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Elman A, Cox S, Gottesman E, Herman S, Kirshner A, Tietz S, Shaw A, Hancock D, Chang ES, Baek D, Bloemen E, Clark S, Rosen T. The critical role of the specialized social worker as part of ED/hospital-based elder mistreatment response teams. J Elder Abuse Negl 2024; 36:384-394. [PMID: 37691425 PMCID: PMC10924767 DOI: 10.1080/08946566.2023.2255742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
The emergency department and hospital provide a unique and important opportunity to identify elder mistreatment and offer intervention. To help manage these complex cases, multi-disciplinary response teams have been launched. In developing these teams, it quickly became clear that social workers play a critical role in responding to elder mistreatment. Their unique skillset allows them to establish close connections with community resources, collaborate with various hospital stakeholders, support patients/families/caregivers through challenging situations, navigate the legal and protective systems, and balance patient safety and quality of life in disposition decision-making. The role of the social worker on these multi-faceted teams includes conducting a comprehensive biopsychosocial assessment, helping to develop a safe discharge plan, and making appropriate referrals, among other responsibilities. Any institution considering developing a multi-disciplinary program should recognize the critical importance of social work.
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Affiliation(s)
- Alyssa Elman
- Department of Emergency Medicine, Weill Cornell Medical College / NewYork-Presbyterian Hospital, New York, NY 10065, USA
| | - Sarah Cox
- Department of Internal Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Elaine Gottesman
- Department of Emergency Medicine, Weill Cornell Medical College / NewYork-Presbyterian Hospital, New York, NY 10065, USA
| | - Seth Herman
- Department of Social Work, NewYork-Presbyterian Hospital, New York, NY 10065, USA
| | - Avery Kirshner
- Department of Social Work, NewYork-Presbyterian Hospital, New York, NY 10065, USA
| | - Sarah Tietz
- Department of Geriatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Amy Shaw
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College / NewYork-Presbyterian Hospital, New York, NY, USA
| | - David Hancock
- Department of Emergency Medicine, Weill Cornell Medical College / NewYork-Presbyterian Hospital, New York, NY 10065, USA
| | - E-Shien Chang
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College / NewYork-Presbyterian Hospital, New York, NY, USA
| | - Daniel Baek
- Department of Emergency Medicine, Weill Cornell Medical College / NewYork-Presbyterian Hospital, New York, NY 10065, USA
| | - Elizabeth Bloemen
- Department of Internal Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Sunday Clark
- Department of Emergency Medicine, Weill Cornell Medical College / NewYork-Presbyterian Hospital, New York, NY 10065, USA
| | - Tony Rosen
- Department of Emergency Medicine, Weill Cornell Medical College / NewYork-Presbyterian Hospital, New York, NY 10065, USA
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Atkinson E, Roberto KA. Global Approaches to Primary, Secondary, and Tertiary Elder Abuse Prevention: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:150-165. [PMID: 36636948 DOI: 10.1177/15248380221145735] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Public health professionals use a three-pronged approach to address broad-reaching issues of societal concern: primary prevention, secondary prevention, and tertiary prevention. Applying this framework to the study of elder abuse, the purpose of this review is to describe the status of elder abuse prevention research on a global scale. Elder abuse prevention articles published between 2015 and 2021 were identified through electronic bibliographic searches (PubMed, Medline, CINAHL, APA PsycINFO, and AgeLine). After removing articles based on inclusion and exclusion criteria, articles were sorted into the three main prevention types and further divided into subcategories for a more in-depth review. Most of the studies identified were conducted in North America (n = 42). Of the 72 articles identified, 13 articles focused on primary prevention (agism, education, and intervention), 35 articles focused on secondary prevention (developing and evaluating screening tools, identifying and reporting abuse, and barriers to detecting and reporting abuse), and 21 focused on tertiary prevention (professional response to cases of abuse, intervention methods, and impact of policy). Collectively, findings bring greater understanding of elder abuse as a public health problem and identify ways of addressing the complexities of elder abuse. Several gaps were identified in the elder abuse prevention literature including the need for global research that includes older adults as stakeholders, evidence-based education and intervention programs, and cultural sensitive and valid tools to identify elder abuse.
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Gottesman E, Elman A, Rosen T. Elder Mistreatment: Emergency Department Recognition and Management. Clin Geriatr Med 2023; 39:553-573. [PMID: 37798065 DOI: 10.1016/j.cger.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
Elder mistreatment is experienced by 5% to 15% of community-dwelling older adults each year. An emergency department (ED) encounter offers an important opportunity to identify elder mistreatment and initiate intervention. Strategies to improve detection of elder mistreatment include identifying high-risk patients; recognizing suggestive findings from the history, physical examination, imaging, and laboratory tests; and/or using screening tools. ED management of elder mistreatment includes addressing acute issues, maximizing the patient's safety, and reporting to the authorities when appropriate.
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Affiliation(s)
- Elaine Gottesman
- Department of Emergency Medicine, Weill Cornell Medical College/NewYork-Presbyterian Hospital, New York, NY, USA
| | - Alyssa Elman
- Department of Emergency Medicine, Weill Cornell Medical College/NewYork-Presbyterian Hospital, New York, NY, USA
| | - Tony Rosen
- Department of Emergency Medicine, Weill Cornell Medical College/NewYork-Presbyterian Hospital, New York, NY, USA.
