Table of Contents

About This Course

1. Introduction to Elder Abuse
2. The Basics of Elder Abuse
3. Substance Use and Other Risk Factors
4. Screening and Assessment
5. Intervention and Treatment
6. Preventing Elder Abuse

Supplements
Case Studies
References
Resources

Out of the Shadows
Uncovering Substance Use and Elder Abuse

What Can Communities Do?

Communities can increase awareness of elder abuse, including conducting public education teams, forming coalitions, and advocating for older people. The Resources section features materials that may be distributed and used to create prevention activities.

Multidisciplinary Teams

Many communities are developing Multidisciplinary Teams (MDTs) to identify abuse in the community and prevent future abuse. The advantage of this model is that it is attuned to specific concerns and sometimes divergent professional viewpoints involved in elder abuse.

MDTs bring together experts from the fields of aging, Adult Protective Services (APS), substance abuse, domestic violence, geriatric medicine, mental health, law enforcement, and many others to explore common areas, integrate new knowledge, develop comprehensive care plans, and promote coordination among agencies. ref They vary in what they do, how often they meet, and other specifics. For example, leadership roles may reside with APS, the local Area Agency on Aging, county attorney's office, a nonprofit group, State Attorney's office, university, or a service provider. ref

MDTs can benefit professionals, clients, and communities by: ref

• Resolving difficult cases
• Enhancing service coordination by clarifying agencies' policies, procedures, and roles
• Identifying services gaps and breakdowns in coordination or communication
• Enhancing professional skills and knowledge
• Providing cross-training in substance abuse, sexual abuse, and elder abuse

A new trend among MDTs is the emergence of specialized teams in areas such as financial abuse and suspicious fatalities. Financial abuse specialist teams (FASTs) focus on home equity loan scams, the misuse of powers of attorney and trusts, confidence crimes, identity theft, investment scams, telemarketing fraud, "sweetheart scams," and homicides for profit. Team members include financial and law enforcement experts in fraud or financial crime. Because financial crime can occur with other crimes, FASTs include persons with expertise in other abuse areas.

Elder Fatality Review Teams include representatives from coroners' or medical examiners' offices; geropsychologists and other mental health professionals; local, State, or Federal law enforcement personnel and prosecutors; and other representatives. Teams work together to improve the community's ability to distinguish accidental from nonaccidental deaths. They may identify problems in the service delivery network, create policies and practices to help evaluate injuries and causes of death, and aid in prosecution of elder abuse.

For many years, hospitals have had MDTs in place to help physicians, social workers, administrators, and other medical personnel plan patient care and create protocols for handling elder abuse. New MDTs build on this model by creating community-based medical teams to help agencies that address elder abuse.

MDTs generally conduct the following prevention activities:

• Creating training materials for bank employees, clergy, gatekeepers, the public, law enforcement, medical students and practitioners, and mandated reporters
• Sponsoring training events such as conferences, workshops, and "train-the-trainer programs" on fraud prevention, medical issues, APS and its role in receiving reports, fiduciary abuse, real estate fraud, and legal issues related to guardianships
• Producing brochures, videos, Web sites, reports, public service announcements, and other materials
• Developing interagency agreements, legislation, protocols, and referral guidelines for APS workers

The National Committee for the Prevention of Elder Abuse (NCPEA) has created a manual, Multidisciplinary Elder Abuse Prevention Teams. The NCPEA manual includes a Checklist for Starting or Revitalizing Teams to help individuals and groups start teams or to help existing teams enhance their performance.