NCCD is pleased to host the "APS Research to Practice" webinar series sponsored by the National Adult Protective Services Association (NAPSA) and National Committee for the Prevention of Elder Abuse (NCPEA) Research Committee, with support from the National Adult Protective Services Resource Center. These organizations share the goals of promoting research in the areas of adult and elder mistreatment, and supporting APS agencies' use of research to inform and strengthen practice. These webinars are held quarterly. Members of the NAPSA-NCPEA research committee, NCCD, and webinar presenters donate their time and resources to these shared learning experiences as together we strive to support front-line practitioners through advancement of knowledge.
In this presentation, Mark Yaffe, M.D., discusses his research on the development and validation of a brief tool for physician use to support identification and assessment of the presence or absence of suspected elder abuse. Use of the tool has the potential to sensitize physicians to elder abuse and promote referrals of possible victims for in-depth assessment by specialized professionals. While the tool was validated for use by family physicians, this presentation will also discuss what potential may exist for use by other health and social service providers, as well as for self-administration by seniors. (Materials: slide presentation)
In this presentation, Holly K. Caldwell, PhD(c), MSN, RN, shared the results of an integrative review of elder abuse (EA) screening instruments for use in primary care. Using criteria similar to the US Preventive Services Task Force review by Nelson et al in 2004, the authors found 10 studies conducted between 2004 and 2011 that met their inclusion criteria. Ms Caldwell will discuss her findings about five novel instruments, advances in EA screening instrument development, including the enhanced ability of such instruments to identify current harm or risk of harm, and strides being made in elder abuse screening instruments designed for use in healthcare and with patients with dementia and their caregivers. Please note that a recording of this webinar is not available due to technical problems, but a copy of the presentation slides is available here.
Increasing demands for demonstrating positive results and outcomes of community services, including Adult Protective Services, have put significant pressure on program administrators and service providers to engage in ongoing evaluation research. In this webinar Dr. Madelyn Iris, Dr. Rebecca Berman, and Lisa Peters Beumer will describe the principles underlying effective organizational capacity-building for evaluation, review critical steps necessary for achieving evaluation goals, and highlight the benefits of engaging in on-going evaluation practice. Examples will be drawn from an innovative program called ASSERT (Assistance, Services and Support for Evaluation Research Training, a practical educational program that provides community services providers with the strategies, approaches and skills they need to conduct meaningful program evaluation and utilization-focused research. (Materials: slide presentation)
In this webinar, Shelly Jackson, Ph.D., shared findings from her research comparing pure financial exploitation (PFE) of an elderly person—financial exploitation that occurs independently of another form of elder abuse—with hybrid financial exploitation (HFE)—financial exploitation that co-occurs with physical abuse and/or neglect. Implications for how professionals intervene and work with victims of pure financial exploitation vs. hybrid financial exploitation are discussed. (Materials: slide presentation)
Presenters Lori Delagrammatikas, Mary Twomey, Krista Brown, Kris K. Brown, and Mary Counihan discuss how researchers and APS practitioners worked together to develop a protocol to improve the consistency of APS investigation findings in California. After researchers identified great variability in APS decision-making across California, APS practitioners developed a protocol which clearly delineated the essential defining elements of each type of abuse/neglect, provided direction and focus for gathering information, and supplied workers with a structure for evaluating the relative strength and integrity of that information. The protocol has been implemented throughout the state and researchers are in the process of studying its efficacy by evaluating the current level of consistency in findings. The webinar describes the research, protocol and training development, evaluation efforts, and the collaborations needed to affect change statewide. (Materials: slide presentation, supplemental materials)
In this follow-up to the Spring 2012 webinar, Kendon Conrad, Ph.D., Madelyn Iris, Ph.D., and Jessica Mazza, MSPH provided participants with an online demonstration of the Elder Abuse Decision Support System (EADSS) that uses standardized measures and short screening forms to assess elder mistreatment and exploitation, as well as expected system outcomes such as increased convenience and efficiency and improved quality of assessments. (Materials: slide presentation)
Kendon Conrad, Ph.D., Madelyn Iris, Ph.D., and Jessica Mazza, MSPH presented on the development of the Elder Abuse Decision Support System (EADSS). Nationally, elder mistreatment and financial exploitation continue to be under-reported, resulting in inaccurate prevalence and incidence statistics, and increased suffering of older adults. Important systemic factors contributing to this problem include lack of valid, standardized assessment procedures, and state-specific definitions and scope of various types of abuse, neglect, and exploitation. Advances in assessment methodology and computer technology offer promising solutions to improve the identification and tracking of elder mistreatment and exploitation, as well as the reduction of some barriers related to the responsive assessment and delivery of services to victims. This presentation describes the development of EADSS, an Elder Abuse Decision Support System, that uses standardized measures and short screening forms to assess elder mistreatment and exploitation, as well as expected system outcomes such as increased convenience and efficiency and improved quality of assessments. The presentation focuses on the Older Adult Financial Exploitation Measure to illustrate the methods used to develop items. (Materials: slide presentation)
