scholarly journals THE INTERVIEW FOR DECISIONAL ABILITIES: DEVELOPING THE EVIDENCE BASE FOR ADULT PROTECTIVE SERVICES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S501-S501
Author(s):  
Theresa Sivers-Teixeira ◽  
Gregory Stevens ◽  
Kelly Sadamitsu ◽  
Christina Penate ◽  
Bonnie Olsen
Keyword(s):  
Case Management ◽  
Evidence Base ◽  
Protective Services ◽  
Elder Mistreatment ◽  
Adult Protective Services ◽  
Trained Subjects ◽  
Training Groups ◽  
Preliminary Results ◽  
Abuse And Neglect ◽  
The Impact

Abstract Adult Protective Services (APS) workers assess clients for abuse and neglect and are asked to determine the client’s understanding of risks they face. Yet, APS workers have little structured training in how to make such judgements. The Interview for Decisional Abilities (IDA 3.0-CA) is a tool designed for use by APS workers to assess the ability of suspected victims of elder mistreatment to make decisions about the risks they face. This study evaluates the impact of training and use of this tool on the knowledge, experiences and ability of APS workers to determine decisional ability. APS workers and supervisors were recruited from central and northern California APS programs and randomized into either control (n=94) or IDA 3.0-CA training groups (n= 95). Baseline surveys measure knowledge of, and experiences with, assessing decisional ability and determining next steps for case management. Additionally, respondents determine the decisional ability of three case scenarios. Three months post-training, controls and trained subjects complete the same survey with a new set of cases. Preliminary results at baseline indicate there were no statistically-significant differences between trained subjects (n=42) and controls (n=50) in their knowledge scores (78.6% correct vs. 81.0%, p=0.6641) or performance assessing decisional ability in the case scenarios (60.1% correct vs. 63.3%, p=0.3497). Reported experiences assessing decisional ability and determining next steps in case management were also similar for trained subjects and controls. Complete results will be presented regarding change in knowledge scores, experiences, and assessing decisional ability in case scenarios compared across trained subjects and controls.

scholarly journals REFINING AN ELDER MISTREATMENT SCREENING AND RESPONSE TOOL TO IMPROVE ACCEPTABILITY IN AN EMERGENCY DEPARTMENT

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S74-S75
Author(s):  
Brian Tanksley ◽  
Theresa Sivers-Teixeira ◽  
Laura Mosqueda ◽  
Bonnie Olsen ◽  
Tim Platts-Mills ◽  
...  
Keyword(s):  
Strong Support ◽  
Public Health Problem ◽  
Evidence Based ◽  
Protective Services ◽  
Online Surveys ◽  
Elder Mistreatment ◽  
Core Element ◽  
Adult Protective Services ◽  
Roles And Responsibilities ◽  
Cross Training

Abstract Elder mistreatment (EM) is a public health problem that is rarely recognized or addressed in emergency departments (ED) where a lack of evidence-based protocols leave clinicians to rely on intuition and inconsistent action plans. In this presentation we will share findings from focus groups and online surveys with ED clinicians and administrators to evaluate the perceived value and likelihood of adopting the National Collaboratory’s third core element: the EM Screening and Response Protocol (EM-SAR). Results indicated a strong support for the EM-SAR tool in general and highlighted specific considerations for refining the tool. Considerations include resistance to adding to the ED workload, need to clarify roles and responsibilities for administering the tool, hesitancy to rely on clinical judgement to assess EM, concerns over Adult Protective Services’ ability to respond to increased reports, and a desire for cross-training and cooperation. These findings and implications for ongoing feasibility testing will be discussed.

scholarly journals Predictors of Depression in Healthcare Patients at Risk of Self-Neglect

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 274-275
Author(s):  
Miriam Rose ◽  
Farida Ejaz ◽  
Courtney Reynolds
Keyword(s):  
Social Support ◽  
Case Management ◽  
Emotional Health ◽  
Control Group ◽  
Intensive Case Management ◽  
Protective Services ◽  
Adult Protective Services ◽  
Post Test ◽  
Predictors Of Depression ◽  
Disabled Adults

