Role-play case study presentation

Face to Face encounter Role-play presentation
Due date March 20
For the next upcoming face to face encounter we would like to
do an acting case study forum. Each student will be subdivided
into groups of 6 students. Each group will be assigned a case
study for which the group will need to select the proper
scientific methods to solve the problem as well as support it
utilizing a nursing theory.
Each student will be assigned a role: Narrator, Nurse
Practitioner, Researcher, Patient, and Theorist. Each student
will need to describe their role in the case study:
First Narrator will provide the story, then the patient and the
nurse practitioner (NP) will displayed interaction based on the
case study (Make it realistic), then the researcher and theorist
will present the scientific steps to reach the solution that the NP
arrived with supporting information and the theorist will present
the nursing theory selected by the group that is best allocated to
your study (Why that Nursing Theory was selected). Time
allowed 15 minutes per group. You are welcome to dress up, use
power point presentation, pictures, music, etc in order to make
the group’s point across. Please provide a short synopsis of the
material being presented.
Rubric
Oral Presentation - RUBRIC
Aspect
Excellent
(A = 4)
Good
(B = 3)
Satisfactory
(C = 2)
Needs Improvement
(D = 1)
Score

Introduction
(1) Gains the attention of the Audience,
(2) Clearly identifies the topic,
(3) Establishes credibility,
(4) Previews the rest of the speech
Meets any three of the four criteria
Meets any two of the four criteria
Meets only one of the four criteria
Preparation
Completely prepared, has obviously rehearsed the speech.
Prepared, but could use additional rehearsals.
Somewhat prepared, but it seems that the speech was not
rehearsed.
Unprepared
Enthusiasm
Facial expression and body language convey strong enthusiasm
and interest
Facial expression and body language sometimes convey strong
enthusiasm and interest
Facial expression and body language seem contrived
Apparent disinterest in the topic
Eye Contact
Eye contact with audience virtually all the time (except for brief
glances at notes)
Eye contact with audience less than 75% of the time
Eye contact with audience less than 50% of the time
Little or no eye contact
Use of Language
Use of language contributes to effectiveness of the speech, and

vocalized pauses
(um uh er etc.)
not distracting
Use of language does not have negative impact, and vocalized
pauses
(Um uh er etc.)
not distracting
Use of language causes potential confusion, and/or vocalized
pauses
(Um uh er etc.)
are distracting
Use of language is inappropriate
Confidence
Speaks neither too quickly nor too slowly
Speaks either slightly too quickly or too slowly
Speaks either too quickly or too slowly
Tempo of speech is inappropriate
Clarity
Speaks clearly and distinctly all the time, no mispronounced
words
Speaks clearly and distinctly nearly all the time, no more than
one mispronounced word
Speaks clearly and distinctly most of the time, no more than one
mispronounced word
Often mumbles or can not be understood, more than one
mispronounced word
Topic
Well focused, creative and appropriate
Appropriate and reasonably focused
Topic is appropriate but lacks some focus or strays a bit
Inappropriate topic
Visual Aids

Visual aids well chosen and presented
Minor problems with visual aids
Significant problems with visual aids
No visual aids
Conclusion
(1) Cues the audience that the end of the speech is at hand
(2) Brings closure
(3) Memorable
Cues the audience and brings closure
Brings closure
Does not bring closure; the audience is left hanging
Questions
Able to answer all questions
Able to answer most questions
Able to answer some questions
Unable to answer most questions
Group 2: Case Study # 2
Carolyn Jones” is a 40-year-old professor of economics. The
past week she has felt tried and weak. The past few days she has
noticed small, red dots on her skin and gums. Even more
upsetting, she cut herself while making dinner and the wound
bled for a long time.
Objectives:
The anatomic location and stimulus for platelet production.
The role of platelets in hemostasis and the consequences of a
low platelet count.
The causes and treatment of thrombocytopenia.
The influence of the spleen on the number of circulating
platelets.
This is a Role – Play presentation
Narrator:

Nurse Practitioner:
Researcher:
Patient:
Theorist.
Full Terms & Conditions of access and use can be found at
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Journal of Elder Abuse & Neglect
ISSN: 0894-6566 (Print) 1540-4129 (Online) Journal homepage:
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The Changing Career of “Elder Abuse and Neglect”
as a Social Problem in Canada: Learning from
Feminist Frameworks?
Joan Harbison PhD
To cite this article: Joan Harbison PhD (2000) The Changing
Career of “Elder Abuse and Neglect”
as a Social Problem in Canada: Learning from Feminist
Frameworks?, Journal of Elder Abuse &
Neglect, 11:4, 59-80, DOI: 10.1300/J084v11n04_05
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The Changing Career
of ‘‘Elder Abuse and Neglect’’
as a Social Problem in Canada:
Learning from Feminist Frameworks?
Joan Harbison, PhD
ABSTRACT. ‘‘Elder Abuse and Neglect’’ was constructed as a
social
problem by experts and has largely been a product of ‘‘expert’’
knowl-
edge building and intervention. The idea of woman abuse as a
social
problem, on the other hand, originated with women themselves.
The
paper examines the changing social context in which some older
people
are currently seeking ownership of responses to mistreatment. It

ex-
plores emerging criticisms of present constructions of ‘‘elder
abuse and
neglect’’ and the needs they imply, and links these to feminist
frame-
works. It then considers the appeal and utility of these
frameworks for
older women active in the fight against mistreatment. [Article
copies available
for a fee from The Haworth Document Delivery Service: 1-800-
342-9678. E-mail
address: [email protected]
<Website:http://www.haworthpressinc.
com>]
KEYWORDS. Elder abuse and neglect, feminist frameworks,
social
construction, ageism
INTRODUCTION
‘‘Elder Abuse and Neglect’’ was constructed as a social
problem by ex-
perts and has largely been a product of ‘‘expert’’ knowledge
building and
Joan Harbison is Associate Professor, Maritime School of
Social Work, Dalhou-
sie University, Halifax, Nova Scotia, B3H 3J5, Canada.
The author acknowledges with gratitude the earlier
collaboration with her col-
league, Marina Morrow, as well as her comments and support
during work on the
present paper.

