In the study, a team of researchers trained 80 caregivers on the Comprehensive Older Adult and Caregiver Help (COACH) method. COACH enables caregivers to give high-quality care while mitigating any impacts of caregiving that may lead them to be abusive. It also empowers caregivers to be on alert against elder mistreatment from other parties.

A bachelor’s level coach was trained on the method, and then met with a caregiver for anywhere from three to 12 phone sessions. Caregivers who took part in the training had a mean age of 61.3, and 76.3% were female. Of the caregivers, 40 met with a coach (the treatment group) and 40 did not (the control group) at the start of the study.

All of the older adults in the study (who the caregivers cared for) were 65 and older. People in hospice, who lived in nursing care facilities or those who were homeless were not included. Caregivers couldn’t live more than 50 miles away from the care recipient to be included in the study.

During their first session, the coach and caregiver examined their strengths and areas for growth, looking at a caregiver survey. Then the coach and caregiver moved forward with a plan of topics for their sessions. Caregivers in both groups received a toolkit, but only the treatment group participated in one-on-one sessions as well.

By the end of the study, a total of 64 caregivers were enrolled. Then the researchers followed up three months after that to see what was going on in terms of elder mistreatment. 

Before the intervention began, 22.5% of the caregivers in the treatment group reported mistreatment in their relationship existed, which dropped to 0% at the end of the study. In the control group, 15.4% of the caregivers reported mistreatment at the start of the study; that went to 23.1% at the end of the study. 

“Although risk factors for and precursors of elder mistreatment are still somewhat unclear, the COACH intervention was developed on the assumption that caregiver support offers a promising path to prevent elder mistreatment against care recipients by helping caregivers manage the stressful and emotionally taxing activities that the role often requires,” the authors said.

The research team examined healthcare utilization records of hundreds of elder abuse victims compared to others in their age group. Nearly 68% of elder abuse victims visited the ED in the 24 months after their mistreatment was identified. In comparison, the rate of ED visits was around 44% among elderly in the same demographic groups who had not reported abuse. Hospitalization rates were higher, too, with almost 39% of abused elders requiring hospitalization in the months after abuse occurred compared to a 26% hospitalization rate among those in the same demographic who were not abused.

Reasons for emergency care visits after elder abuse varied, according to the report. Injuries were one reason for visits, but the study team also found multiple visits across separate hospitals and emergency departments and visits for low-urgency problems were also common among abused elders.

ED use and hospitalization were much higher in abused elders in the 12 months after the abuse occurred than in the 12 months prior to the abuse, the study notes.

What wasn’t answered in the study was exactly why abused elderly more often sought care after abuse, and how this information could be used for earlier abuse detection and intervention. 

The study, which was published in the Journal of the American Medical Association (JAMA), highlights the high cost of elder abuse — both financial and otherwise — and the need for better protections. In many cases, abuse is only identified during emergency care visits or other hospitalizations, the research team notes.

Presenters include Penny Hommel, the co-director of the Center for Social Gerontology; Jaye Martin, executive director of Maine Legal Services for the Elderly; and Denis Culley, staff attorney for Maine Legal Services for the Elderly. The webinar is part of a series of National Elder Rights Training Project webinars for the National Legal Resource Center. 

For more information about the event click here or email trainings@nclc.org.

To register for the event, which will be hosted by Laura Snow, click here. For more information, email elderabuseprevention@jseniors.org.

What it is

The White House Conference on Aging is a once-a-decade national conversation about the needs of our aging population. The goal, according to the WHCOA website, is “to identify and advance actions to improve the quality of life of older Americans.” The first WHCOA was held in 1961, with subsequent conferences in 1971, 1981, 1995, and 2005. As indicated on the conference’s website, the 2015 conference takes place during a year that marks the 50^th anniversary of Medicare, Medicaid and the Older Americans Act, as well as the 80^th anniversary of Social Security.

The 2015 WHCOA agenda

Next year’s conference will focus on four main areas:

• Retirement security

• Long-term services and supports that allow elders to remain in the community

• Healthy aging

• Preventing financial exploitation, abuse and neglect of elders (elder justice)

The executive director

2015 WHCOA Executive Director Nora Super has previously held roles as director of public affairs at the Office of the National Coordinator for Health Information Technology, the director of health- and long-term care for AARP, the director of public policy and long-term care relations for Kaiser Permanente, and principal research associate at the National Health Policy Forum.

What it does

For a positive view of the conference, Anne Montgomery’s article for the National Academy of Social Insurance points out concrete actions taken as a result of previous conferences. 

According to Montgomery, the 1961 conference led to the development of 50 State Units on Aging as part of the Older Americans Act; the 1971 WHCOA resulted in the creation of the Supplemental Social Insurance program and establishing the National Institute on Aging within the National Institutes of Health; the 1995 WHCOA lead to the National Family Caregiver Support Program; and the 2005 WHCOA “provided momentum for reauthorizing the Older Americans Act in 2006, which strengthened the role of Aging Disability Resource Centers.” 

Delegates to past conferences commented on her article, stating that the WHCOAs have been crucial in identifying problems and their solutions.

No stranger to controversy

For a pessimistic view of the upcoming conference, read Howard Gleckman’s forbes.com article, “Will the White House Conference on Aging Accomplish Anything?” Gleckman notes that the $3 million dollar budget asked for this conference is less than a third of the budget for the 2005 conference. He speculates that this will lead to smaller meetings at various locations or online rather than at one larger venue, creating a less cohesive group with more difficulty building consensus. He further believes that the conference is “doomed” due to partisanship and that the agenda is too broad for any topic to get the necessary attention.

