This study explores the relationship between Adult Protective Service (APS) referrals and the link between dementia type behaviors. The question is does self-neglect, due to dementia precipitate multiple APS referrals? A quantitative-study was conducted based upon a random selection of fifty client files from the years 2014 and 2015. The information collected was based upon data provided to the APS hotline and what was determined by the APS investigators. SPSS software was used to determine the values of the data. Table 1 displays the results of demographics with 37% males and 63% females. Results of this study are inconsistent with the existing literature.

Self-Neglect among older adults is a major concern in the United States. It is estimated that one in ten older adults report experiencing some form of abuse or potential for neglect (Acierno et al., 2010). The National Center on Elder Abuse has estimated that for every one case of elder abuse, neglect, exploitation, or self-neglect reported to authorities, about five more cases go unreported (National Elder Abuse Incidence Study, 1998). Among literature regarding elder mistreatment, researchers have indicated self-neglect as the most common form of elder abuse and neglect reported to adult protection and social service agencies (Dong, Simon, & Evans, 2012). Maintaining the environment is one of the most frequently cited concerns of elder self-neglect reported to adult protection services (Dyer et al., 2006). This study evaluated the efficacy of an intervention, found within the environmental neglect literature, as an intervention for environmental symptoms of self-neglect among older adults.

No description available.

No description available.

Social workers working for adult protective services (APS) face many clinical challenges to ensure the safety and well-being of older adult clients. APS social workers often interact with older adults who engage in self-neglecting behaviors that compromise their ability to function in a healthy and independent manner. The purpose of this research study was to explore challenges in direct social work practice to identify how APS services can be improved when working with the older adult population, particularly individuals who engage in hoarding behaviors. Using action research methodology, 2 focus groups were conducted to explore the experiences and knowledge of social workers who are trained in APS and in-home supportive services programs and work directly with the older adult hoarding population when investigating cases of self-neglect. The theoretical framework of cognitive behavioral theory guided the analysis of focus group data to provide insights into understanding the core manifestations of hoarding and how social workers working with this population can provide appropriate services. The overall findings of the study resulted in identifying improvements to APS service interventions. Study findings inform recommendations that allow APS social workers to effectively work with older adults who exhibit hoarding behaviors, while also advancing professional development in the field of social work. Understanding practice challenges to appropriately serve older adults that exhibit hoarding behaviors is essential in effecting positive social change in the lives of vulnerable and disadvantaged older adults, APS agencies, and communities.

Självförsummelse är ett fenomen som är vanligast bland personer som har nedsatt beslutsfattande till följd av olika kognitiva funktionsnedsättningar som demens. Fenomenet handlar om personer som har uppenbara behov, men av olika skäl tackar nej till stöd. Fenomenet i sin tur utgör en utmaning för biståndshandläggare som arbetar med målgruppen. Denna studie syftade till att få en förståelse och fördjupad kunskap om hur biståndshandläggare arbetar med äldre personer med demens, samt hur de bemöter utmaningarna när självförsummelse är aktuellt. Studien lyfte även fram vilka stöd biståndshandläggare har i arbetet och hur biståndshandläggare upplever stöden. Metoden som applicerades i studien var kvalitativ metod i form av semistrukturerade intervjuer med fem biståndshandläggare. Det teoretiska ramverket i studien består av styrkeperspektiv, lösningsfokuserad praktik samt omsorgsrationalitet. Utifrån intervjuerna analyserades empirin med tematisk analys. Det huvudsakliga resultatet av studien var att biståndshandläggare möter flera utmaningar i arbetet med målgruppen. Vidare visade studien att biståndshandläggare utvecklat egna strategier för att möta utmaningarna i arbetet. En genomgående utmaning i arbetet är socialtjänstlagens betoning på självbestämmande samtidigt som äldre personer med demens har svårigheter att tillgodose sina behov. Studien visade även att den svåraste utmaningen är hur biståndshandläggare ska hanterat dilemmat kring personens autonomi och självbestämmande som är reglerad av socialtjänstlagen, samtidigt som biståndshandläggaren försöker tillgodose stödbehovet hos äldre personer med demens och som uppvisar självförsummande beteende. Studien visade även att biståndshandläggarna upplever att deras stöd i arbetet till viss del är tillräckligt, men vissa biståndshandläggare önskar mer kompetensutveckling kring demens. / Self-neglect is a phenomenon that is prevalent within individuals who have low decision-making abilities as a result of cognitive impairment like dementia. The phenomenon is about people that have obvious needs but resists care. The phenomenon in turn creates a challenge for professionals who work with them. The purpose of this study was to explore and gain a deeper understanding for how social workers meet the challenges in working with elderly people with dementia who self-neglect. This study also had an aim to highlight the different support systems that social workers can utilize when met with challenges, and how they experience these support systems. Strengths-perspective, solution-focused practice and care rationality were used as the theoretical framework for the study. Through a qualitative approach, semi-structured interviews were conducted with five social workers. The empirical material was then analyzed using thematic-analysis which showed that social workers meet great challenges when working with the described demographic. The analysis showed that social workers have adapted and developed their own strategies in order to meet these challenges. The study concluded that the hardest challenge arises when social workers meet the dilemma of conserving a self-neglecting person’s autonomy and self-determination, which is regulated by law, while simultaneously trying to meet their needs. The study further showed that some social workers perceived their support systems as adequate, while some other social workers expressed the need of competence development pertaining to dementia.

