Exploring the Help-Seeking Experience of Concerned Persons: Findings From an Elder Abuse UK Helpline

Abstract Despite their potential role in elder abuse cases, knowledge about concerned persons outside of North America is scarce. This paper will discuss findings from a study focusing on concerned persons in the UK, by addressing their profile, the impact of helping, and several variables relating to help-seeking. Researchers used secondary data from a charity’s helpline, encompassing a year of recorded cases (N = 1623). Concerned persons (n = 1352) were often related to the victim (80%) and/or perpetrator (59%). In 43% of cases, they reported impact as a result of their awareness of the situation or supporting the victim. This impact was thematically analysed and ranged widely in terms of severity, from slight worry to being subjected to the perpetrator’s homicide threats, and it often affected the person’s mental health or financial situation. Concerned persons reported substantial barriers to action relating to the access to and responses from formal services.


WHEN CONCERNED FAMILY MEMBERS INTERVENE IN ELDER FAMILY FINANCIAL EXPLOITATION: GOALS AND OUTCOMES Marlene Stum, University of Minnesota, Twin Cities, Saint Paul, Minnesota, United States
The role and experience of non-abusing concerned family members (CFMs) in elder family financial exploitation (EFFE) is largely unexplored. This paper examines the experience of "trying to do the right thing," focusing on what CFM's were trying to accomplish (motivating goals), and resulting outcomes utilizing data from a qualitative study of 28 CFMs (primarily female adult children of an older victim, and siblings of primary perpetrator). Five common goals appear to be motivating CFM involvement, driven by a priority to ensuring the victim's quality of life, as well as the desire to honor and respect the victim's wishes, protect the victim's financial well-being, preserve family relationships, and deal with the perpetrator(s). CFM help-seeking resulted in a wide range of outcomes, from making a difference by connecting victims to supportive services and interrupting the financial exploitation, to mixed results, and in other cases frustration with no desirable outcomes.

WHEN HELPING HURTS: NONABUSING FAMILY, FRIENDS, AND NEIGHBORS IN THE LIVES OF ELDER MISTREATMENT VICTIMS
Risa Breckman, 1 David Burnes, 2 Sarah Ross, 3 Philip Marshall, 4 J. Jill Suitor, 5 Mark Lachs, 6 and Karl Pillemer, 3 1. Weill Cornell Medicine/ NYC Elder Abuse Center,New York,New York,United States,2. University of Toronto,Toronto,Ontario,Canada,3. Cornell University,Ithaca,New York,United States,4. Historic Preservation Program,Roger Williams University,Bristol,Rhode Island,United States,5. Purdue University,West Lafayette,Indiana,United States,6. Weill Cornell Medicine,New York City,New York,United States Research conducted by the NYC Elder Abuse Center (NYCEAC) at Weill Cornell Medicine and colleagues found that concerned persons experience significant distress knowing about elder abuse and trying to assist victims. Data will be presented from a nationally representative survey which included items on concerned persons in elder abuse. Thirty-one percent of all respondents reported that they had a relative or friend who experienced elder abuse; of these, 61% had attempted to help the victim and over 80% reported the experience is very or extremely stressful (2017). By both knowing about and becoming involved in elder abuse situations, concerned persons experience significant emotional and practical problems and often need professional help. NYCEAC's Elder Abuse Helpline for Concerned Persons is the first of its kind in the country. The Helpline's services and structure will be explained, and possibilities for replication in other locations will be explored. Despite their potential role in elder abuse cases, knowledge about concerned persons outside of North America is scarce. This paper will discuss findings from a study focusing on concerned persons in the UK, by addressing their profile, the impact of helping, and several variables relating to helpseeking. Researchers used secondary data from a charity's helpline, encompassing a year of recorded cases (N = 1623). Concerned persons (n = 1352) were often related to the victim (80%) and/or perpetrator (59%). In 43% of cases, they reported impact as a result of their awareness of the situation or supporting the victim. This impact was thematically analysed and ranged widely in terms of severity, from slight worry to being subjected to the perpetrator's homicide threats, and it often affected the person's mental health or financial situation. Concerned persons reported substantial barriers to action relating to the access to and responses from formal services. This paper examines non-perpetrator family members' experience of trying to help when faced with elder family financial exploitation. Utilizing data from a qualitative study of 28 Concerned Family Members (CFMs) who were primarily adult children of older victims, findings provide evidence of the critical role CFMs play in helping the victims. Six help-seeking tasks are identified, including gathering evidence, learning new systems, and taking on money management roles. CFMs often put the victim's health and well-being before their own, becoming secondary victims in the process. CFMs experienced a wide range of costs to their individual health and well-being, including physical, emotional, psychological, social and financial dimensions (e.g. stress, depression, inability to sleep, isolation, harassment, threats to personal safety, physical abuse, attorney and court costs, time off work). Findings have implications for supporting CFMs and addressing practical and health-related needs as secondary victims.