The paper was developed from a paper authored by Joan
Harbison and Marina
Morrow presented at the Second National Conference on Elder
Abuse, Toronto,
March, 1999.
Journal of Elder Abuse & Neglect, Vol. 11(4) 1999
E 1999 by The Haworth Press, Inc. All rights reserved. 59
JOURNAL OF ELDER ABUSE & NEGLECT60
intervention. Until recently older people’s participation in
responses to the
mistreatment of their peers has remained at the margins. Their
increasing
involvement has been supported by a period of emphasis by
service and
research funders on consumer and community participation,
more than the
initiatives of older people themselves. The idea of woman abuse
as a social
problem, on the other hand, originated with women. Women,
mainly of
younger generations, became intensely involved in lobbying
against woman
abuse and in providing services to women that would support
them in identi-
fying and leaving abusive situations and creating new lives
beyond them.
This paper reviews the arguments about why older people so far
have not
taken charge of responses to the mistreatment of their peers. It
examines the

changing social context in which some older people are
currently seeking
ownership of responses to mistreatment, while others seek
varying degrees
and types of participation. It questions whether ‘‘expert’’
responses to older
people’s mistreatment, constructed as ‘‘elder abuse and
neglect,’’ may come
under pressure to give way to lower cost community-centered
responses,
given the changing demographic situation, the socio-economic
and political
directions fostered by governments, and the demands of some
older people. It
explores emerging criticisms of present constructions of elder
abuse and
neglect and the needs they imply. It then considers why, so far,
feminists have
had little involvement in elder abuse and neglect and reflects on
some emerg-
ing feminist perspectives on the subject and their potential
utility in the field
and acceptability to older people. Finally, it identifies issues
that older people
will need to confront in incorporating feminist ideas into their
work to com-
bat mistreatment.
WHY HAVE OLDER PEOPLE NOT TAKEN OWNERSHIP
OF THE MISTREATMENT OF THEIR PEERS?
The ways in which the mistreatment of older people have been
constructed
or understood, mainly by professionals and academics, have not
easily lent
themselves to the involvement of older people as full

participants. Instead the
mistreatment of older people under the guidance and domination
of service
providers and policy makers has become confined within a
construction
identified as ‘‘elder abuse and neglect’’ (Baumann, 1989;
Biggs, 1996; By-
theway, 1995; Dunn & Sadler, 1993; Harbison, 1998; Leroux &
Petrunik,
1990; McCallum, 1994). This terminology reflects attempts to
contain the
problem of mistreatment as one which can be addressed at the
level of the
individual, for instance as emanating from interpersonal
relationships in a
dysfunctional family or from the illegal or criminal behaviors of
family
members or others (Biggs, Phillipson, & Kingston, 1995;
Whittaker, 1996).
These societal responses to the mistreatment of older people
parallel those in
Joan Harbison 61
response to many of the social problems of our times. The
‘‘therapeutic idea
in contemporary society’’ (Epstein, 1994, p. 3) refers to both
the pervasive
Freudian-based belief in the psycho-dynamic determinism of
human behav-
ior, and its corollary that all human behavior is amenable to
positive change
through the intervention of professional experts. This
therapeutic approach

[‘‘therapeutism’’] may also be seen as a ‘‘non-coercive social
control mecha-
nism’’ of the state (Epstein, 1994, p. 7). Not only are
individuals, and the
groups to which they belong, portrayed as inadequate to deal
with their own
problems but group demands based on broader interpretations
are discour-
aged. Where elder abuse and neglect remains constructed as ‘‘a
family af-
fair’’ (where even the need for, and negative outcomes of,
residential care can
be seen as a failure of the family to provide), there is less
chance that older
people will protest, en masse, about the social attitudes and
conditions of an
ageist society (Biggs, 1996; Bytheway, 1995). Hence, older
people have
received little support to take on major roles in combating
mistreatment at
either the individual or societal level.
Further there is evidence that throughout the history of Western
Societies
‘‘ . . . ambivalence has been a recurring theme in social
attitudes towards
older people’’ (Biggs, 1996; Phillipson & Kingston, 1995, p.
89). This in-
cludes social tensions relating to older people’s control over
property, as well
as their social, physical, and financial, demands on families.
(This contradicts
the popular myth of an earlier time when all older people were
respected and
loved by younger generations.) For the last several generations
the assault on

older people’s dignity and status in society has flowed from the
needs of the
economy and the labor market. From the 1950s on, retirement,
and more
recently early retirement, have become ‘‘ . . . in a real sense a
euphemism for
unemployment’’ (Townsend, 1981, p. 10). Older people were
encouraged to
think of themselves as disengaging from life and giving up
responsibility for
their own lives, as well as for those of others, and handing that
responsibility
to professional experts and caregivers (Cumming & Henry,
1961). The inter-
nalization of these essentially ageist social values and social
roles may play
an important part not only in older people’s failure to take
charge of re-
sponses to mistreatment but in their willingness to suffer it in
silence. More-
over, the greater proportion who are women are in ‘‘double
jeopardy’’ from
ageism and sexism (Aitken & Griffen, p. 63). The reluctance to
assume
public roles which have not been part of their lives as
housewives and moth-
ers is reinforced by the fact that these domestic roles no longer
lend them
status in society (Aitken & Griffen, 1996; Harbison et al.,
1995). There is also
much discussion in the literature of how belief in traditional
family values
may deter older people from bringing their situation to the
attention of others.
Where older people believe that the family is the source of
caring and protec-

tion and that its privacy should be protected, it is seen as
failure, betrayal, and
threat [of the unknown] to denounce it (Quinn & Tomita, 1997,
pp. 5-7;
Podnieks, 1992).
THE POTENTIAL FOR CHANGE
A number of factors which are now coalescing suggest that both
the image
and reality of how most older people live their lives may be
undergoing
important changes. These include in particular: the ageing of
the population,
and within it the impact of feminism grown older, and the
‘‘baby boom
effect’’; the perception of the costs to society of continuing to
construct older
people as dependent; the consequent interests of governments,
professionals,
and older people themselves in reframing ageing in a positive
way; and
successful ageing and the discovery of older people as a market
which is
influencing their reconstruction in the media.
Changing ‘‘Dependencies’’: Reconstructing Ageing
As noted above many of the ‘‘dependencies’’ of older people
were initially
created by the state in the interests of the economy. Further,

