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Elder Abuse Prevention Interventions

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Elder Abuse

Abstract

There are a plethora of prevention intervention strategies and services available to assist in identifying elders at risk for mistreatment, services available for those who are identified as high risk for mistreatment, and far-ranging but uncoordinated universal awareness and education activities and initiatives mostly mounted at local levels. However, we have little or no evidence of the long-term efficacy of the many different strategies and services currently employed to reduce the occurrence or the severity of elder abuse and neglect through prevention interventions. Without a valid body of outcomes-based evidence, informed by well-designed and sound methodological research, we do not know if the investment in our current programs and services has any positive payoffs in terms of improved individual or societal well-being. This chapter sets forth a framework for differentiating elder abuse prevention interventions from treatments, and reviews the current state of knowledge regarding the impacts of universal, selective, and indicated prevention interventions. The chapter answers the following questions: Are elder abuse public awareness and education effective universal prevention strategies? Are screening, continuing education and training effective selective prevention strategies? Are individualized counseling, home visits combined with case management, and multidisciplinary teams effective indicated prevention strategies? Recommendations are presented for building a body of reliable and valid prevention intervention research that emphasizes experimental design, sophisticated data analysis, and rigorous evaluation.

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Notes

  1. 1.

    The 15 second spot was produced by the University of Delaware in its capacity as co-manager of the National Center on Elder Abuse. The negotiated price for placement was $35,000 for a cost of reach of 1.22 cents a view. Actor William Mapother donated his time and production costs. The branded message was “Why Should I Care?”

  2. 2.

    Although originally written specifically for this chapter, this section was incorporated into another manuscript that was subsequently published prior to the publication of this book [102].

  3. 3.

    The value of WEAAD goes beyond its impact as a prevention measure. WEAAD and its myriad events “reinforce the concept that elder abuse is a universal problem experienced by a diverse and vast audience, and also serve to generate a sense of inclusiveness for those working to address the issue ([68], p. 346).” This, alone, makes WEAAD a powerful social event, as well as a continuing motivation for those who work to better the lives of abused and neglected elders and who, more often than not, face frustrations on a daily basis.

  4. 4.

    These time periods were chosen with the assumption that new and/or continuing WEAAD activities would commence in month 12, if this continues to be an annual event. Thus, evaluation would be continuous and sustained over a period of years.

  5. 5.

    For example, Colorado Senior Reach, in its first 28 months, trained 5561 community partners who identified 478 people in need of, and eligible for, assistance. Mid Kansas Senior Outreach in its first 32 months trained 13,992 community partners who identified 483 people in need of and eligible for assistance [9].

  6. 6.

    As explained earlier in this chapter, once elder abuse or neglect is substantiated, interventions are no longer preventive, but consist of treatments.

  7. 7.

    The forensic team concept was launched at the University of California at Irvine in 2003, in which professionals from the justice system, health care, protective services, and mental health would meet regularly to engage in multidisciplinary consultation, case examination, action recommendations, and service delivery. A key feature is that these forensic teams would meet regularly under one roof, called a Forensic Center [78]. Due to their similarity in function and concept, this chapter uses the term “multidisciplinary team” to include forensic teams.

  8. 8.

    The first three program examples from Alaska, University of Southern California, and New York were chosen, as they were, at the time of this writing, three of the five projects most recently funded by the U.S. Administration on Aging to test and evaluate prevention interventions.

  9. 9.

    These specific recommendations are from the remarks of Mark Lachs, Weill Cornell Medicine, Cornell University; Richard Gelles, University of Pennsylvania; Karl Pillemer, Cornell University; David Burns, University of Toronto; and Laura Mosqueda, University of Southern California.

  10. 10.

    The RE-AIM framework has primarily been used in translational research in the public health arena to help improve the sustainable adoption and implementation of effective, generalizable, evidence-based interventions. Sweet et al. [110] describes the five assessment points as: reach (percentage and characteristics of people from a given population who participate—as subjects or as staff—in the intervention); effectiveness, (positive and negative outcomes of the intervention); adoption (the percent of possible organizations and staff that have agreed to participate in the intervention); implementation (the extent to which the program was delivered as intended and its cost); and maintenance (outcomes sustained at the individual level for at least 6 months, and that intervention or practice or policy is institutionalized at the organizational level).

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Stein, K. (2017). Elder Abuse Prevention Interventions. In: Dong, X. (eds) Elder Abuse. Springer, Cham. https://doi.org/10.1007/978-3-319-47504-2_20

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