Arlene Groh, RN, BA, Rick Linden, Ph.D., Elizabeth Nieson, RN, and Detective Constable David Haughey will provide information about the origins of the project; will consider the evaluation findings, the current status of Waterloo's response and possible reapplication of Waterloo's model. In 2000, The Community Care Access Centre (CCAC) of Waterloo Region, in partnership with social service agencies, secured funding to design, implement and evaluate a restorative justice approach to financial, physical and emotional abuse and the neglect of older adults by someone in a position of trust. Dr. Rick Linden with funding from The Law Commission of Canada and Justice Canada completed an evaluation. In April 2011 his findings were published in The Journal of Elder Abuse and Neglect. www.tandf.co.uk/journals/WEAN. The original program had some success but referrals to the restorative justice program were low. The program evolved to the Elder Abuse Response Team (EART), a partnership between the Waterloo Region Police Services and the CCAC (2004) whose practice is embedded in restorative justice values and principles and which follows best practice in conflict management. The new program has been very successful in increasing referrals and in ensuring that community partners work well together. (Materials: slide presentation)
Jackie Berman, Ph.D. and Art Mason presented findings from the New York State Elder Abuse Prevalence Study. From the executive summary of the full report: This study is one of the most ambitious and comprehensive studies to quantify the extent of elder abuse in a discrete jurisdiction ever attempted, and certainly the largest in any single American state. With funding from the New York State William B. Hoyt Memorial Children and Family Trust Fund, a program administered under NYS Office of Children and Family Services, three community, governmental, and academic partners (Lifespan of Greater Rochester, the New York City Department for the Aging and the Weill Cornell Medical College) formed a collaborative partnership to conduct the study. (Materials: slide presentation)
Dr. Holly Ramsey-Klawsnik and Dr. Pamela B. Teaster discuss selected findings from "The Study of Sexual Abuse of Vulnerable Adults in Care Facilities." This study was funded by the National Institute on Aging and analyzed detailed data regarding 429 reported sexual abuse cases that were investigated by Adult Protective Services and/or licensing authorities in five states across the nation. The presentation discusses findings regarding the victims, perpetrators, abuses, APS investigations, case findings, and case outcomes. Discussion will focus on using these research findings to improve APS response to allegations of sexual abuse in care facilities. (Materials: slide presentation)
Jane N. Nathanson, Social Work and Rehabilitation Consultant, and Specialist in Human-Animal Health & Welfare, discusses her work in the area of animal hoarding. This presentation is based on her recent publication in the Journal of Elder Abuse & Neglect, 2009 Oct;21(4):307-24. Article abstract: Substantial research and literature indicate how people and companion animals form relationships that are, for the most part, mutually beneficial. Yet there are highly dysfunctional human-animal relationships that do occur, meriting attention and remediation. One of the most perplexing and problematic human-animal relationships is encountered in cases of animal hoarding--a deviant behavior associated with extremely deleterious conditions of comorbid animal and self-neglect. Adult Protective Services workers often encounter theoretical and methodological dilemmas with these complex cases. To intervene most effectively, it becomes critical to elucidate some of the developmental factors of animal hoarding behavior and its correlation with self-neglecting behaviors in general. This article presents an in-depth diagnostic perspective as derived from the author's research and clinical experience. An analysis of the complex dynamics of the relationship between animal hoarders and their pets is presented in conjunction with accepted theories of self-neglect. With enhanced knowledge and understanding of animal hoarding, human service professionals will be better prepared to respond to these clients, evoke greater rapport and cooperation, and engage in the interdisciplinary efforts that are essential for optimal resolution. (Materials: slide presentation, presentation outline)
Deborah O'Connor, Ph.D., RSW, a professor in the School of Social Work at the University of British Columbia, and the (founding) Director of the Centre for Research on Personhood in Dementia, talks with us about her work upon which the theories presented in the recent article entitled "Assessing Capacity Within a Context of Abuse or Neglect" were based. This article is available in the Journal of Elder Abuse and Neglect, volume 21, issue 2. This article examines the unique aspects associated with assessing and determining capacity for older adults who are living in a situation of abuse or neglect. Specifically, examining how living in a situation of abuse or neglect may influence the determination of capacity and exploring the implications of conducting an assessment within a potentially abusive context. (Materials: slide presentation)
Jason Schillerstrom, M.D, of the University of Texas Health Science Center at San Antonio describes recent research findings detailing the prevalence of general cognitive, executive function, and visuospatial impairments, as well as depression in APS clients referred to psychiatry for a decision making capacity evaluation. The significance of disproportionate executive impairments will be discussed and webinar participants will specifically learn how clock drawing tasks can be used to screen for cognitive impairments relevant to decision making capacity. (Materials: CLOX I, slide presentation, webinar Q&A)