Multidisciplinary and Collaborative Approaches in Responding to Elder Abuse

Efforts to prevent, identify and intervene in elder abuse, neglect and exploitation cut across many disciplines and organizations. While adult protective services (APS) professionals are primarily responsible for the investigation of such cases, any professional or volunteer working with older and vulnerable adults may encounter those who are at risk or who have been mistreated. Once referred for services, a number of practitioners or agencies may be assisting the individual or family. In order to provide services effectively and efficiently, those involved need to coordinate their efforts to enhance their response and maximize valuable, and limited, resources.

The following bibliography emphasizes the need for, and the effectiveness of, integrated responses to elder abuse. References have been selected that highlight collaborative approaches among APS, health, mental health and social services, law enforcement and the criminal justice system, domestic violence programs, financial institutions, clergy, humane associations, ombudsmen, advocates and volunteers. Coalitions and formal networks are also featured along with coordinated efforts involving local, state and federal agencies. Both formal initiatives (such as multidisciplinary teams or MDTs, also known as interdisciplinary or I-Teams) and informal but promising practices are described.

(To search for brief descriptions of formal agreements that define the roles and responsibilities of those entities engaged in formal collaborations, visit the MOU data base on the CANE Web site at: http://cane.udel.edu . To search for additional training material on the topic, visit the NCEA Training Library for Adult Protective Services and Elder Abuse.)

Most of the reference materials can be obtained through local university and community libraries or interlibrary loan services. Some must be ordered directly through the publisher or production company. When available, contact and pricing information is included with the abstract. Increasingly, many resources are available online, and the web addresses are also included.* If you have difficulty obtaining any of these materials, please contact the CANE office for assistance by emailing cane-ud@udel.edu or telephoning (302) 831-3525.

Note: This is a selected annotated bibliography, which does not include all published references related to this topic. The included references have been selected to provide readers with a current and comprehensive collection of articles representing a variety of perspectives on the subject. To access these and other annotated bibliographies, visit the CANE Bibliography Series on the NCEA Web site. To search for additional references on this and other topics related to elder abuse, please visit the CANE Web site at: http://cane.udel.edu.

*Web addresses may change without notice. If an address provided is no longer accurate, we recommend using a generic search engine, such as Google, to find a current link. If you cannot locate the online publication, contact the CANE offices for assistance by e-mailing cane-ud@udel.edu or telephoning (302-831-3525).

The National Center on Elder Abuse (NCEA) serves as a national resource for adult protective services, elder rights advocates, law enforcement and legal professionals, public policy leaders, researchers, and citizens. It is the mission of NCEA to promote understanding, knowledge sharing, and action on elder abuse, neglect, and exploitation.

The NCEA is administered under the auspices of the National Association of State Units on Aging.

NCEA Partners
        National Association of State Units on Aging (NASUA), Lead Partner
        American Bar Association (ABA) Commission on Law and Aging
        Clearinghouse on Abuse and Neglect of the Elderly (CANE) at the University of Delaware
        National Adult Protective Services Association (NAPSA)
        National Committee for the Prevention of Elder Abuse (NCPEA)

This publication was made possible through the support provided by the National Center on Elder Abuse. Major funding for the National Center on Elder Abuse comes from the U.S. Administration on Aging, Department of Health and Human Services.
Grant No. 90-AM-2792.

Opinions or points of view expressed do not necessarily reflect the official position or policies of the U.S. Administration on Aging.

2006

1. T6523-320
Brandl, B., Dyer, C., Heisler, C., Otto, J., Stiegel, L. & Thomas, R.
Elder Abuse Detection and Intervention A Collaborative Approach
Springer Publisher; New York, NY; 2006.
Book
As quoted from the publisher's Web site, this book "... Offers a new, collaborative approach geared to enhance case review, improve victim safety, raise abuser accountability, and promote system change. Sharing the common goal of promoting elder victim safety, experts in adult protective services, law enforcement, prosecution, health care, advocacy, and civil justice have formed a unique, multidisciplinary team approach to tackle the following critical topics: establishing a collaborative description of elder abuse history; identifying the criteria for the reporting of cases; accessing the intervention systems involved; highlighting benefits and obstacles to success; reviewing policy, legislation, research, and social change..." (Note: This book is not available through CANE. It can be ordered online at: http://www.springerpub.com/prod.aspx?prod_id=3114x or by telephone at: 1-877-687-7476. Price: $45.00.)

2. S6387-9
Curtis, L.
Partnering with Faith Communities to Provide Elder Fraud Prevention, Intervention, and Victim Services
OVC Bulletin; April 2006.
Online resource
This article provides an overview of an elder fraud prevention program, an initiative of the Denver District Attorney's Office, combining education and intervention through faith communities. The components of the Clergy Against Senior Exploitation (CASE) Partnership, an eighteen month demonstration project of the Office of Victims of Crime, U.S. Department of Justice, are described and include efforts to form alliances between the District Attorney's office and various faith communities, train clergy regarding elder fraud, provide education and outreach to seniors, distribute monthly fraud alerts and provide assistance to seniors through crime reporting, victim support, and fraud prevention services. Follow-up surveys of both clergy and senior participants suggest that the project was effective in raising awareness and developing prevention strategies. Measurable goals, flexibility in customizing programs to meet the needs of individual faith denominations, sharing "best practices," and employing adult learning techniques were identified as key in the successful implementation of the project. Due the success of this program, it has been successfully replicated in three other Colorado sites, and is scheduled to be replicated throughout the country. (Note: This publication is accessible online at: http://www.ojp.usdoj.gov/ovc/publications/bulletins/elderfraud_case/pfv.html .)

3. S6386-11
Dubble, C.
A Policy Perspective on Elder Justice Through APS and Law Enforcement Collaboration
Journal of Gerontological Social Work; Vol. 46 (3/4), 35-55; 2006.
Journal article (scholarship)
In this overview, the historic, economic, political, ideological and societal aspects of policies that promote collaboration between adult protective services (APS) and law enforcement in response to elder mistreatment are examined. The impact of the right to self-determination upon legal interventions (such as reporting issues, prosecution) is among the topics considered. Efforts of the AARP and the National Center on Elder Abuse to promote awareness of elder mistreatment are highlighted. In conclusion, the need for, and the costs associated with, policies that reflect elder justice are discussed.

4. S6335-10
Jayawardena, K. & Liao, S.
Elder Abuse at End of Life
Journal of Palliative Medicine; Vol. 9 (1), 127-136; February 2006.
Journal article (scholarship)
This article provides palliative care professionals, including the hospice team, with an overview of elder abuse and neglect issues that may be encountered during end of life care. The authors point out that caregiver stress should be of special consideration when assisting terminally ill patients. All health care professionals should be aware of family dynamics and cultural issues relevant to patients' circumstances. The multidisciplinary nature of hospice care is also effective in addressing elder abuse and neglect. Providing education regarding the dying process, assistance in delegating responsibilities and providing referrals when necessary are not only elements of good care provision, but are also strategies that reduce stress and may prevent abuse and neglect. If the need to report mistreatment to protective services arises, members of the palliative care team are in a position to collaborate with APS in various ways: by providing information regarding mistreatment, as well as regarding patient and family needs; by assisting in engaging the victimized patient in protective services; by participating in the evaluation of the patient's capacity to make decisions; and in communicating ongoing concerns.

5. S6273-15
National Association of State Units on Aging (NASUA) for the National Center on Elder Abuse
Domestic Violence in Later Life: A Guide to the Aging Network for Domestic Violence and Victim Service Programs
National Center on Elder Abuse; Washington, D.C.; Spring 2006
Issue Brief (online)
As quoted from the introduction: "As the 'Baby Boom' generation born between 1946 and 1964 ages, it is likely more victims of late life violence and abuse will seek out or be referred to the specialized services provided by domestic violence programs. This potential calls for increased collaboration between aging and domestic violence networks to assure maximum support and safety for victims and survivors of abuse in later life. The national aging network of State Units on Aging, Area Agencies on Aging, Tribal and Native organizations, and direct service providers - especially long term care ombudsman programs, adult protective services, legal services, and information and referral/assistance - has a key role to play in speaking out for older victims. With this Issue Brief we hope to encourage expanded dialogue and connections with allied partners..." The publication provides an overview of the aging network, established under the Older Americans Act (OAA), and describes key entities, providers of the four broad categories of support (access services, elder rights, services in the community, and in-home services) and the key values underlying the network. Indicators of domestic violence in later life are highlighted. Guidelines for responding to older victims are also presented. A list of state and national resources is also provided. (Note: This issue brief is accessible online at: nceaissuebrief.agingnetworkguideDV.pdf .)

6. S6140-55
Patronek, G., Loar, L. & Nathanson, J.
Animal Hoarding: Structuring Interdisciplinary Responses to Help People, Animals, and Communities at Risk
The Hoarding of Animals Research Consortium/HARC; Tufts University, MA; 2006
Manual (online)
While the majority of self-neglect cases do not involve animal hoarding, animal hoarding cases often accompany cases of human self-neglect. This manual contains the findings from a forum held in April, 2004, attended by representative stakeholders (human health and welfare, municipal government, and animal welfare) regarding the process of effective intervention in animal hoarding cases. The goal of the forum was to generate an understanding of the role each discipline plays in resolving cases and minimizing recidivism. The manual presents an overview of various stakeholders, and a plan to maximize the resources each brings; discusses the means to foster cooperation among collaborating agencies; identifies different types of hoarders; describes how to establish integrated interventions based upon the characteristics of the agencies involved, the hoarder and the specific case; and discusses the means to reduce recidivism and to effect long-term change. Appendices include models of documents needed to establish an interdisciplinary team, including sample ordinances, statutory models, and memoranda of understanding. (Note: This publication is available online at http://www.tufts.edu/vet/hoarding/pubs/AngellReport.pdf . Hard copies are available. Price (including s/h): $15 each for orders of 1-5 copies $10 each for orders of 6-15 copies. For orders of >15 copies, please contact them for volume discounts. Make check payable to MSPCA and mail to: MSPCA, Attn: Jan Holmquist 350 South Huntington Avenue Boston, MA 02130.)

