Presents an insightful, interdisciplinary approach for preventing elder abuse E ncompassing the c... more Presents an insightful, interdisciplinary approach for preventing elder abuse E ncompassing the contributions of leading scholars in public health and gerontology, this is a rich repository of key ideas, concepts, and issues regarding elder abuse and the role of public health initiatives in its prevention. Th e text frames elder abuse as a public health problem, stressing that eff orts toward prevention are well within the scope of work performed by public health professionals. It describes major public policy/public health initiatives as they relate to elder abuse, analyzes elder mistreatment as a global and human rights issue, and supports the development of core competencies for public health work to prevent elder abuse. Th e text describes in detail major theoretical and applied issues within elder mistreatment and grounds these issues within the basic functions and essential services of public health. It then addresses skill development using the core competencies for public health professionals. The book is the first to tie the basic functions and essential public health services to core public health competency domains and creates a topic-specific framework for effective public health practice. An annotated section includes the most up-to-date resources for both public health and elder abuse, including toolkits, stakeholder lists, and references. A discussion of future directions for the fi eld sets the agenda for a committed interdisciplinary approach to ameliorating and preventing elder abuse.
The problem of how to conceptualize elder mistreatment goes back several decades, and is especial... more The problem of how to conceptualize elder mistreatment goes back several decades, and is especially important for ethnic minority populations, who may have perspectives that differ from the dominant society. This community-based participatory research study, which examined perceptions of mistreatment by family among 100 urban and rural older American Indians, permits a rare glimpse into how Native elders themselves understand this issue. Here, good treatment was conceptualized in terms of being taken care of, having one's needs met, and being respected. We found relatively high standards for how elders should be treated -such as the belief that an elder's needs should be anticipated and met without the elder needing to ask-in the face of widespread accounts of the mistreatment of elders within the community, largely through various acts of financial exploitation and neglect. Substance abuse and culture loss were blamed for much of the elder mistreatment occurring in contemporary Native communities.
Background: Taeniasis and cysticercosis are two diseases caused by Taenia solium, a parasite tran... more Background: Taeniasis and cysticercosis are two diseases caused by Taenia solium, a parasite transmitted between humans and pigs, leading to considerable economic loss and disabilities. Transmission of the parasite is linked to environmental and behavioural factors such as inadequate sanitation and hygiene, poor pig management, and consumption of infected pork. This study used implementation research method to design a health education intervention strategy for reducing T. solium infections in Burkina Faso, a country endemic for the parasite.
Free-roaming dogs are a common phenomenon on many American Indian reservations as well as globall... more Free-roaming dogs are a common phenomenon on many American Indian reservations as well as globally. Lack of canine restriction may be pathologized by outsiders, assumed to be a "problem" that reflects underlying individual or community dysfunction. Seldom investigated are the cultural logics underlying the lack of restriction, and the positive role that dogs may be playing in the community. This paper examines relationships between a northern plains reservation community and their dogs. We found these relationships to be complex and multifaceted, harkening back to a pre-contact past when human survival itself depended on the dog, and extending into a present shaped by a broad range of cultural notions about the human-dog relationship. We explore the concept of dog restriction, asking what it means for connections with dogs in a context where relationships with dogs run deep, but have been disrupted by settler colonialism. We found a community that very much desires dogs and views them positively, with their role as protector highly valued on nearly every level. While traditional notions guided many behaviors toward dogs, other conceptualizations were simultaneously in play, including rural ideas about animals as well as American popular culture. Our findings call into question the ethnocentric bias that construes all free-roaming dogs as strays, which is linked to cultural notions of "pet ownership" that equate love for dogs with restrictions on their movement.
Dementia is an issue of increasing importance in indigenous populations in the United States. We ... more Dementia is an issue of increasing importance in indigenous populations in the United States. We begin by discussing what is known about dementia prevalence and elder family caregiving in American Indian, Alaska Native, and Native Hawaiian populations. We briefly highlight examples of culture-based programming developed to address a number of chronic diseases and conditions that disproportionately affect these communities. These programs have produced positive health outcomes in American Indian, Alaska Native, and Native Hawaiian populations and may have implications for research and practice in the dementia context of culture-based interventions. Evidence-based and culture-based psychosocial programming in dementia care for indigenous populations in the United States designed by the communities they intend to serve may offer elders and families the best potential for care that is accessible, respectful, and utilized.