these dependen-
cies were fostered by burgeoning professionalism based on
gerontological
theory and an exponential growth in the health care industry
(Estes, 1993;
Estes & Binney, 1989; Evans, 1985; Gibson, 1993). However,
demographic
projections of the ageing of society combined with concern
about the costs of
services to older people have reinforced in the public sphere
society’s long
standing ambivalence about the rights and entitlements of older
people
(Bytheway, 1995). This is clearly illustrated in articles debating
the question
‘‘Do Seniors Have It Too Good?’’ written by journalism
students (The Hali-
fax Commoner, University of Kings’s College School of
Journalism, Novem-
ber 20th, 1998).
We need to get off our high and mighty lazy behinds and get to
work.
We are not defined by our history. Today’s seniors worked hard
to
ensure they had a retirement program. If we want one, we need
to make
one for ourselves. (Watt, N., p. 12)
Yes, the senior generation endured a cataclysmic Depression,
turned
back the tides of fascism, then ushered in social reform and
civil rights
for an encore. Grandma and Grandpa are certainly worthy of our
re-
spect, but not at the expense of our well-being. I refuse to keep

selling
out my future for their present. It’s high time the senior
generation
started paying its own way. (Pachal, P., p. 12)
Joan Harbison 63
The last quotation illustrates how constructions of older people
as depen-
dent and a burden on society have an alarming potential to
support intergen-
erational conflict. Governments need to be wary of ‘‘ . . .
[shifting the]
potential blame from their own economic management [failure]
to particular
segments (or victims) within the society’’ (Gibson, 1995, p. 22;
see also
Aber-Schlesinger & Schlesinger, 1999, p. 291; Gee &
MacDaniel, 1994;
Minkler, 1991; Vincent, 1995). Emerging revisionism in
demographic pro-
jections given publicity under newspaper headings such as
‘‘Amazing Facts:
Boom gloom’s voice of reason’’ (Little, 1999, Globe & Mail).
Little bases his
discussion on research by Denton and Spencer, at McMaster
University Re-
search Institute for Quantitative Studies in Economics and
Population, which
suggests that previous projections and their interpretations
over-rated both
the rate of population ageing and its negative economic impact.
Even if this
new information is supported by further research, it may take

some time to
gain hold of the public imagination. Meanwhile governments
are engaged in
extricating themselves from the responsibilities and costs for
the care of older
people and are attempting to shift these responsibilities to
‘‘families’’ includ-
ing older people themselves (Vincent, 1995). At the same time
academics and
other researchers are discovering (or rediscovering) the mental
and physical
powers of older individuals (see, for instance, Sperry & Rosen,
1996) which
may imply their ability to care for themselves and others.
Successful Ageing and the Discovery of Older People as a
Market
Over the last ten years or so the idea that older people can age
‘‘successful-
ly’’ has been growing. In 1998 Rowe and Kahn, in their
Successful Aging,
reported on ten years of research which concluded that lifestyle
choices
(more than genes as popularly supposed) determined how well
we age both
mentally and physically. Older people, or at least those over
fifty who are
relatively well-off financially, have been discovered as a
market. There is
now an industry based on the notion of older people’s capacity
for self-im-
provement through new learning, spiritual development, mental
and physical
fitness, travel, and culture (Foot, 1996). A necessary
accompaniment to this,

supporting the notion of older people as consumers of goods and
services for
an active (as opposed to passive and dependent) life, has been a
shift in the
popular media images of ageing. For instance, Chen and Nan
Zhou, in an
analysis of the portrayal of older people in Canadian magazine
advertise-
ments published in 1994, described their findings as remarkably
different
from those of earlier studies by themselves and others. Older
people are
portrayed in a much more positive manner than previously.
They con-
cluded that this was on account of an ‘‘overwhelming’’
potential for profit
(p. 214). They also noted that a change in Canadian societal
values meant
that ‘‘. . . advertising that demeans any group is no longer
tolerated’’ (p. 215).
Driven by demography, socio-economic policies, research
findings, and
market forces the public face of older people is changing. Once
older people
were mainly viewed as frail, vulnerable, of limited capacities,
and subject to
care by others. Now they are being reconstructed as physically
and mentally
able with the capacity to take care of themselves. Further, many
public
portrayals are as people with choices based on sufficient or

surplus income.
The positive outcomes of this reconstruction of ageing are
offset by a number
of factors. These include the continuing tendency to deny the
negative as-
pects of ageing associated with structural inequalities in society
such as
poverty, especially among women and aboriginals, as well as
issues of power
related to gender, culture, ethnicity, and class. There is some
evidence that
older people’s portrayal as well-off, self-involved and
physically and mental-
ly sound has already produced resentment in younger age
groups who are
fearful of what opportunities their own futures hold. Those
older people
without these characteristics may be seen as individually
responsible for their
failure to age ‘‘successfully’’ and to provide for their old age,
rather than as
casualties of social, structural, or physiological circumstances.
As well, some
older people are attempting to isolate themselves from ageism
by living in
‘‘seniors’’ communities. Often these ‘‘communities’’ are
created by profit
oriented entrepreneurs whose promises of positive care are
likely to evapo-
rate with their older residents’ financial resources and
increasing health care
needs.
The implications of these changes for other changes in society
which
would lessen ageism and the mistreatment of older people are

uncertain. The
career of ‘‘elder abuse and neglect’’ as a social problem may be
shifting in a
new direction. In 1990 Leroux and Petrunik questioned whether
‘‘elder abuse
and neglect’’ would become a fully fledged social problem.
Harbison and
Morrow (1998) noted that in Canada throughout the 90s ‘‘elder
abuse and
neglect’’ had the attention and support, not only of the experts
lobbying for
its legitimacy but of governments and other funding agencies.
Presently, for
reasons discussed above, in particular governments’ restrictions
on funding
for social programs, ‘‘elder abuse and neglect’’ in Canada is
unlikely to
receive new resources (Aber-Schlesinger & Schlesinger, 1999).
Based on the
commitment of experts, and increasingly of older people’s
activism, its mo-
mentum is such that ‘‘elder abuse and neglect’’ is unlikely to
fade away.
However, its construction as a social problem may change.
‘‘PARTNERSHIPS’’ BETWEEN SENIORS AND EXPERTS:
WHOSE PRIORITIES?
The new societal constructions of older people identified above
with their
potential relationship to government policies, have implications
for responses
Joan Harbison 65

