Taking Action Against Elder Mistreatment

Connecting Community-Based Resources and Health Systems to Keep Older Adults Safe By Kristin Lees Haggerty, Alice Bonner, and Debi Lang

Healthcare systems, including emergency departments, offer an untapped way to identify and respond to elder mistreatment.

E lder mistreatment (EM) affects an estimated 10 percent of adults ages 60 and older in the United States (Acierno et al., 2010), and is associ- ated with an increased risk of death (Dong, 2005), poorer physical health (Lachs et al., 1998; Scho- feld, Powers, and Loxton, 2013), and negative psychological health outcomes (Dyer et al., 2000), as well as increased time spent in healthcare facilities (Dong and Simon, 2013a, 2013b, 2013c). Despite evidence of the prevalence of elder mistreatment, the existence of Adult Protective Services (APS) in all states, and laws mandating the reporting of suspected mistreatment in most states, many instances of EM go unreported (Lachs and Berman, 2011) and unaddressed. Healthcare professionals, while seemingly well- positioned to identify mistreatment, are among the least likely to report it (Rosenblatt, Cho, and Durance, 1996).

Barriers to identifying and reporting include difficulty distinguishing elder abuse, lack of awareness about EM and the reporting process (Rodríguez et al., 2006; Schmeidel et al., 2012), a dearth of tools to address the problem, time constraints, and challenges in communicating with other healthcare providers (Rosen et al., 2017, 2018). Recognizing that the hospital emergency department (ED) provides a unique opportu- nity to identify EM that may otherwise go unno- ticed, The National Collaboratory to Address Elder Mistreatment (The Collaboratory), a group of EM experts, innovators, and researchers, was convened via support from The John A. Hartford Foundation and the Gordon and Betty Moore Foundation, and developed the Elder Mis- treatment Emergency Department Care Model (EMED). The approach to building this model

abstract Healthcare systems, particularly hospital emergency departments (ED), offer an opportu- nity to identify and respond to elder mistreatment (EM), but often are uninvolved in coordinated com- munity responses. This article describes how key informant interviews with health systems, Adult Protective Services, and other stakeholders led to the Community Connections Toolkit, a core element of The National Collaboratory to Address Elder Mistreatment’s Elder Mistreatment Emergency Department Care Model. The toolkit is designed to help hospitals engage with key community organizations to keep older adults safe from EM once discharged. | key words : emergency departments, elder mistreatment, key informant interviews, the Community Connections Toolkit

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Volume 44 . Number 1 | 59

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