1. Family members encountered difficulties when an elder was hospitalized for an acute episode of... more 1. Family members encountered difficulties when an elder was hospitalized for an acute episode of a chronic illness. 2. It is important for nurses to recognize the kinds of difficulties that family members experience and develop strategies to alleviate them. 3. Failure to include family members in discharge planning can place elders at risk for readmission to the hospital.
Whereas recent reports from national studies have presented extremely high rates for many persona... more Whereas recent reports from national studies have presented extremely high rates for many personality disorders in American Indian communities, persistent concerns about the meaning of these symptoms have left many troubled by these reports. American Indians as a group are known to suffer disproportionately from a number of violent experiences, but the dynamics of this violence have received little attention. This paper examines perspectives on violence in the lives of 15 northern plains tribal members who met criteria for antisocial personality disorder and comorbid alcohol use disorder. It explores how study participants constructed and understood their own violent encounters, as well as the motivations they described (characterized here as reputation, leveling, retaliation, catharsis, and self-defense). Violence was gendered in this study, with men generally presenting as perpetrators and women as victims. Men often described themselves as ready participants in a violent world, while women were quite clear that aggression for them was often simply required as they tried to defend themselves from male violence. While this analysis does not replace clinical analyses of violence in antisocial personality disorder, it does reveal an underlying cultural logic that may play a role in shaping the recourse to violence for that minority of individuals for whom it appears to be the obvious choice.
Social Psychiatry and Psychiatric Epidemiology, 2013
Purpose To determine conditional risk of posttraumatic stress disorder (PTSD) in two culturally d... more Purpose To determine conditional risk of posttraumatic stress disorder (PTSD) in two culturally distinct American Indian reservation communities. Method Data derived from the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project, a cross-sectional population-based survey that was completed between 1997 and 2000. This study focused on 1,967 participants meeting the DSM-IV criteria for trauma exposure. Traumas were grouped into interpersonal, non-interpersonal, witnessed, and ''trauma to close others'' categories. Analyses examined distribution of worst traumas, conditional rates of PTSD following exposure, and distributions of PTSD cases deriving from these events. Bivariate and multivariate logistic regressions estimated associations of lifetime PTSD with trauma type. Results Overall, 15.9 % of those exposed to DSM-IV trauma qualified for lifetime PTSD, a rate comparable to similar US studies. Women were more likely to develop PTSD than were men. The majority (60 %) of cases of PTSD among women derived from interpersonal trauma exposure (in particular, sexual and physical abuse); among men, cases were more evenly distributed across trauma categories. Conclusions Previous research has demonstrated higher rates of both trauma exposure and PTSD in American Indian samples compared to other Americans. This study shows that conditional rates of PTSD are similar to those reported elsewhere, suggesting that the elevated prevalence of this disorder in American Indian populations is largely due to higher rates of trauma exposure.
Although elder mistreatment among ethnic minorities is increasingly gaining attention, our empiri... more Although elder mistreatment among ethnic minorities is increasingly gaining attention, our empirical knowledge of this phenomenon among American Indians remains quite limited, especially with respect to measurement. The Shielding American Indian Elders (SAIE) Project used a collaborative approach to explore culturally informed measurement of elder mistreatment in two American Indian elder samples (a Northern Plains reservation and a South Central metropolitan area). The project sought to investigate the performance characteristics of the commonly used Hwalek-Sengstock Elder Abuse Screening Test (HS-EAST), as well as to examine the psychometric properties of a new measure developed to capture culturally salient aspects of mistreatment in American Indian contexts--the Native Elder Life Scale (NELS). Using methods and samples comparable to those in the literature, the HS-EAST performed adequately in these Native samples. The NELS also shows promise for use with this population and assesses different aspects of elder mistreatment than does the HS-EAST.
