Mary C. Sengstock

Validation of the Hwalek-Sengstock Elder Abuse Screening Test

Elder abuse is recognized as an underdetected and an underreported social problem. Difficulties in detecting elder abuse are compounded by lack of a standardized, psychometrically valid instrument for case finding. The authors examined the construct validity of the 15-item Hwalek- Sengstock Elder Abuse Screening Test (H-S/EAST). Nine items were found to discriminate significantly among three groups: (a) elders whose reported abuse was substantiated by adult protective services (APS) case workers, (b) elders whose reported abuse was not substantiated by APS workers, and (c) a community-based comparison group. The data suggest that this short, easy-to-administer screening device can be useful to service providers interested in identifying people at high risk of the need for protective services.

Assessing the Probability of Abuse of the Elderly: Toward Development of a Clinical Screening Instrument

Over the years, several investigators and service providers have indicated the need for a tool to screen elderly victims for the possibility of abuse and neglect. We examined over 100 items for their predictive value in discriminating cases of abuse/neglect from comparable cases of elderly persons known not to be victims. Data were collected by nine social/ health agencies on 50 cases of abuse/neglect and 47 control cases. Through a series of discriminant function data reduction analyses, nine items were identified that were 94% accurate in classifying cases into abuse/neglect and control groups. We discuss implications of these findings for future research and program planning.

Community Dimensions of Elderly Self-Neglect

SUMMARY Much recent literature has focused on the impact of self-neglecting behavior on elders. Little attention, however, has been paid to the impact of this phenomenon on the communities in which self-neglecting elders live. Family members, neighbors, and service professionals can all be adversely affected by the behavior of these patients. This article reflects on the ways in which the community is affected by elder self-neglect and discusses the inherent conflicts between protecting the rights of the individual and the rights of the community.

Domestic Abuse of the Elderly Which Cases Involve the Police

This article examines the role of the police in cases of elder abuse. This study of police involvement grew out of an earlier study conducted in 1981 by the Wayne State University Institute of Gerontology. This study analyzed 77 cases of elder abuse reported by medical and social service providers in the Detroit Metropolitan Area. Analysis of these cases suggested that there was a lack of involvement of the police in elder abuse cases. These observations were confirmed in interviews with the two supervisors of the only Adult Protective Services units in Wayne County (Detroit), along with an analysis of a random sample of 75 of the 360 cases reported to the Adult Protective Services division of Wayne County Department of Social Services in 1983. Case examples and reasons why the Adult Protective Services (APS) workers do not refer elder abuse cases to the police are discussed.

Adult Protective Services Workers Assess the Effectiveness of Mandatory Reporting of Elder Maltreatment in Michigan

Mandatory reporting is the method by which most states deal with the problem of elder abuse. However, the effectiveness of this approach has been the topic of little research. In this study, we report on a series of qualitative interviews with workers involved in the mandatory reporting process in the State of Michigan. The workers were involved either as mandated reporters or as representatives of the state who receive the reports (Adult Protective Services workers). Numerous problems were identified, including inadequate staffing in the state agency responsible for receiving reports of elderly abuse, lack of a standardized mechanism for submitting reports, poor training in a variety of areas for both reporters and APS workers, inadequate communication and coordination among agencies involved in the process, confidentiality concerns at all levels, inability of agencies to identify persons responsible for previous abuse of the elderly, and lack of involvement of knowledgeable workers in the establishment and administration of the law. Workers were also concerned that the needs of the elderly received little attention from officials at all levels (courts, prosecutors, and state government), most of whom were perceived to consider the needs of the children to be primary. On the positive side, workers in both types of agencies appeared highly committed to their clients and went considerably out of their way to be of assistance.

Multicultural Families—What Makes Them Work?

Encouraging people from different cultural backgrounds to get along with each other has long been a concern in American society. Multicultural families offer an opportunity to examine the possibilities of living and working with persons from different cultures. This paper presents an initial analysis of 29 open-ended interviews with individuals whose parents were from different cultural backgrounds. Issues considered include the following: How did the members get along? How did they “maneuver” their varying cultural differences? Do they tend to follow one cultural pattern more than another? If so, which? How do children adjust to the multiculturalism—especially in a world which often assumes a single culture? Hopefully this analysis of multicultural patterns in the intimate relations of a family can help to suggest ways to improve multicultural relations in other social settings as well.

Contributions of clinical sociology to the medical field

Health care in the United States is a complicated structure of social roles, processes, and communication, involving both patients and professionals. Understanding the social dimensions of the health care process can assist health professionals in providing better care to their patients. This paper analyzes several dimensions of the health care system, as suggested in a paper by Kallen (Kallen D. J. 1984. Clinical Sociology Review 2:78–93.) These include the perceptions of participants in the system; structures of the groups involved, including their roles and norms; the process by which groups, as opposed to individuals, operate; and finally the need for the clinical sociologist as a “system maintenance specialist,” to deal with these problems.

Sociological Work in Communities

The gap between academic and applied/clinical sociology is well exemplified by an analysis of the sociological treatment of the concept of “community.” This concept usually rates at least a mention in introductory sociology and social problems textbooks (Broom et al., 1984; Henslin, 1999; Sullivan & Thompson, 1988). But many sociological theory textbooks make no mention of “community,” as indicated by the index and table of contents (Coser & Rosenberg, 1982; Perdue, 1986; Waters, 1994). Community discussions are largely limited to applied and clinical sociology books and journal articles (Alinsky, 1984a,o; Anderson, 1986; Bridger, 1997; Glassner & Freedman, 1979; Schultz, 1996; Straus, 1984).