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Abstract
This dissertation utilizes the Theory of Planned Behavior (TPB) (Fishbein & Ajzen, 2010) to examine social workers’ beliefs about reporting suspected elder abuse to Adult Protective Services (APS). The research was conducted in a mostly suburban county in Pennsylvania with a non-probability, purposive, convenience sample. Twenty-one Master’s-prepared social workers from community-based settings (agency/faith-based/private, in/outpatient health and mental health) completed web-based surveys and participated in key informant interviews. Using the TPB, study results showed reporting suspected elder abuse is a complicated clinical decision in which social workers hope for positive outcomes, but worry about negative ones. These outcome beliefs translated into conflicting attitudes both for and against reporting suspected elder abuse. Respondents tended to believe clients did not want services from APS. They also expressed concern about the safety of clients, especially if the client seemed particularly vulnerable or cognitively impaired. They grappled with the ethical tension of protecting clients’ safety and guarding clients’ self-determination. Respondents believed in consulting with colleagues and making team-based decisions when elder abuse was suspected, but they acknowledged this might entail navigating different opinions about reporting to APS. These ethical and normative beliefs translated into conflicting subjective pressures for and against reporting to APS. Respondents shared perceptions about their skills related to identifying elder abuse and assessing clients’ capacity. They expressed concerns about having the appropriate details to make complete reports to APS and worried APS would not open cases for investigation and services. A few respondents shared positive views about working with APS, but more expressed frustration about the lack of communication and with the limitations and quality of services. Study results suggest social workers need regular, specialized, site-specific training about identifying elder abuse and assessing capacity. Social work settings should consider embedding elder abuse screenings into routine intake assessments and holding joint ethics workshops with APS. Recommendations are made for reexamining some aspects of the Pennsylvania elder protection law. The TPB helped organize the data into a parsimonious set of constructs and brought into sharp focus the complexity of deciding whether to report suspected elder abuse for this sample of social workers.