Abstract More than half of reports to Adult Protective Services agencies nationwide involve allegations of self-neglect. An intensive case management intervention for preventing self-neglect was evaluated in a longitudinal study conducted collaboratively by a large healthcare system, Adult Protective Services, and a gerontological research institute. Patients (444) who were older (60+ years) and/or disabled (18+ years) were randomly selected for participation from 19 primary-care clinics if they had risk factors for self-neglect, including depression, substance abuse, dementia, and/or impairment in activities of daily living. Average age was 68 years (SD=12.5), 68% were Hispanic, 68% had monthly income of less than $1,361, and 67% were female. Clinics were randomized into intervention and control groups. Intervention clinic patients received intensive case management services; control clinic patients received usual care, including social work services. Subjects were interviewed at baseline and four months later. The Stress Process Model guided a multiple regression analysis. Domains of background characteristics, primary and secondary stressors, and support (patients in intervention or control group) were entered in blocks to predict depression levels at post-test. While no significant differences were found in post-test depression levels between intervention and controls, the final model was statistically significant (adjusted R2=.452). Significant predictors of depression were: younger age (disabled adults), poorer self-rated physical and emotional health, greater loneliness, and less social support. Future analyses will examine effects of moderating variables on post-test depression levels. Practice implications of preliminary analyses include addressing disabled adults’ mental health needs, especially if they are isolated and lack social support.

scholarly journals ELDER MISTREATMENT FOLLOW-UP: CONNECTING EMERGENCY DEPARTMENTS AND COMMUNITIES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S75-S75
Author(s):  
Alice Bonner ◽  
Kristin Lees-Haggerty ◽  
Debi Lang ◽  
Bree Cunningham ◽  
Jason Burnett ◽  
...  
Keyword(s):  
Protective Services ◽  
Post Discharge ◽  
Elder Mistreatment ◽  
Core Element ◽  
Adult Protective Services ◽  
Case Examples ◽  
Ensure Patient Safety ◽  
The Us ◽  
Resource Levels

Abstract To effectively address elder mistreatment (EM) in the emergency department (ED) hospitals must have mechanisms that promote and, to the extent possible, ensure patient safety post-discharge. However, the realities of working within busy hospitals--limited staff time, financial resources, and EM-specific expertise--prevent many EDs from being able to dedicate staff for patient follow up or develop EM multi-disciplinary teams. The fourth core element of the NCAEM’s ED Care Model aims to address this need with a roadmap for leveraging existing community resources. The roadmap provides streamlined tools to help hospitals assess their needs, identify existing teams and resources in their community, and connect with Adult Protective Services and other organizations. In this presentation we will present these tools and share case examples from beginning stages of feasibility testing in hospitals across the US. We will discuss specific strategies for implementing the model in hospitals of differing types, sizes, and resource levels.

Assessing Elder Mistreatment: Instrument Development and Implications for Adult Protective Services

2009 ◽  
Vol 52 (8) ◽  
pp. 815-836 ◽  
Author(s):  
Elizabeth K. Anthony ◽  
Amanda J. Lehning ◽  
Michael J. Austin ◽  
Michael D. Peck
Keyword(s):  
Instrument Development ◽  
Protective Services ◽  
Elder Mistreatment ◽  
Adult Protective Services

scholarly journals Elder Mistreatment Victims during the COVID-19 Pandemic: Administrative Data from San Francisco Adult Protective Services

2021 ◽  
Author(s):  
Pi-Ju Liu ◽  
Aining Wang ◽  
Laura M. Schwab-Reese ◽  
Sara K. Stratton
Keyword(s):  
San Francisco ◽  
Emotional Abuse ◽  
Unmet Needs ◽  
Service Providers ◽  
Estimation Method ◽  
Protective Services ◽  
Elder Mistreatment ◽  
Adult Protective Services ◽  
Health Crisis ◽  
Medical Needs

