Seniors' Self-Administration of the Elder Abuse Suspicion Index (EASI): A Feasibility Study

This study explored the feasibility of seniors aged 65 and over with MMSE ≥24 completing the EASI-sa, a self-administrable version of the Elder Abuse Suspicion Index (EASI). A convenience sample of 210 was stratified by age, sex, and language (English and French). All completed the EASI-sa within an estimated 5 minutes, 82.9% within 2 minutes. Completion time decreased with higher education, but was not affected by age, sex, language, or measured physical or mental health. No questions went unanswered; no words were poorly understood or discomforting. The EASI-sa completion was associated with a significantly increased understanding about elder abuse (p < 0.0001).     

Multidisciplinary Team Perspectives on Older Adult Hoarding and Mental Illness

This qualitative study examined multidisciplinary team members' perspectives of their involvement in older adult hoarding cases. Fifteen informants, as representatives of four hoarding teams, described cases in which teams did or did not work well together. Specifically, informants described their (a) team characteristics, (b) awareness of hoarding as a mental health illness, (c) barriers to providing mental health services for older adults who hoard, and (d) components of successful teamwork within the team and with the older adult as hoarder. Implications include research to better guide interventions, team training to develop common perspectives, and policy development that supports mental health representation on teams and in-home mental health treatment.     

An Adult Protective Services' View of Collaboration With Mental Health Services

Mental Health Services (MHS) meet mental health needs of older adults through active, outpatient, community-based care. Adult Protective Services (APS) are involved with needs of older adults who have mental disability and mental illness. Adult Protective Services and MHS staff may to work together when they respond to the needs of victims and adults at risk for abuse, neglect, self-neglect, and exploitation. The purpose of this study was to understand effective APS–MHS collaborations (e.g., leadership, organizational culture, administration, and resources in predicting success). A survey that was sent to members of the National Adult Protective Services Association (NAPSA) revealed that both APS and MHS have strong commitments to protecting clients' rights and autonomy, but there appear to be differences between the two with regard to implementation, apparent in cases involving clients with diminished mental capacity who are at imminent risk, but who refuse help. Strengths of APS–MHS collaborations included improved communication and better service for at-risk clients.     

Development and Validation of a Tool to Improve Physician Identification of Elder Abuse: The Elder Abuse Suspicion Index (EASI)©

ABSTRACT

This study aimed to develop and validate a brief tool for physician use to improve suspicion about the presence or absence of elder abuse. A literature review on elder abuse, obstacles to its identification, limitations of detection tools, and characteristics of screeners employed by physicians were used to generate elder abuse detection questions for critique by 31 doctors, nurses, and social workers in focus groups. Six resulting questions became the Elder Abuse Suspicion Index (EASI) administered by 104 family doctors to 953 cognitively intact seniors in ambulatory-care settings. Findings were compared to a recognized, detailed elder abuse Social Work Evaluation (SWE) later administered to participants by social workers blinded to the results of the EASI. The EASI had an estimated sensitivity and specificity of 0.47 and 0.75, usually took less than 2 minutes to ask, and 97.2% of doctors felt it would have some or big practice impact. This research is a first phase in the development and validation of a user-friendly tool that might sensitize physicians to elder abuse and promote referrals of possible victims for in-depth assessment by specialized professionals.     

Productive Engagement Among Older Americans: Prevalence,Patterns, and Implications for Public Policy

This study estimates the prevalence of productive engagement among adults aged 60 and over residing in the United States over a nine-year period. We analyze three waves of data from the Americans' Changing Lives Study, which allows the findings to describe the non-institutionalized older American population. Focusing upon five activities—formal paid employment, irregular paid work, unpaid volunteerism, caregiving, and informal assistance to others—we identify changes in the engagement rates, examine the extent to which engagement occurs through single or multiple concurrent activities, and document intra-individual patterns of engagement within and across forms of productive activity, including the continuity, initiation, and cessation of involvement. The findings reveal that late-life productive engagement is widespread, with the majority of older individuals involved in multiple forms of activity concurrently. Non–market-based activities such as caregiving, informal assistance, and volunteering are most prevalent. Initiation and cessation of activities are common and yield more complex patterns and lower rates of non-participation than are revealed in cross-sectional analyses. Time spent in productive engagement is highly variable and exhibits an overall decline across time. We conclude by highlighting policy strategies to increase the availability and quality of opportunities for productive engagement and promote planning for engagement in late life.     

Family and Culture,and the Samoan Youth

This qualitative study examines the Samoan family and culture as possible sources of risk and/or protection for delinquency among Samoan youth. Study participants included Samoan American youth and parents living in one U.S. state. Data were collected via individual interviews. Results indicate that family practices, dynamics, and socioeconomic status; cultural factors such as Samoan customs and traditions (Fa'aSamoa); and structural factors such as oppression and discrimination may serve as sources of risk and/or protection for delinquency among these Samoan youth. A theory is proposed based on familial, cultural, and structural factors related to delinquency among Samoan youth. Implications for future research, policy, and practice specifically focusing on the cultural aspects of the lived experiences of Samoan youth and their families living in the United States are discussed.