Presents an insightful, interdisciplinary approach for preventing elder abuse E ncompassing the c... more Presents an insightful, interdisciplinary approach for preventing elder abuse E ncompassing the contributions of leading scholars in public health and gerontology, this is a rich repository of key ideas, concepts, and issues regarding elder abuse and the role of public health initiatives in its prevention. Th e text frames elder abuse as a public health problem, stressing that eff orts toward prevention are well within the scope of work performed by public health professionals. It describes major public policy/public health initiatives as they relate to elder abuse, analyzes elder mistreatment as a global and human rights issue, and supports the development of core competencies for public health work to prevent elder abuse. Th e text describes in detail major theoretical and applied issues within elder mistreatment and grounds these issues within the basic functions and essential services of public health. It then addresses skill development using the core competencies for public health professionals. The book is the first to tie the basic functions and essential public health services to core public health competency domains and creates a topic-specific framework for effective public health practice. An annotated section includes the most up-to-date resources for both public health and elder abuse, including toolkits, stakeholder lists, and references. A discussion of future directions for the fi eld sets the agenda for a committed interdisciplinary approach to ameliorating and preventing elder abuse.
The problem of how to conceptualize elder mistreatment goes back several decades, and is especial... more The problem of how to conceptualize elder mistreatment goes back several decades, and is especially important for ethnic minority populations, who may have perspectives that differ from the dominant society. This community-based participatory research study, which examined perceptions of mistreatment by family among 100 urban and rural older American Indians, permits a rare glimpse into how Native elders themselves understand this issue. Here, good treatment was conceptualized in terms of being taken care of, having one's needs met, and being respected. We found relatively high standards for how elders should be treated -such as the belief that an elder's needs should be anticipated and met without the elder needing to ask-in the face of widespread accounts of the mistreatment of elders within the community, largely through various acts of financial exploitation and neglect. Substance abuse and culture loss were blamed for much of the elder mistreatment occurring in contemporary Native communities.
Background: Taeniasis and cysticercosis are two diseases caused by Taenia solium, a parasite tran... more Background: Taeniasis and cysticercosis are two diseases caused by Taenia solium, a parasite transmitted between humans and pigs, leading to considerable economic loss and disabilities. Transmission of the parasite is linked to environmental and behavioural factors such as inadequate sanitation and hygiene, poor pig management, and consumption of infected pork. This study used implementation research method to design a health education intervention strategy for reducing T. solium infections in Burkina Faso, a country endemic for the parasite.
Free-roaming dogs are a common phenomenon on many American Indian reservations as well as globall... more Free-roaming dogs are a common phenomenon on many American Indian reservations as well as globally. Lack of canine restriction may be pathologized by outsiders, assumed to be a "problem" that reflects underlying individual or community dysfunction. Seldom investigated are the cultural logics underlying the lack of restriction, and the positive role that dogs may be playing in the community. This paper examines relationships between a northern plains reservation community and their dogs. We found these relationships to be complex and multifaceted, harkening back to a pre-contact past when human survival itself depended on the dog, and extending into a present shaped by a broad range of cultural notions about the human-dog relationship. We explore the concept of dog restriction, asking what it means for connections with dogs in a context where relationships with dogs run deep, but have been disrupted by settler colonialism. We found a community that very much desires dogs and views them positively, with their role as protector highly valued on nearly every level. While traditional notions guided many behaviors toward dogs, other conceptualizations were simultaneously in play, including rural ideas about animals as well as American popular culture. Our findings call into question the ethnocentric bias that construes all free-roaming dogs as strays, which is linked to cultural notions of "pet ownership" that equate love for dogs with restrictions on their movement.
Dementia is an issue of increasing importance in indigenous populations in the United States. We ... more Dementia is an issue of increasing importance in indigenous populations in the United States. We begin by discussing what is known about dementia prevalence and elder family caregiving in American Indian, Alaska Native, and Native Hawaiian populations. We briefly highlight examples of culture-based programming developed to address a number of chronic diseases and conditions that disproportionately affect these communities. These programs have produced positive health outcomes in American Indian, Alaska Native, and Native Hawaiian populations and may have implications for research and practice in the dementia context of culture-based interventions. Evidence-based and culture-based psychosocial programming in dementia care for indigenous populations in the United States designed by the communities they intend to serve may offer elders and families the best potential for care that is accessible, respectful, and utilized.
