Module 2: A Victim-Centered Response Office on Violence Against Women ABUSE IN LATER LIFE: CROSS-TRAINING FOR VICTIM SERVICE PROVIDERS Module 2: A Victim-Centered Response OVW and NCALL 2012 Dynamics of Abuse in Later Life - Module 1 PowerPoint Handout

A Victim-Centered Response In domestic and sexual violence movements described as “empowerment” In APS described as “self-determination” Both built on principle of listening to victims and recognizing a victims strengths NCALL, OVW (2012)

Module 2 Objectives As a result of this training, participants will be able to: Discuss how life experience and societal influences impact working with older survivors of abuse Identify strategies to meet victims where they are at Create a safety plan with older victims Describe existing services and strategies to work effectively with other victim service providers NCALL, OVW (2012) 3

Life Experiences & Societal Influences © Photo by Patrick Doheny NCALL, OVW (2012)

Who Lives in Our Community? Add local demographic information about various ethnic and racial communities in your area. NCALL, OVW (2012)

Culture Integrated patterns of human behavior that include thoughts, communications, actions, customs, beliefs, values, and institutions of groups NCALL, OVW (2012) Dynamics of Abuse in Later Life - Module 1 PowerPoint Handout

NCALL, OVW (2012)

Dynamics of Abuse in Later Life - Module 1 PowerPoint Handout NCALL, OVW (2012) Dynamics of Abuse in Later Life - Module 1 PowerPoint Handout

Historical Trauma “…a cumulative emotional psychological wounding, over the lifespan and across generations, emanating from massive group trauma experiences.” NCALL, OVW (2012)

Video: Listen to the Grandmothers Tribal Law and Policy Institute and OVW NCALL, OVW (2012)

The Affects of Historical Trauma (Large Group Discussion) How may these types of experiences affect a person’s interactions with service providers today? NCALL, OVW (2012) Dynamics of Abuse in Later Life - Module 1 PowerPoint Handout

Affects of Historical Trauma (Teach-Behind) Lack of trust in services Hesitant to give information about personal life Misperceptions or fears Resistance to worker’s case plan NCALL, OVW (2012)

Things to Consider Misperceptions and miscommunication Respect and dignity NCALL, OVW (2012)

Aging and Our Community Add local statistical information about older adults in your community. NCALL, OVW (2012)

Ageism … “any attitude, action, or institutional structure which subordinates a person or group because of age or any assignment of roles in society purely on the basis of age.” Ageism reflects a prejudice in society against older adults NCALL, OVW (2012) Dynamics of Abuse in Later Life - Module 1 PowerPoint Handout

Ageism in Society NCALL, OVW (2012) Dynamics of Abuse in Later Life - Module 1 PowerPoint Handout

Ageism Exercise (Interactive Exercise) NCALL, OVW (2012) Dynamics of Abuse in Later Life - Module 1 PowerPoint Handout

Ageism Discussion (Large Group Discussion) How many of us have heard or said similar comments? Ageists statements may be meant as a compliment What assumptions were made that would not have been made about a younger victim with similar circumstances? NCALL, OVW (2012)

How Can We Challenge Ageism How Can We Challenge Ageism? (Individual Reflection, page 23 in workbook and Large Group Discussion) In our personal attitudes and behaviors Within our agency Within other systems and agencies In the media and community NCALL, OVW (2012) Dynamics of Abuse in Later Life - Module 1 PowerPoint Handout

Challenging Ageism in Our Personal Attitudes and Behaviors (Large Group Discussion) NCALL, OVW (2012)

Personal Attitudes and Behaviors (Teach-Behind) Attend training on ageism and/or diversity Read about ageism Participate in discussions about ageism and our responses to ageism Challenge our own ageist attitudes and beliefs NCALL, OVW (2012)

Challenging Ageism Within Our Agency (Large Group Discussion) NCALL, OVW (2012)

Within Our Agency (Teach-Behind) Hire older staff: welcome older board members and volunteers Review policies and protocols Display images of older individuals Create a group agreement to hold each other accountable NCALL, OVW (2012)