to the mistreatment of older people. In Canada the question of
ownership of
elder abuse and neglect is under discussion. Part of the agenda
of the Second
National Conference on Elder Abuse held in Toronto in March,
1999, was a
proposal to establish a Canadian Network for the Prevention of
Elder Abuse.
A number of seniors commenting on the proposal viewed it as
an opportunity
to identify ways in which seniors could take the lead in
responses to ‘‘elder
abuse and neglect.’’ However, the nature and degree of the
ownership desired
is not yet clear and is likely to differ among the many and
diverse groups of
seniors who are now active in various ways in attempts to deal
with their
mistreatment (see discussion in Gray Power–Working Session,
Second Na-
tional Conference on Elder Abuse: Proceedings, 1999).
CONSTRUCTIONS OF ‘‘ELDER ABUSE AND NEGLECT’’:
WHOSE NEEDS? WHOSE RESPONSES?
To date academics and professionals from a wide variety of
backgrounds
within health and gerontological frameworks have mainly been
responsible
for the construction of ‘‘elder abuse and neglect’’ (Baumann,
1989; Biggs,
1996; Bytheway, 1995; Dunn & Sadler, 1993; Harbison, 1998;
Leroux &
Petrunik, 1990; McCallum, 1994; MacLean, 1995), whereas ‘‘ .
. . elderly

people and their advocates have been minor players in defining
the discourse
on elder abuse’’ (Neysmith, 1995a). Mistreated older people are
seen as
‘‘adults in need of protection,’’ ‘‘persons subject to illegal
acts,’’ ‘‘victims of
domestic violence,’’ or as ‘‘agents for their own lives’’
(Harbison & Morrow,
1998). The first three of these constructions identify certain
‘‘needs’’ (Fraser,
1989) most of which can ‘‘best’’ be met by individualized,
professional
interventions (Epstein, 1994).
Where adults are viewed as in need of protection the
implication is that
they, like children, are unable or unwilling to make appropriate
decisions for
themselves and that targeted legislation (adult protection,
mandatory report-
ing, guardianship) is required which allows others to make
decisions on their
behalf. This overlooks the increasingly well publicized evidence
that only a
small minority of older people, including older abused people,
are mentally
incompetent. Despite the arguments of many academics and
lawyers (Colling-
ridge, 1993; Coughlan et al., 1995; Gordon & Tomita, 1990;
McCallum,
1993; McDonald et al. 1991; Neysmith, 1995; Robertson, 1995)
that targeted
legislation can be used successfully in only a small number of
situations
(usually those subject to guardianship), the belief among
professionals, older

people in general, and seniors’ organizations, that legislation
can provide
satisfactory solutions for many manifestations of mistreatment
continues.
(For an exception see discussion in McKenzie, 1999, pp. 435-
436). Legisla-
tion is not only usually paternalistic in itself, it is also
frequently invoked
(because it exists) where its use may be an infringement on the
rights of
mentally competent adults (Coughlan et al., 1995). Where
legislation governs
interventions professionals receive formal designation to
intervene. Hence,
older people are rarely eligible to assist their peers.
Despite provisions which would allow for prosecution, little use
has been
made of the existing Canadian criminal code to address those
suffering
mistreatment as victims of illegal acts relating to financial
abuse or fraud or
physical or sexual assault. This appears to follow strongly held
beliefs
among older people that abuse should be contained within the
family and is
‘‘ . . . reinforced by the ways in which abuse and neglect are
understood by
professionals as individual or family issues, without reference
to larger politi-
cal and economic forces’’ (Harbison & Morrow, 1998, p. 702;

see also Neys-
mith, 1995a). Where abuse occurs outside the family, not
infrequently the
case with fraud, seniors may nevertheless be too embarrassed or
intimidated
to pursue legal action. As well, under-resourced police
departments have ‘‘ . .
. been slow to recognize the need to develop initiatives for
dealing with
seniors’’ (Hill, 1999, p. 445). Where police have become
involved prelimi-
nary evidence suggests that failure to gain sufficient evidence to
charge or
convict in cases of suspected abuse, especially where families
are involved
(see for instance discussion in McKenzie, 1999) has led police
departments to
advance professional ownership of abuse and neglect through
close liaison
with professional agencies (see, for instance the establishment
of an inter-dis-
ciplinary community consultation team in Calgary, Alberta;
Hill, 1999, pp.
453-454, where seniors’ input into elder abuse and neglect is
fostered sepa-
rately through a Senior’s Police Advisory Committee which
deals with policy
issues external to the family). Initiatives which focus on
professional inter-
vention may well receive support from older people. However,
while they are
developed to protect older people from the consequences of
ageism, when
older people’s needs and the responses to them are identified by
others they
also retain the ageism that they are intended to address

(Harbison, 1998;
McKenzie, 1999).
There is a long history of attempts by younger women to engage
and refine
police intervention in domestic violence. However, older
people’s need for
privacy and the protection of their families frequently inhibit
them from
involving police. Further, given the reported lack of success of
police inter-
ventions and the predominance of professionals in responses to
mistreatment
of older people, it is not surprising that professionals have
promoted and
engaged in the development of responses based on
interdisciplinary team-
work, counseling, and family mediation (Kurrle, 1993;
Lithwick, 1999;
Quinn & Tomita, 1997). As well, the literature consistently
suggests that
many older victims of mistreatment choose to remain in abusive
families.
Therefore the services provided focus on dysfunction in the
family (Nah-
Joan Harbison 67
miash, 1999; Quinn & Tomita, 1997) rather than ‘‘complex
gender issues’’ or
power conflicts in society (Whittaker, 1996). Some older people
are wary of
these approaches fearing that ‘‘ . . . when a response involves
labeling seniors