7. S6254-21
Uekert, B., Dancy, D., Peters, T. & Herman, M., for the National Center for State Courts
Policy Paper: Report from the First National Meeting of the Elder Abuse and the Courts Working Group Meeting
National Center for State Courts; Williamsburg, VA; June 2006.
Policy paper (online)
The multidisciplinary Elder Abuse and the Courts Working Group was "established by the NCSC in 2005 to increase judicial awareness, build court capacity, and develop tools that courts can use to improve the identification of and response to the growing problem of elder abuse." The first meeting of the Working Group was held in April 2006 and resulted in five recommendations: to encourage judicial leadership; to increase judicial and court awareness of elder abuse; to foster the training of judges and court staff; to improve court documentation of elder abuse; and to encourage funding agencies to provide adequate resources to allow for an improved court response. (Note: To access the paper to review suggested strategies, visit: http://www.ncsconline.org/famviol/elderabuse/pdf/MeetingReportFINAL.pdf .)

8. S6419-7
Reingold, D.
An Elder Abuse Shelter Program: Build It and They Will Come, A Long Term Care Based Program to Address Elder Abuse in the Community
Journal of Gerontological Social Work; Vol. 46 (3/4), 123-135; 2006.
Journal article (scholarship)
This article describes the establishment of the Weinberg Center, part of The Hebrew Home for the Aged at Riverdale. The goals of the Center are to promote public education and awareness regarding elder abuse in the community; to implement strategies for identifying and engaging victims; and to provide a long term care based shelter. The Center initiatives employ a multidisciplinary approach in collaboration with the Bronx District Attorney, the Manhattan District Attorney, New York City Adult Protective Services, New York Weill Cornell Medical Center, Pace Women's Justice Center, Westchester Adult Protective Services, Westchester District Attorney, and Westchester County Department of Senior Programs and Services. The Center provides both short term emergency shelter as well as long term care planning, which includes the client's safe return home with community supports, or transition to one of the Hebrew Home's housing arrangements.

9. S6440-27
Schuyler, D. & Liang, B.
Reconceptualizing Elder Abuse: Treating the Disease of Senior Community Exclusion
Annals of Health Law; Vol. 15; Summer 2006.
Journal article (scholarship)
This paper outlines a multidisciplinary approach to assessing the needs of the elderly within the community and addressing existing abuse and neglect. An overview of elder abuse is presented, including a history of federal and state (notably California) initiatives. In particular, the function of multidisciplinary teams (MDTs) is highlighted along with a number of model programs: the Elder Abuse Forensic Center in Santa Ana, California; the Family Justice Center of San Diego, California; and the Elder Justice Centers of Tampa and Palm Beach, Florida. The components of a proactive, community systems approach include local needs assessment sensitive to the cultural needs of an area; the identification of service providers; and facilitating access between service providers and seniors.

10. S6389-4
Wigelsworth, A., Mosqueda, L., Burnight, K., Younglove, T. & Jeske, D.
Findings From an Elder Abuse Forensic Center
The Gerontologist; Vol. 46 (2), 277-283; 2006.
Journal article (research)
Employing a variety of research methods, including case study reviews and surveys of team members, the authors present the findings of an evaluation of the effectiveness and efficiency of the multidisciplinary Elder Abuse Forensic Center (EAFC). The EAFC, which was established in 2003 and addresses cases involving mistreatment of elders and vulnerable adults, is comprised of representatives from adult protective services (APS), social services, law enforcement, the district attorney's office, a medical response team, public guardian, the long term care ombudsman program, mental health services, victims services and domestic violence. The satisfaction survey indicated that overall, collaborators believed the multidisciplinary format of case management and review was more time efficient than handling cases within a single agency or discipline; they also concurred that the interventions of the EAFC were more effective. They were more neutral on the question of whether the case outcomes would have been different if not addressed by the EAFC. Two cases are presented that highlight the collaborative process of the format, but also suggest that the degree of complexity in addressing such cases is not limited to forensic issues but include other issues such as family dynamics and ethical concerns.

2005

11. P5926-20
Anetzberger, G. et al.
Multidisciplinary Teams in the Clinical Management of Elder Abuse        
The Clinical Gerontologist; Vol. 28 (1/2), 157-171; 2005.        
Journal article (scholarship)
This article is part of an issue that utilizes three case studies to analyze elder mistreatment from the perspectives of various practitioners as they collaborate on clinical management. This entry describes the function of multidisciplinary teams in the assessment and intervention of elder abuse and neglect cases. After presenting an overview of the team, the authors present highlights of the team review of the case studies previously analyzed from individual clinical perspectives. (Note: This issue was co-published as a book entitled The Clinical Management of Elder Abuse, Anetzberger, G., ed.; The Haworth Press, Inc., Binghamton, NY; 2004. See item #19 of this listing. The book is not available through CANE; for further information, visit the Haworth Press, Inc. Web site at: www.haworthpress.com or telephone 1-800-429-6784 in the US/Canada or 607-722-5857 outside US/Canada.)

12. S6385-7
Baker, M. & Heitkemper, M.
The Roles of Nurses on Interprofessional Teams to Combat Elder Mistreatment
Nursing Outlook; Vol. 53 (5), 253-259; September/October 2005.
Journal article (scholarship)
This article describes the contributions that nurses can make to interdisciplinary teams addressing elder mistreatment, such as the King County Elder Abuse Project (EAP) of Seattle, Washington. Established in 2001 by the King County Prosecuting Attorney's office, the EAP was designed to facilitate the prosecution of cases of mistreatment among elders and individuals with disabilities; foster collaboration with law enforcement; and provide training on elder mistreatment to first responders in the community. Specifically, nurses can assist in chart reviews, provide education to other team members, and provide education to the public. Participation in the EAP by faculty from the University of Washington School of Nursing has led to the institution's development of a Master's degree program, the Advanced Practice Forensic Nurse Specialists.

13. S6436-11
Bartels, S. et al.
Improving Mental Health Assessment and Service Planning Practices for Older Adults: A Controlled Comparison Study
Mental Health Services Research; Vol. 7 (4), 213-223; December 2005.
Journal article (research, evidence based practice)
This control study measured the effectiveness of an intervention process designed to improve routine screening of a number of problem areas for geriatric clients: substance abuse; dangerousness and suicide risk; and caregiver burden and risk for elder abuse and neglect. A multidisciplinary team developed a quality improvement toolkit that incorporated standardized assessment, decision and support mechanisms, and service planning to be implemented by non-physician, home health care and community mental health providers. Forty-four clinicians from 13 agencies working with 100 clients were assigned to either the control or intervention group. Baseline assessments revealed only 20 to 25 percent of all clinicians were routinely screening for various safety issues such as caregiver burden and risk for mistreatment. Following the intervention, medical record reviews indicated that over 90 percent of the clinicians using the toolkit routinely screened for caregiver burden, risk for abuse and neglect, and other safety factors, while the control group showed no improvement. The intervention group demonstrated improvement in all screening areas. (Note: A description of this project, including the instruments utilized, is accessible online at: http://www.rwjf.org/reports/grr/035254.htm .)

14. P5917-11
Dyer, C., Heisler, C., Hill, C. & Kim, L.
Community Approaches to Elder Abuse
Clinics in Geriatric Medicine; Vol. 21 (1), 429-447; 2005.
Journal article (scholarship)
In this article, the authors provide an overview of various collaborative teams and the issues they encounter as they address elder abuse and elder neglect in the community. In particular, they consider the function of medical case management teams, legal intervention teams, adult protective services (APS) teams, fiduciary abuse specialist teams (FAST), and fatality review teams (FRTs). The article concludes with a discussion of the role of the physician, nurse and other healthcare practitioners in addressing elder mistreatment.

15. S6339-5
Heath, J. et al.
Interventions from Home-Based Geriatric Assessments of Adult Protective Service Clients Suffering Elder Mistreatment
Journal of the American Geriatrics Society; Vol. 53 (9), 1538-1542; September 2005.
Journal article (research)
This retrospective study describes the interventions applied in 211 cases referred to the "Linking Geriatrics with Adult Protective Services" (LGAPS) multidisciplinary assessment team (New Jersey). In this program, a geriatric health care team, in collaboration with a referring social worker, conducted comprehensive in-home medical and functional assessments of referred clients. Among those referred, many had experienced multiple categories of mistreatment, but the most common category experienced was self-neglect (76 percent), followed by caregiver neglect (47 percent), financial exploitation (29 percent) and physical abuse (15 percent). Based upon these assessments, home health services were initiated for 46 percent of the APS clients; 35 percent were placed in alternative settings (54 were placed in nursing homes, 16 in assisted living facilities, and six in other settings); and in 36 percent of the cases, mostly those involving neglect by caregivers, guardianship proceedings were initiated. Urgent pharmacological interventions were required in 25 percent of the cases, primarily due to acute pain or significantly high blood pressure. In 19 percent of the cases, hospitalization was necessary, primarily due to physical abuse. (Note: This article draws upon the same data as CANE file # S6455-4, article #15 of this compilation.)

16. S6455-4
Heath, J. et al.
The Prevalence of Undiagnosed Geriatric Health Conditions Among Adult Protective Service Clients
The Gerontologist; Vol. 45 (6), 820-823; 2005.
Journal article (research)
The purpose of this retrospective study was to determine the prevalence of undiagnosed health conditions among adult protective services (APS) clients from two counties in New Jersey. Two-hundred eleven clients referred to the Linking Geriatrics with Adult Protective Services (LGAPS) program were assessed by a multidisciplinary health and social service team. Dementia was diagnosed in 62 percent of the referred clients, and depression was diagnosed in 37 percent. Nutritional concerns and pain were also identified, along with 22 cases of alcohol misuse. Dementia was positively correlated with financial exploitation and caregiver neglect. The detection of many medical conditions underscores the benefits of collaborative approaches in addressing elder mistreatment. (Note: This article is based upon the same data set as CANE file # S6339-5, item # 14 of this compilation.)

