Search

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]

Objectives To determine whether there are subtypes of elder self-neglect ( SN) with different risk factors that can be targeted using medical and social interventions. Design Cohort study using archived data of Adult Protective Services ( APS) substantiated cases of elder SN between January 1, 2004, and December 31, 2008. Setting Houston, Harris County, Texas. Participants Adults aged 65 and older with APS region VI substantiated SN between January 1, 2004, and December 31, 2008 (N = 5,686). Measurements Adult Protective Services caseworkers used the Client Assessment and Risk Evaluation ( CARE) tool during home investigations, assessing risk of harm in the domains of living conditions, financial status, physical and medical status, mental health, and social connectedness. Latent class analysis was used to identify unique subtypes of elder SN. Results Four unique subtypes of elder SN were identified, with approximately 50% of individuals manifesting physical and medical neglect problems. Other subtypes included environmental neglect (22%), global neglect (21%), and financial neglect (9%). Older age, Caucasian descent, and mental status problems were more strongly associated with global neglect behaviors. African Americans were more likely to experience financial and environmental neglect than Caucasians and non-white Hispanics. Conclusion Elder SN consists of unique subtypes that may be amenable to customized multidisciplinary interventions. Future studies are needed to determine whether these subtypes impose differential mortality risks and whether multidisciplinary tailored interventions can reduce SN and prevent early mortality. [ABSTRACT FROM AUTHOR]