The number of older persons is growing at a shocking rate. In spite of this reality, the South African health care sector does not prioritise older persons, causing their health to be poorly managed. Not only does poor health management affect the health of the older person, but also economic factors. This causes a high burden on the public health sector of South Africa, with specific reference to the Primary Health Care (PHC) clinics. PHC clinics in this country are not only overcrowded due to staff shortages, but also owing to the rapidly ageing population and the large number of younger persons affected by the high unemployment rate of South Africa. The above-mentioned factors keep the professional nurses in the clinic from spending time on proper physical examinations and provision of health education to older persons. This causes older persons to lack knowledge regarding self-care, potentially leading to unintentional self-neglect, which decreases their quality of life. Studies conducted on older persons concluded that the older person wants to be involved in health promotion, but needs the necessary knowledge to take care of him- or herself. Therefore, the researcher's overarching aim with this study was to develop guidelines to facilitate self-care amongst older persons. Such guidelines aim at constituting an indirect approach to promote the health of the older person. Health education on self-care should be conducted in self-care support groups, since community experience teaches that some older persons in the community do not apply self-care skills learned without some form of support. The aim with these guidelines is to decrease unintentional self-neglect by empowering the older person to make autonomous decisions regarding self-care, in order to increase quality of life. RESEARCH AIM AND OBJECTIVES In order to reach the overarching aim of this study, which comprises the development of guidelines to facilitate self-care amongst the older persons in the Potchefstroom district, the study firstly includes a literature review to understand self-care and related constructs from a theoretical perspective. Secondly, the Appraisal of self-care agency scale-A (ASA-A) and Exercise of self-care agency scale (ESCA) were used as questionnaires to assess the self-care of the selected older persons. Lastly, after determining the self-care of the older persons, the study investigates the relationship between these two questionnaires through correlational analysis. RESEARCH DESIGN A quantitative, descriptive, correlational and contextual design was used in this study to .reach the overarching aim and respective objectives. RESEARCH METHOD The researcher firstly conducted a literature review to understand self-care and related constructs. Thereafter the researcher employed two structured questionnaires, the ASA-A and ESCA, were employed to collect data. The questionnaires were developed to measure self-care (self-care is determined by measuring the self-care agency). These questionnaires were based on Dorothea OrenYs self-care deficit theory of nursing, the same theory that this research study is based on. Minor adaptations were made to both the questionnaires prior to administration to the predominantly Setswana-speaking older population. The study formed part of the larger Multinational Prospective Urban and Rural Epidemiological study (PURE-SA study - ethical approval number 04M10). All the older persons identified in the peri-urban population of the PURE-SA study living in the Potchefstroom district and who were willing to participate were included in the sample. Trained fieldworkers assisted the researcher in data collection. Of the 198 older persons, 192 participated, accumulating to a 98% response rate. Lastly the researcher correlated the ASA-A and ESCA to determine their relationship as an added benefit to this research study. RESULTS The findings indicate that although the studied older population was of a lower socio-economic status with a lower literacy level, their overall self-care was relatively good. Seven self-care deficits were identified namely time management skills affecting self-care, energy deficit affecting self-care, sleep deprivation, lack of knowledge and ability to acquire knowledge with regard to health and self-care, lack of a rest, exercise and self-care programme, self-care deficit caused by physical deterioration and, lastly, the lack of performance of activities to prevent/decrease self-care deficits. These identified self-care deficits supported the development of guidelines to facilitate self-care amongst older persons, together with Menon's psychological health empowerment model, as well as an in-depth literature review on self-care and related constructs to understand self-care from a theoretical perspective. Furthermore, the study compared the ASA-A and ESCA questionnaires to determine the relationship between these questionnaires. The two questionnaires had a very good correlation with each other, conclusion that either of these two questionnaires could be used to measure self-care of a population. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2010.