17. Stiegel, L., for the American Bar Association Commission on Law and Aging
Elder Abuse Fatality Review Teams A Replication Manual
American Bar Association; Washington, D.C.; 2005.
Manual (online**)
With funding from the Office of Victims of Crime of the U.S. Department of Justice, the American Bar Association Commission on Law and Aging, and its subcontractor, the National Adult Protective Services Association, developed a project to encourage the establishment of elder abuse fatality review teams (EA-FRT) and to promote the promising practices identified by the demonstration teams. As quoted from the manual, "The goal of the project was to expand the fatality review team concept to deaths resulting from or related to elder abuse in order to foster examination of and improvement in response of adult protective services, law enforcement officers, prosecutors, victim assistance providers, health care providers, and others to the growing numbers of victims of elder abuse. The goal was met through the following objectives: 1) Funding four demonstration projects and conducting other assessment activities to identify promising practices that support communities in establishing and continuing EA-FRT; 2) using the seed money as an incentive to ensure that victim services providers and other pertinent systems are involved in the four demonstration projects; and 3) developing and disseminating a replication guide and presenting workshops at relevant conferences in order to encourage communities to adopt the EA-FRT concept and the promising practices identified by the demonstration projects." The manual is based upon the experiences of teams established in Houston, Texas; Maine (see item # 22 of this compilation); Orange County, California; and Pulaski County, Arkansas. In addition, teams from Pima County, Arizona; Sacramento, San Diego, and San Francisco, California contributed significantly to this effort. (Note: The replication manual is available online at ABA Commission on Law and Aging Web site at: http://www.abanet.org/aging/fatalitymanual.pdf . **A limited number of free hard copies are available for individuals who cannot download the manual online. Contact: Lori Stiegel, Associate Staff Director, Commission on Law and Aging, American Bar Association /ABA, 740 15th Street, NW, Washington, DC 20005-1009. Email: lstiegel@staff.abanet.org .)

2004

18. M106-198 and M107-99
Albright, A., Brandl, B., Rozwadowski, J. & Wall, M., for the National Clearinghouse on Abuse in Later Life, a Project of the Wisconsin Coalition Against Domestic Violence/WCADV, and AARP National Legal Training Project
Building a Coalition to Address Domestic Abuse in Later Life (Planning and Training Guide, and Participant Manual)
National Clearinghouse on Abuse in Later Life, a Project of the Wisconsin Coalition Against
Domestic Violence/WCADV; Madison; WI; revised 2004.
Manual (online)
As quoted from NCADV, these publications were: "...developed to show how communities and professionals from various disciplines can learn from each other and work together to address domestic abuse in later life. However, this revised version is a result of specific recommendations from several nationally respected institutes to enhance the cultural competency of this curriculum. Both a trainer's guide and participants' manual are available. The one-day training is intended to allow various community members to discuss current strategies to deal with elder domestic violence and to begin the development of new (or the enhancement of current) strategies to assist older women. (Note: Both manuals are accessible online. The planning and training guide is available at http://www.ncall.us/docs/BuildingCoalitionTrainerRev.pdf and the participant's manual is available at http://www.ncall.us/docs/BuildingCoalitionParticipantRev.pdf. Hard copies are available at through Wisconsin Coalition Against Domestic Violence/WCADV, 307 S Paterson St, Suite 1, Madison, WI 53703, telephone (608) 255-0539. Price: $5.00 for each. They are also catalogued in the NCEA Training Library for Adult Protective Services and Elder Abuse.

19. S6319-196
Anetzberger, G., ed.
The Clinical Management of Elder Abuse
Haworth Press, Inc.; 2004.
Book
By focusing on three case studies, the authors present multidisciplinary perspectives on how to evaluate possible elder mistreatment and develop a coordinated, comprehensive response. The chosen case scenarios present complex issues common among protective services clients: questions of self-neglect, physical and psychological abuse, domestic violence, caregiver burden, family and relationship dynamics, substance abuse and other concerns. Each case is examined by an attorney, physician, nurse and social worker, and then discussed conjointly. (Note: This book is not available through CANE. For more information visit Haworth Press, Inc. at http://www.haworthpress.com/ or telephone 1-800-429-6784 in US/Canada and 607-722-5857 outside US/Canada. This volume was also featured in the Clinical Gerontologist, Vol. 28 No. 1/2, 2005. See item #11 of this compilation.)

20. S6536-11
Foster-Fishman, P., et al.
Building Collaborative Capacity in Community Coalitions: A Review and Integrative Framework
American Journal of Community Psychology; Vol. 29 (2), 241-261; 2004.
Journal article (research)
As quoted from the abstract: "This article presents the results of a qualitative analysis of 80 articles, chapters, and practitioners' guides focused on collaboration and coalition functioning. The purpose of this review was to develop an integrative framework that captures the core competencies and processes needed within collaborative bodies to facilitate their success. The resulting framework for building collaborative capacity is presented. Four critical levels of collaborative capacity -- member capacity, relational capacity, organizational capacity, and programmatic capacity -- are described and strategies for building each type are provided. The implications of this model for practitioners and scholars are discussed." (Note: Not specific to elder abuse.)

21. P5754-7
Governor's Elder Abuse Task Force (Oregon, Governor Kulongoski)
Governor's Elder Abuse Task Force - Final Report
State of Oregon; October 2004.
Government report (online)
This report contains the findings and recommendations of Oregon's Elder Abuse Task Force. Among the recommendations are the need for the development of a quick response for criminal background checks; the development of a registry of perpetrators who have abused vulnerable adults; the development of a criminal history registry; the creation of a list of crimes (including sex abuse, etc.) that potentially disqualify individuals from employment in care provision settings; the development of a notification system by the Department of Corrections (DOC) to nursing facility administrators when a predatory sex offender is being placed in that facility; the recruitment of county medical examiners for multidisciplinary teams (MDTs); the development of memoranda of understanding (MOUs) between agencies involved in MDTs; the prioritization of victim's services; enhanced training; increased coalition building and public awareness campaigns. Specific statutory changes are also outlined. (Note: This report can be accessed online at: http://governor.oregon.gov/Gov/pdf/elder_abuse_report.pdf .)        

22. P5604-14
Hamilton, R., for the Maine Elder Death Analysis Review Team (MEDART)
Maine Elder Death Analysis Review Team 2003 Annual Report
Maine Elder Death Analysis Review Team (MEDART); 2004.
Report (online)
In March, 2003, Maine was selected as one of four demonstration sites for the American Bar Association Commission on Law and Aging's "Promising Practices in the Development of Elder Abuse Fatality Review Teams" project. (See item # 17 of this compilation.) The ABA's stated goal was "...to expand the fatality review team concept to deaths resulting from elder abuse in order to foster examination of and improvement in response of adult protective services, law enforcement officers, prosecutors, victim services, health care providers and others to the growing number of victims of abuse..." The Maine Elder Death Analysis Review Team (MEDART) is comprised of representatives of the offices of the state medical examiner, attorney general, victim advocacy program, assisted living services, state police, Ombudsman program, sheriff's association, chief of police association, and behavioral and developmental services. This report provides case summaries for the two completed reviews from 2003. Recommendations generated by these reviews are outlined, and include the need for: hospital policy regarding a family's legal right to make medical determinations when legal authority to do so has not been established; developing hospital procedure for the enforcement of ethics committees' recommendations; strengthening existing legislation and therefore penalties for the endangering of a dependent person; a requirement that health care professionals attain education regarding issues of dehydration and malnutrition among elderly and dependent adults; and developing a system of required referral to APS for Mainecare (Medicaid) recipients who have not had a provider claim filed in over three years. (Note: This report is accessible online at http://www.maine.gov/ag/dynld/documents/MEDART03.PDF .)

23. V54
The Humane Society of the United States
Animal Hoarding: A Community Task Force Solution
Humane Society of the United States, Washington, D.C.; 2004.
Video
This seven minute video presents an overview on animal hoarding as a societal and public health problem. It counters the myths that many people hold that animal hoarders as simply benign and eccentric, and describes the need for interdisciplinary and interagency collaboration to address the problem. (Note: This video is not available through CANE. To order, contact The Humane Society of the United States (HSUS), 2100 L Street, NW, Washington, DC 20037, 202/452-1100, Companion Animal section or visit the web site at: http://www.humanesociety.org/ . Price: $6.00.)

24. P5750-6
Mosqueda, L., Burnight, K., Liao, S. & Kemp, B.
Advancing the Field of Elder Mistreatment: A New Model for Integration of Social and Medical Services
The Gerontologist; Vol. 44 (5), 703-708; 2004.
Journal article (research)
This article reviews the development and function of a model program for the integrated delivery of medical and social services to vulnerable adults. The Vulnerable Adult Specialist Team (VAST) was introduced in Orange County, California, in 2000, with the purpose of providing the county's APS, law enforcement and district attorneys' offices access to trained medical expertise when addressing cases of elder mistreatment. The team is comprised of two geriatricians, a psychologist, a gerontologist and a project coordinator. The authors analyzed the data concerning cases referred to VAST during the first two years of its existence. Ninety-eight referrals were made during the first year, increasing to 171 during the second year. The most common reason for referrals was mental status evaluation (35 percent), followed by medical evaluation (22 percent), a combination of mental status and medical evaluation (27 percent), medical information or referral (10 percent), review of records and/or photos (5 percent), and vague needs (6 percent). According to follow-up evaluation, the team's services were considered most helpful in confirming abuse, in documenting impaired capacity, and in reviewing medications and clarifying medical problems.

