|January 2005 | Volume 7 | No. 3
Policy & Legislation
The 108th Congress adjourned without passing the long-awaited Elder Justice Act introduced by now retired Senator John Breaux (D-LA).
On a more positive note, the Elder Justice Coalition has said it expects that members of the new 109th Congress will consider similar bipartisan legislation. The appointments of Senators Mike Enzi (R-WY) as the new Chair of the Senate Health Education, Labor and Pensions Committee, Gordon Smith (R-OR) as Chair of the Senate Special Committee on Aging, and Senator Arlen Specter (R-PA) as Chair of the Senate Judiciary Committee are viewed as a positive development. Of note, all 44 Senate co-sponsors of the original bill, S. 333, have returned for the 109th Congress.
The Executive Committee of the Coalition continues to meet with administration officials and Senate and House staff. We will keep you posted on developments as they unfold.
A Mini-White House Conference on Elder Abuse, Neglect and Exploitation will be held at the upcoming joint conference of the American Society on Aging/National Council on Aging in Philadelphia on Saturday, March 12. Robert Blancato, President, National Committee for the Prevention of Elder Abuse and White House Conference on Aging Policy Committee Member, will lead the session.
Other presenters include NCEA Director Sara Aravanis of the National Association of State Units on Aging, Susan J. Aziz, International Federation on Ageing, and Marie-Therese Connolly, U.S. Department of Justice.
The results of the discussion will lead to a draft recommendation for consideration and adoption by the delegates at the 2005 White House Conference on Aging to be held in Washington, DC in October.
Plan to attend this important meeting . . .
The American Society on Aging, with funding from the Archstone Foundation, has scheduled many workshops and presentations on elder abuse as a special track.
Find out more >> http://www.preventelderabuse.org/new/asa_ncoa_conference.html.
ASA/NCOA 2005 Joint Conference >> http://www.agingconference.org/jc05/index.cfm
At its annual conference last September, the National Adult Protective Services Association adopted a resolution urging the 2005 White House Conference on Aging to consider elder and vulnerable adult abuse in the policy deliberations.
NAPSA further recommended that the WHCoA should use the National Elder Abuse Policy Summit recommendations and the 2004 Elder Justice Act proposal as a starting point for discussions, and that APS programs be involved throughout the process.
2004 NAPSA 15th Annual Conference - A White House Conference on Aging Designated Event
The Kentucky Medical Association's Subcommittee on Domestic Violence has announced the release of an updated version of its Model Healthcare Protocol on Abuse, Neglect, and Exploitation. Initially developed in March 1997 and updated in August 2004, the guidelines cover child, spouse/partner, adult, and elder abuse.
On the Internet >> http://www.kyma.org/Committees/Protocol_Index.php
In Focus: Adult Protective Services/Mental Health Collaboration
This month, the National Center on Elder Abuse released the results from a study conducted by the National Committee for the Prevention of Elder Abuse confirming what many have known all along:
"Increasingly complex needs of clients with mental health problems living in the community, together with severe cutbacks in fiscal allocation for services, create both fertile ground and a critical need for collaborative efforts between APS and mental health services."
The study, which was carried out by Professor Pam Teaster, PhD and colleagues at the University of Kentucky and Colorado Adult Protective Services, points out that collaboration is not without challenges. "Critical issues, such as parameters surrounding confidentiality requirements, criteria for addressing "crisis situations, and resource limitations, can cause friction and frustration," she writes.
The intent of this study was to see how much collaboration is going on and to identify keys to success. Among the study's findings:
An Adult Protective Services View of Collaborative Efforts with Mental Health Services Pam Teaster, PhD., Lisa Nerenberg, MPH, Patricia Stanis, PhD and Kim Stansbury, MSW
Read the report >> http://www.elderabusecenter.org/pdf/APSMHSFinal041014.pdf
The Cleveland Foundation has recently awarded a grant to the Cuyahoga County Community Mental Health Board (CCCMHB) to facilitate collaboration between the mental health system and the Cuyahoga County Department of Senior and Adult Services Protective Services Program. The goal is to reduce fragmentation and improve services for adults 18 and over with mental illness who are at risk of abuse, neglect, and exploitation.
