The Role of Emotional Vulnerability and Abuse in the Financial Exploitation of Older People From Culturally and Linguistically Diverse Communities in Australia

A Scoping Review of Aging Experiences Among Culturally and Linguistically Diverse People in Australia: Toward Better Aging Policy and Cultural Well-Being for Migrant and Refugee Adults

BACKGROUND AND OBJECTIVES

Australia's population is growing, aging, and becoming more ethnically diverse, resulting in barriers and challenges around social inclusion for non-English-speaking migrants and refugees. This scoping review investigates the experiences of aging within Australia among older adults from culturally and linguistically diverse (CALD) migrant and refugee backgrounds to identify barriers to social integration.

RESEARCH DESIGN AND METHODS

A scoping review of English language literature and gray literature on the experiences of aging among CALD migrants and refugees living in Australia was conducted from January 2000 to January 2021, according to Arksey and O'Malley's review process. A total of 34 studies were identified for analysis.

RESULTS

Three primary themes were identified: (a) sociocultural similarities in settlement experiences, (b) engagement with technology for social connection, and (c) engagement with family and community networks.

DISCUSSION AND IMPLICATIONS

Aging, language, sociocultural, and technology contexts shape attitudes to belonging, as well as access to sociomedical services. We argue a cultural well-being framework may assist in developing policy for improved social integration of older CALD adults. As the focus is on social and cultural experiences, all studies with a primary focus on medical and other chronic conditions were excluded. Future studies could include health-related articles to present a more comprehensive approach regarding older CALD adult needs. Follow-up research could focus on the impact of the coronavirus disease 2019 pandemic on the experiences of older adults in Australia, in particular those of CALD backgrounds.

What we need as we get older: needs assessment for the development of a community geriatrics service in an Australian context

Background

The aim of this study was to inform the development of a Community Geriatrics Service (CGS) that addressed the healthcare and social needs of community dwelling older people in an Australian context.

Methods

Stakeholders (N = 108) took part in a ‘needs assessment’ involving 30-min semi-structured interviews with general practitioners (GPs; N = 49), and three 2-h focus groups (community engagement meetings; N = 59) with older people, informal caregivers, allied healthcare workers, and nursing home directors. Data were transcribed and thematically coded, mapped to source and weighted to the frequency that the theme was raised across sources.

Results

Five themes informing CGS development and delivery emerged: active health conditions (management of behavioural and psychological symptoms of dementia, falls, multimorbidity, and other relevant conditions), active social challenges (patient non-compliance, need for aged care social workers, caregiver stress, elder abuse, social isolation, and stigma), referrals (availability of specialists, communication, specialist input, and advance care directives), access (lack of transport options, and inaccessibility of local geriatrics clinics and specialists), and awareness (lack of awareness, knowledge, and resources).

Conclusions

The CGS will need to address access, referral processes and health system navigation, which were perceived by stakeholders as significant challenges. These findings warrant the development of a CGS with an integrated approach to aged care, pertinent for the health and social needs of the elderly.

Successful Family-Driven Intervention in Elder Family Financial Exploitation: A Case Study

BACKGROUND AND OBJECTIVES

The prevalence and consequences of elder family financial exploitation reinforce the need for a range of effective intervention strategies. This paper describes how and why one family successfully intervened in the family-based financial exploitation, constructing, and achieving meaningful processes and outcomes for the specific family and context.

RESEARCH DESIGN AND METHODS

Case data analysis and interpretation was guided by Stake's (2015) systematic phases of case summary (factual information), inductive case themes (issue relevant meanings), and case features (abstractions to the existing knowledge). The case was selected from a larger study examining the meaning and experience of elder family financial exploitation based on the following case boundaries: reliance on family members with minimal private sector support, no report to the authorities, and successful outcomes for the victim, perpetrator, and the family system.

RESULTS

The case family successfully resolved family-based financial exploitation by (a) honoring the victim's wishes, (b) providing support and accountability for the perpetrator, (c) restoring family relationships and functioning, and (d) family-driven decision making. A family systems approach and the application of restorative justice principles are identified as overarching case features.

DISCUSSION AND IMPLICATIONS

As a study of a previously undocumented experience of successful family involvement, the case findings are useful for researchers and practitioners when constructing and examining the effectiveness of future intervention strategies.

Epistemological erasure: The subject of abuse in the problematization of 'elder abuse'

The academic field of literature pertaining to elder abuse emerges largely from gerontology with contributions from a variety of disciplines including geriatric medicine, nursing, public health, law, psychology, sociology and social work. This paper presents a critical review of articles drawn from this literature to identify current directions leading the development of empirical research in this field. The objective measurement of prevalence, the identification and correlation of psycho-social risk factors and practice-based research oriented to intervention and prevention are identified as privileged sites for scientific investigation. These sites are critically analysed in terms of their underpinning rationalities to reveal the operation of a hegemonic post-positivist epistemological framework. This framework enables an expert professional discourse to structure knowledge and the field of inquiry through constructions of the 'subject of abuse' as a statistical figure, a factorial subject of risk and universally vulnerable. These modes of representation preclude subjective lived experience and, in doing so, inaugurate an 'epistemological erasure' of the embodied subject of abuse. The review attends to the limited body of qualitative research in the field, some of which claims a politicized empiricism of 'voice'. However, whilst the findings produced by this research suggest theoretically and conceptually fertile lines of inquiry, these have not disrupted or extended the dominant discourses in the field. This paper argues that an epistemological gulf, riven through a politics of evidence, ensures the reproduction of dominant discourses and their attendant limitations in ways that forestall the conceptual and theoretical advancement of the field.

“Death Is Better Than Misery”

As the proportion of elders in developing nations increases and the ability of families to meet their needs is stretched thin, the risk of elder abuse will grow. This study examined the types and nature of abuse and neglect from the perspective of elders in Ethiopia who experienced abuse in noninstitutional settings. A qualitative design guided by hermeneutic phenomenology was used to explore the lived experiences of abuse and neglect of 15 Ethiopian elders. Nine women and six men ranging in age from 64 to 93 years were interviewed. Most were victims of multiple forms of abuse, especially financial exploitation, emotional abuse, and neglect. Economic vulnerability was a clear underlying factor contributing to elders' risk for encountering abuse. Effective prevention efforts must address the societal level factors that ultimately contribute to elder abuse while also holding individuals responsible for their harmful behaviors against elders.