25. R6058-3
Palmer, A.
Law Enforcement and Adult Protective Services Working Together: A Team Approach to Elder Abuse Cases
Age in Action; Vol. 19 (3), Summer 2004.
Journal article (scholarship, online)
This article highlights the Central Virginia Task Force on Older Battered Women (OBW Task Force), a regional coalition of aging, domestic violence (DV), law enforcement, and legal services agencies dedicated to raising awareness of the needs of women who experience DV and sexual assault in later life. Established in 1998, the project focuses on developing collaborative and interdisciplinary community responses to address violence against older women. A case study is presented from Henrico County that illustrates how adult protective services (APS) and the police department conducted a joint investigation of a sexual assault of a 65 year old assisted living facility resident. Key elements for a successful collaboration are identified, and include the need for all members to understand and respect the expertise and distinct role of each member, that investigators attempt to conduct interviews together whenever possible, and that time and resources are shared effectively. (Note: This article is available online only at: http://www.vcu.edu/vcoa/ageaction/agesu04.htm .)

26. P5509-7
Shields, L., Hunsaker, D. & Hunsaker, J.
Abuse and Neglect: A Ten-Year Review of Mortality and Morbidity in our Elders in a Large Metropolitan Area
Journal of Forensic Science; Vol. 49 (1), 122-127; January 2004.
Journal article (research)
This article reports upon a ten-year retrospective study of mortality and morbidity of elders whose deaths were attributed to homicide or suspected neglect. Data was drawn from the State Medical Examiner's Office (serving a metropolitan region of Kentucky and Indiana) and the Office's Clinical Forensic Medicine Program. In all, 74 deaths of victims aged 60 and over had been evaluated through medicolegal autopsies (1992 through 2001) and identified as due to homicide (n=52) or neglect (n=22). Causes of homicide were gunshot wounds, assaults (stabbing and beating), and asphyxia. The most common cause of death in neglect cases was found to be bronchopneumonia. In 45 percent of the cases, the perpetrator was undetermined; in 31.8 percent the perpetrator was the spouse; in four percent it was another family member; and in one percent it was an acquaintance. The importance of multidisciplinary and multi-agency collaboration and the role of the forensic pathologist are stressed when investigating cases of elder deaths under suspicious circumstances.

27. P5747-238
Vierthaler, K., for the Pennsylvania Department of Aging and the Pennsylvania Coalition Against Rape (PCAR)
Addressing Elder Sexual Abuse: Developing a Community Response
Pennsylvania Department of Aging and the Pennsylvania Coalition Against Rape (PCAR); 2004.
Curricula (online)
This multimedia curriculum is designed to promote collaboration and community partnerships in addressing elder sexual abuse. It is divided into six modules (covering the topics of sexual violence, gerontology, elder sexual abuse, detection of elder sexual abuse, Pennsylvania laws applied to elder sexual abuse, and collaboration) which contain an outline and talking points, suggested activities to illustrate the themes identified, handouts, and other tools. The material presented includes a history of the recognition of rape as a crime of violence. There is also a brief summary of the role and function of the Pennsylvania Coalition Against Rape (PCAR) and the Pennsylvania Area Agency on Aging (AAA). The module on elder sexual abuse focuses on differences experienced by the older victim, which include increased risk for physical injury and longer recovery time. It includes information on domestic and institutionalized victimization.

2003

28. S6537-112
Allen, N. & Hagen, L. for the National Resource Center on Domestic Violence (NRCDV)
A Practical Guide to Evaluating Domestic Violence Coordinating Councils
National Resource Center on Domestic Violence (NRCDV); Harrisburg, PA; 2003.
Online resource
This manual discusses coordinating councils, task forces and committees as the means for promoting education, public awareness, prevention of, and intervention in domestic violence, and presents a detailed method for evaluation of the effectiveness of these initiatives. Four areas of effectiveness are considered: the quality of the internal working climate; the quality of the council infrastructure; the scope and nature of the council's activities; and the interim benefits of the collaboration, such as improved communications among participants, etc.

29. P5310-00
American Bar Association (ABA) Commission on Law and Aging
Resource Packet on Domestic Violence and Sexual Abuse in Later Life
American Bar Association (ABA) Commission on Law and Aging, with funding from Office on Violence Against Women at the U.S. Department of Justice through the ABA Fund for Justice and Education; Washington, D.C., July 2003.
Resource packet
This resource packet was designed for use in developing training and educational programs to address the needs of older victims of domestic violence and sexual abuse. It includes an adaptable PowerPoint presentation (with CD), resource materials from the National Clearinghouse on Abuse in Later Life (NCALL) and the Wisconsin Coalition Against Sexual Assault (WCASA), a list of state Adult Protective Services (APS) administrators, and reprints of the following articles: "Developing Services for Older Women Who are Victims of Domestic Violence or Sexual Assault," "Developing Services for Older Victims of Domestic Violence or Sexual Assault: The Approach of Wisconsin Coalitions," and "Domestic Violence Among the Elderly: A Blueprint for the Criminal Justice System." (Note: The resource packet is available for $15.00, which includes shipping and handling, through the ABA Commission on Law and Aging, 740 15th St. NW, 9th Floor, Washington, D.C., 20005. Telephone 202/662 8690; web site: www.abanet.org ; email abaaging@abanet.org .)

30. P5249-7
Carney, M., Kahan, F. & Paris, B.
Elder Abuse: Is Every Bruise a Sign of Abuse?
Mount Sinai Journal of Medicine; Vol. 70 (2) 69-74; March 2003.
Journal article (scholarship)
This article presents a case study that illuminates the roles that physicians and other health care professionals can play in the prevention, detection and management of elder abuse and neglect. The author presents a summary of the patient's history over a two-year period. The medical team suspects that the 84 year old woman is being neglected and physically abused by her adult son, who is disabled, unemployed and financially dependent upon his mother. Following a home visit by the social worker, adult protective services is notified. Office, family, and home visits, multidisciplinary assessments and referral for supportive services are among the interventions documented and discussed as part of the treatment plan.

31. S6290-7
DeMonnin, J.
Case Study: Elder Abuse Financial Exploitation
Victimization of the Elderly and Disabled; Vol. 6 (3), pp35, 36, and 46; September/October 2003.
Newsletter article
This case study focuses on the financial exploitation of an 80 year old woman by her adult granddaughter and the effective, though complex and time consuming, efforts to successfully prosecute the case. Multidisciplinary collaboration involving law enforcement and adult protective services (APS) of Washington County, Oregon is described.

32. P5435-8
Fulmer, T. et al.
Themes From a Grounded Analysis of Elder Neglect Assessment by Experts
The Gerontologist; Vol. 43 (5), 745-752; 2003.
Journal article (research)
This exploratory research highlights the program used by the Mount Sinai Medical Center's Neglect Assessment Team (NAT), an interdisciplinary team that is comprised of a geriatric nurse practitioner, a social worker and a geriatrician. Patient data collected using the Elder Assessment Instrument (EAI) was reviewed in NAT meetings; the discussions were audiotaped, transcribed and analyzed to identify relevant themes of neglect. Participants were aged 70 or over who had presented to the emergency department of the Mount Sinai Hospital, scored 18 or higher on the Folstein Mini-Mental Status Exam, and had a paid or unpaid caregiver for at least 20 hours weekly. In all, 19 cases of neglect and 4 practice cases from the literature were analyzed. Four themes emerged which became the framework for further analysis: "...understanding the underlying health status of the elder and caregiver, understanding the socioeconomic and life circumstances of the dyad, credibility of data collected by others, and the consequences of the assessment outcome..." While the screening for neglect with instruments such as the EAI is important in clinical settings such as the emergency room, the review by an interdisciplinary team provides a more in-depth assessment and is a valuable tool for case disposition.

33. M105-156
The Humane Society of the United States, and the Wisconsin Department of Health and Family Services
Creating Safer Communities for Older Adults and Companion Animals
The Department of Health and Family Services; Madison, WI and the Humane Society of the United States; Washington, D.C.; September 2003.
Manual
As quoted from the Foreword, this manual is intended to assist "...professionals in the adult protective services, elder abuse and animal protection fields to expand their working knowledge of the role of companion animals in patterns of abuse, exploitation and self-neglect..." While the manual highlights Wisconsin statutes and systems, much of the material can be adapted for use in other regions to foster multidisciplinary approaches in addressing such topics as animal hoarding and self-neglect and animal cruelty as an indicator of family violence. (Note: This manual is not available through CANE. To obtain an order form, contact Susan Veleke at
DHFS/DDES/Bureau of Aging & Long Term Care Resources, P.O. Box 7851,
Madison WI 53707-7851, email: StopAbuse@dhfs.state.wi.us or phone: (608) 267-7285
Price: $5.00.)

34. P5137-7
Kahan, F. & Paris, B.
Why Elder Abuse Continues to Elude the Health Care System
Mount Sinai Journal of Medicine; Vol. 70 (1), 62-p68; 2003.
Journal article (research)
The Mount Sinai Hospital Elder Abuse Program, a collaborative effort between social workers and physicians, was created in 1998. The purpose was to identify elderly patients in the hospital who had experienced elder abuse or neglect, to assist them in attaining compensation, and to provide counseling, support, advocacy and referral. A case study is presented to illustrate the difficulties in providing services. Over a two-year period, 182 cases were identified and assessed, with approximately half of those referred patients having a diagnosis of memory impairment. This article presents information regarding the population served through this model program, and addresses the obstacles found in the health care setting. The program emphasizes the importance of interdisciplinary team work and the continued education of health care professionals regarding potential signs and symptoms of elder mistreatment.