Terry Lester, Adult Project Administrator for the Cuyahoga County Community Mental Health Board, said that she expects that by year's end new protocols and service agreements will be in place that will reduce the likelihood of people "falling through the cracks."
The foundation grant funds have been earmarked to cover the costs of a facilitator to guide discussions and help build bridges of understanding between agencies not accustomed to working together. "We really have a strong need to get everybody on the same page," Ms. Lester said.
Over nine months, beginning in January, representatives of key agencies will work jointly on a mental health and adult protective services coordination plan. The team will continue to meet on a monthly basis to review cases after the grant is completed.
In Los Angeles County, the Department of Mental Health and the Department of Community and Senior Services/Adult Protective Services have formed a strong partnership called GENESIS that provides mobile health and mental health support for frail homebound elders. Launched a decade ago, GENESIS is an innovative approach that has won acclaim statewide for maximizing interagency coordination through formal interagency agreements, use of shared assessment protocols, clinical case conferences, joint planning, and disposition.
A unique feature of GENESIS is its ability to help victims of elder abuse who have mental health problems. GENESIS' mobile, "trans/multidisciplinary" teams are each composed of a licensed clinical social worker and registered nurse who conduct joint in-home visits to provide mental health assessment for older people, crisis stabilization, short-term treatment, and linkage to needed services. In addition, GENESIS has on staff a geriatric internist, nurse practitioner, and gerontologist.
In 1999, GENESIS signed a formal memorandum of understanding (MOU) with Adult Protective Services to provide assessment to older adults, who APS believes may have a mental health issue that puts them at risk.
Among the recent statistics reported by GENESIS:
GENESIS also has working agreements with community mental health agencies, health providers and case management programs, law enforcement agencies, hospitals, and religious organizations.
When it comes to elder abuse and neglect cases, Danny Redmond, an RN with the Department of Mental Health who will be teaching a suicide intervention course for APS workers next month, said that a member of the team "usually goes with the referring social worker when making the initial contact and does what ever follow-up is clinically appropriate." He added that, "Sometimes that's simply to report that we don't find a mental disorder on the initial assessment, and sometimes that's to do quite a bit of coordinated intervention with them and with other agencies."
The award-winning program is housed in the Los Angeles County Department of Mental Health's Older Services Bureau.
Examples of Adult Protective Services/Mental Health Cases >> http://dmhconnection.lacounty.info/genesis_3_y_%20report.pdf
For more information, contact Danny Redmond, [email protected], (213) 351-5480
The National Institutes of Health recently awarded $1.7 million to the Texas Elder Abuse and Mistreatment Institute (TEAM) at Baylor College of Medicine to increase understanding of the problem of elder self neglect and lay the groundwork for solutions.
Obviously, a very positive step for the field, specific aims of this interdisciplinary planning grant are to:
A newly-formed consortium called the Consortium for Research in Elder Self-Neglect will carry out the initiative under the leadership of Dr. Carmel Dyer, MD, Associate Professor of Medicine at Baylor College of Medicine, Houston. Dr. Dyer also directs the Harris County Hospital District抯 geriatrics program.
For more information, contact:
Dr. Carmel Dyer, [email protected], (713) 873-4872
National Alcohol Screening Day
Mental Health Month
Older Americans' Mental Health Week
National Alcohol and Drug Addiction Recovery Month
National Depression Screening Day
ConferencesFebruary 6-8, 2005
15th Annual Conference on State Mental Health Agency Services Research, Program Evaluation, and Policy
"The Knowledge-Implementation Nexus: Addressing Critical Issues in Public Mental Health
Renaissance Harborplace Hotel
Sponsored by the National Association of State Mental Health Program Directors Research Institute, the conference will focus on three critical issues in the public mental health system: Recovery/Resiliency; Co-occurring Disorders; Evidenced-based Practices.
