This article traces the development of services to prevent and treat elder abuse over a twenty-year time span. It begins by describing the various forms of elder abuse and the challenges they pose to service providers and program developers. Also described are abuse reporting statutes, the roles of various agencies involved in abuse investigations and responses, services commonly needed by victims, funding sources, and common impediments to service delivery.
Several Archstone Foundation funded projects developed and implemented training curricula on elder abuse for mandated reporters such as dentists, adult protective services workers, paramedics, and coroner investigators. Common education and training issues emerged, including the need to provide basic content on normal aging and the need for creating standardized trainings. Strategies include integrating elder abuse and neglect content into existing courses, building relationships with stakeholders, and customizing content and delivery to student needs and preferences. Projects developed relevant, practice-based content, decided on curriculum delivery methods, engaged learners, and provided feedback to them. A main outcome is the permanent institution of elder abuse content in training curricula.
Mental Health Services (MHS) meet mental health needs of older adults through active, outpatient, community-based care. Adult Protective Services (APS) are involved with needs of older adults who have mental disability and mental illness. Adult Protective Services and MHS staff may to work together when they respond to the needs of victims and adults at risk for abuse, neglect, self-neglect, and exploitation. The purpose of this study was to understand effective APS-MHS collaborations (e.g., leadership, organizational culture, administration, and resources in predicting success). A survey that was sent to members of the National Adult Protective Services Association (NAPSA) revealed that both APS and MHS have strong commitments to protecting clients' rights and autonomy, but there appear to be differences between the two with regard to implementation, apparent in cases involving clients with diminished mental capacity who are at imminent risk, but who refuse help. Strengths of APS-MHS collaborations included improved communication and better service for at-risk clients.
The study purpose was to develop and pilot an undue influence screening tool for California's Adult Protective Services (APS) personnel based on the definition of undue influence enacted into California law January 1, 2014. Methods included four focus groups with APS providers (n = 33), piloting the preliminary tool by APS personnel (n = 15), and interviews with four elder abuse experts and two APS administrators. Social service literature-including existing undue influence models-was reviewed, as were existing screening and assessment tools. Using the information from these various sources, the California Undue Influence Screening Tool (CUIST) was developed. It can be applied to APS cases and potentially adapted for use by other professionals and for use in other states. Implementation of the tool into APS practice, policy, procedures, and training of personnel will depend on the initiative of APS management. Future work will need to address the reliability and validity of CUIST.
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