35. R6014-11
Koin, D.
A Forensic Medical Examination Form for Improved Documentation and Prosecution of Elder Abuse
Journal of Elder Abuse & Neglect; Vol. 15 (3), 109-119; 2003.
Journal article (scholarship)
This article describes the process of developing the "Forensic Medical Report: Elder/Dependent Adult Abuse and Neglect" form, a tool intended to enhance the documentation, and ultimately the prosecution, of elder abuse and neglect cases. Although the tool was designed to meet the legislative requirements of the state of California, it is adaptable for use in other locations. Members of the health care system, law enforcement, criminal justice system, social services, and forensic technology fields were represented on the development team. The following issues were addressed: the need for an instrument that could be utilized in a number of health care settings; who would complete which portions of the form; and what demographic data would be collected (and how this may advance further research in elder abuse). The most controversial issues were related to the assessment of cognitive ability, and to the length of the examination form. Revisions of the draft form were completed with input from approximately 200 reviewers throughout the state. The first part of the instrument documents demographic information, and includes a checklist to document concurrent forms of abuse. It also includes an assessment of independent and cognitive functioning. The second part provides detailed documentation of the physical status of the victim in terms of symptoms and injuries.

36. P5421-108
National Association of Triads, Inc. (NATI)
National Association of Triads, Inc. (NATI) Handbook
National Association of Triads,, Inc. (NATI); Alexandria, VA; 2003.
Handbook (online)
Triad is a three-way coalition among police chiefs, sheriffs and older and retired leaders, first formed in 1988, to reduce crime against older residents. This handbook explains how to design and implement such a program in local communities. It provides practical guidelines on developing the advisory council, often known as SALT or Seniors and Law Enforcement Together, which is a key to the success of any Triad. Initially, the representatives must survey the area seniors to determine what needs must be addressed (violent crime, financial exploitation, etc.), and then continue to evaluate the objectives identified. Triad offers advocacy and support to older victims of crime at all stages of intervention (from reporting through court room procedures), combats vulnerability (through prevention and education programs), may develop reassurance programs (such as Adopt a Senior, senior buddy systems or telephone reassurance programs), and fosters a greater understanding of the needs of older citizens among police offices through training. A detailed discussion regarding the needs of older victims with Alzheimer's dementia is included. Appendices include such forms as cooperative agreement, departmental policy, a sample letter of invitation, evaluation forms, survey forms, and informational forms on various programs. (Note: This publication is available online at: http://www.nationaltriad.org/tools/NATI%20Manual-5-2006.pdf#search=%22NATI%20Handbook%22 .)

37. P5412-33
Nerenberg, L., for the National Committee for the Prevention of Elder Abuse (NCPEA), National Center on Elder Abuse (NCEA)
Multidisciplinary Elder Abuse Prevention Teams: A New Generation
National Center on Elder Abuse (NCEA), Washington, D.C.; September 2003.
Online resource
This publication, intended to provide guidance for community responders developing a coordinated response to elder abuse, describes the key characteristics of multidisciplinary teams, and presents models of teams that address various aspects of elder mistreatment, such as financial abuse. Multidisciplinary teams foster the development of treatment plans that maximize client autonomy and enhance accessibility to services; provide supervision and support for team members; provide the opportunity to observe patterns of abuse; and improve the identification of systemic problems and service gaps in the community's response to elder mistreatment. Team composition and recruitment, administrative issues, funding and support, membership agreements, contracts, memorandums of understanding (addressing such issues as attendance, conflict of interest, confidentiality, etc.), case review processes, outcome evaluations, and sources of technical assistance are among the topics detailed. A checklist for starting or "revitalizing" a team is provided. Specialty teams are reviewed, including financial abuse specialist teams (FAST) and Rapid Response FASTs, fatality review teams and community-based medical teams. Model programs are highlighted, including the Vulnerable Adult Multidisciplinary Team of Dane County, Wisconsin, the San Francisco Consortium for Elder Abuse Prevention, the Elder Death Investigation Review Team or EDIRT of Sacramento, California, and the Senior Strength M-Team of Peoria, Illinois. (Note: This publication is available online at: EldAbs_complete.pdf )

38. S6188-10
Payne, B.
Justification for Punishing Crimes Against the Elderly: Perceptions of Police Chiefs, Nursing Home Professionals, and Students
Journal of Offender Rehabilitation; Vol. 38 (1), 33-51; 2003.
Journal article (research)
In this study, participants from two different occupational groups (police chiefs and nursing home professionals) along with sociology and criminal justice students, were surveyed regarding their beliefs on punishment and rehabilitation of elder abuse offenders, and the implications that these results hold for processing cases of elder mistreatment. Respondents were asked to rank six different abuse scenarios (including institutional intentional and unintentional abuse, white collar crime, and theft) in terms of perceived severity, then to indicate what consequences he or she would recommend for the offender and why. Justifications included the following categories: specific deterrence, general deterrence, rehabilitation, retribution, incapacitation, and victim compensation. In general, police chiefs and students were more likely to hold punitive attitudes, while nursing home personnel demonstrated more rehabilitative attitudes. The author points out that these results suggest the need to foster an interdisciplinary, collaborative approach when designing interventions for abusers.

39. S6288-4
Snyder, J.
Elder Fraud Project Introduced in Philadelphia
Victimization of the Elderly and Disabled; Vol. 6 (3), 33, p45-p46; September/October 2003.
Newsletter article
The Elder Abuse Pilot Project, funded by the Administration on Aging, was a joint initiative of the Philadelphia Corporation for Aging (PCA) and the First Union National Bank/Wachovia Corporation. The program was designed to promote collaboration between adult protective services (APS) and financial institutions and involved the development of consumer awareness literature and training curricula, as well as the training and education of frontline bank employees. From March 1, 2003 through June 20, 2003, 51 cases were tracked by the bank, 44 suspected cases were referred to APS (28 of which were substantiated), and a number of interventions were employed, involving APS service delivery, the filings of criminal complaints, guardianship and powers of attorneys appointed or removed, etc. Actual financial losses prevented in these cases totaled over $200,000.

40. P5458-26
Teaster, P.B. & Nerenberg, L., for the National Committee on Elder Abuse (NCPEA), National Center on Elder Abuse (NCEA)
A National Look at Elder Abuse Multidisciplinary Teams
National Center on Elder Abuse (NCEA); Washington, D.C.; 2003.
Agency report (online)
In this report, 31 coordinators of the 40 identified multidisciplinary teams (MDTs) throughout the U.S. responded to an email survey (included) regarding the function and goals of these unique collaborative work groups. Participants included not only traditional teams dealing with varied types of abuse cases, but one fatality review team, seven financial abuse specialist teams, medically oriented teams, and two teams dealing exclusively with systemic (versus clinical) issues. Coordinators indicated the provision of consultation and assistance to workers dealing with difficult abuse and neglect cases as their primary function, and three-quarters of the teams participated in advocacy, training and education, and coordinated care planning and investigation. Other characteristics of teams were examined, including: attendance policies (with nearly half of the teams counting between five and ten participants regularly, and only one-quarter of the teams having a formalized attendance requirement); composition (93.5 percent had law enforcement representatives, 83 percent had APS representatives, and 80 percent had geriatric mental health professionals); level of team formality; funding and source of administration; and costs. Challenges identified include lack of participation by specific professions and lack of cases to present. (Note: This report is available online at the NCEA web site at: mdt.pdf . It draws upon the same data set as item #41 of this compilation.)

41. R6016-17
Teaster, P. B., Nerenberg, L. & Stansbury, K.
A National Look at Elder Abuse Multidisciplinary Teams
Journal of Elder Abuse & Neglect; Vol. 15 (3), 91-107; 2003.
Journal article (research)
This research provides insight regarding elder abuse multidisciplinary teams (MDTs) throughout the U.S. An email survey yielded responses from 31 MDT coordinators representing specialized teams such as fatality review teams, financial abuse specialist teams (FAST), medically oriented teams, as well as more traditional teams. The most prevalent functions of the teams were the provision of expert consultation to service providers, and the identification of service gaps. Additionally, teams served to update all members regarding new services in the field. The survey gathered information on average attendance and policies, categories of membership, level of team formality, administration, leadership, funding, sources of technical assistance, challenges, and tangible products (such as training materials, etc.). One interesting finding is that, counter to anecdotal evidence, there did not appear to be significant concern regarding confidentiality issues. Researchers suspect that this may be due to effective confidentiality agreements (in place among nearly two-thirds of the sampled teams) and other safeguards taken. (Note: This article draws upon the same data set as item #40 of this bibliography.)

2002

42. M41-115
Abramson, B. (editor)
Elder Abuse Interdisciplinary Team (I-Team) Manual
Wisconsin Department of Health and Family Services; February 2002.
Manual (online)
This manual describes the purpose and process of developing an Elder Abuse Interdisciplinary Team (I-Team) to better meet the needs of victims within the community. I-Team goals include heightened awareness of abuse and neglect, an increase in victim identification, and the coordination of service delivery among various involved agencies. The manual includes a description of members who may comprise the team as well as case selection criteria. Appendices include samples of mission statements, confidentiality statements, and case presentation worksheets. (Note: This manual is accessible online at: http://www.dhfs.state.wi.us/aps/ .)

43. P5456-32
Aravanis, S. & Downs, C., for the National Center on Elder Abuse (NCEA)
Sentinels: Reaching Hidden Victims - Project Final Report
National Center on Elder Abuse (NCEA), Washington, D.C.; May 2002.
Agency report (online)
The goal of the National Center on Elder Abuse (NCEA) Sentinel Project, which was established in 1999, is to identify and assist elders who are isolated and at risk for mistreatment. In order to identify such individuals, 1280 sentinels from various national organizations such as Meals on Wheels, the Humane Society of the United States, and the National Association of Retired Senior Volunteer Program Directors, were trained to identify those individuals at risk, and typically isolated in their homes. The initiative resulted in the development of over 20 outreach products designed to promote awareness of elder abuse and appropriate services, and over 6,000 people were provided with such materials. In addition to an increase in APS referrals, issues were identified that hindered the process of service delivery to those in need. Those issues include the need for cross training among various professionals and advocates, and improved communications among those working with elders. (Note: This publication is available online at the NCEA web site at: sentinel0205.pdf .)

