1. + Geriatric Advocacy Competencies Scott Wright, Rachel Peloquin, Jessica Stewart, Wan-hsuan Lin, Emily Morgan, & Peter Williams

2. + Elderly Client Empowerment Emphasize Autonomy, Meaning, and Ability Discuss the realities of Ageism Empower client to overcome internalized Ageism

3. + Client Advocacy (microlevel) Barriers to individual development : Physical Ability: chronic pain, transport Cognitive Ability: degenerative diseases, memory issues Mental Health: highest rate of suicide & least likely to seek counseling Spiritual Concerns: death anxiety & issues of meaning/purpose Counselor Competency: Geriatric issues As of 2009 only 2 graduate-level counseling programs in the USA are certified in gerocounseling in accordance with the Counsel for Accreditation of Counseling and Related Educational Programs (Foster, Kreider, & Waugh, 2009).

4. + Counselor Competencies Part psychoeducational: Navigate specialized resources i.e. Adult Community Center Programs/Activities, Medicare & Medicaid, community transportation services Part Collaborative: Develop list of individualized barriers specific with client (brainstorm) i.e. feelings of isolation, diagnosed with a medical condition, loss of license Part Creative: Create specialized plan and discuss how to implement i.e. Client discloses that they feel like they have no one to talk to since their spouse passed away. Together, you discuss options: continue individual therapy, enroll in group therapy (bereavement-centered), attend community center.

5. + Community Collaboration Failure to Thrive (FTT) in Elderly Clients Causes Malnutrition Depression and dementing illnesses Age-related changes Inadequate support system Attributes Problems in social relatedness Physical/cognitive dysfunction Feelings of exclusion, shame, helplessness and worthlessness Loneliness Giving up

6. + Community Collaboration What will help? Reminiscing Create opportunities for elderly to share their stories and become socially involved School mentoring program Support groups at churches with others in their demographic Day Care To improve social interaction and increase activity Work with organizations such as People Inc. and Aurora Adult Day Services to be sure that they are reaching the population and meeting these specific needs Art therapy, exercise, nutritious meals

7. + Community Collaboration Validation Therapy Acknowledging the person’s feelings as valid to restore dignity Restore self-worth, reduce stress and justify living Work with health care agencies and eldercare programs to educate them and train them to use validation therapy in their programs Family system

8. Systems Advocacy Definition: Attempting to change systems such as policies, rules or laws of government, organization or agency to facilitate client’s development or meet their needs Working on how existing systems can be made more “older person friendly”

9. Example: Quality of Life Partnership Multi-agency signposting scheme - enable elderly to access preventive services Provide opportunities for frontline staff to learn from each other Older Person’s Accommodation Strategy - a theme on housing information and advice

10. + Public Information A public information counselor must advocate for the elderly on a macro-level Educate the public about ageism Be aware of stereotyping & microaggressions The elderly experience societal oppression in Western Cultures Undervalued (physically and cognitively) Underemployed Those with disabilities have an additional minority status Sometimes difficult to get them to seek counseling More likely to go to a religious figure rather than a professional therapist May avoid the topic due to stigma that is more prevalent within their cohort

11. + Public Info. – Adverse Drug Effects Oliver et al. (2009) found an increasing amount of emergency room visits due to adverse drug reactions in the elderly (65 years+) There is a need to increase the availability of information to the public about drug interactions and polypharmacy among the elderly A better way of educating the elderly themselves and those who may live with them is important Awareness about what multiple doctors are prescribing at once is crucial, especially for those who are experiencing cognitive decline

12. + Social and Political Advocacy

13. + Types of Problems Abuse Financial Physical Sexual Research Funding Dementia Nutrition Innovative Care Models Seeking a better experience and lower costs

14. + ALLIES AARP (American Association of Retired Persons) ELDERADVOCACYBLOG.COM HEALTH INFORMATION COUNSELING AND ADVOCACY GROUP AMERICAN HEALTH CARE ASSOCIATION INNOVATIVECAREMODELS.COM LONG TERM CARE OMBUDSMAN http://www.ltcombudsman.org/ombudsman

15. + Questions?

16. + References Baldridge, D. (2004). Double jeopardy: Advocating for Indian elders. Generations, 28, 75–78. American Society on Aging. Retrieved from http://generations.metapress.com/index/ 925742r572481706.pdfhttp://generations.metapress.com/index/ Cohen, E. S. (1990). The elderly mystique: Impediment to advocacy and empowerment. Generations: Journal Of The American Society On Aging, 14(Suppl), 13-16. Foster, T. W., Kreider, V., & Waugh, J. (2009). Counseling students’ interest in gerocounseling: a survey study. Gerontology & geriatrics education, 30(3), 226-42. doi:10.1080/02701960903133489 Horton, C. (2009). Creating a stronger information, advice and advocacy system for older people. Retrieved from http://www.jrf.org.uk/ system/files/information-systems-for-older-people-summary.pdfhttp://www.jrf.org.uk/

17. + References (cont.) Kimball, M. J., & Williams-Burgess, C. (1995). Failure to thrive: the silent epidemic of the elderly. Archives of psychiatric nursing, 9(2), 99-105. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/7755414 Kohler, I., & Kendall, J. (2010). Bringing dementia out of the shadows for BME elders: a report on the Ethnic Minority Dementia Advocacy Project ( EMDAP ). Dementia Advocacy Network at Advocacy Plus, 14(1), 12-16. Olivier, P., Bertrand, L., Tubery, M., Lauque, D., Montastruc, J.-L., & Lapeyre-Mestre, M. (2009). Hospitalizations because of adverse drug reactions in elderly patients admitted through the emergency department: a prospective survey. Drugs & aging, 26(6), 475-82. doi:10.2165/00002512-200926060-00004