Challenging Ageism in Other Systems and Agencies (Large Group Discussion) NCALL, OVW (2012)

Other Systems and Agencies (Teach-Behind) Work with agencies with expertise in aging victims and learn from each other During team meetings, respectfully challenge ageist comments or assumptions NCALL, OVW (2012)

Challenging Ageism in the Media and Community (Large Group Discussion) NCALL, OVW (2012)

In the Media and Community Challenge media accounts that portray older victims in a negative light Challenge ageism in advertising Present positive images of older people Ask older staff, volunteers, and survivors to assist with community education projects NCALL, OVW (2012)

Video: Barriers and Obstacles National District Attorneys’ Association, Terra Nova Films, NCALL, OVW

Meeting Older Victims Where They Are At NCALL, OVW (2012)

Strengths Based Response Builds on victim’s strengths, natural allies and support networks Uses empowerment and self-determination strategies NCALL, OVW (2012) 30

Resiliency Individuals have the capacity to make changes in their lives to respond to a difficult situation especially if certain conditions exist. NCALL, OVW (2012) 31

Conditions That Support Resiliency Care and support from others  Belief in their ability to succeed  Positive peer relationships & influence Spiritual connection NCALL, OVW (2012) 32

Victim-Centered Advocacy “Seeks to craft alternatives that will enhance a victim’s safety, given the realities facing each victim” (Davies et.al, 1998) Victim safety and self-determination are paramount and can restore some control to the victim Requires active listening NCALL, OVW (2012)

Questions to Consider Asking What is working well? What would you like to see continue? Who has helped in the past and may be willing to help now? If changes are successful, what would your life look like 6 months from now? NCALL, OVW (2012) 34

Reasons Older Victims Remain in Relationships with Abusers (Small Group Exercise) Internal personal values that the victim holds Abuser tactics used to make it difficult for a victim to leave Societal influences that create additional barriers and obstacles NCALL, OVW (2012)

Reasons Older Victims Stay – Internal Values (Large Group Discussion) NCALL, OVW (2012)

Reasons Older Victims Stay – Internal Values (Teach-Behind) Love for an adult child; not wanting to see a child go to prison or live on the streets Family values and commitment to spouse/partner and children Belief that the perpetrator will change Belief that it may be safer for a victim to remain with the abuser than to leave Belief that if the abuser receives help the abuse will end NCALL, OVW (2012)

Reasons Older Victims Stay – Abuser Tactics (Large Group Discussion) NCALL, OVW (2012)

Reasons Older Victims Stay – Abuser Tactics (Teach-Behind) Threatening violence if the victim leaves Threatening suicide and/or homicide Blaming the victim and using guilt and justification to get the victim to stay Isolating the victim from family, friends, and others Manipulating the victim to believe they cannot make it on their own NCALL, OVW (2012)

Reasons Older Victims Stay – Societal Influences (Large Group Discussion) NCALL, OVW (2012)

Reasons Older Victims Stay – Societal Influences (Teach-Behind) Lack of affordable housing options Lack of system response and collaboration Isolation of seniors in our society Racism, ageism, and sexism that may affect delivery of services from agencies Limited financial options Lack of options for help for perpetrator NCALL, OVW (2012)

Tips For Working With Older Victims Understand – these are difficult decisions Respect – these are the victim’s decisions Support – it can be easy to fall into the trap of blaming the victim NCALL, OVW (2012) 42

Tips For Working With Older Victims Expect – victims may want contact with family and/or partners Recognize – making major life changes takes time and is a process Collaborate – working with other professionals can help our understanding of victims choices NCALL, OVW (2012)

Let Victims Know It is not unusual to return to or maintain contact with an abuser Acknowledge that these are difficult decisions Call anytime: help is available NCALL, OVW (2012) 44

What You Can Do Create a plan to maintain contact (if safe and the victim is interested) Provide information and referrals Be clear about options and outcomes Create a safety plan with the victim NCALL, OVW (2012) 45

Break NCALL, OVW (2012)

Planning for Victim Safety NCALL, OVW (2012)

Planning For Victim Safety (Large Group Discussion) What do you focus on when thinking about victim safety? NCALL, OVW (2012)