44. P5614-21
Balaswamy, S.
Rating of Interagency Working Relationship and Associated Factors in Protective Services
Journal of Elder Abuse & Neglect; Vol. 14 (1), 1-20; 2002.
Journal article (research)
This research was designed to examine the perceived satisfaction of the relationships among collaborative agencies addressing elder abuse and neglect. Participants were selected from human service agencies in five counties in Ohio, including agencies mandated to receive and investigate allegations of elder mistreatment, social service agencies involved in investigation and service delivery, and agencies within the community mandated to report suspected abuse. In all, 34 adult protective services (APS) professionals and 120 individuals from community agencies completed questionnaires regarding their perceptions of the quality of interdisciplinary effectiveness. Respondents were asked to evaluate the performance of agencies involved, the accessibility of staff, difficulty in being understood, productivity in terms of service provision, investigation, and obtaining feedback, frequency of disagreements, and the degree to which such disagreements were resolved and by what means. Community agency participants who were more experienced with elder abuse cases were more likely to be less satisfied with the APS system. APS providers' satisfaction with community agencies appeared related to the extent to which they could access individuals and resolve conflicts regarding case management and disposition.

45. M43-96 & M44-89
Brandl, B., of the National Clearinghouse on Abuse in Later Life (NCALL), the Pennsylvania Coalition Against Domestic Violence, and the Pennsylvania Department of Aging
From a Web of Fear and Isolation to a Community Safety Net - Cross-Training on Abuse in Later Life - Participant Manual and Training Curriculum
2002
Manuals
These tools were developed to foster a coordinated approach among community service professionals addressing the needs of domestic violence victims in later life. As quoted from the introduction, "...The training has been designed to initiate or strengthen communication among local service providers through interactive exercises. Each participant will leave the training with a community-based action plan designed by the local team describing the next steps they want to take to improve services for older victims in their area..." Other training objectives include learning to distinguish caregiver stress from power and control issues of domestic violence, and understanding the EMPOWER model as it applies to older battered women. The curriculum also addresses the importance of safety planning. (Note: Both the training curriculum and participant manual are available through the National Clearinghouse on Abuse in Later Life {NCALL} at Wisconsin Coalition Against Domestic Violence/WCADV, 307 South Paterson St., Suite 1, Madison, WI 53703. Telephone 608-255-0539. To order online visit: http://store.wcadv.org . The cost of each manual is $35.00 plus s/h.)

46. S6289-2
Friddle, J.
AARP ElderWatch
Victimization of the Elderly and Disabled; Vol. 5 (3), p42; September/October 2002.
Newsletter article
AARP ElderWatch is an initiative of the AARP Foundation and the Colorado Attorney General's office designed to address financial exploitation of the elderly. This article highlights key features of this multidisciplinary collaboration and reports upon some of the initial successes observed. In particular, coordination of efforts among law enforcement and adult protective services (APS) has been extremely valuable.

47. P5145-6
Heath, J., Dyer, C., Kerzner, L., Mosqueda, L. & Murphy, C.
Four Models of Medical Education about Elder Mistreatment
Academic Medicine; Vol. 77 (11), 1101-1106; November 2002.
Journal article (scholarship)
While an Association of American Medical Colleges (AAMC) study indicates that approximately three-quarters of the medical school deans report some curricular coverage of elder abuse, just over one-third of the graduates recall being taught about the topic. This article presents a comparison of four medical education models that incorporate community based Adult Protective Services (APS) agencies into their geriatric curricula. The programs (from the University of California, Irvine College of Medicine, the Hennepin County Medical Center in Minnesota, Baylor College of Medicine Geriatrics Program of the Harris County Hospital in Texas, and the Robert Wood Johnson Medical School of the University of Medicine and Dentistry of New Jersey) team with local APS departments in assessment and medical consultation regarding cases of elder abuse and neglect. Each model is highlighted, and the differences and similarities are discussed and presented in a tabular format. Most differences relate to the program participants (which span various medical specialties) and to the specific clinical services that are provided to the APS agency.

48. P5111-99
Hobart, M. for the Washington State Coalition Against Domestic Violence
"Tell the World What Happened to Me." - Maria Teresa Macias, 1959-1996 - Findings and Recommendations from the Washington State Domestic Violence Fatality Review
Washington State Coalition Against Domestic Violence; December 2002.
Agency report (online)
The goal of Washington State Domestic Violence Fatality Review (DVFR) team is to generate cooperation and communication among the local community services and the criminal justice system that address domestic violence in order to provide more effective intervention and response. Since 1997, 308 people died due to domestic violence (including perpetrator suicide) in the state of Washington. Six percent of the victims were aged 61 to 90, and nine percent were aged 51 to 60. This report discusses the findings and recommendations that were generated as the result of the in-depth examination of 11 such homicides that occurred between January, 2001 and August, 2002. The potential role of family and friends, multiple systems failures, the need for advocacy for DV victims throughout the criminal justice proceedings and during dissolution of marriages, issues of weapons, mental health and substance abuse, and the need for judicial education and oversight are among the topics addressed. The appendix contains the history of the DVFR and a summary of the first report entitled "Honoring Their Lives, Learning from Their Deaths: Findings and Recommendations from the Washington State Domestic Violence Fatality Review December 2000." (Note: This report is available online at http://www.wscadv.org/resourcesPublications.cfm?aId=9BD46C63-C298-58F6-057ECC5EAD82FCD7 . Not specific to elder abuse.)

49. P5293-10
Malks, B., Schmidt, C. & Austin, M.
Elder Abuse Prevention: A Case Study of the Santa Clara County Financial Abuse Specialist Team (FAST) Program
Journal of Gerontological Social Work; Vol. 39 (3), 23-40; 2002.
Journal article (scholarship)
This article presents a description of the Santa Clara County Financial Abuse Specialist Team (FAST) Program. The FAST, in operation since 1999, is a collaborative effort involving Adult Protective Services (APS), the Public Administrator/Guardian's Office, County Counsel, the District Attorney's office and the Department of Adult and Aging Services. The article describes the process in which the referral is addressed, including those that require an emergency response in order to protect assets. Cases warranting legal intervention are transferred to the District Attorney's office for further investigation and possible prosecution. The benefits of the rapid response team and the criticisms of the process (which include those that claim it promotes loss of autonomy) are discussed, along with lessons learned since the program's inception.

50. P5565-9
Mays, W.
Elder Abuse and Mental Health
Journal of Elder Abuse & Neglect; Vol. 14 (4), 21-29; 2002.
Journal article (scholarship)
At the first National Policy Summit on Elder Abuse (December, 2001, Washington, D.C.), mental health needs of older individuals were considered a priority. This article provides an overview of issues faced by the mentally ill aged, including the historically poor integration of mental health and adult protective services (APS), minimal consumer involvement, minimal specialized psychiatric evaluation, and Medicare and Medicaid limitations. It also describes initiatives such as the New Freedom Commission on Mental Health's Subcommittee on Older Americans, the Older Adult Consumer Mental Health Alliance, the National Coalition on Mental Health and Aging, and the federally mandated Preadmission Screening and Resident Review (PASARR or PASSR) that are providing opportunity for enhanced service delivery. The article contains contact information and web addresses for many of these initiatives.

51. P5599-134
National Council on Aging (NCOA) for the Substance Abuse and Mental Health Services Administration (SAMHSA), Department of Health and Human Services (HHS)
Promoting Older Adult Health: Aging Network Partnerships to Address Medication, Alcohol, and Mental Health Problems
Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA); 2002.
Agency report (online)
This publication profiles promising practices of 15 organizations linking older adults with supportive services for mental health and substance abuse issues. The initiatives are grouped into the categories of education and prevention, outreach, screening, referral, intervention and treatment, and service improvements through coalitions and teams. Each entry describes the model program and includes contact information as well as program evaluation findings. The highlighted programs are: Healthy Aging Program, Salt Lake County, Utah; Health Enhancement Program, Seattle/King Counties, Washington; Little Havana Health Program, Miami/Dade County, Florida; Gatekeeper, Spokane, Washington; PATCH, Baltimore, Maryland; Geriatric Regional Assessment Team, Seattle/King Counties, Washington; Kit Clark Senior Services, Boston, Massachusetts; Over 60 Health Center, Berkeley, California; Elder Substance Abuse Outreach Program, Chicopee, Massachusetts; Center for Older Adults and Their Families, New York, New York; Older Adult Outreach and Education Service, Ann Arbor, Michigan; Adair Elder Care, Adair, Kentucky; Alcohol and Drug Services - Prevention for the Elderly, Fairfax County, Virginia; Elders Wrap-Around Team, Concord, New Hampshire; Mental Health and Aging Coalition, Indiana, Kentucky, Ohio. Appendices include information on other nominated best practices.

52. P5099-7
Payne, B.
An Integrated Understanding of Elder Abuse and Neglect
Journal of Criminal Justice; Vol. 30, 535-547; 2002.
Journal article (scholarship)
In describing the need for an integrated approach to elder abuse, the author discusses reasons for the current, fragmented approach, and how this creates an inadequate response for those victimized. A review of the way that gerontology, criminology, social work, medicine and psychology view this phenomenon is provided. The components of an integrated perspective are identified as integrating definitions, assessing the scope of the problem, explanations for and understanding of the consequences and interventions. Examples of multidisciplinary responses are provided and include FAST teams and Elder Person's Estate Units (EPEU). The involvement of senior volunteers is also discussed.

