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Survey on Abuse in Later Life: Professionals and Service ProvidersThank you for taking the time to fill out this survey by the ADD YOUR PROJECT NAME. Our community has received funding from the Department of Justice’s Office on Violence Against Women to create or enhance services for older victims of abuse. In order to gather the kinds of information that will help us plan activities and services that better respond to the needs of victims of abuse in later life, we are asking older adults and service providers throughout our community to share their experiences. Your ideas are important to us. Individuals who are age 50 and older may be hit, yelled at or sexually assaulted. They may be neglected or have had money or possessions stolen. Older victims are most generally harmed by someone they know; often someone they love or trust, such as a spouse, partner, adult child or other family member or a caregiver. You may know an older adult who has been or is being harmed. You may want to talk to someone after taking this survey. Contact project staff for support and information about local resources.This provider survey is designed to gather information in three areas: Your organization’s perspectives about helpful services for older adults (age 50 and over) who may be experiencing some form of abuseYour organization’s experience with issues of abuse in later life Background information about your organization-419100139700Section A: Services/Opportunities That Might Help Older Individuals00Section A: Services/Opportunities That Might Help Older IndividualsPlease check the top three (3) services you think would be helpful for older individuals who are being hurt by a spouse, partner, adult child or family member or caregiver. Advocate or Case Manager (a professional to work with older victims to create a plan about what to do next)Affordable civil legal help to stop the abuse (such as help getting a restraining order or changing a power of attorney)Assistance with balancing checkbooks, managing finances and creating personal budgetsCounseling for older victimsHelp for older victims taking care of the house or apartmentHelpline that is available 24-hours a day, 7 days a week you can call for information and supportLegal advocacy (someone to help if older victims needs to go to court)Money for rent or moving expenses, food, prescriptions if medication and medical supplies if they are not available due to interference from the abuser Options for pets (such as foster care or shelter for pets while older victims are staying at a shelter)Protective or restraining orders (legal orders to keep an abuser away)Personal advocacy (someone to talk to about the abuse and to provide emotional support)Safe shelter (safe emergency housing for someone who is in danger)Support groups (a small group of older survivors of abuse who meet regularly to talk to each other and support each other)Transitional housing (temporary housing from 12 – 24 months for older victims who need a place to stay while they take next steps)Transportation to medical appointments, victim services and courtPlease use the space below to describe other victim services you think would be helpful: __________________________________________________________________Where do you think would be a good place to hold services for older victims? (Check all that apply.)Area Agency on AgingChurch, synagogue or other faith community buildingDomestic abuse victim service programHealth care centerHousing complex for older adultsLibrarySenior centerSexual abuse victim service programPlease use the space below to suggest other locations: _______________________________________________________What hours should services be available? (Check all that apply)MorningsAfternoonsEveningsWeekdaysWeekends24 hours a day, 7 days a weekWhat information could be helpful for older victims? (Check all that apply)Childcare information (how to provide care for own children, grandchildren or great grandchildren living in the home where an older adult is being harmed)Criminal justice system information (what happens after a spouse, partner or family member is arrested?)Employment and job training informationFinancial information (such as how to balance a checkbook or create a budget OR how to stop abuser from stealing from victim)Housing information (emergency shelters, transitional housing or affordable permanent housing)Information about available servicesInformation about controlling relationships and why they happenInformation about how to leave an abuserInformation about legal issues (protective orders, wills, guardianships)Information about programs for abusers (e.g., Where are they located? Are they effective?)Information about sexual abuse Safety planning (working with a professional to create a plan to live more safely or free from an abuser)Referrals to other services and agencies that can offer help in the communitySpiritual/religious issuesSubstance abuse (drugs or alcohol)Tips on caregiving (Two examples: tips on how to manage the stress of providing care to a person who is hurtful OR tips on how to provide care for a family member while living with an abuser) Please use the space below to describe what other information you think would be helpful for victims of abuse in later life: _____________________________________________________________How should we let older individuals know about available help? (check all that apply)BillboardsBrochures about servicesFacebook or YouTubeFaith-based publications such as newsletters or materials distributed at servicesInternetNewspaper adsPosters or flyersPresentations to community groupsPublications for older adults such as free senior newspapersRadio adsTelevision adsPlease use the space below to suggest other ideas: _____________________________________________________________Where would you recommend posting posters or brochures? (Check all that apply)Area Agencies on AgingBathrooms of restaurants and other public placesBeauty parlors or barber shopsChurches, synagogues or faith communitiesHealthcare settingsLibrariesNursing homes, assisted living or other facilitiesSenior centersSenior housing locations Please use the space below to suggest other places:___________________________________________________________________________What other suggestions do you have to help older individuals who are struggling with controlling and hurtful situations?