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Elder Abuse Workshop: VISION Report

Ms. Connolly reviewed the preliminary comments from participants from the VISION survey, noting that not all the information was tabulated:

Short-Term Research Priorities

Incidence and Prevalence (21)

• Document incidence and prevalence (17).
• Conceptualize comprehensive national prevalence and incidence study (3).
• Use existing data sources to collect data.

Interventions (13)

There was a lot of interest in intervention. One issue is that we want to know more but realize that people are still being hurt, so we must try to bridge that gap between finding the best interventions and intervening.

• Criminal justice response research (5).

• Intervention theory development and testing/evaluation (5).

• Effectiveness of EA (elder abuse) interventions.

• Effectiveness of trainings.

• Effectiveness of Forensic Centers and other MDTs (multidisciplinary teams) and IDTs (interdisciplinary teams).

Risk Factors and Detection (11)

• Risk factors to identify characteristics of abusers (6).
• Screening tools (4).
• Improve detection reporting of abuse and neglect.

Laws and Justice System Approach (6)

• Create model laws and systems.
• Criminal justice response research (5).

Consequences

• Follow up on individuals who have been abused.

Theory/Model Development (4)

• Understand the role of childhood trauma.
• Conceptual differences in how EA manifests itself (3).

Definitions (4) (define by discipline)

Characteristics

• Cultural characteristics in how EA manifests itself (2).
• Victim and perpetrator characteristics.

Examining Elder Deaths—Interest in How to Mine the Data that We Have

• Elder deaths in LTC.
• Suspect elder deaths, especially from neglect.
• What are markers that make death suspicious?

Process—Practitioners and Researchers Need to Maintain Communication

• Health effects of elder abuse, neglect, exploitation.
• Hospice end-of-life care.
• More on resident-on-resident abuse.
• Psychological abuse in nursing homes.
• Cost of elder abuse.

Long-Term Research Priorities

• Intervention research (20).
• Determining effectiveness of our ("best") practices (9).
• Effectiveness of intervention and prevention (especially APS) (5).
• Emphasis on effective victim-safety response intervention (3).
• Data to inform development and evaluation of intervention.
• Survey ombudspersons and guardianship about effectiveness of their programs.
• Identify risk and protective factors (8) (longitudinal).
• National incidence and prevalence study (8).
• Assess long-term impact on victims (4).

Models/Theory/Causes (4)

• Model/theory testing.
• Causes of elder abuse.
• Screening tool for practitioners.
• Make measurement useful to practitioners and researchers in field.
• Longitudinal documentation of EA throughout justice agencies.

Greatest Challenges

• Funding (9).
• Ageism/mindset (7).
• Capacity - ethics questions (6).
• Agency cooperation/participation (5).
• IRB (5).
• Developing definitions (5).
• Mandated reporting issues (3).
• Research to practice (3).
• Confidentiality (3).
• Finding subjects (3).
• Lack of research guidelines (2).
  • Bring in more researchers (2).
• Multidisciplinary collaboration (2).
• Fears of providers (2).
• Not reinventing the field.
• Acceptance of universities.
• Informed consent.
• Large studies with a large n.
• Conceptual clarity/models.
• Good research.

What Help Do We Need From Federal Agencies and Others?

• Facilitate/promote.
  • Discussion about ethics, methods and IRBs.
  • Multiple agency funding.
  • State justice institute might be co-funder.
• Establishment of research priorities (field or government).
  • Bring together agencies (NIA, NIJ, AARP and others) for more planning.
  • Work on best practices.
  • Communication with public/media outreach.
  • Multisite projects.
  • Learning from other fields.
• Dissemination.
  • Disseminate research findings as they become available.
• Implement.
• Next steps.
• Legislation.
• Help pass the EJA (Elder Justice Act).
• Access.
  • Help with access to facilities.
• Funding (6)
  • Encourage other agencies and funders to participate and help with research.
  • More RFPs (requests for proposals) with more money.
  • Streamline awards.
  • Increase funding levels.
  • Fund research that builds.

Critical Research Priorities

• Funding, funding, funding.
• Bring in private foundations.
• More private-public funding.
• Fund a center for comprehensive assessment.
• Evaluation - especially key interventions (e.g., APS).
• Awareness.
  • Increase awareness, MADD (Mothers Against Drunk Driving) model.
  • Public outrage that EA not acceptable.
• Coordination.
  • Among medical and social services, criminal justice.
  • Among all entities.
• Assessment/screening of outcome.

Ideas in a Box

• Use OSCAR or MDS to look at differences over time with states with different levels of criminal background checks.

• Impact of deinstitutionalizations on APS.

• Relationship between APS and nursing home/long-term care placement.

• Examine/research guardianship and conservatorship.

• Examine hidden cases of EA in courts.

• Study efficacy of criminal background checks—do they improve safety or quality?

• Number of persons in nursing homes on Medicaid because of financial exploitation.

• (Reverse) mortgage, annuity, insurance fraud.

• Comprehensive study of abuse by adult sons.

• Develop screening tool for courts in guardianship monitoring to detect abuse.

• Meta-analysis in IRB issues and in research, barriers to research on elder abuse.

• How does the language we use impact the outcome in these cases?

• Elder abuse in dementia patients?

• Develop "lethality risk factors" (Carmel Dyer).

Stay tuned..!