2001

53. P5771-15
Chang, V. & Greene, R.
Study of Service Delivery by Community Mental Health Centers as Perceived by Adult Protective Services Investigators
Journal of Abuse & Neglect of the Elderly; Vol. 13 (3), 25-39; 2001.
Journal article (research)
Noting the need for coordination between adult protective services (APS) and mental health services to assist mentally impaired vulnerable adults, researchers designed this qualitative study to evaluate the perceptions that Indiana APS investigators held regarding their interactions with the state's Community Mental Health Centers (CMHCs). Thirty-three of the state's 34 investigators participated in the interview process which addressed topics such as the problems and frustrations perceived when referring to CMHCs, procedural issues, quality of working relationships, needed improvements, and service gaps. In particular, diagnostic issues (mental illness versus dementia or other medical conditions, such as traumatic brain injury) posed barriers to evaluation and psychiatric hospitalization of endangered adults. Other issues included problems in sharing information due to perceived conflicts with confidentiality on the part of the mental health clinicians, and limited placement options, especially for clients demonstrating aggressive behaviors related to dementia. Investigators identified a number of strengths, including effective working relationships and increased understanding regarding information sharing on behalf of endangered clients. Increased dialogue and interdisciplinary team approaches were among the recommended interventions to enhance service delivery.

54. D2414-5
Patronek, G.
The Problem of Animal Hoarding
Municipal Lawyer, p6-p9, p19; May/June 2001.
Journal article (scholarship, online)
The author, a veterinarian and founder of the Hoarding of Animal Research Consortium (HARC) of Massachusetts, offers an overview of animal hoarding. He emphasizes the need for interdisciplinary team approaches as hoarders often "fall through the cracks" among humane, aging, mental health and criminal justice professionals. He also stresses the importance of recognizing abused and neglected animals as possible markers for other forms of domestic violence and neglect, including elder abuse. Management recommendations are provided. (Note: This article is available at http://www.tufts.edu/vet/hoarding/pubs/municipalawyer.pdf .)

55. P5098-9
Payne, B.
Understanding Differences in Opinion and 'Facts' Between Ombudsmen, Police Chiefs, and Nursing Home Directors
Journal of Elder Abuse & Neglect; Vol. 13 (3), 61-77; 2001.
Journal article (research)
This study focuses on the philosophical differences and perceptions/misperceptions of three groups that address elder abuse in nursing home settings: ombudsmen, police chiefs and nursing home directors. The research considers whether the three groups differ in their opinions on issues regarding elder abuse, and whether they vary in the knowledge they possess regarding elder mistreatment. Seventy-three nursing home professionals, 119 police chiefs, and 203 ombudsmen from Alabama, California, Colorado, and New York were surveyed. Of the differences observed, nursing home directors were more likely to attribute blame to the victims than the other professional groups. Also, males were more likely to blame the victims, to see nursing homes as unsafe, and were less likely to view elder abuse as problematic. Knowledge of these differences can be used to enhance communication, cooperation and coordination among these professional groups responding to resident abuse.

56. P5231-20
Payne, B., Berg, B. & James, L.
Attitudes about Sanctioning Elder Abuse Offenders Among Police Chiefs, Nursing Home Employees, and Students
International Journal of Offender Therapy and Comparative Criminology
Vol. 45 (3), 363-382; 2001.
Journal article (research)
This article examines differing attitudes towards the use of sanctions to address elder abuse offenses. Fifty-four nursing home administrators, 132 nursing home staff, 68 police chiefs and 127 criminal justice and sociology students participated in a survey wherein they were asked to rank sanctions for various elder abuse scenarios. The scenarios represented instances of financial abuse and fraud, theft, physical abuse and neglect. Sanctions included jail sentences, probation, fines and community service, and supervisory reprimand. Results revealed differences in perceptions; while police chiefs viewed theft as the most serious, the other groups viewed physical abuse as most serous. Such differences impact prevention and intervention strategies. Techniques such as role playing and group discussion within multidisciplinary trainings are warranted to bridge gaps in attitude.

1999

57. N4676-11
Nerenberg, L.
Culturally Specific Outreach in Elder Abuse
Chapter 13, 205-220, Understanding Elder Abuse in Minority Populations; T. Tatara, ed., Brunner/Mazel - Taylor & Francis Group, Phila., PA; 1998.
Book chapter
Noting that cultural norms greatly influence perceptions of elder mistreatment and the acceptance of outreach services, the author examines some experiences of existing programs in order to offer guidelines in developing culturally specific services. Included is a history of the San Francisco Consortium for Elder Abuse Prevention, coordinated by the Goldman Institute on Aging. The Consortium is a network of more than 70 public and private agencies that provide services and support to clients who are at risk of, or are experiencing, elder abuse. A fundamental principle of this model is that pre-existing agencies are socially, culturally and geographically equipped to provide services to particular populations. In discussing the successes and shortcomings of several programs, the author identifies ways in which culturally specific strategies may be counter to traditional outreach efforts, yet more effective in serving minorities.

2000

58. S6204-7
Allen, J.
Financial Abuse of Elders and Dependent Adults: The FAST (Financial Abuse Specialist Team) Approach
Journal of Elder Abuse & Neglect; Vol. 12 (2), 85-91; 2000.
Journal article (scholarship)
The Financial Abuse Specialist Team (FAST) of Orange County, California, a multidisciplinary team designed to address cases of elder financial abuse and exploitation, is described in this article. Representatives from a variety of fields and organizations comprise the team, and include volunteers from adult protective services (APS), law enforcement and the legal system, the public guardian office, financial and banking institutions, and mental health and other health and human services. Using a case scenario, the collaborative process of the consultation is highlighted as specific members work to address the client's needs.

59. S6203-5
Aziz, S.
Los Angeles County Fiduciary Abuse Specialist Team: A Model for Collaboration
Journal of Elder Abuse & Neglect; Vol. 12 (2), 79-83; 2000.
Journal article (scholarship)
This article describes the development of the Los Angeles County Area Agency on Aging Fiduciary Abuse Specialist Team (FAST), a team which provides consultation and training to adult protective services professionals and other practitioners who may encounter cases of elder financial abuse and exploitation. In addition, team members provide training and education to professionals and the public to raise awareness of the problem and to generate multidisciplinary approaches to prevention and intervention.

60. S6200-6
Aziz, S. et al.
The National Telemarketing Victim Call Center: Combating Telemarketing Fraud in the United States
Journal of Elder Abuse & Neglect; Vol. 12 (2), 93-98; 2000.
Journal article (scholarship)
This brief article describes the National Telemarketing Victim Call Center (NTVCC), a model program designed to combat fraud and exploitation. This collaborative effort of the FBI, the U.S. Postal Inspectors, and other members of the Los Angeles Boiler-Room and Telemarketing Task Force (BAT), involves calling potential victims of telemarketing fraud to warn them that they may be targeted, and to provide information on fraud prevention. Calls made by the NTVCC are based upon the names obtained during fraud investigations when "mooch lists" are confiscated. Such lists are typically maintained and circulated by organized scam artists.

61. S6184-12
Blakely, B. & Dolon, R.
Perceptions of Adult Protective Services Workers of the Support Provided by Criminal Justice Professionals in a Case of Elder Abuse
Journal of Elder Abuse & Neglect; Vol. 12 (3/4), 71-94; 2000.
Journal article (research)
After presenting an overview of the history of the coordination of protective services and the legal system in addressing elder abuse cases, this article examines perceptions held by adult protective services (APS) professionals regarding support from criminal justice professionals. Three-hundred sixty-five APS professionals from 43 states completed a survey regarding perceived helpfulness of law enforcement, prosecutors and other criminal justice representatives. Findings suggest that police were perceived to be "more than somewhat helpful" in detecting and treating elder abuse; victims' assistants were rated to be "less than somewhat helpful". In terms of types of assistance that could be provided through the criminal justice system, APS professionals had the highest expectation that law enforcement would escort them to the homes of clients. Prosecution of perpetrators was by far the service they thought most difficult to obtain, followed by arrest of perpetrators.

62. N4552-5
Dyer, C. & Goins, A.
The Role of the Interdisciplinary Geriatric Assessment in Addressing Self-Neglect of the Elderly
Generations; p23-p27; Summer 2000.
Journal article (scholarship)
In order to address the apparent relationship between medical conditions and risk factors for elder mistreatment, particularly self-neglect, Baylor College of Medicine Geriatrics Program collaborated with the Texas Department of Protective and Regulatory Services in 1997 to form the Texas Elder Abuse Mistreatment Institute (TEAM). This article describes the role of the interdisciplinary geriatrics assessment team, comprised of physicians, nurses, social workers and other health professionals who provide an integrated approach to prevention, identification and intervention in elder abuse and neglect.

63. N4551-5
Menio, D. & Keller, B.
CARIE: A Multifaceted Approach to Abuse Prevention in Nursing Homes
Generations; p28-p32; Summer 2000.
Journal article (scholarship)
This article describes a multi-layered approach to addressing and preventing elder mistreatment within long-term care facilities. The Coalition of Advocates for the Rights of the Infirm Elderly (CARIE), a Philadelphia-based organization, has advocated for improved quality of nursing home services and residents' rights for over twenty years. In tandem with the Long Term Care Ombudsman Program, this organization serves to address both individual complaints and institutionwide deficits through education of staff and policy implementation. Discussion of Dr. Karl Pillemer's evaluation of the CARIE curriculum, "Competence with Compassion: An Abuse Prevention Training Program for Long Term Care Staff," is included. (For more information on this approach, visit the CARIE website at: http://www.carie.org.)

64. N4900-10
Stiegel, L., Heisler, C., Brandl, B. & Judy, A.
Developing Services for Older Women Who Are Victims of Domestic Violence or Sexual Assault
Victimization of the Elderly and Disabled; Vol. 3 (2), 17-28 and Vol. 3 (4) 49-60; 2000.
Journal article (scholarship)
This two part article reports upon the information generated during a teleconference held on December 16, 1999, under the STOP Grants Technical Assistance Project (STOP TAP). The conference was designed to assist State STOP Grant Program Administrators and domestic violence advocates in the development of services for older battered women and victims of sexual assault. Among the topics discussed were recommendations to enhance the criminal justice system's response to these older victims, including suggestions for training and education. The need for collaboration among APS, criminal justice systems and domestic violence programs was emphasized. Several model programs, including those of the Wisconsin Coition Against Domestic Violence (WCADV) and the Wisconsin Coalition Against Sexual Assault (WCASA), were highlighted.