as recipients of services, it also implies a lack of equity and
respect and in that
way mimics the abusive relationship’’ instead of building on
older people’s
strengths, resiliency, and capacity for change (McKenzie, 1999,
p. 439).
Further, the reasons for older people’s ‘‘need’’ to remain in
their families lie
in the ineffectiveness of society in general, and specific
communities in
particular, to address the mistreatment of older people as a
social and struc-
tural issue as well as on an individual basis. This includes
acknowledging that
much abuse occurs outside the family, in particular in
residential institutions
(Beaulieu & Belanger, 1995). From her perspective as a senior’s
advocate
active in elder abuse, McKenzie suggests that ‘‘ . . . components
of this
work [addressing mistreatment] include a broad range of
responses and a
multi-layered or holistic that is consistent with local needs and
abilities’’
(1999, p. 439). The Ontario Older Women’s Network (OWN)
echoes this
need for a broad-based approach in their study of shelter needs
for abused
older women (OWN/Kappel Ramji Consulting Group, 1998).
Older people’s participation in responses to mistreatment is
both increas-
ing and becoming more visible within the Canadian context.
Currently many
seniors’ organizations at both the national and the
provincial/local level have

undertaken initiatives concerning the mistreatment of older
people. Often
these involve partnerships among professionals, academics, and
seniors
themselves. Indeed such partnerships have, in many instances,
become the
pre-requisite for funding education, research, and services
relating to mis-
treatment and ‘‘elder abuse and neglect’’ (ARA Consulting
Group, 1994).
Hence older people’s views of mistreatment, and their
appropriate roles in
addressing it, have come under the influence of existing expert
constructions
of the problem of mistreatment of older people as ‘‘elder abuse
and neglect.’’
Within this ideological framework roles have been legitimized
for older
people (as reflected for instance in many of the papers
presented at the
Second National Conference on Elder Abuse, Toronto, 1999, see
SNCEA
Proceedings). These roles include those as: consultants to
governmental bod-
ies about developing and implementing policies relating to
abuse and neglect;
consultants or participants in research about mistreatment;
members of
boards and advisory committees of organizations offering
services to abused
older people; members of seniors’ organizations which have
other purposes
but which involve themselves in addressing some aspects of
mistreatment;
members of seniors’ organizations established to address issues
of mistreat-

ment through public advocacy and education; volunteer
participants assisting
in direct service provision by professionals to older people who
may reveal
themselves as suffering mistreatment; and direct service
providers to older
people who identify themselves as mistreated.
However, the degree to which the roles and activities in which
they engage
constitute older people acting as agents for their own lives, in
the sense that
their understanding of the conditions and circumstances of
mistreatment are
based on their own experiences rather the hegemonic
interpretations of oth-
ers, remains in question (Aronson, 1992; Sax, 1993).The
complexity of this
issue, and the difficulty of transcending the pervasive ideology
of therapeut-
ism (Epstein, 1994) are illustrated where the stated intent to
‘‘empower’’
older people nevertheless retains them firmly in roles as clients
to be helped,
and volunteers who assist professionals at the margins of
helping. ‘‘Profes-
sional intervenors are busy people who are limited in the time
they can give
for each client. Trained volunteer buddies who are carefully
supervised can
help to fill this gap for the client and pay regular friendly

visits’’ (Nahmiash,
1999, p. 397).
What has emerged as territory relatively uncontested by
professionals is
the education of older people about elder abuse and neglect by
their peers
(although professionals are often hired as collaborators or
assistants). It is not
surprising therefore that educational materials, often produced
with the help
of government grants, usually refer to categories of abuse
identified by pro-
fessionals and academics such as financial abuse, physical
abuse, neglect,
and psychological abuse. However, these categories are
illustrated by the
individual experiences of older people, in written case histories,
in person, or
in video films (see, for example, the work of Way-Clark and
Pace for Cana-
dian Pensioners Concerned, Nova Scotia, 1994). While older
people recog-
nize that mistreatment occurs within an ageist society,
suggested interven-
tions are usually those of social workers, counselors, nurses,
lawyers, and the
criminal justice system as opposed to interventions which attack
the social
origins of abuse. For the reasons discussed above these
professional re-
sources are under pressure. The idea of community responses to
abuse and
neglect is one which is therefore attractive to governments as
funders as well
as older people who experience ageism in its many forms

(Bytheway, 1995).
One example of this shifting of responsibility to the community
is the Com-
munity Response Networks Initiative in British Columbia
(McKenzie, 1999,
p. 438). As well, the British Columbia Coalition to Eliminate
Abuse of
Seniors initiated an effort to address financial abuse of seniors
where seniors
played ‘‘ . . . a major role in the design and implementation of
the project’’
(Ward-Hall, 1999, p. 326). (This was funded by Health Canada.)
Older people are as diverse as any other group in society.
Further, much
has been made of the fact that within our ageing society they
now represent at
least two generations (see discussion in Higgs, 1995). Not all
are ‘‘joiners’’
and even those who are active in many seniors’ group activities
may choose
Joan Harbison 69
to ‘‘leave elder abuse to the experts.’’ Many choose to work in
collaboration
with professionals. However, some older people, not
infrequently those who
are or have been professionals in policy or the caregiving
professions, are
beginning to assert their rights to take ownership of the
directions for elder
abuse through leadership in national and provincial/local
organizations and

specific initiatives. One Voice: the National Seniors’ Network
entitled a press
release promoting its community action resource kit ‘‘From
Consultation to
Action: Empowering Seniors to Combat Abuse of Older
Adults.’’ In a back-
ground paper for a Round Table discussion about the creation of
a Canadian
Network for the Prevention of Elder Abuse, Jill Hightower
emphasized both
the importance of using her experience as an older person and
of addressing
ageism at the societal level (Hightower, 1998, pp. 19-21). Ms.
Hightower was
formerly a policy analyst for a provincial department of health
and executive
director to the British Columbia Institute of Family Violence
and is currently
a consultant and seniors’ activist in B.C. The Older Women’s
Network
(OWN) Ontario initiated its own study on the shelter needs of
older women
based on its concern ‘‘ . . . about the lack of public awareness,
professional
sensitivity and gaps in services in the area of abuse of older
women’’ (OWN/
Kappel Ramji Consulting Group, 1998). A chief focus of
discussions among
seniors, academics, and professionals leading to the creation of
a Canadian
Network for the Prevention of Elder Abuse was the position of
seniors’
leaders that seniors should have leadership roles in the Network
‘‘ . . . to
ensure ownership of the issues’’ (Second National Conference
on Elder