Planning For Safety Discussion History of violence Weapons in the home Dangerous dogs or other pets Environmental issues—rugs that are not secured to floors, hot water heaters set too hot, cords the victim may trip over Are basic needs meet—food, heat, water, phone? NCALL, OVW (2012)

Safety Planning Process to jointly create a plan to enhance safety 50 NCALL, OVW (2012) 50

A Survivor-Centered Plan Where will the victim live? Does the victim have access to resources? Are these resources available? Are there health issues that affect the options available to the victim? Who else is affected by the abuse? What legal issues need to be addressed in the safety plan? NCALL, OVW (2012) 51

Issues to Explore What are the victim’s concerns if she decides to leave her abuser? What has the victim tried to stay safe in the past?  How did it work? Has she left before?  If so, what happened? NCALL, OVW (2012) 52

Issues to Explore How does the victim think the abuser might react if changes are made? What is the timeframe for the victim’s safety plan?  (staying or leaving) NCALL, OVW (2012) 53

Video: Ruth National Center on Domestic and Sexual Violence NCALL, OVW (2012) 54

Safety Planning Strategies (Large Group Discussion) What are some strategies the woman in the video used as part of her safety plan? NCALL, OVW (2012) 55

Strategies Used (Teach-Behind) Copied papers at the school Stored money under the porch Red towels as a signal of trouble Code word as a signal of trouble Spare set of keys Extra medications in a safe place A plan to leave house/room Identified potential weapons in the house and rooms to avoid during an attack NCALL, OVW (2012)

Tessa and Valerie (Page 17 in Workbook) Life partners for seven years Tessa uses a wheelchair or cane to get around Valerie is emotionally abusive Valerie threatened to kill Tessa and herself when Tessa asked her to leave NCALL, OVW (2012)

Safety Planning with Tessa (Small Group Exercise) What are some of Tessa’s strengths and natural supports? What are some of Tessa’s concerns? What options might you discuss with her to create a safety plan? NCALL, OVW (2012) 58

What are some of Tessa’s Strengths and Natural Supports What are some of Tessa’s Strengths and Natural Supports? (Large Group Discussion) NCALL, OVW (2012)

Strengths and Natural Supports (Teach-Behind) She has a job She owns her own home She has friends at work and in the community She has a good relationship with her adult children and mother NCALL, OVW (2012)

What are some of Tessa’s concerns? (Large Group Discussion) NCALL, OVW (2012)

Tessa’s Concerns (Teach-Behind) She is afraid of Valerie. She is afraid that her mother will find out about her relationship with Valerie. She is concerned that she will lose friends. She is concerned that Valerie will commit suicide. She is afraid Valerie is monitoring her activities using technology. She is concerned about finances since Valerie currently controls the money. NCALL, OVW (2012)

Safety Planning Options to Discuss (Large Group Discussion) What safety planning options did you consider with Tessa? NCALL, OVW (2012)

Safety Planning Options to Consider with Tessa (Teach-Behind) Code word, signal like the red towel, getting copies of papers, saving money Discuss the gun and other weapons Explore the pros and cons of a protection order Discuss options for a phone Discuss her support system Find out what she tried in the past and how it worked Discuss how Valerie might react to decisions/choices Discuss any financial issues NCALL, OVW (2012)

Tessa: What If… (Large Group Discussion) Has moderate dementia NCALL, OVW (2012) 65

Moderate Dementia (Teach-Behind) Is there a caring individual/family member who could look in on Tessa? Could services be brought into the home so there are more eyes and ears watching? Be sure health care providers and home health aides know if an APS or criminal investigation is taking place if the abuser is Tessa’s care provider. NCALL, OVW (2012)

Tessa: What If (Large Group Discussion) Does not speak English NCALL, OVW (2012) 67

Does Not Speak English (Teach-Behind) Use a language line or certified interpreter to assist with safety planning. Do not use family members as interpreters.   NCALL, OVW (2012)

Tessa: What If (Large Group Discussion) Does not want to leave pets or garden NCALL, OVW (2012) 69

Does Not Want to Leave Pets or Garden (Teach-Behind) Obtain a restraining/protective order to remove Valerie so Tessa can remain in the home. Find out if the Humane Society or other animal- friendly agency can provide shelter or foster care for pets or livestock. Find out if the court can include pets in a restraining/protective order. NCALL, OVW (2012)

Existing Services for Older Victims NCALL, OVW (2012)

First Call (Interactive Exercise) Domestic violence program Sexual assault program Adult protective services Criminal justice Aging services Family members or friends Other No one NCALL, OVW (2012) 3.

