social Services

Goal of reporting is to:

Find a solution to the problem not to make
situation worse

Keep the Older Person at home
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Enlist resources
Other Possible Interventions
 Referral
to counselling (older person &/or
abuser)
 Dietary assistance
 Housing assistance
 Mediation service
 Emergency responses for housing, food,
health (crisis intervention)
 Placement in Long Term Care
Key Points
Multiple types of Elder Abuse typically
occur – Polyvictimisation
 Complexities professionals confront
 Collaborative efforts are necessary in
responding effectively to Elder Abuse
cases
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