Social Sciences and Humanities Research Council of Canada and the WHO Department of Ageing and Life Course.

Person-centered care (PCC) shifts focus away from the traditional biomedical model in favor of embracing personal choice and autonomy for people receiving health services. It has become an important avenue for improving primary care, and older adults remain a priority target for PCC because they are more likely to have complex care needs than younger individuals. Nevertheless, despite a growing body of evidence regarding its use, PCC still lacks an agreed-upon definition. A literature review was conducted to explore extant scholarship on PCC for older adults, assess corresponding definitions of PCC, and identify important elements of quality PCC. Nearly 3,000 articles published between 1990 and 2014 were identified. Excluding search results outside the parameters of this study, the final review comprised 132 nonduplicate sources focused on patient-centered care or PCC in older adults. Fifteen descriptions of PCC were identified, addressing 17 central principles or values. The six most-prominent domains of PCC were holistic or whole-person care, respect and value, choice, dignity, self-determination, and purposeful living. The body of evidence reviewed suggests that PCC is an important area of growing interest. Although multiple definitions and elements of PCC abound-with many commonalities and some overlap-the field would benefit from a consensus definition and list of essential elements to clarify how to operationalize a PCC approach to health care and services for older adults. This work guided the development of a separate American Geriatrics Society expert panel statement presenting a standardized definition and a list of PCC elements for older adults with chronic conditions or functional impairment. J Am Geriatr Soc 64:e1-e7, 2016.

Low-income Latino immigrants are understudied in elder abuse research. Limited English proficiency, economic insecurity, neighborhood seclusion, a tradition of resolving conflicts within the family, and mistrust of authorities may impede survey research and suppress abuse reporting. To overcome these barriers, we recruited and trained promotores, local Spanish-speaking Latinos, to interview a sample of Latino adults age 66 and older residing in low-income communities. The promotores conducted door-to-door interviews in randomly selected census tracts in Los Angeles to assess the frequency of psychological, physical, and sexual abuse, financial exploitation, and caregiver neglect. Overall, 40.4% of Latino elders experienced some form of abuse and/or neglect within the previous year. Nearly 25% reported psychological abuse, 10.7% indicated physical assault, 9% reported sexual abuse, 16.7% indicated financial exploitation, and 11.7% were neglected by their caregivers. Younger age, higher education, and experiencing sexual or physical abuse before age 65 were significant risk factors for psychological, physical, and/or sexual abuse. Years lived in the United States, younger age, and prior abuse were associated with increased risk of financial exploitation. Years spent living in the U.S. was a significant risk factor for caregiver neglect. Abuse prevalence was much higher in all mistreatment domains than findings from previous research on community-dwelling elders, suggesting that low-income Latino immigrants are highly vulnerable to elder mistreatment, or that respondents are more willing to disclose abuse to promotores who represent their culture and community.

No abstract

Policy implications include the importance of individualized care-management assessments that direct targeted referrals to appropriate services. Findings support the need for individualized care-management assessment and service planning, suggesting that a "one size fits all" approach to HCBS will not meet the varied needs of diverse consumers.