Abuse, Proceedings, 1999, p. 254). The increasing demand to
attain leader-
ship comes mainly from the younger generation of older women.
This raises
the question of whether feminism ‘‘grown older’’ will influence
the direction
that responses to the mistreatment of older people will take in
the future.
FEMINIST THEORETICAL FRAMEWORKS
AND ‘‘ELDER ABUSE AND NEGLECT’’
There is a general agreement that the abuse of older women has
been
neglected by feminist theorists and activists (Aitken & Griffin,
1996, Aron-
son, Thornewell, & Williams, 1995; Crichton, Bond, Harvey, &
Ristock,
1999; Neysmith, 1995a, Whittaker, 1996). In part, this may be
attributable to
earlier understandings of the nature and consequences of ageing
which cen-
tered on dependency, frailty, and disengagement from life, and
thus disquali-
fied them from agency (Bytheway, 1995; Cumming & Henry,
1961). It has
also been suggested that ‘‘ . . . the overemphasis on
‘experience’ in second-
wave feminism has made feminists focus very closely on their
specific life
stages and immediate experiences, thus leading to a lack of
engagement with
issues not pertinent to their own situation’’ (Aitken & Griffen,
1996, p. 6). In

any case the dependency legitimized for older people was not
challenged in
the same way as that of younger women. However, now that
ageist stereo-
types of older people are coming under scrutiny, and elder
abuse and neglect
is becoming established as a social problem (Leroux & Petrunik,
1991, Har-
bison & Morrow, 1998; see also discussion of the emergence of
woman abuse
in DeKeseredy & McLeod, 1997), some older people are
beginning to make
demands on their own behalf. At the same time a number of
feminist theorists
have begun to explore the issue of violence against older women
(Aitken &
Griffin, 1996; Neysmith, 1995a, Whittaker, 1995) and some
common under-
standings have emerged. These theorists point out that power
structures with-
in society ensure that women and particularly older women have
been subject
to oppression and economic disadvantage all of their lives. For
these reasons
they insist that abuse against older women should be a public
issue and one
which is addressed not just through changes in ageist attitudes
in society but
through changes in social policies. They all recognize a need to
focus on the
particular concerns of women belonging to cultural and ethnic
minority
groups. They also assert the centrality of gender in women’s

lives and note
that attention to this fact is lacking in both how elder abuse and
neglect is
constructed and in research which purports to be gender neutral
(Neysmith,
1995b; Walker, 1990). What is the likelihood that older women
will accept
these ideas so that the paths of action of older women activists
in the area of
mistreatment of older people will begin to parallel those of
earlier feminists
working in women abuse?
While all feminists challenge women’s subordination to men
and male
power within society, they hold differing views about the nature
of this
subordination and how it should be addressed (Crichton et al.,
1999; Currie,
1998). Some focus on reforming societal institutions, such as
the marriage,
family, and the legal system; others view these institutions as
fundamentally
patriarchal and oppressive and not amenable to the kind of
changes necessary
to deal with women’s subordination and repression. Still others
focus on the
economic oppression of women (Currie, 1998). Although
acknowledging the
difficulty of translating theory into action, Currie points out:
The point of
feminist theory is not simply to explain the social world but to
change it.
From this perspective beliefs about how patriarchy operates to
sustain the
subordination of women become expressed in collective

movements and
individual actions to end women’s subordination. In the final
analysis, femi-
nist practice is the test of feminist theory (1998, p. 44).
The older women that are involved in responding to elder abuse
and
neglect appear to best fit the mold of what has been termed
liberal feminism.
That is, they do not reject outright existing institutions such as
marriage, the
family, and the law, although they may see them as having
limitations. They
also frequently look to governments and governmental policy
changes for
Joan Harbison 71
support for their efforts to bring about change. To some extent
these positions
are predicated on a seniors’ leadership which as with the early
feminist
movement appears as chiefly white, female, middle-class, and
heterosexual
(Bonnycastle & Rigakos, 1998). What is striking about older
women leaders
in the fight against mistreatment and in their lobby for
ownership of the issue,
is their continuing interest in developing collective solutions, at
the local and
provincial level, involving seniors of both sexes as well as
professionals,
academics, and governments.

The Issue of Gender
Despite their leadership in seniors’ efforts to address elder
abuse, the
actions and writings of most older women give little indication
that they wish
to emphasize the issue of gender. (There are exceptions, for
instance, the
work of the Ontario Older Women’s Network which explored
the shelter
needs of older women, see OWN, 1998.) This may be because
they embrace
a broadly based collectivist approach. Even when the gendered
situation of
older women is acknowledged and discussed, it is usually within
a context of
gender inclusiveness (see McKenzie, 1999). In establishing the
Canadian
National Network on Elder Abuse, the rights and benefits and
the cessation of
abuse are being sought for all seniors. Women’s issues are not
identified as
separate and unique (Gray Power Working Session Grounding
Assumptions
and Principles, Proceedings: Second National Conference on
Elder Abuse,
Toronto, 1999). It seems then that these older women do not
wish to promote
the understanding of women’s oppression through elder abuse at
the expense
of abused older men. It may also be a manifestation of both
internalized and
societal sexism which sustains their belief that they are of less
value than men
and may need men’s power to succeed. However, pondering the
case of

