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"Effective Elder Abuse Interventions: Case Management vs Empowerment and Mediation" research findings released

18 Dec 2013

According to the 2011 Census data, there were about one million elders aged 65 or above residing in Hong Kong, this constitutes 13.3% of the overall population. Elder abuse is an increasingly serious social problem with the growing older population.

The impact of elder abuse on the victims, their families and society at large should not be underestimated. Apart from increased morbidity and mortality risks of the victims, elder abuse also burdens our health care, social welfare, justice and financial systems. Internationally, it has been estimated that one in every ten elderly persons would fall victim of abuse or neglect. Most abused elders in Hong Kong, however, were reluctant to seek help proactively due to traditional beliefs. As is evident, reporting rates of elder abuse is extremely low. It is essential to identify effective elder abuse intervention programmes.

Dr. Elsie Yan, Jockey Club Cadenza Fellow, Assistant Professor, Department of Social Work and Social Administration, HKU

CADENZA: A Jockey Club Initiative for Seniors, set up by The Hong Kong Jockey Club Charities Trust, donated HK$6.48million to the Hong Kong Christian Service to launch the CADENZA Community Project: Elder at PEACE to seek to identify evidence-based intervention programmes for elder abuse. The research was conducted in Kwai Tsing District, which is one of the worst affected areas in terms of the number of reported cases of elder abuse according to the Social Welfare Department.  The study is a pioneering investigation of the effectiveness of the two elder abuse intervention models namely “Case Management” and “Empowerment and Mediation”.

Research Findings: Phase One

To evaluate the effectiveness of “Case Management” and “Empowerment and Mediation” (Table 1), the research team conducted a 30-month longitudinal study and successfully invited 82 participants who received a three-month service provided by the Hong Kong Christian Service (47 for “Case Management” and 35 for “Empowerment and Medication” respectively).  The age of the participants ranged from 60 to 86, 77% of them were females, and 73% had one or more chronic condition(s) that require medical attention.

Table 1:

At the end of the three-month intervention, 68 participants were successfully interviewed. Results indicate that both intervention programmes have a positive impact on the clients. Improvements were recorded in terms of clients’ self-care abilities, mental health, sense of self efficacy. Significant decrease in psychological abuses was reported but not in physical abuse (Table 2).  The two programmes do not differ in terms of their effectiveness.

Table 2:

Research Findings: Phase Two

Three months following the Phase One Study, 50 participants were successfully interviewed for a second time. Although improvement in one of the indicators diminished, results showed that improvements in other areas sustained (Table 3). The two programmes do not differ in terms of their effectiveness.

Table 3:

Conclusion

Ms. Bonnie Cheung, Project Director, CADENZA Community Project: Elder at PEACE, Hong Kong Christian Service

To effectively intervene elder abuse, it is of utmost importance to strengthen frontline professionals’ training in handling elder abuse cases, to develop effective interventions programmes that approach elder abuse from different perspectives, and to deploy resources flexibly. Since the present study is a pioneering pilot project, further study should be conducted to differentiate the effects of the two interventions and to assess their effectiveness in handling respective types of elder abuse cases, so as to identify the key elements responsible for improvement in elder abuse cases. It would also be beneficial to promote the use of these two intervention programmes, and to encourage abused elders to seek help.

Case Sharing

The 80-year-old Mui had been living with her daughter since her retirement. Upon the request of her daughter, Mui only received a meager HK$100 per month and left the rest of the government financial subsidy to her daughter. Despite the fact that Mui could barely survive on that small amount of money, she turned a blind eye and stayed quiet in order to avoid any conflicts with her daughter. Eventually, Mui plucked up her courage and requested that she manage her own financial subsidy. Her daughter was furious and decided that she would draw a line between herself and Mui. She made Mui keep all her belongings within the space of her bed, she refused to take care of Mui even when she was sick, and at times she treated Mui “as if she is transparent”.

Being treated like a total stranger by her own daughter, Mui was deeply hurt and decided that she would need to seek help. With the assistance of a social worker, Mui moved to a new unit in a public housing estate, made new friends, and enrolled in the elderly centers. She now finds herself surrounded by love and friendship in a new community and is moving on with her own life.

"CADENZA: A Jockey Club Initiative for Seniors" is a project launched by The Hong Kong Jockey Club Charities Trust with a donation of HK$380 million in 2006. The project aims at nurturing academic leadership in social gerontology and changing the mindset and attitude of the general public through a range of training and public education programmes. Cross-sectional collaboration between organizations and the implementation of innovative elderly services and programmes are also encouraged in order to bring about a new mode of elderly care services to prepare for a rapidly ageing society. Details of CADENZA are available at www.cadenza.hk.

Any enquiries please contact:

Dr. Elsie Yan, Assistant Professor, Department of Social Work and Social Administration
(Tel: 39174373 / 60106093 Email: elsieyan@hku.hk), and
Miss Vanessa Sit, Faculty of Social Sciences (Tel: 39171203 / 92678877 Email: vansit@hku.hk)