Who attends?

According to the 2005 WHCOA final report, delegates for the 2005 conference were selected by governors of all 50 states, Puerto Rico, the District of Columbia, and the U.S. territories, members of the 109^th Congress, the National Congress of American Indians, and the policy committee. (For the record, I’d accept a nomination to be a 2015 delegate.)

How we can get involved

The WHCOA Get Involved page of the conference website offers three ways for citizens to contribute to the planning of the 2015 conference:

• Sign up for weekly updates by joining the mailing list

• Share written thoughts about issues being addressed at the conference

• Share written or short video stories from older Americans and their caregivers about issues being addressed at the conference.

My take

Maybe Gleckman is right and the conference is doomed to failure from the start. But every week for almost 20 years, I’ve marched into rehab residents’ rooms and encouraged them to do everything they could to make rehab a success because at least then they will know that whatever happens, they tried their best. I feel the same way about the conference.

Five years ago, before I started my blog, I was just some shrink grumbling under her breath about the crazy way things worked — or didn’t — in LTC. And now I’m contributing to a larger conversation through this blog, other articles and talks in the field. I’m a big believer in the power of the Internet to bring new voices to the table. It’s possible that online WHCOA meetings could add something valuable and unexpected to the conference.

I also appreciate that there’s an opportunity to contribute the opinions of our residents and their families and staff via the WHCOA web page. Maybe we won’t be as effective as comedian John Oliver when he exhorted his listeners to contact the FCC about net neutrality and their volume of messages broke the FCC website. 

But we can certainly try.

Eleanor Feldman Barbera, PhD, author of “The Savvy Resident’s Guide,” is a 2014 Award of Excellence winner in the Blog Content category of the APEX Awards for Publication Excellence program. She also is the Gold Medalist in the Blog-How To/Tips/Service category of the 2014 American Society of Business Publication Editors Midwest Regional competition. A speaker and consultant with nearly 20 years of experience as a psychologist in long-term care, she maintains her own award-winning website at MyBetterNursingHome.com.

“The Elder Justice Roadmap” defines elder abuse as any “physical, sexual and psychological abuse, as well as neglect, abandonment and financial exploitation, is defined as elder abuse.”

Most adverse events in nursing homes are largely due to inadequate treatment, care and staffing — leading to a 22% increase in unnecessary hospitalizations and costing Medicare $2.8 billion, the report stated. 
 
To form a plan on how to combat elder abuse in long-term care facilities, as well as in all senior residential settings, 750 practitioners and leading experts were asked to complete the following sentence: “To understand, prevent, identify or respond to elder abuse, neglect, or exploitation, we need…”

The following top five priorities were identified:

1. Increase public awareness of elder abuse
2. Conduct further research on mental health and cognitive capacity issues 
3. Provide better training and support for caregivers
4. Quantify costs of elder abuse
5. Invest more resources in services

In addition to these priorities, the government initiative calls for stronger monitoring of services, policies and oversight through survey, licensing agencies and the development of law enforcement and prosecution units that specialize in elder abuse.

The initiative was funded by the U.S. Department of Justice with support from the Department of Health and Human Services. In further support of the initiative’s mission, the DOJ created an interactive, online curriculum for attorneys and the HHS developed a voluntary national adult protective services data system, DOJ announced Wednesday.

To access the full report, click here

The Harry and Jeanette Weinberg Center for Elder Abuse Prevention at the Hebrew Home is dedicated to helping elder abuse victims in many ways, from providing emergency shelter to educating the community to advocating on Capitol Hill and on the state and local levels.  We are facing a national epidemic – and it will only increase as the Baby Boomer population ages.  We must take action and never stop advocating for those who cannot.

The Hebrew Home at Riverdale successfully advocated both the US Department of Housing and Urban Development and the New York State Department of Health to expand and alter their policies to prioritize senior housing applicants who are victims of elder abuse. As a result of this unwavering advocacy, we secured state funding to open The Terrace, an assisted living program on our Riverdale campus. Today, we offer long-term housing for elder abuse victims in a comfortable, home-like environment that provides healthcare, social opportunity and a safe place to call home. For some, this safety is a first in their lives.

On the federal level, the Hebrew Home advocated for HUD to permit elder abuse victims to have priority admission to our federally subsidized  low-income 202 apartment building, Hudson House. Hudson House provides apartments with amenities – close proximity to shops, nicely decorated living space and a built-in social system.

While attending the Dallas conference, I sat in the auditorium, watching the photo montage and video before accepting this award.  Each image provided a glimpse into our work and the people in our care. The photo of a woman getting her blood pressure checked. The video of another woman surrounded by the smiling and reassuring faces of our staff. Photos of elected officials visiting the Hebrew Home and learning of our mission. All of these images were gratifying and inspirational. Every day, the Hebrew Home, and the staff of the Weinberg Center, advocates.  We speak up. We take action. Ultimately, we make a difference.

I am so proud of our accomplishments, but the fight is far from over.  Our greatest hope with the receipt of this award is that long term care organizations throughout our nation will replicate our successful shelter model so that together, we can help end elder abuse.  Older Americans deserve our collective commitment.

Daniel Reingold is the president and CEO at Hebrew Home at Riverdale.