Scenario1 Age 58. Partner calls you “fat and stupid.” Partner takes your paycheck, puts you on an allowance and monitors your phone calls. Who would you call first? NCALL, OVW (2012) 3.

Scenario 2 Age 68. Partner has broken your wrist and threatened to kill you if you leave. Who would you call first? NCALL, OVW (2012) 3.

Scenario 3 Age 73. Partner had cancer and died last year. Your adult son has moved in and is stealing your Social Security check and pension. Who would you call first? NCALL, OVW (2012) 3.

Scenario 4 Age 75. Adult son forces you to watch pornography with him. Who would you call first? NCALL, OVW (2012) 3.

Scenario 5 Age 80. You have a heart condition and need assistance with activities of daily living. Son is not giving you your meds properly. Does not assist with bathing and feeding. Fires all home health aides and others who try to help you. Who would you call first? NCALL, OVW (2012) 3.

First Call Discussion (Large Group Discussion) How did you feel about the choices available to you? Other No one NCALL, OVW (2012) 3.

First Call Discussion (Large Group Discussion) Male victims Gay, lesbian, bisexual or transgender older victims Immigrant victims NCALL, OVW (2012) 3.

Break NCALL, OVW (2012)

Who Might be Involved Advocates Aging Network Faith Leaders Health Professionals Adult Protective Agencies Friends Private Law Firm Ombudsman Family NCALL, OVW (2012)

Primary Victim Services Adult Protective Services Aging Network Domestic Violence Programs Sexual Assault Programs Systems-based victim advocate NCALL, OVW (2012)

APS Eligibility criteria (age based or vulnerable adult) Who generally reports? What is your confidentiality policy? Add number to call to report When are workers available: (e.g., M – F business hours; 24 hours/365 days a year) Use more than one slide if necessary NCALL, OVW (2012)

APS In what timeframe do you respond to report? What is involved in an investigation? Do you offer victim services or do you refer or both? Use more than one slide if necessary NCALL, OVW (2012)

Aging Network Describe who you serve (e.g., 60+) List services that are available through various agencies in the community What is your confidentiality policy? Phone # to call (or website) NCALL, OVW (2012)

Domestic Violence Program Who do you serve? (e.g., women and men; only IPV or other relationships) How do victims reach you? Include phone number but also let folks know if you only receive calls or if you reach out to victims. NCALL, OVW (2012)

Domestic Violence Program What is your confidentiality policy? List hours open What services to you offer that are specifically tailored for older adults? Use more than one slide if necessary NCALL, OVW (2012)

Sexual Assault Program Who do you serve? How do victims reach you? Include phone number but also let folks know if you only receive calls or if you reach out to victims. NCALL, OVW (2012)

Sexual Assault Program What is your confidentiality policy? List hours open What services to you offer that are specifically tailored for older adults? Use more than one slide if necessary. NCALL, OVW (2012)

Systems-based Victim Advocate Who do you serve? (e.g., only victims who report crimes?) How do victims reach you? Include phone number but also let folks know if you only receive calls or if you reach out to victims. NCALL, OVW (2012)

Systems-based Victim Advocate List hours open What services to you offer that are specifically tailored for older adults? Use more than one slide if necessary. NCALL, OVW (2012)

Additional Considerations Who specializes in working with persons with physical limitations? Who specializes in working with persons with cognitive limitations? Who works with the Deaf community? NCALL, OVW (2012)

Additional Considerations Who works with older lesbian, gay, bisexual or transgender victims? Who can work with older immigrant victims? What legal assistance and/or services can these agencies provide? Who works with non-English speaking victims? NCALL, OVW (2012)