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Kayser J, Morrow-Howell N, Rosen TE, Skees S, Doering M, Clark S, Hurka-Richardson K, Bin Shams R, Ringer T, Hwang U, Platts-Mills TF, Network TG. Research priorities for elder abuse screening and intervention: A Geriatric Emergency Care Applied Research (GEAR) network scoping review and consensus statement. J Elder Abuse Negl 2021; 33:123-144. [PMID: 33797344 PMCID: PMC8204570 DOI: 10.1080/08946566.2021.1904313] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The Geriatric Emergency Care Applied Research (GEAR) Network (1) conducted a scoping review of the current literature on the identification of and interventions to address elder abuse among patients receiving care in emergency departments and (2) used this review to prioritize research questions for knowledge development. Two questions guided the scoping review: What is the effect of universal emergency department screening compared to targeted screening or usual practice on cases of elder abuse identified, safety outcomes, and health care utilization?; and What is the safety, health, legal, and psychosocial impact of emergency department-based interventions vs. usual care for patients experiencing elder abuse? We searched five article databases. Additional material was located through reference lists of identified publications, PsychInfo, and Google Scholar. The results were discussed in a consensus conference; and stakeholders voted to prioritize research questions. No studies were identified that directly addressed the first question regarding assessment strategies, but four instruments used for elder abuse screening in the emergency department were identified. For the second question, we located six articles on interventions for elder abuse in the emergency department; however, none directly addressed the question of comparative effectiveness. Based on these findings, GEAR participants identified five questions as priorities for future research - two related to screening, two related to intervention, and one encompassed both. In sum, research to identify best practices for elder abuse assessment and intervention in emergency departments is still needed. Although there are practical and ethical challenges, rigorous experimental studies are needed.
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Affiliation(s)
- Jay Kayser
- School of Social Work, University of Michigan - Ann Arbor, Ann Arbor, Michigan, USA.,Department of Developmental Psychology, University of Michigan - Ann Arbor, Ann Arbor, Michigan, USA
| | - Nancy Morrow-Howell
- Brown School of Social Work, Washington University, St. Louis, Missouri, USA
| | - Tony E Rosen
- Department of Emergency Medicine, Weill Cornell Medicine, New York - Presbyterian Hospital, New York, USA
| | - Stephanie Skees
- Brown School of Social Work, Washington University, St. Louis, Missouri, USA
| | - Michelle Doering
- Becker Medical Library, Washington University, St Louis, Missouri, USA
| | - Sunday Clark
- Department of Surgery, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Karen Hurka-Richardson
- Department of Emergency Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Rayad Bin Shams
- Quantworks, Inc, Healthcare and Life Sciences, Carrboro, North Carolina, USA
| | - Thom Ringer
- Department of Emergency Medicine, Schwartz/Reisman Emergency Medicine Institute, Sinai Health System, Toronto, Ontario, Canada.,Department of Emergency Medicine, Schwartz/Reisman Emergency Centre, Mount Sinai Hospital, Toronto, Ontario, Canada.,Department of Emergency Medicine, University Health Network, Toronto, Ontario, Canada
| | - Ula Hwang
- Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA
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Bloemen EM, Rosen T, Lindberg DM, Krugman RD. How Experiences of Child Abuse Pediatricians and Lessons Learned May Inform Health Care Providers Focused on Improving Elder Abuse Geriatrics Clinical Practice and Research. JOURNAL OF FAMILY VIOLENCE 2021; 36:389-398. [PMID: 34121804 PMCID: PMC8189565 DOI: 10.1007/s10896-020-00143-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The experience of physicians and other health care providers in child abuse pediatrics in the last six decades includes successes and failures, which can offer critical insights to inform the growing field of health care providers focusing on elder abuse clinical practice and research. We identify and describe in detail relevant lessons learned, including balancing an urgent call to action with a need for robust evidence to support clinical conclusions. We discuss solutions to research challenges, including the lack of a uniform gold standard for abuse diagnosis and how to ethically recruit subjects who may have cognitive impairment and also be crime victims. We offer recommendations on recruiting and training a specialized health care workforce. We make suggestions for health care providers about how to navigate the legal world including issues with expert testimony and also how to participate in policymaking and development of rational systems. We emphasize the importance of developing and supporting partnerships within the field, with allied fields inside and outside medicine, and internationally. We also highlight the value of connecting researchers and clinicians focused on different types of family violence.
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Affiliation(s)
- Elizabeth M. Bloemen
- University of Colorado School of Medicine, 13001 E 17th Pl, Aurora, CO 80045, New York, NY 10065, USA
| | - Tony Rosen
- Department of Emergency Medicine, Weill Cornell Medicine / NewYork-Presbyterian Hospital, 525 E. 68 St., Room M130, New York, NY 10065, USA
| | - Daniel M. Lindberg
- The Kempe Center for the Prevention & Treatment of Child Abuse & Neglect, University of Colorado School of Medicine, 12401 E. 17th Ave. Mailstop B-215, Aurora, CO 80045, USA
| | - Richard D. Krugman
- The Kempe Center for the Prevention & Treatment of Child Abuse & Neglect, University of Colorado School of Medicine, 12401 E. 17th Ave. Mailstop B-215, Aurora, CO 80045, USA
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