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LEC - Revisiting Structured Decision Making

| Raelene Freitag

2012 Summer Webinar - The Elder Abuse Decision Support System, Part II

| Moderated by Kathy Park

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)

2012 Spring Webinar - The Elder Abuse Decision Support System

| Moderated by Kathy Park

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)

2012 Winter Webinar - Addressing Elder Abuse: The Waterloo Restorative Justice Approach to Elder Abuse Project

| Moderated by Kathy Park

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. 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)

2011 Fall Webinar - Under the Radar: New York State Elder Abuse Prevalence Study

| Moderated by Kathy Park

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) 

2011 Spring Webinar - The Study of Sexual Abuse of Vulnerable Adults in Care Facilities

| Moderated by Kathy Park

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) 

| Dennis Wagner, PhD | Kristen Johnson, PhD | Andrea Bogie, MSW | Kathy Park

In 2008, the New Hampshire Department of Health and Human Services Bureau of Elderly and Adult Services (BEAS) and the National Council on Crime and Delinquency (NCCD), with funding provided by the National Institute of Justice (NIJ), collaborated to construct an actuarial risk assessment to classify BEAS clients by their likelihood of elder maltreatment and/or self-neglect in the future. Studies in adult and juvenile corrections and child welfare have demonstrated that active service intervention with high risk clients can reduce criminal recidivism and the recurrence of child maltreatment (Wagner, Hull, & Luttrell, 1995; Eisenberg & Markley, 1987; Baird, Heinz, & Bemus, 1981). The purpose of this research was to examine a large set of individual and referral characteristics, determine their relationship to subsequent elder self-neglect and/or maltreatment, and develop an actuarial risk assessment for BEAS workers to complete at the end of an investigation to inform their case decisions. BEAS and NCCD pursued development of an actuarial risk assessment with the goal of reducing subsequent maltreatment of elderly and vulnerable adults who have been involved in an incident of self-neglect or maltreatment by another person (i.e., abuse, exploitation, or neglect). The actuarial risk assessment described in this report provides BEAS workers with a method to more accurately identify high risk clients and therefore more effectively target service interventions in an effort to protect their most vulnerable clients.

2010 Fall Webinar - Animal Hoarding: Comorbidity of Animal and Self Neglect

| Moderated by Kathy Park

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)

| Children's Research Center

Structured Decision Making News, Applying the Structured Decision Making® Model in New Ways 

2010 Summer Webinar - Conducting a Person-centered Assessment of Decisional Capacity in a Context of Abuse: Guidelines and Considerations (Part I)

| Moderated by Kathy Park

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)

2010 Spring Webinar - Executive Function in Self-neglecting Adult Protective Services Referrals Compared with Elder Psychiatric Outpatients

| Moderated by Kathy Park

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) 

| Katherine Park | Kristen Johnson, PhD | Shannon Flasch | Andrea Bogie, MSW

A new NCCD Focus article, "Structuring Decisions in Adult Protective Services," describes the value of structured decision frameworks in the growing field of adult protective services (APS). The article highlights findings on risk factors for future adult maltreatment from research literature as well as NCCD's efforts to develop an actuarial-based risk assessment for APS in partnership with the New Hampshire Bureau of Elderly and Adult Services under a grant from the National Institute of Justice.