The number of older persons is growing at a shocking rate. In spite of this reality, the South African health care sector does not prioritise older persons, causing their health to be poorly managed. Not only does poor health management affect the health of the older person, but also economic factors. This causes a high burden on the public health sector of South Africa, with specific reference to the Primary Health Care (PHC) clinics. PHC clinics in this country are not only overcrowded due to staff shortages, but also owing to the rapidly ageing population and the large number of younger persons affected by the high unemployment rate of South Africa. The above-mentioned factors keep the professional nurses in the clinic from spending time on proper physical examinations and provision of health education to older persons. This causes older persons to lack knowledge regarding self-care, potentially leading to unintentional self-neglect, which decreases their quality of life. Studies conducted on older persons concluded that the older person wants to be involved in health promotion, but needs the necessary knowledge to take care of him- or herself. Therefore, the researcher's overarching aim with this study was to develop guidelines to facilitate self-care amongst older persons. Such guidelines aim at constituting an indirect approach to promote the health of the older person. Health education on self-care should be conducted in self-care support groups, since community experience teaches that some older persons in the community do not apply self-care skills learned without some form of support. The aim with these guidelines is to decrease unintentional self-neglect by empowering the older person to make autonomous decisions regarding self-care, in order to increase quality of life. RESEARCH AIM AND OBJECTIVES In order to reach the overarching aim of this study, which comprises the development of guidelines to facilitate self-care amongst the older persons in the Potchefstroom district, the study firstly includes a literature review to understand self-care and related constructs from a theoretical perspective. Secondly, the Appraisal of self-care agency scale-A (ASA-A) and Exercise of self-care agency scale (ESCA) were used as questionnaires to assess the self-care of the selected older persons. Lastly, after determining the self-care of the older persons, the study investigates the relationship between these two questionnaires through correlational analysis. RESEARCH DESIGN A quantitative, descriptive, correlational and contextual design was used in this study to .reach the overarching aim and respective objectives. RESEARCH METHOD The researcher firstly conducted a literature review to understand self-care and related constructs. Thereafter the researcher employed two structured questionnaires, the ASA-A and ESCA, were employed to collect data. The questionnaires were developed to measure self-care (self-care is determined by measuring the self-care agency). These questionnaires were based on Dorothea OrenYs self-care deficit theory of nursing, the same theory that this research study is based on. Minor adaptations were made to both the questionnaires prior to administration to the predominantly Setswana-speaking older population. The study formed part of the larger Multinational Prospective Urban and Rural Epidemiological study (PURE-SA study - ethical approval number 04M10). All the older persons identified in the peri-urban population of the PURE-SA study living in the Potchefstroom district and who were willing to participate were included in the sample. Trained fieldworkers assisted the researcher in data collection. Of the 198 older persons, 192 participated, accumulating to a 98% response rate. Lastly the researcher correlated the ASA-A and ESCA to determine their relationship as an added benefit to this research study. RESULTS The findings indicate that although the studied older population was of a lower socio-economic status with a lower literacy level, their overall self-care was relatively good. Seven self-care deficits were identified namely time management skills affecting self-care, energy deficit affecting self-care, sleep deprivation, lack of knowledge and ability to acquire knowledge with regard to health and self-care, lack of a rest, exercise and self-care programme, self-care deficit caused by physical deterioration and, lastly, the lack of performance of activities to prevent/decrease self-care deficits. These identified self-care deficits supported the development of guidelines to facilitate self-care amongst older persons, together with Menon's psychological health empowerment model, as well as an in-depth literature review on self-care and related constructs to understand self-care from a theoretical perspective. Furthermore, the study compared the ASA-A and ESCA questionnaires to determine the relationship between these questionnaires. The two questionnaires had a very good correlation with each other, conclusion that either of these two questionnaires could be used to measure self-care of a population. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2010.

This thesis comprises a rigorous and coherent body of work related to the use of the HCR-20 and the START to inform risk assessment and management of secure mental health inpatients. The thesis contributes significant theoretical and applied knowledge by: 1) investigating the extent to which these tools can be generalised beyond restricted validation samples to the full range of individuals in contact with secure services, 2) determining whether they can aid assessment and management of adverse outcomes beyond aggression, and 3) offering practical, empirically-derived advice for clinicians regarding management strategies that may reduce the occurrence of adverse events. This collection of papers has used considerably novel methods, such as rocreg analysis in risk assessment of behavioural outcomes, and high quality, routinely collected data to gain a more realistic representation of what occurs in clinical practice. Further, the papers draw on larger sample sizes than have previously been reported in this area, allowing for more complex statistical analysis. This thesis has helped clarify the contexts in which these instruments perform effectively and therefore has important implications for clinical risk assessment in inpatient settings. Specifically, there is evidence that the HCR-20 and the START may aid assessment and management of aggression for the majority of groups examined, and that both tools have some efficacy for predicting self-harm among female populations. However, the HCR-20 should not be used to inform prediction and management of aggression and self-harm for individuals with developmental and organic disorders and is unlikely to be beneficial at informing risk management strategies targeting self-harm among males; the START should not be used to inform prediction and management of substance abuse, victimisation, or unauthorised leave. Finally, this thesis highlights a number of directions for future research to continue advancement in this area.

No description available.