Elder mistreatment is recognized internationally as a prevalent and growing problem, meriting the attention of policymakers, practitioners, and the general public. Studies have demonstrated that elder mistreatment is sufficiently widespread to be a major public health concern and that it leads to a range of negative physical, psychological, and financial outcomes. This article provides an overview of key issues related to the prevention and treatment of elder mistreatment, focusing on initiatives that can be addressed by the White House Conference on Aging. We review research on the extent of mistreatment and its consequences. We then propose 3 challenges in preventing and treating elder mistreatment that relate to improving research knowledge, creating a comprehensive service system, and developing effective policy. Under each challenge, examples are provided of promising initiatives that can be taken to eliminate mistreatment. To inform the recommendations, we employed recent data from the Elder Justice Roadmap Project, in which 750 stakeholders in the field of elder mistreatment were surveyed regarding research and policy priorities.
This article discusses the intersection of the justice system and elder abuse, arguing for a multidisciplinary framework for approaching the problem. It concludes with 12 recommendations for enhancing the justice system's response to elder abuse.
Objectives: This pilot study describes implementation procedures of goal attainment scaling (GAS) and examines the feasibility of using GAS to measure the multifarious intervention outcome of case resolution in elder mistreatment (EM) adult protective services (APS).Methods: Substantiated EM victims (n = 27) were recruited prospectively from the State of Maine APS. An adapted GAS approach was implemented involving development of a prepopulated goal scale menu and web-based GAS application.Results: The GAS menu comprised 18 goals and corresponding scales spanning several domains of case resolution: social support, service access, health/functioning, enhancing independence, and protective measures. The overall GAS process had mean length 33.8 min per case. The mean GAS summary t-score (54.3) aligned with theoretical expectations.Discussion: Without a measure of case resolution, research cannot compare the effectiveness of different EM intervention models. Findings suggest that GAS is a feasible, client-centered strategy to measure the multifarious EM intervention case resolution outcome.
KEYWORDSAdult protective services; client-centered measurement; elder abuse; elder neglect; elder selfneglect; goal attainment scaling Background and objectives
Elder self-neglect is a complex issue for the legal system-one not always easily distinguished from other types of elder abuse, neglect, and exploitation. The issue inherently implicates several disciplines, and although self-neglect is not prosecuted per se, prosecutions of other types of elder abuse, neglect, and exploitation may affect self-neglect as well. In addition, other types of legal intervention, such as guardianship actions, may serve to protect vulnerable older people, but it is critical to ensure that such interventions do not inappropriately infringe on the older person's civil liberties or result in exploitation or worse. There are daunting challenges to doing work in this field-death; ageism; medical, legal, and ethical complexities; and a chronic paucity of funding. It is nevertheless imperative that researchers expand their efforts to elucidate the nature and scope of elder self-neglect; its interplay with other forms of abuse, neglect, and exploitation; and the most effective mechanisms for intervention and prevention. Such efforts, and in particular interdisciplinary approaches to these common problems, are critical to improving care for the nation's older people and assisting millions of families and practitioners.
Despite a growing number of elder abuse cases nationwide, response programs such as Adult Protective Services (APS) lack a defined, prolonged intervention phase to address these complex situations. This paper presents RISE, a model of elder abuse intervention that works alongside APS or other systems that interact with at-risk older adults. Informed by an ecological-systems perspective and adapting evidence-based modalities from other fields (including motivational interviewing, teaming, restorative justice, goal attainment scaling), the RISE model intervenes at levels of the individual older adult victim, individual harmer, their relationship, and community to address elder abuse risk and strengthen systems of support surrounding the victim-harmer dyad. The RISE model addresses an intervention gap in existing systems to better meet the needs of elder abuse victims and others in their lives, leading to more sustainable outcomes.
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