THE IMPACT OF FUNCTION FOCUSED CARE FROM ACUTE CARE TO HOME CARE AND NURSING HOMES
Chair: Silke Metzelthin Co-Chair: Sandra Zwakhalen Discussant: Barbara Resnick Functional decline in older adults often lead towards acute or long-term care. In practice, caregivers often focus on completion of care tasks and of prevention of injuries from falls. This task based, safety approach inadvertently results in fewer opportunities for older adults to be actively involved in activities. Further deconditioning and functional decline are common consequences of this inactivity. To prevent or postpone these consequences Function Focused Care (FFC) was developed meaning that caregivers adapt their level of assistance to the capabilities of older adults and stimulate them to do as much as possible by themselves. FFC was first implemented in institutionalized long-term care in the US, but has spread rapidly to other settings (e.g. acute care), target groups (e.g. people with dementia) and countries (e.g. the Netherlands). During this symposium, four presenters from the US and the Netherlands talk about the impact of FFC. The first presentation is about the results of a stepped wedge cluster trial showing a tendency to improve activities of daily living and mobility. The second presentation is about a FFC training program. FFC was feasible to implement in home care and professionals experienced positive changes in knowledge, attitude, skills and support. The next presenter reports about significant improvements regarding time spent in physical activity and a decrease in resistiveness to care in a cluster randomized controlled trial among nursing home residents with dementia. The fourth speaker presents the content and first results of a training program to implement FFC in nursing homes. Nursing Care of Older Adults Interest Group Sponsored Symposium

KEEP MOVING TOWARD RECOVERY! FUNCTION-FOCUSED CARE IN HOSPITALIZED STROKE AND GERIATRIC PATIENTS
Janneke de Man-van Ginkel, 1 Carolien Verstraten, 1 Marieke Schuurmans, 2 Silke Metzelthin, 3 Johannes Reitsma, 1 and Lisette Schoonhoven, 2 1. Julius Center for Health Sciences and Primary Care,UMC Utrecht,Utrecht,Utrecht,Netherlands,2. University Medical Center Utrecht,Utrecht,Utrecht,Netherlands,3. Maastricht University,Maastricht,Limburg,Netherlands Many hospitalized patients experience decline in functional status. Function Focused Care (FFC) has demonstrated to improve patients' functional status in long-term care. In a stepped wedge cluster trial in 893 hospitalized geriatric and stroke patients, we investigated the effectiveness of FFC compared to usual care (FFC: n=427, UC: n=466) on ADL and mobility. We measured the Barthel Index and the Elderly Mobility Scale, and analysed using a mixed-model multilevel method. At discharge, 3 month and 6 months, the mean difference (MD) was in favour of FFC, although at none of the time points the level of significance was reached: the MD for ADL was respectively: 0.79 (95%CI: -0.98-2.56), 0.43 (95%CI: 0.10-1.79), and 0.57 (95%CI: -1.34-2.48). For mobility, the MD was respectively 0.89 (95%CI: -1.01-2.80), 0.78 (95%CI: -1.18; 2.75), and 1.09 (95%CI: -0.88-3.07). Although the results are inconclusive, FFC shows a tendency to improve ADL and mobility in hospitalized patients. Part of a symposium sponsored by Nursing Care of Older Adults Interest Group.

A TRAINING PROGRAM FOR PROFESSIONALS TO ENCOURAGE INDEPENDENCE OF HOME-LIVING OLDER ADULTS: A PROCESS EVALUATION
Teuni Rooijackers, 1 G.A. Zijlstra, 1 Erik van Rossum, 2 Ruth G. Vogel, 1 Marja Veenstra, 3 Gertrudis I.J. Kempen, 1 and Silke Metzelthin, 1 1. Maastricht University, Maastricht,Limburg,Netherlands,2. Zuyd Hogeschool,Heerlen,Limburg,Netherlands,3. Burgerkracht Libmurg,Sittard,Limburg,Netherlands Stay Active at Home (SAaH) was developed to change homecare professionals' behavior towards encouraging older adults' independence in daily activities. This mixed-methods study evaluated SAaH regarding implementation, mechanisms of impact, and context. SAaH was implemented in five Dutch homecare teams (162 professionals). Quantitative data were collected from all professionals, and five focus groups with 23 professionals and 4 interventionists were performed. Data were analyzed using descriptive statistics and qualitative content analysis. SAaH was feasible to implement. Professionals visited on average 73% of the programme meetings. They reported positive changes in their knowledge, attitude, and skills, and perceived social and organizational support regarding the new way of working. The extent to which professionals applied SAaH in practice varied. SAaH was easier to apply among new clients. Perceived barriers were time pressure and staff shortages, and people's resistance to change. Tailoring the intervention to professionals' needs and wishes could improve their compliance. Part of