AbstractThis study examined elder mistreatment victims’ experiences at the beginning of the COVID-19 pandemic, focusing on their COVID-19 awareness and unmet needs. San Francisco Adult Protective Services (APS) caseworkers conducted phone interviews with clients or collaterals (client’s family, trusted other, or service provider) to inquire about clients’ awareness of COVID-19 and unmet needs. Nine-hundred-and-thirty-four (71%) of 1,313 APS’ past clients or their collaterals were interviewed, with 741 (79%) responding positively to COVID-19-awareness questions, and 697 (75%) having no unmet needs. Binary logistic regression with Firth adjusted maximum likelihood estimation method revealed that older persons (p < .05), self-neglectors (p < .05), and victims of neglect (p < .05) were less aware of COVID-19. Unmet needs varied by mistreatment type. Victims of isolation were more likely to have medical needs (p < .05), while victims of emotional abuse were more likely to report loneliness (p < .001). Case notes reflected clients who were well-prepared for the pandemic, versus those who required additional assistance to follow preventative measures of the COVID-19 pandemic to stay home. Although the majority of San Francisco APS’ past clients experienced no unmet needs at the beginning of the COVID-19 pandemic, the prolonged length and intensity of the pandemic could have exacerbated this vulnerable group’s situation. Collaboration between service providers is key in assisting victims experiencing unmet needs to live safely in a public health crisis, especially underserved victims of specific ethnic backgrounds.

scholarly journals Adult Protective Services Study on the Impact of COVID-19

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 86-87
Author(s):  
Karen Roberto ◽  
Pamela Teaster ◽  
Jyoti Savla ◽  
Imogen Fua ◽  
Karl Urban ◽  
...  
Keyword(s):  
State Level ◽  
Phase Iii ◽  
Protective Services ◽  
Policy And Practice ◽  
Adult Protective Services ◽  
Work Arrangements ◽  
Telephone Interviews ◽  
Managerial Support ◽  
Phase Study ◽  
The Impact

Abstract The purpose of study was to explore changes in implemented of APS programs in response to the COVID-19 pandemic. This three-phase study began with telephone interviews with eight state-level APS administrators of early phase “hot-spots” that were used to inform questions for the Phase II national survey of state APS programs. Forty-seven states completed an on-line survey on the effects of the pandemic on work and workload, policy and practice, staff, partnerships, and preparedness. Phase III interviews with 7 local APS programs provided an “on-the-ground” view of challenges of meeting clients’ needs. Although most APS programs reported fewer reports of adult maltreatment than before the pandemic, the stress and disruption of COVID-19 required new work arrangements, to which programs adapted technological and managerial support to care for the needs of both APS staff and the clients they served. Finding provide insight for policy and planning requirements for future catastrophic events.

scholarly journals Recognizing and Intervening on Elder Abuse, Neglect, and Exploitation in the Age of COVID-19

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 73-73
Author(s):  
Pi-Ju Liu ◽  
Pamela Teaster
Keyword(s):  
Older Adults ◽  
Social Services ◽  
Service Providers ◽  
Elder Abuse ◽  
Protective Services ◽  
Policy And Practice ◽  
Future Health ◽  
Elder Mistreatment ◽  
Adult Protective Services ◽  
Age Related

Abstract The rapid outbreak of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to a global pandemic. Public health measures to prevent the spread of COVID-19, such as social distancing and self-quarantine, have drastically altered people’s lives and led to social isolation, financial instability, and disrupted access to healthcare and social services. Older adults have not only borne the brunt of the highest COVID-19 mortality rates, but recent studies also describe growing reports of elder mistreatment. It is necessary to attend to these age-related disparities during the remainder of the COVID-19 pandemic and future health crises. This symposium includes four presentations on researchers’ findings in elder mistreatment during the COVID-19 pandemic. Dr. E-Shien Chang will compare prevalence of elder mistreatment before and since the pandemic, and highlight associated risk and protective factors during the pandemic. Dr. Lena Makaroun will examine changes in elder mistreatment risk factors among caregivers during the pandemic. Dr. Pamela Teaster will present Adult Protective Services’ (APS) policy and practice changes in response to the pandemic to demonstrate the pandemic’s impact on service providers. Lastly, Dr. Pi-Ju (Marian) Liu will appraise elder mistreatment victims’ awareness of COVID-19 and their unmet needs during the pandemic. Following the four presentations, Dr. Pamela Teaster will moderate a discussion on how elder mistreatment is a growing concern, especially during the pandemic, and what service providers are doing to protect older adults.

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