Contact: Vera Hollen, (703) 739-9333, ext. 116, [email protected]
March 3-6, 2005
American Association for Geriatric Psychiatry 2005 Annual Meeting
Manchester Grand Hyatt
San Diego, CA
On March 3, the Geriatric Mental Health Foundation is hosting an all-day forum, focused on issues affecting late life mental illness. The forum, co-sponsored by the University of California, San Diego and the Older Consumer Adult Mental Health Alliance, is an officially designated White House Conference on Aging event. Open to the public.
For information go to >> http://www.aagpmeeting.org/join.html
March 10, 2005
Mental Health and Aging Coalitions: Partnering to Address the Mental Health and Substance Abuse Needs of Older Adults
Presented by ASA's Mental Health and Aging Network
2005 Joint Conference of the American Society on Aging
and National Council on the Aging
NCEA News & Resources
As you can see we've successfully launched our inaugural e-newsletter. We hope you like our new format. We are excited by the prospect of reaching even more people in the field.
If you know of others who might be interested to receive the NCEA e-News directly, please refer them to the sign up form on our Web site http://www.elderabusecenter.org/
As a national center and information hub, one of the things we do is keep a close watch on trends. Those of you who have been in the field for awhile know that media coverage of elder abuse used to be sparse, to say the least. Once upon a time, very few of the nation's papers devoted attention to the problem, and only a few journalists seemed to grasp the complexity of the issues.
While it may have taken awhile, I am very pleased to report that news and commentary about elder abuse is increasing. With NAPSA's help we now conduct a daily news scan to monitor the reportage. Each month more than 100 important breaking stories are summarized in a news digest and shared with members of the NCEA Listserve.
An important breakthrough came last month when the New York Times featured a front-page story of a complex elder abuse case. "Bowed by Age and Battered by an Addicted Nephew", published December 12, makes compelling reading. Investigative reporter and writer N.R. Kleinfield captured the essence of elder abuse in all its terribleness: the often troubling family dynamics, the challenges of interagency collaboration, the dilemma of protection versus freedom of choice and self-determination.
In our efforts to raise awareness, these kinds of human interest stories are encouraging. All of us, advocates, front line workers, law enforcement, and health care providers alike, can take pride that elder abuse is no longer as hidden from the public's eye.
—Sara Aravanis, Director, National Center on Elder Abuse
NCEA is pleased to announce the availability of funding for projects to develop and test interventions designed to reach underserved and isolated elders who are victims of or at risk of elder abuse. Up to six grants of no more than $5,000 each will be awarded under this solicitation.
Acceptable projects will address one or more of the following goals: increase information or awareness; improve services; link target groups more effectively to services; and/or initiate or enhance community partnerships. Eligible applicants include public or non-profit community based organizations, or faith based organizations, or tribal organizations.
Applications must be submitted by Tuesday, March 15, 2005.
To request the grant application, please send an e-mail to Suzanne Stack at [email protected]. If you do not have access to e-mail, please contact Suzanne by phone (202) 898-2578, ext. 131.
Your help and expertise are truly needed! NCEA is attempting to collect memoranda of understanding and memoranda of agreement related to elder abuse, neglect, or exploitation, including but not limited to the delivery of adult protective services.
Please send your pertinent documents by e-mail to the Clearinghouse on Abuse and Neglect of the Elderly at [email protected]. If it is not possible to transmit documents electronically, please mail or fax them to CANE, 211 Alison Hall West, Department of Consumer Studies, University of Delaware, Newark, DE 19716
If you have questions about this initiative, please contact Karen Stein, Ph.D. at (302) 831-6081.
A new series of annotated bibliographies compiled by the Clearinghouse on Abuse and Neglect of the Elderly has just been released:
Sign up today for
See our Web site for details.
On the Front Lines
SOURCES: Oklahoma Department of Human Services, Office of Communications
1The statistics highlighted in this column are gathered from a variety of state-specific data sources and should be cited using the sources referenced. Readers should note that elder abuse incidence and prevalence rates vary among states and differ depending upon the definitions used and state laws regarding reporting. The National Center on Elder Abuse cannot guarantee and assumes no responsibility for the accuracy or completeness of the information.