65. P5089-313
U.S. Department of Justice, Office of Justice Programs
Our Aging Population: Promoting Empowerment, Preventing Victimization, and Implementing Coordinated Interventions - Symposium Report of the Proceedings
U.S. Department of Justice, Office of Justice Programs; December 2000.
Online resource
This publication contains the proceedings of a symposium co-sponsored by the Department of Justice and Department of Health and Human Services in October, 2000. The symposium focused on three topics: financial abuse and consumer fraud, elder abuse and neglect in the home, and institutional abuse and neglect. Attorney General Janet Reno identified the following three priorities: prevention, multidisciplinary collaboration, and prosecution. A number of workshops were presented focusing on promising programs and interventions developed throughout the country. This publication also includes program descriptions of those presented, including the South Carolina Vulnerable Adult Medical Protocol, the Texas Elder Abuse Mistreatment (TEAM) Team, the Maricopa Elder Abuse Prevention Alliance, Los Angeles County Fiduciary Abuse Specialist Team (FAST), and many others. It also includes the recommendations made by the Tribal Caucus, with emphasis upon the need for coordination among the FBI, the Bureau of Indian Affairs, and state and local law enforcement agencies operating within Indian Country. (Note: This publication is available online at http://www.ojp.usdoj.gov/docs/ncj_186256.pdf .)

1998

66. P5070-4
May, C., McCreadie, C., Bennett, G. & Tinker, A.
Working Together: Report of Research on General Practitioners and Elder Abuse
Journal of Health and Social Care in the Community; Vol. 6 (6), 464-467; 1998.
Journal article (research)
This report, part of a research project assessing general practitioners' (GPs) knowledge and experience of elder abuse, explores how frequently these professionals worked collaboratively with other professionals when addressing such cases. Data is taken from a study of the GPs in Tower Hamlets in inner London, 1996. Seventy-three of the region's 107 GPs responded to the mailed questionnaire, generating a response rate of 68 percent. Forty-two percent of the GPs reported routinely being in contact with community nurses, and 39 percent were in contact with other GPs regarding abuse issues. The percentage of GPs in contact with other health professionals appeared to increase along with knowledge of at risk situations. While GPs may be the first to suspect or identify elder abuse, they are unlikely to be the professionals best suited for case management, therefore interdisciplinary collaboration is encouraged. (U.K.)

1996

67. P5165-8
Menio, D.
Advocating for the Rights of Vulnerable Nursing Home Residents: Creative Strategies
Journal of Elder Abuse & Neglect; Vol. 8 (3), 59-72; 1996.
Journal article (scholarship)
This article highlights the role that the Coalition of Advocates for the Rights for the Infirm Elderly (CARIE) played in effecting changes following the criminal prosecution of a major nursing home corporation in Pennsylvania. Rather than closing facilities and displacing residents, the nursing homes were placed under the authority of temporary management. A multidisciplinary task force was developed and included members of the Attorney General's office, law enforcement, Department of Health, Department of Aging ombudsmen and protective services programs, and professionals with expertise in law and nursing home management. An appointment of the "Special Ombudsman," funded in part by the fines paid by the corporation, allowed for greater representation of the isolated residents and for monitoring of the troubled nursing homes.

1995

68. P5439-3
staff, NCEA Exchange
From the Frontlines: Family Violence Task Force
NCEA Exchange; Vol. 2 (3), 6-8; 1995.
Newsletter article
This article highlights some of the initiatives of the National Center on Elder Abuse (NCEA) 1995 Best Practices in Coordination Competition winner, the Family Violence Task Force of Suffolk County, New York. The multidisciplinary task force has advocated for elder abuse legislation, presented training programs, held conferences and developed the Elder Abuse Consultation Team.

69. N4571-11
Stiegel, L.
Preventing the Blind Men and the Elephant Syndrome: The Need for Coordination with Adult Protective Services
Clearinghouse Review; p658-p663; October 1995.
Journal article (scholarship)
Observing that various professionals maintain different perspectives on elder abuse that affect their responses to those who have been victimized, the author highlights a number of ways that attorneys can collaborate with others to address the problem effectively. Federal and state laws and initiatives that enhance coordination among different entities are described. Coalitions and multidisciplinary teams are discussed as means that promote a comprehensive response among Adult Protective Services (APS), health and social services, law enforcement and legal professionals. (Note: This article is unavailable at no cost through the American Bar Association Commission on Law and Aging. Product Code A2240. To order, visit the publications page at: http://www.abanet.org/aging/publications/publicationslistorder.shtml#abuse , or mail request to:
ABA Commission on Law and Aging, 740 15th St., N.W., Washington, DC 20005-1022; Telephone 1-202-662-8690, or email at abaaging@abanet.org.

1990

70. F3116-18
Nerenberg, L. et al.
Linking Systems and Community Services: The Interdisciplinary Team
Approach
Journal of Elder Abuse & Neglect; Vol. 2 (1/2), 101-135; 1990.
Journal article (scholarship)
A panel of experts from the legal, medical, adult protective services, criminal justice, and family counseling/mental health professions discuss two difficult elder abuse case studies to showcase an interdisciplinary team approach in developing solutions to the problems of victims and abusers.

1988

71. V15
Produced by San Francisco Institute on Aging
Serving the Victim of Elder Abuse
Terra Nova Films, Distributor, Chicago, IL; 1988
Video
The emphasis of this 21 minute video is the need for collaboration of professionals from
various disciplines to effectively assist victims of elder abuse. Adult protection, mental health, civil law, financial management and geriatric care are among the disciplines represented in the collaboration. (Note: To order, contact Terra Nova Films, 9848 S. Winchester Ave., Chicago, IL 60643, online at http://www.terranova.org . Telephone 1-800-779-8941. Price: $165.00, rental $45.00 plus $9.00 s/h. Item code: SVEAVHS.)

Online resources:

A number of model programs and promising practices are featured in the preceding bibliography. The following list contains Web addresses for several organizations that promote collaborative approaches in addressing elder mistreatment. For a more complete listing, please visit the NCEA Website Menu: Resources/Online links.

Or search the NCEA Promising Practices database.

Information on state and local coalitions and task forces in the U.S.


Additional training and education resources on this and other topics may be obtained through the NCEA Training Library for Adult Protective Services and Elder Abuse. The training library was developed by the National Adult Protective Services Administration (NAPSA), a partner of the NCEA, in collaboration with REFT, Inc. For more information, visit: http://ncea.aoa.gov/NCEAroot/Main_Site/Library/Training_Library/About_Training_Library.aspx .

Clearinghouse on Abuse and Neglect of the Elderly - MOU Data Base
http://cane.udel.edu
Memoranda of Understanding (MOU), also known as Memoranda of Agreement, are important tools in allowing for effective interagency collaboration. These agreements are intended to provide clarification of the roles of various professional groups who participate in the management of elder abuse cases. CANE and the American Bar Association Commission on Law and Aging, partners of the NCEA, are cataloguing these agreements. Interested parties can search the data base from the CANE Web site to obtain brief descriptions of MOUs and contact information for parties using these protocols.

If you have a MOU that you would like to have catalogued in the database, please contact CANE at cane-ud@udel.edu or 302-831-3525.

National Committee for the Prevention of Elder Abuse
www.preventelderabuse.org
The National Committee for the Prevention of Elder Abuse (NCPEA), a partner of the National Center on Elder Abuse (NCEA), is an association of researchers, practitioners, educators, and advocates dedicated to protecting the safety, security, and dignity of America's most vulnerable citizens. It was established in 1988 to achieve a clearer understanding of abuse and provide direction and leadership to prevent it through the advancement of research, advocacy, public and professional awareness, interdisciplinary exchange, and coalition building. The "Technical Assistance Toolbox: Guidelines for Establishing and Coordinating a Fiduciary Abuse Specialist Team" is from the NCPEA Web site at: http://www.preventelderabuse.org/communities/fast.html .

Elder Abuse Forensic Center (EAFC)
http://www.elderabuseforensiccenter.com/
Established in 2003, EAFC is a collaboration of professionals from legal, medical, social services, and law enforcement agencies who address elder and vulnerable adult abuse and neglect cases.

Institute on Aging - Consortium for Elder Abuse Prevention
http://www.ioaging.org/professionals/elder_abuse_consortium_san_francisco.html
Through the coordinated efforts of member agencies, the Consortium provides a wide range of services to vulnerable seniors aimed at preventing or responding to abuse or neglect. Affiliates include public, private, and nonprofit agencies, provide case management, legal assistance, information and referral, crisis intervention, medical services, mental health counseling, and support services to victims and vulnerable seniors.

Rural Victimization Project
Florida State University School of Social Work Institute for Family Violence Studies
http://familyvio.ssw.fsu.edu/rural/
The Rural Victimization Project has developed a number of educational materials, accessible online, for a variety of professionals and volunteers who may encounter victims of all types of domestic violence. Tutorials have been designed for Meals on Wheels and elder services volunteers, mental health professionals and animal abuse investigators.

Texas Elder Abuse and Mistreatment Institute (TEAM)
http://www.houstongec.org/file.php/1/Participant_Guide/TEAM%20Institute%20Description%20final%20new%20logo.doc
The Texas Elder Abuse and Mistreatment (TEAM) Institute is a collaboration among the Baylor College of Medicine (BCM) Geriatrics Program at the Harris County Hospital District (HCHD) and the Texas Department of Family and Protective Services (TDFPS) - Adult Protective Services (APS). The mission of the TEAM institute is to
improve the condition of abused or neglected elders through interdisciplinary clinical care, education and research.