Elder Mistreatment Abuse, Neglect, and Exploitation in an Aging America (2003) / Chapter Skim
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7. Evaluating Interventions
7. Evaluating Interventions
Pages 121-139
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From page 121... ...
Mandatory reporting and interventions by adult protective services, the core elements of the current system for preventing and ameliorating elder mistreatment, have never been subjected to a rigorous evaluation. Nor have most other interventions targeted at preventing elder mistreatment or addressing the needs of victims and abusers.
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From page 122... ...
The occupations and professions commonly mandated to report include: Health care professionals Mental health professionals Caregivers (whether paid or unpaid) Home care providers Employees of nonresidential programs for the elderly Employees of sheltered workshops and similar nonresidential programs Employees of residential facilities for the elderly Social workers Long-term care ombudsman program staff and volunteers Employees of adult protective services programs
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From page 123... ...
discusses some studies indicating significant underreporting of elder mistreatment by physicians and other health care professionals, long-term care ombudsmen, and residents of long-term care facilities and their family members. The pane!
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From page 124... ...
The panel strongly recommends systematic studies of reporting practices and the effects of reporting, taking maximum advantage of the opportunity for comparisons of practices and outcomes in states with and without mandated reporting. ADULT PROTECTIVE SERVICES Adult protective services agencies are the backbone of communitybased efforts to respond to elder mistreatment.
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From page 125... ...
Wisconsin's review concluded that the role of the adult protective services system should be focused exclusively on providing social services and that investigations should be conducted solely by law enforcement agencies (Wisconsin Department of Health and Family Services, 2001~. In the context of investigations, a method being increasingly used, modeled on the child protective system, is the state abuse registry.
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From page 126... ...
Research is needed on the effectiveness of adult protective services interventions, ideally in study designs that compare outcomes in cases in which services were provided with those in which eligible recipients declined offered services or other cases in which mistreatment of an equivalent nature has been identified. It should be noted that a large proportion in some states, more than half of the reports coming into adult protective services concern elderly persons who are neglecting their own care.
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From page 127... ...
Thus it is essential for researchers studying adult protective services interventions (or studying other interventions de.
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From page 128... ...
While some training has been done locally by adult protective services, recently the national organization of emergency medical technicians, in conjunction with the National Center on Elder Abuse, has completed a curriculum for their members on elder mistreatment. Research on emergency medical technicians who are trained and that call in social services (adult protective services)
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From page 129... ...
Officers who recognize the signs of mistreatment and know what community agencies are available to provide assistance can help the victim by bringing in adult protective services, providing referrals to community services, or in other ways. Linking to other agencies is particularly critical when law enforcement officers arrest a caregiver for elder mistreatment and remove him or her from the home; otherwise the victim may be left without needed care.
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From page 130... ...
PROFESSIONAL SPECIALIZATION AND COLLABORATION Many professions, advocacy groups, and other organizations are involved in efforts to prevent and respond to elder mistreatment. Although adult protective services is the backbone of the system, community-based interventions draw on the health professions, law enforcement personnel and all participants in the criminal justice system, the bar and other participants in the civil justice system, financial institutions, and many others.
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From page 131... ...
The Title VII elder abuse prevention monies fund state units on aging to conduct prevention activities at the state level or to fund area agencies on aging to implement prevention activities at the local level. Community collaborations have played an increasingly important role in recent years by suggesting interventions when serious elder mistreatment occurs.
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From page 132... ...
to develop and disseminate information on elder mistreatment, including adult protective services. The Department of Justice has sponsored some focus groups, a roundtable on forensic issues, a national symposium on elder mistreatment and consumer fraud, and several conferences encouraging law enforcement involvement in mistreatment cases, development of training programs for banking personnel, curricula to educate various professionals about the need for and benefit of collaboration, support of fatality review teams, and the development of recommendations related to forensic issues.
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From page 133... ...
. Virtually nothing is now known, for example, about the nature and effectiveness of regulatory efforts relating to assisted living facilities and other residential care facilities other than nursing homes (Harrington et al., 2000~.
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From page 134... ...
Adult protective services programs, health care professionals, and participants in the criminal justice and civil justice systems also may be involved in responding to mistreated residents of nursing homes and other long-term care facilities in much the same way that they respond to victims who live in their own homes. The literature on compliance with, and enforcement of, federal regulations governing nursing homes has been reviewed by the Institute of Medicine (2001)
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From page 135... ...
. Although a discussion of solutions to staffing problems in nursing homes is beyond the scope of this report, there is no question that improving the numbers of staff and decreasing turnover rates would contribute to elder mistreatment prevention.
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From page 136... ...
This elder mistreatment prevention curriculum is designed for nursing assistants in long-term care facilities. The program has three major objectives: to increase staff awareness of actual elder mistreatment and potentially abusive situations; to equip nursing assistants with appropriate conflict intervention strategies; and thereby to reduce staff-resident conflict and abusive behaviors by staff.
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From page 137... ...
that conduct random, unannounced visits of nursing homes and assisted living facilities. The teams are generally composed of representatives from the attorney general's office, law enforcement, the long-term care ombudsman program, and other government enforcement agencies, including code enforcement officers and local or state fire marshals.
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From page 138... ...
. Second, in all 60 housing projects, half of the households reporting elcler abuse incidents to the police were ranclomly assigned to receive home visits by a team of a police officer and a domestic violence counselor.
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From page 139... ...
Research is needed on the effectiveness of adult protective services interventions, ideally in study designs that compare outcomes in cases in which services were provided with those in which eligible recipients declined offered services or other cases in which mistreatment of an equivalent nature has been identified. · Intervention or prevention research based in existing health care environments that come into contact with mistreated elders, such as hospitals, emergency departments, and emergency response services, should be a priority as it takes advantage of the existing expertise and resources of these services.
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