County Adult Protective Services - Web site map http://www.okdhs.org/APS/sitemap.htmlStatutes
Research & Scholarship
"Maximizing Treatment of Substance Abuse in the Elderly"
"Identifying Older People at Risk of Abuse During Routine Screening Practices"
STUDY AND RESULTS
"Predictors of Self-Neglect in Community-Dwelling Elders"
STUDY AND RESULTS
"Sexual Abuse of Older Adults: APS Cases and Outcomes"
News & Notes
Quality of Care in Nursing Homes - New Report Shows Progress Being Made on Curbing Use of Physical Restraints
On December 22, U.S. Department of Health and Human Services Secretary Tommy G. Thompson and Centers for Medicare & Medicaid Services Administrator Mark B. McClellan, MD, PhD, announced the results of the first two years of the Nursing Home Quality Initiative (NHQI) and aggressive new efforts to further improve care in the nation's nursing homes.
According to the latest federal Centers for Medicare and Medicaid Services data, nearly all of the states reported declines in the use of physical restraints in nursing homes.
The 2005 Action Plan sets some new specific actions directly related to elder abuse prevention. Some examples of the commitments:
Further details of the action plan are available at > > http://www.cms.hhs.gov/quality/nhqi/
Last month, Dr. McClellan also announced the names of the states that were chosen to participate in a federal pilot that aims to consolidate and centralize systems for conducting criminal history background checks of prospective employees in long term care. The two-year demonstration will look at costs and efficacy of different approaches. The seven pilot states are Alaska, Idaho, Michigan, Nevada, New Mexico, South Carolina, and Wisconsin.
Find out more . . .
Questions about the background check pilot program can be e-mailed to [email protected] More about the pilot states can be found at:
The Family Violence Prevention Fund announced in January the debut of its new electronic journal, Family Violence Prevention & Health Practice, dedicated to addressing family violence in the health care and public health setting. The first issue was released January 11.
Published by the National Resource Center on Domestic Violence, a project of the Family Violence Prevention Fund, this new eJournal is free of charge. To learn more about the publication, go to http://endabuse.org/health/ejournal/.
Crimes Against Persons Age 65 or Older, 1993-2002, Bureau of Justice Statistics Special Report, by Patsy Klaus, BJS Statistician, U.S. Department of Justice, January 2005 http://www.ojp.usdoj.gov/bjs/pub/pdf/cpa6502.pdf
Mental Health Association of New York City Launches National Suicide Prevention Lifeline 1-800-273-TALK
Earlier this month, the Mental Health Association of New York City and its partners, the National Association of State Mental Health Program Directors, Columbia University, and Rutgers University, announced the launch of the federally-funded National Suicide Prevention Lifeline 1-800-273-TALK. More than 109 crisis centers in 42 states currently participate in the National Suicide Prevention Lifeline network.
On the Internet >> http://www.suicidepreventionlifeline.org/
Planning is now underway for the World Congress in 2005. To receive email announcements and updates, go to http://lb.bcentral.com/ex/manage/subscriberprefs.aspx?customerid=13260
"Older persons with mental health/substance abuse problems are particularly at-risk as victims of elder abuse, but may be afraid or unable to report abuse. Police officers and protection and advocacy staff should be trained in identifying symptoms of mental illness and substance abuse in older adults. Clear and appropriate protocols that specify how to deal with older adults when there is a question of whether the person is suffering from depression, delirium and dementia (or a combination of all three) is needed."
-Creating A Continuum Of Care For Older Persons With Behavioral Health Needs In Southeast Pennsylvania: Proposed Continuum of Care Model, position paper prepared by the Delaware Valley Mental Health Aging Advocacy Committee of the Mental Health Association of Southeastern Pennsylvania
The NCEA Newsletter is supported in part by a grant, No. 90-AM-2792, from the U.S. Administration on Aging, Department of Health and Human Services.
Points of view or opinions expressed in this publication do not necessarily represent the official views of AoA/HHS or any of the NCEA's affiliated partners.
|NATIONAL CENTER ON
National Association of State Units on Aging
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Washington, DC 20005
PHONE: (202) 898-2586
FAX: (202) 898-2583
E-MAIL: [email protected]
WEB SITE: www.elderabusecenter.org