1. Family members encountered difficulties when an elder was hospitalized for an acute episode of... more 1. Family members encountered difficulties when an elder was hospitalized for an acute episode of a chronic illness. 2. It is important for nurses to recognize the kinds of difficulties that family members experience and develop strategies to alleviate them. 3. Failure to include family members in discharge planning can place elders at risk for readmission to the hospital.
Whereas recent reports from national studies have presented extremely high rates for many persona... more Whereas recent reports from national studies have presented extremely high rates for many personality disorders in American Indian communities, persistent concerns about the meaning of these symptoms have left many troubled by these reports. American Indians as a group are known to suffer disproportionately from a number of violent experiences, but the dynamics of this violence have received little attention. This paper examines perspectives on violence in the lives of 15 northern plains tribal members who met criteria for antisocial personality disorder and comorbid alcohol use disorder. It explores how study participants constructed and understood their own violent encounters, as well as the motivations they described (characterized here as reputation, leveling, retaliation, catharsis, and self-defense). Violence was gendered in this study, with men generally presenting as perpetrators and women as victims. Men often described themselves as ready participants in a violent world, while women were quite clear that aggression for them was often simply required as they tried to defend themselves from male violence. While this analysis does not replace clinical analyses of violence in antisocial personality disorder, it does reveal an underlying cultural logic that may play a role in shaping the recourse to violence for that minority of individuals for whom it appears to be the obvious choice.
Social Psychiatry and Psychiatric Epidemiology, 2013
Purpose To determine conditional risk of posttraumatic stress disorder (PTSD) in two culturally d... more Purpose To determine conditional risk of posttraumatic stress disorder (PTSD) in two culturally distinct American Indian reservation communities. Method Data derived from the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project, a cross-sectional population-based survey that was completed between 1997 and 2000. This study focused on 1,967 participants meeting the DSM-IV criteria for trauma exposure. Traumas were grouped into interpersonal, non-interpersonal, witnessed, and ''trauma to close others'' categories. Analyses examined distribution of worst traumas, conditional rates of PTSD following exposure, and distributions of PTSD cases deriving from these events. Bivariate and multivariate logistic regressions estimated associations of lifetime PTSD with trauma type. Results Overall, 15.9 % of those exposed to DSM-IV trauma qualified for lifetime PTSD, a rate comparable to similar US studies. Women were more likely to develop PTSD than were men. The majority (60 %) of cases of PTSD among women derived from interpersonal trauma exposure (in particular, sexual and physical abuse); among men, cases were more evenly distributed across trauma categories. Conclusions Previous research has demonstrated higher rates of both trauma exposure and PTSD in American Indian samples compared to other Americans. This study shows that conditional rates of PTSD are similar to those reported elsewhere, suggesting that the elevated prevalence of this disorder in American Indian populations is largely due to higher rates of trauma exposure.
Although elder mistreatment among ethnic minorities is increasingly gaining attention, our empiri... more Although elder mistreatment among ethnic minorities is increasingly gaining attention, our empirical knowledge of this phenomenon among American Indians remains quite limited, especially with respect to measurement. The Shielding American Indian Elders (SAIE) Project used a collaborative approach to explore culturally informed measurement of elder mistreatment in two American Indian elder samples (a Northern Plains reservation and a South Central metropolitan area). The project sought to investigate the performance characteristics of the commonly used Hwalek-Sengstock Elder Abuse Screening Test (HS-EAST), as well as to examine the psychometric properties of a new measure developed to capture culturally salient aspects of mistreatment in American Indian contexts--the Native Elder Life Scale (NELS). Using methods and samples comparable to those in the literature, the HS-EAST performed adequately in these Native samples. The NELS also shows promise for use with this population and assesses different aspects of elder mistreatment than does the HS-EAST.
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Papers by Lori Jervis