-37147593345Section B: Organizational Experience with Issues of Abuse in Later Life 00Section B: Organizational Experience with Issues of Abuse in Later Life Do you think your organization serves any clients or individuals (age 50 or over) who may be victims of abuse in later life? Yes No Are members of your staff familiar with the indicators and dynamics of abuse in later life? Yes No When providing services, does your organization use any type of screening tool or questions with older clients to identify possible concerns of abuse? Yes No Do you know the location / contact information of your local victim service providers? Yes No Do you know what kinds of services are available to older victims in your community? Yes No Have you ever contacted a crisis center victim advocate about an older victim? Yes No Are you familiar with state elder abuse and/or vulnerable adult reporting laws? Yes No Are you familiar with the process of reporting your concerns about possible abuse in later life? Yes No Have you ever reported your concerns about an older adult who may be a victim of abuse in later life? Yes No If you responded “yes,” please answer (a) and (b) below: (a) To whom did you report your concerns? (Please check all that apply.)Your supervisor Police Fire Department (EMS)Adult Protective Services Local Crisis CenterOther: ___________________________________________________________ (b) Were the recipients of your report helpful? (Please comment) ______________________________________________________Have you or members of your staff received any training on abuse in later life? Yes No Do you have literature, information and posters about abuse in later life displayed in your facilities? Yes No From your organization’s perspective, what do you think might be the biggest obstacles to providing appropriate services to victims of abuse in later life? (Check the top 3 choices.)Health care problems (older victim or offender)Lack of options for counseling, support groups and safety planning for older victimsLack of organizational capacity (staffing, facilities, training, funding) for victim service providersLack of professional training about abuse in later life Lack of public awareness about abuse in later lifeLack of reporting Lack of transportation Lack of understanding about available community resourcesLimited affordable housing options for older victimsLimited money and resources so older victims can live independently or access services or legal assistanceVictim fear, shame, or embarrassmentPlease use the space below to describe other obstacles: _____________________________________________________________What kinds of supports would be most helpful to your organization in responding to the needs of older victims of abuse?Clearer policies and procedures Increased opportunities for networking and collaboration More accessible/accommodating facilities for older victims of abuseMore outreach efforts in community Training for staffDon’t knowPlease use the space below to suggest other kinds of support that would be helpful: ___________________________________________________________ -152400-80010 Section C: Organizational Background Information00 Section C: Organizational Background InformationFrom the list below, please check the type of organization that best identifies the focus of your organization’s services: Adult day services Adult protective services or lead elder abuse agency Aging networkBusinessCaregiver supports CourtsDomestic violence victim service program EMS/First responderFaith-based services Health careHome care services Information/referral Law enforcementLong-term care facility Mental health services OmbudsmanProsecutors’ officeSexual assault victim service programSystems-based advocacy (advocacy housed in a law enforcement or prosecutors office or a health care setting) Other: _______________________________________________________________How many people are involved in your organization? Staff: ________Volunteers: ________Members: ________Does your organization serve individuals age 50 and older? ___ Yes___ NoCONTACT INFORMATION (optional)Name of group or organization:________________________________________________________________Organization's contact information (phone, mailing address, e-mail)________________________________________________________________ (Mailing Address)_____________________________ ___________________________ (Phone) (E-Mail)Name and title of person completing survey________________________________________________________________Please complete and return this survey by *******.This survey was revised by the National Clearinghouse on Abuse in Later Life (NCALL) and the Office on Violence Against Women (OVW) based on a survey created and implemented by the Merrimack County Coordinated Community Response team in Concord, New Hampshire. -276225103505Thank you for taking the time to complete this survey! Your responses will help us make decisions about the best ways to offer services and opportunities to older individuals in this community. If you choose to mail back your survey, we have provided a self-addressed, stamped envelope. ADD YOUR ADDRESS HERE If you have questions about this survey or would like to know more about the work of NAME OF YOUR PROJECT, contact NAME OF CONTACT PERSON. Phone: ADD PHONEE-Mail: ADD EMAIL00Thank you for taking the time to complete this survey! Your responses will help us make decisions about the best ways to offer services and opportunities to older individuals in this community. If you choose to mail back your survey, we have provided a self-addressed, stamped envelope. ADD YOUR ADDRESS HERE If you have questions about this survey or would like to know more about the work of NAME OF YOUR PROJECT, contact NAME OF CONTACT PERSON. Phone: ADD PHONEE-Mail: ADD EMAIL ................
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