Notes and Reflections (Page 23 in Workbook) Jot down thoughts you have from this session Are there ideas you want to take back to your organization? NCALL, OVW (2012)

Collaboration NCALL, OVW (2012)

Collaboration The act of working together; united labor 96 NCALL, OVW (2012)

Informal Methods of Collaboration Joint interviews Case consultations Referrals and follow-ups Working an a project, fundraiser, or public awareness campaign together NCALL, OVW (2012)

Formal Methods of Collaboration Case review teams: Multidisciplinary Systems Change: Coordinated community response councils or fatality review teams Topic specific: Financial exploitation teams NCALL, OVW (2012)

Benefits of Collaboration More resources for victims New ideas about how to approach a case A more seamless response to victims and offenders Shared ownership and responsibility for case outcomes Less “finger pointing” Victim safety NCALL, OVW (2012)

Some Challenges Understanding each other’s framework for approaching cases Information sharing and confidentiality Turf Ego Lack of resources Lack of understanding of what other agencies can and cannot do NCALL, OVW (2012)

Confidentiality Guiding principle of domestic and sexual violence victim advocates Required with most domestic violence funding including VAWA Assists with building relationship with victims and increases victim safety Requires advocates to balance confidentiality requirements and benefits of collaboration NCALL, OVW (2012)

Case Review: Marta and Terrell (Small Group Exercise) Silently, review your professional scenario of this case and then give an overview to the team at your table Discuss your role and what services/remedies your agency can offer Marta NCALL, OVW (2012)

Marta and Terrell Collaboration (Large Group Discussion) What did you learn from this experience? NCALL, OVW (2012)

Different Information Different Information? (Large Group Discussion) (Participants Workbook page 19 - 21) What different information did you have from others at your table? NCALL, OVW (2012)

Different Information (Teach-Behind) APS aware of possible financial exploitation and health issues  Domestic violence advocate had information about how fearful Marta was of Terrell and about the weapons in the house The sexual assault advocate aware of bruising on Marta’s breast and inner thighs suggesting the possibility of a sexual assault Systems-based victim advocate aware of criminal charges against Terrell and learned Marta not available to talk on the phone Home health service organization aware of a decline in Marta’s health and the missing dog NCALL, OVW (2012)

What is our Common Ground? (Large Group Discussion) NCALL, OVW (2012) 106

Common Ground (Teach-Behind) Focus on victim safety Wanting a better life for the victim Wanting the abuse to stop Wanting to improve current responses NCALL, OVW (2012)

How can our Different Approaches Benefit Victims How can our Different Approaches Benefit Victims? (Large Group Discussion) NCALL, OVW (2012)

Benefits in Different Approaches (Teach-Behind) More complete picture Victim autonomy and safety Coordination of services Provides more resources and less duplication of services More holistic approach Overcome agency limitations NCALL, OVW (2012)

Victim-Centered Approach Respect victim confidentiality and privacy Keep focused on victim safety and offender accountability Avoid assumptions about what is best victims Take direction from victims Work together to overcome barriers and obstacles NCALL, OVW (2012)

Summary Life experience and societal influences may impact working with older survivors of abuse. Meeting victims where they are at will improve the services provided. A victim-driven safety plan is crucial for victim safety. Collaboration improves victim safety and understanding between agencies. NCALL, OVW (2012)

Notes and Reflections (Page 23 in Workbook) What would you like to see happen in your community? Are there ideas you want to take back to your organization? NCALL, OVW (2012)

Questions and Wrap-Up NCALL, OVW (2012)

Questions Final questions? NCALL, OVW (2012)

Four Keys Focus on victim safety Be aware of and avoid assumptions Recognize abuser tactics Work collaboratively NCALL, OVW (2012)

Why We Do This Work NCALL, OVC and Terra Nova Films 116 Insert Sam & Lois: Getting Free video NCALL, OVW (2012)

Thank you! Please complete your evaluations NCALL, OVW (2012)

Trainers Contact Information Add trainers’ contact info Add trainers’ contact info NCALL, OVW (2012)