Caregiver stress is widely believed to be an important contributing factor in elder abuse. Caregiver support groups led by social workers can help reduce caregiver stress and improve the care dependent elderly receive. However, because all states have laws encouraging or even requiring reporting of suspected elder abuse, support group facilitators may find themselves facing ethical dilemmas about whether or not to file a report when a support group participant's behavior or comments suggest possible elder abuse or neglect.

In this article, Rene Bergeron, MSW, PhD, University of New Hampshire, and Betsey Gray, MSW, University of New England, use case studies to explore the inherent conflict between encouraging caregivers to share their frustrations in a confidential support group environment and the duty to report any abuse that may be revealed by participants. Among the questions they raise are: Should the facilitator file a report of suspected abuse after a participant once expressed concern that she might become frustrated enough to hit her mother? How should the facilitator cope with a situation in which a mentally impaired caregiver expressed occasional desires to hit his elderly father due to the verbal abuse his father frequently inflicted on him? Does a facilitator have the right or duty to inform nursing home staff of past abuse inflicted on a current patient by her daughter, who regularly visits her mother? Or, should the facilitator file a neglect report because he or she fears a support group participant who refuses to place her mother in a nursing home may be unable to provide adequate care for her mother at home? The current social work literature offers few articles that address these issues of ethics and confidentiality in group work situations.

Recommendations for Social Workers

Bergeron and Gray offer a number of recommendations to help facilitators address such complex ethical decisions. First of all, caregiver support group facilitators should have a thorough knowledge of state Elder Abuse Reporting laws. They can also improve their decision-making by developing an ongoing dialogue with state Elder Abuse Protection workers. Support group facilitators can also help avoid or simplify abuse reporting dilemmas by informing potential support group participants of situations in which confidentiality will be breached, including in cases of suspected abuse, and explaining what constitutes abuse as well as the consequences of an abuse report. Additionally, facilitators should carefully monitor participant disclosures during group sessions to avoid situations in which caregivers feel emotionally coerced to reveal abuse. Finally, Bergeron and Gray urge facilitators to seek support and mentorship among their peers, and they issue a call for more research on this under-explored topic.