In Pursuit of a Useful Framework to Champion Elder Justice
In Pursuit of a Useful Framework to Champion Elder Justice
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寻求一个有用的框架来维护老年司法
DOI：
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发表时间：
2012
期刊：
影响因子：
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通讯作者：
A. Navarro
中科院分区：
文献类型：
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作者：
L. Nerenberg;M. Davies;A. Navarro
从加州的老年人正义联盟的协调，合作和宣传的经验教训。长期的老年人正义表明，生活不受虐待，忽视和剥削是一项基本权利，必须通过公共政策，保障内置到核心老龄化服务，获得司法系统，并在虐待报告时作出强有力的反应。2006年，当加州的服务提供者讨论防止虐待老年人的挑战时，他们得出结论，需要州政府的领导和政策改革。他们成立了一个委员会，主办了一次峰会，制定了一个全面的蓝图，并发起了加州老年人正义联盟（CEJC）。在这篇文章中，原长老会的成员反映了这一过程，并提供了宣传的建议。它需要一个团队：全州范围内的老年人司法倡导的集体方法当来自阿奇斯通基金会的老年人虐待和虐待倡议的代表会面时，谈话总是转向系统性的挑战。无论工作环境或方案类型如何，服务提供者都遇到了协调障碍、服务差距和公共政策改革的需要。他们还看到了政策在全州如何解释、实施或执行方面的明显差异。很明显，只有通过集体行动才能解决这些问题。团队的类型和操作程序许多挑战是由多学科团队确定的，这是加州老年人虐待预防计划的一个突出特点。该州是几个杂交品种的所在地，包括金融滥用专家小组（FAST）和虐待老年人法医中心，它们采用团队方法。FAST为调查和应对金融滥用案件的专业人员提供咨询和支持;成员包括金融机构员工，股票经纪人，保险代理人以及其他可以解释金融产品和行业标准，法规和实践的人。有些人包括来自多个联邦执法和监管机构的代表，这些机构可能对虐待老年人的案件有管辖权，包括联邦贸易委员会、联邦调查局和美国邮政服务局。法医中心团队还为成人保护服务（APS）和执法调查人员提供支持。成员包括老年医学、民法和刑法、神经心理学方面的专家，以及发育残疾人和长期护理设施居民的倡导者。团队成员可以进行家庭评估，在会议期间和会议之间提供咨询，接受转介服务，并在法律的诉讼中作证（Navarro等人，2010年）。除了解决客户的财务、法律的、社会和情感需求外，团队成员还受益于跨学科的沟通和协作。虽然加州法律承认多学科团队（加州福利和机构法典，第15610.55节; law. one. le。com/california/welfare/15610.55.html），并允许APS工作人员与团队成员共享信息，但它没有充分解决团队成员的保密问题。例如，FAST成员对允许私营部门专业人员参加会议表示担忧，法医中心团队成员质疑在会议上交换的信息是否可以被传唤或在民事诉讼中“可接受”。没有明确的方向，从国家，县法律的顾问有时决定谁可以和谁不能参加会议，以及如何信息可以使用，在整个国家的差异。团队确定最大的需求团队成员和其他专业人员也确定了未满足的需求，需要集体行动，包括以下：更多的资源，神经精神病学评估，法医财务会计，和医疗记录审查;持续开展心智能力教育;加强执法部门的参与;明确指导执法部门如何在金融犯罪调查期间保护证据、保护资产和保密;指导如何为“长期”欺诈受害者提供服务（反复受害者）;关于受害者赔偿和援助的信息，以及改善受害者获得赔偿和援助的途径，特别是针对金融犯罪受害者的赔偿和援助;以及，关于可以加强服务提供或证实虐待的研究结果的信息，包括关于瘀伤的研究（Wiglesworth等人.
Lessons in coordination, collaboration, and advocacy from California's Elder Justice Coalition.The term elder justice suggests that living free from abuse, neglect, and exploitation is a fundamental right that must be assured through public policy, safeguards built into core aging services, access to the justice system, and a robust response when abuse is reported. When service providers in California discussed challenges to preventing elder abuse in 2006, they concluded there was a need for state leadership and policy reform. They formed a workgroup, hosted a summit, produced a comprehensive blueprint, and launched the California Elder Justice Coalition (CEJC). In this article, members of that original workgroup reflect on the process and offer suggestions for advocacy.It Takes a Team: A Collective Approach to Statewide Elder Justice AdvocacyWhen representatives from the Archstone Foundation's Elder Abuse and Neglect Initiative met, the conversation invariably turned to systemic challenges. Regardless of work settings or program type, service providers encountered coordination breakdowns, service gaps, and a need to reform public policy. They also saw glaring disparities in how policy was interpreted, implemented, or enforced across the state. It was clear that only through collective action could these problems be addressed.Types of teams and operating proceduresMany of the challenges were identified by multi-disciplinary teams, which are a prominent feature in elder abuse prevention programs in California. The state is home to several hybrid varieties, including Financial Abuse Specialist Teams (FAST) and elder abuse forensics centers, which use a team approach. FASTs provide consultation and support to professionals investigating and responding to financial abuse cases; members include financial institution employees, stockbrokers, insurance agents, and others who can explain financial products and industry standards, regulations, and practices. Some include representatives from multiple federal law enforcement and regulatory agencies that may have jurisdiction in cases of elder abuse, including the Federal Trade Commission, the Federal Bureau of Investigation, and the U.S. Postal Service.Forensic center teams also provide support to Adult Protective Services (APS) and law enforcement investigators. Members include experts in geriatric medicine, civil and criminal law, neuropsychology, and advocates for persons with developmental disabilities and residents of long-term-care facilities. Team members may conduct home assessments, provide consultation during and between meetings, accept referrals for services, and testify in legal proceedings (Navarro et al., 2010). In addition to addressing clients' financial, legal, social, and emotional needs, team members benefit from crossdisciplinary communication and collaboration. They also develop investigative and assessment skills, and produce guidelines and strategies that can be used in training.Although California law recognizes multidisciplinary teams (California Welfare and Institutions Code, Section 15610.55; law.onecle. com/california/welfare/15610.55.html) and permits APS workers to share information with team members, it does not adequately address team members' confidentiality concerns. FAST members, for example, raised concerns about permitting private-sector professionals to participate at meetings, and forensic center team members questioned whether information exchanged at meetings could be subpoenaed or was "discoverable" in civil proceedings. Without clear direction from the state, county legal advisors have sometimes determined who can and who cannot attend meetings and how information can be used, resulting in variations across the state.Teams identify greatest needsTeam members and other professionals also identified unmet needs requiring collective action, including the following: more resources for neuropsychiatry evaluations, forensic financial accountings, and medical record reviews; ongoing education in mental capacity; greater participation by law enforcement; clear direction to law enforcement in how to secure evidence, protect assets during financial crime investigations, and maintain confidentiality; guidance in serving "chronic" fraud victims (those repeatedly victimized); information about, and improved access to, victim compensation and assistance, particularly for financial crime victims; and, information about research findings that can enhance service delivery or substantiate abuse, including research on bruising (Wiglesworth et al. …