Elder abuse detection in nursing facilities: using paid clinical competence to address the nation's shame

Each year, five million senior citizens are the victims of abuse in our country-and that figure is a likely underestimate. In California alone, it is estimated that over 225,000 seniors are abused annually. Nursing home residents are particularly vulnerable to abuse, with one-fifth to one-third of these institutions cited for abusive activities that result in actual harm. Regular violations of minimum care regulations by nursing homes have been documented in every state. Despite legal protections, as a practical matter, the review, assessment, and investigation of nursing home care and potential senior abuse is the primary responsibility of voluntary ombudsmen. These volunteers are responsible for regular visits and determination of nursing home quality and resident treatment. This Article contends that, despite their commitment to the cause, voluntary ombudsmen are not a sufficient cure for the scourge of elder abuse. Rather, clinically-trained personnel with legal knowledge must assume the role that lay volunteer ombudsmen are inappropriately expected to play. Use of clinical case managers, who have expertise in assessing clinical factors and can be trained in legal matters, offers significant potential to assist in the detection, and, further, reporting and prosecution of elder abuse. The author concludes that only through use of those with appropriate training and knowledge can the epidemic of elder abuse be effectively addressed.     

The Court of Public Opinion: Lay Perceptions of Polygraph Testing

We sampled a total of 411 participants and randomly assigned them one of three brief trial vignettes that contained either no-polygraph evidence, evidence of a passed polygraph test, or evidence of a failed polygraph test. Participants rendered guilt judgments and answered a series of questions concerning the trial in particular, and polygraph tests in general. Similar to previous studies on the impact of polygraph evidence on jurors' guilt judgments, this sample of jury-eligible adults indicated that they did not find polygraph test evidence to be persuasive. Moreover, it mattered little to participants whether the results indicated the defendant passed a polygraph test, or that he failed a polygraph test. However, when our findings are compared to those of previous surveys involving experts in the field of psychophysiology, they differ in a number of important respects. The implications for decisions regarding admissibility (e.g., U.S. v. Alexander, 1975 and U.S. v. Scheffer, 1998) are discussed.     

MUDDLING THROUGH THE MURKY WATERS OF TROXEL

A critical case in the area of third-party visitation rights was decided by the U. S. Supreme Court in July 2000 ( Troxel v. Granville ). A plurality in this case held that a Washington grandparent visitation statute was not facially unconstitutional but was as applied to the facts of that case. The author discusses the varying opinions of the Supreme Court justices in the Troxel decision. Next, he analyzes the plurality opinion to determine the appropriate standard of review in grandparent visitation cases. Following is a consideration of how the decision will affect other state grandparent visitation legislation. Examining these issues, the author concludes that future third-party visitation cases will be decided on a fact-specific, case-by-case basis.     

Can the Body Change the Score? Application of Sensory Modulation Principles in the Treatment of Traumatized Adolescents in Residential Settings

There is a compelling need for varied “trauma specific” treatment models for children and adolescents with complex trauma in residential treatment whose affect and behavioral dysregulation disrupts daily living and impedes treatment engagement. This conceptual paper introduces exploratory applications of sensory motor approaches to the treatment of affect and behavioral dysregulation. Sensory Integration, a specialization within occupational therapy (Ayres 1972, 2004) provides knowledge of the sensory motor systems and strategies for sensory modulation that addresses arousal regulation, which underlies this dysregulation. The article describes three clinically supported approaches to the use of sensory modulation in residential treatment sites: use of sensory rooms; use of sensory integration occupational therapists at residential treatment sites; and a trauma psychotherapy that utilizes sensory motor strategies to improve regulation and support trauma processing.     

Sufficiency Re-examined: A Capabilities Perspective on the Assessment of Functional Adult Literacy

There is a growing consensus that the dichotomous categories of literate and illiterate should be abandoned. However, the dichotomy has considerable utility in the analysis of educational achievements and inequality in developing countries. Statistics on functional adult literacy are intended to tell us whether people have achieved a minimum level or threshold of functioning necessary for their daily life. We should therefore carefully consider the implications of such change.     

Shelter Poverty in Ohio: An Alternative Analysis of Rental Housing Affordability

ABSTRACT

In the United States, housing is most commonly considered unaffordable when a household spends more than 30% of income on housing and utilities. Although easy to calculate, it fails to account for how other categories of essential expenses affect income available to spend on housing. This article compares the ratio-based approach with shelter poverty, a measure that accounts for these elements, evaluating differences in results between the two methods among renters in Ohio. Shelter poverty identifies a higher rate of households in economic distress due to housing market conditions. Further, the average “affordability gap” is four times higher using the shelter poverty than with the 30% threshold. Relative to shelter poverty, the ratio method underestimates the unaffordability of rental housing in economically distressed areas, as measured by median household income, and modestly overestimates it in high-income areas.