Marjorie, an older woman who had been in an abusive marriage
for over 50
years, McKenzie makes the following comments:
This label [of elder abuse] that we ask seniors to wear has great
signifi-
cance in planning services or in the development of policies and
legisla-
tion that eventually determine what kind of response occurs.
There may
be very good reasons to separate the response for abuse of frail
older
people and people with disabilities from general violence
against
women. A feminist analysis of those reasons would significantly
con-
tribute to the theoretical framework being used to develop
programs to
help seniors. (1999, p. 436)
This raises the question of the potential for dialogue between
older people
and feminists to expand the debate on older people’s
involvement in elder
abuse and neglect.
Feminist Commentaries and Interventions
With regard to interventions, the comments and
recommendations in the
literature reflect both similar and sometimes differing and/or
conflicting

views of feminism. There is a general concern about the way in
which the
career of ‘‘elder abuse and neglect’’ has tended to ‘‘mimic
science . . . as a
successive, linear story of increasing complexity but also of
greater ‘truth’’’
(Aitken & Griffen, 1996), rather than developing as a fully
fledged social
problem. Hence approaches to research and interventions have
been circum-
scribed and individualized, located within dysfunctional
families, and sup-
posedly ‘‘gender neutral’’ without adequately addressing
broader social is-
sues (Aitken & Griffin, 1996; Harbison & Morrow, 1998;
Neysmith, 1995b).
There is therefore a call for all research and interventions into
elder abuse to
address gender issues and gender stereotyping. The need to
move away from
‘‘ . . . the hold of family violence ‘experts’ on the elder abuse
terrain’’
(Whittaker, 1996, p. 157) where ‘‘ . . . elderly persons and their
advocates
[are] minor players in defining the discourse’’ (Neysmith,
1995a, p. 52) is
declared. That the experiences of older women should guide
both individual
interventions and policy directions is also stressed (Whittaker,
1996; Ney-
smith, 1995a).
Feminist writers express differing opinions regarding the use of
the crimi-
nal justice system. The arguments include those which consider
it unaccept-

able to use a system which reflects and perpetuates patriarchal
oppression of
women, those whose concern is that criminal justice
interventions are limited
to identifying and punishing criminals (Currie, 1998; Whittaker,
1996), and
those who argue that the justice system discriminates according
to class,
culture, and ethnicity, and that ‘‘ . . . individuals caught in the
net of formal
social control will not be representative of abusers; they are
likely to be those
men with fewest resources and least ability to resist labeling
and prosecu-
tion’’ (Currie, 1998, p. 47). Some women worry that
intervention by the
police deflects attention away from abuse rather than addressing
it, when
charges are not laid and follow-up does not occur (Currie, 1998,
DeKeseredy &
McLeod, 1997). Other women activists object on the grounds
that criminal-
ization forces women ‘‘ . . . to ally themselves with and
strengthen the same
patriarchal and racist institutions complicit in practices of
gender domina-
tion’’ (Bonnycastle & Rigakos, 1998, pp. 17, 18). At the same
time these
efforts are perceived as draining energy from longer-term goals
which ad-
dress socio-structural issues. However, DeKeseredy and
McLeod also give
several examples of innovative ways in which the justice system
has at-
tempted to accommodate to the needs of women thus making it
a ‘‘ . . . less

blunt instrument of change’’ (1997, pp. 174-175).
Feminists also seem uncertain about the helpfulness of shelter
accom-
modations for older women. The diverse needs and abilities of
older women
Joan Harbison 73
and the fact that most want to remain in their own homes are
noted (Whittak-
er, 1996; Wolf, 1999). The Older Women’s Network initiated
and oversaw a
study in Ontario (OWN, 1998) which concluded that there were
insufficient
reasons to establish separate facilities for older women. Instead
they sug-
gested that existing shelters be made ‘‘ . . . accessible to and
inclusive of all
women seeking their services’’ (p. iv) and that alternatives be
developed
which might include access to safe shelter in existing housing,
retirement, or
nursing homes. Their recommendations are supported by those
of Wolf
(1999) who after studying shelters in the United States
concluded ‘‘ . . . as to
whether elder shelters are a viable solution [to elder abuse,
neglect, and
exploitation], it is too early to say’’ (p. 164). Yet it has also
been pointed out
that shelters were a focus for collective consciousness raising
and activity in
the development of responses to woman abuse (Neysmith,

1995a, Wolf,
1999).
A striking example of this volunteer commitment to fight elder
abuse and
neglect can be seen in the efforts of the 5000 member, Kerby
[Seniors] Center
in Calgary, Alberta. The Center established a need for and
became involved
with elder abuse work in the 1980s. In the early 1990s they
carried out a
study focusing on ‘‘intervention and treatment,’’ funded by the
Family Vio-
lence Prevention Division of Health and Welfare Canada
(McCreight, 1999,
p. 240). They identified needs both for public education and for
a shelter
through the study. They then ‘‘. . . authored and published a
handbook
‘Golden Years: Hidden Fears’ for use by frontline workers
dealing with elder
abuse’’ (McCreight, 1999, p. 240). Within two years of forming
a Shelter
Steering Committee, they had raised $1,700,000 to build and
furnish the
shelter and had an ongoing plan to raise operating funds
(McCreight, 1999).
The comment ‘‘ . . . all of Kerby’s supports and services will be
there for our
clients in the shelter’’ indicates that this shelter has a different
orientation
than that of the early stages of the woman abuse shelter
movement with its
focus on abuse as a political issue (Dekeseredy & McLeod,
1997). It may also
reflect the need for seniors to do things their way.

Where women act as both formal and informal caregivers for
older people,
feminists have some very specific concerns. Informal caregivers
in particular
have been the subject of research that emphasizes abuse as a
response to
stress. Recent research also supports concern about the effects
of stress on
those working in formal care institutions (Baltes, 1996). Some
feminists
focus on the demands and stresses of caregiving and call for
support, educa-
tion, and training (Aitken & Griffen, 1996). Others comment on
why caregiv-
ers are predominantly women as well as the strong societal
expectation that
they take on caregiving tasks (Baines, Evans, & Neysmith,
1991). Feminists
also question the implications of constructing elder abuse and
neglect as
responses to stress among [women] caregivers rather than as a
larger societal
issue of the distribution of power and resources among men and
women
(Aronson, 1990; Baines, Evans, & Neysmith, 1991). However,
here again the
older women who are caregivers may be interested in immediate
supports for
their caregiving role as well as, or instead of, challenging the
legitimacy of a

