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The Geriatrician clinicians of the Texas Elder Abuse and Mistreatment Institute – Forensic Assessment Center Network (TEAM-FACN) in Houston, have many years of experience providing capacity assessment services for Adult Protective Services (APS) and Texas courts. A process has developed which is efficient, consistent, and evidence-informed. In the last two years, telecommunication has been added to this process to conduct assessments of APS clients in areas of Texas remote from the Houston area. Of the 545 capacity assessments TEAM-FACN has completed across the state of Texas over the first two years of adding telecommunication, 211 (39%) were conducted with in-person interviews and 334 (61%) were conducted using videoconference interviews. APS and the courts in remote areas of Texas have embraced the use of the videoconference assisted capacity assessments. This article describes this evidence-informed process and how telecommunication technology is incorporated to expand the reach of the service. [ABSTRACT FROM AUTHOR]

Objectives: To describe the Texas Elder Abuse and Mistreatment Institute Forensic Assessment Center Network (TEAM‐FACN), a novel statewide elder mistreatment (EM) virtual assessment program using low‐cost videophone technology and innovative web‐based coordination to connect an Adult Protective Services (APS) agency and its clients, rural and urban, to a centralized geriatric and EM expert medical team for virtual in‐home assessments. Design: Descriptive. Setting: Community. Participants: APS clients aged 18 and older. Intervention: Virtual and in‐home assessments. Measurements: Program use and type of services provided. Results: In the first 8 months, 300 APS clients from all regions of the state were referred for assessment. Outcomes realized include a quadrupling in number of client assessments. TEAM‐FACN physicians provided an average of 2 services, which included 216 mental health assessments, with 123 conducted virtually; 42 medical assessments; 45 guardianship filings; 5 employee misconduct registry reviews; and more than 230 interdisciplinary team meetings to discuss case findings, safety plans, and medical and social interventions. Conclusion: TEAM‐FACN provides an innovative and viable way to increase access of urban and rural older and adults who are being mistreated to expert geriatric and EM protective service assessments. J Am Geriatr Soc 67:151–155, 2019. [ABSTRACT FROM AUTHOR]

Mistreatment and self-neglect among older adults are linked to significantly high mortality rates, but research in this area is hindered by a lack of standardized assessments to identify these circumstances. No available assessment has been tested for construct validity (CV) or measurement invariance (MI) across gender or race/ethnicities. This study presents the CV and MI properties of a comprehensive assessment of elder mistreatment (EM) and self-neglect (SN). The 57-item Texas Adult Protective Services Client Assessment and Risk Evaluation (CARE) tool was completed on 7,580 substantiated cases of EM and SN. Confirmatory factor analysis (CFA) and cross-validation techniques were used to assess CV, and MI techniques were used to assess item and domain bias across genders and race/ethnicities. Model fit was estimated using robust estimators. A 43-item CARE tool with 5 domains reached good fit and cross-validated (X2 DIFF TEST, p = 0.69). Overall, the construct reliability ranged from 0.78 (physical/medical) to 0.93 (living conditions).The same model was measurement invariant across gender (X2 DIFFTEST, p = 0.02). The financial status domain could not be used for the Hispanic population, but a 4-factor CARE tool model was measurement invariant across African Americans, Caucasians, and Hispanics (X2 DIFFTEST, p = 0.05). The constructs of the CARE tool appear to be valid and reliable assessments of EM and SN. Overall, the use of this assessment to identify EM and SN does not result in health or social service disparities among older adults. Further research on this topic is needed. [ABSTRACT FROM AUTHOR]