role which is intrinsic to at least the older generation’s
perception of woman-
hood.
CONCLUSIONS
Feminist theoretical frameworks for woman abuse and the
experiences of
feminists with interventions for woman abuse have raised
questions and
initiated debates. These questions and debates illuminate the
problems of
responses to the mistreatment of older people. However, they do
not neces-
sarily offer solutions to many of the issues raised in relation to
older women’s
involvement in responses to elder abuse and neglect. Nor does it
appear that
many older women embrace the more contentious aspects of
feminism. It is
likely that the failure of older women to explore these
ideologically based
dilemmas surrounding power relations between men and women,
class, race,
and sexual orientation, is based on many factors. For instance it
may be that
older women do not identify these issues and dilemmas as
relating to their
situations because, as within the early feminist movement, older
people with
the capacities and confidence to join in the fight against ageism
and elder
abuse and neglect may typically be ‘‘ . . . white, western,
heterosexed, and
middle class’’ (Bonnycastle & Rigakos, 1998, p. 40). Or it may
be that most

of the older women who are committed to combating the
mistreatment of
their peers also wish to avoid generating the kinds of conflicts
that have been
endemic to feminism and which many feminists are struggling
to overcome
(Dekeseredy & McLeod, 1997). Older women may also fear that
if they
actively seek the engagement and support of younger women,
older people’s
issues may become subsumed by them. Such fears have
credibility given
comments such as that of Whittaker (even if her views are not
representative
of many other feminists) that ‘‘ . . . elder abuse is just one part
of a spectrum
of male hatred and violence against women [so] that it is a
mistake to separate
off any particular manifestation or to see it as a special case’’
(1996, p. 155).
Older women recognize that for most of their peers such
positions in relation
to men, and by implication families, are untenable.
On the other hand feminist frameworks can be judged helpful in
other
areas. One of the things that will be crucial for the future of
elder abuse and
neglect, as it has been for woman abuse, is the basis on which
research
questions are constructed. For instance, feminist authors are
able to present
detailed challenges to the findings of purportedly gender neutral
research
which makes claims such as there are as many women abusers
as men

Joan Harbison 75
(Crichton et al., 1999; Dekeseredy & McLeod, 1997; Dobash &
Dobash,
1990; Neysmith, 1995b). Women are a major part of the
equation in elder
abuse and neglect, not only as the subjects of abuse but as
caregivers in the
home and in institutions of abused older people. It is therefore
important that
the generation of information about elder abuse should take
gender issues
fully into account whether investigations are based on
secondary analysis or
on the creation of new data.
Feminists active in woman abuse strongly support the notion of
responses
to abuse based on the ownership and experiences of those who
are the subject
of the abuse. These ideas have clearly been taken up by older
women, and to
a lesser extent by older men, active against elder abuse and
neglect. However,
older women differ from younger women. Younger women’s
concerns about
survival outside of the abusive situation may be primarily
financial; older
women are concerned not only about their need for financial
resources but
also about needs for scarce health and social services both for
themselves and
their loved ones [elderly parents and spouses]. Hence, it is

perhaps not sur-
prising that while they are willing to criticize ageism inherent
in clinical and
legal interventions they do tend to yield those areas to
professional experts.
The territory to which they are laying claim is that of educating
their peers
and the general public about ageism and mistreatment in its
various forms.
These educational initiatives may enhance older people’s
agency to varying
degrees, given the pervasive influence of professional
constructions of ‘‘elder
abuse and neglect.’’ Nevertheless, they do allow older people
opportunities to
come together to explore collectively their understanding of
mistreatment
and how to address it. At the same time, it is uncertain whether
these efforts
are sufficient to capture the sustained attention of the media in
a way that
both promotes societal concern for abused older people and at
the same time
corrects ageist stereotypes (DeKeseredy & McLeod, 1997).
For older people committed to gaining control of responses to
‘‘elder
abuse and neglect’’ there may be hidden dangers in not entering
areas of
potential conflict. Where conflicts are not confronted, the
danger of frag-
mentation among groups is perhaps just as great as where they
are. With
fragmentation comes loss of group power. There are a
remarkable number of
seniors groups involved in varying types of actions against

abuse and neglect.
(The National Network for the Prevention of Elder Abuse was
conceived as a
national organization. Perhaps this was one of the reasons that
its ownership
was the subject of debate.) A critical mass of older people with
common
purposes will be necessary to garner the resources to gain better
understand-
ing of issues.
At present older people are taking on the fight against the
mistreatment of
older people through non-conflictual strategies and mainstream
institutions.
In question is whether this will be sufficient to sustain elder
abuse and neglect
as a social problem and curb its growth as a new area for the
development of
health and gerontological expertise:
In the long term any serious attempt to work to prevent elder
abuse
must address, through research, advocacy and education, the
overall
institutionalized ageism within our society which is reflected in
stereo-
typing and discrimination in newspapers, television and
everyday life.
(Hightower, 1998, p. 19)

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SOCIOLOGY OF AGING JOURNAL ARTICLE REVIEW
The article review itself should consist of four parts. Use
numbered sub-headings to show which part of the assignment
you are addressing:
1. Reason for choosing this article: Why this one?
a. Include a personal reaction to the topic or issue and the
article itself here.
2. Summary of the article: Write this immediately after reading
your article, when it is freshest in your mind. Think of it as
your ‘impressions’ of what it is about:
a. Do not include massive amounts of detail – this is not a
summary.
b. A summary contains a balanced presentation of relevant ideas
about the article so that another person is able to tell what it is
about.
c. Depending on the length of the article, anything more than
about a page is going beyond summarizing.
3. Assessment of the article: This is the core of the review,
assess the article critically, which doesn’t necessarily mean
negatively:
a. What did you think of the main thesis/purpose of the author?
b. How well did the author state and support their position?
c. What evidence/arguments do they use to do so?
d. What else do you feel needs to be said or examined besides
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e. Are there identifiable paradigms and/or theoretical
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f. How radical – or mainstream – is the assessment?
g. Does the author engage in empathetic analysis?
h. Don’t just give a superficial treatment of plusses or minuses:
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4. Quotations. As you read the article keep track of statements
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double spaced should be sufficient for each of these.
GRADING CRITERIA :
· Is the article scholarly, and does it address an important social
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· Is the article adequately and correctly cited?
· Are each of the four parts stated above addressed, and in
sufficient detail?
· Is the review written coherently and grammatically?
· Does the review meet the criterion?
2

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