Conceptual Model and Map of Psychological Abuse of Older Adults

Psychological abuse of older adults is a hidden and pervasive problem that is not well conceptualized nor well measured. Goals. The goals were to (a) conceptualize psychological abuse using three-dimensional concept maps, and (b) develop theoretical models. Methods. Statements describing the construct were generated by local and national panels. These were sorted and rated using Concept Systems software whereby the concepts were depicted as a map. Results. The concept maps guided development of theoretical hierarchies. Significance. Theoretical models may help to develop measures to estimate prevalence better and may enable more precise screening for triage into appropriate interventions.     

Conceptual model and map of psychological abuse of older adults

Psychological abuse of older adults is a hidden and pervasive problem that is not well conceptualized nor well measured. Goals. The goals were to (a) conceptualize psychological abuse using three-dimensional concept maps, and (b) develop theoretical models. Methods. Statements describing the construct were generated by local and national panels. These were sorted and rated using Concept Systems software whereby the concepts were depicted as a map. Results. The concept maps guided development of theoretical hierarchies. Significance. Theoretical models may help to develop measures to estimate prevalence better and may enable more precise screening for triage into appropriate interventions.     

Experience with a multi-year fleet planning model

The fleet planning problem requires determination of the changing airline fleet mix based on existing traffic levels and projected growth, on the existing fleet, various aircraft types available in the future, and other operational and financial considerations. Several applicable mathematical formulations have been reported. One of these has been programmed for the computer and used by the authors for several years. This paper discusses the application of that model to real airline planning situations. Such practical experience has effected changes in the program and the manner it is used in fleet planning studies.     

Development and implementation of online training modules on abuse,neglect, and exploitation

Online training for care managers to identify, report, and prevent abuse, neglect, and exploitation was developed for a demonstration involving the dually eligible Medicare and Medicaid population. It was composed of three modules covering background, screening, and reporting abuse. Of 453 enrollees, 273 completed at least one module and 212 completed all three. Pre- and post-training surveys for each module were used to examine changes in the proportion of correct answers for each question, using the related-samples Cochran’s Q statistic. Improvements in knowledge from pre- to post-training were evident in modules covering background on abuse and reporting abuse, but not in the module about communication principles and screening for abuse. Its content may have already been familiar to the trainees, who were primarily social workers and nurses. Lessons learned are being used to adapt the training for a wider audience to increase public awareness of abuse.     

The National Elder Mistreatment Study: An 8-year longitudinal study of outcomes

Objectives: To conduct an 8-year follow-up of the National Elder Mistreatment Study (NEMS) and specify risk ratios for negative outcomes of elder abuse, including DSM-5 defined depression, generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), and poor self-reported health.

Methods: Attempts were made to re-contact, via Computer Assisted Telephone Interview, all 752 NEMS participants who reported mistreatment since age 60 at Wave I, as well as a randomly selected sample of non-mistreated NEMS participants

Results: 183 NEMS Wave I elder abuse victims and 591 non-victims provided data. In bivariate analyses, elder mistreatment 8 years earlier increased risk of negative outcomes by 200–700%. However, multivariate analyses revealed that Current (Wave II) social support was highly protective against most negative outcomes (excepting PTSD), and even appeared to nullify effects of mistreatment on GAD and poor self-reported health.

Conclusions: Outcomes of elder mistreatment have not been studied prospectively in a national sample. The NEMS 8-year follow-up findings indicate a strong relationship between elder mistreatment at Wave I and negative emotional and physical health 8 years later. Fortunately, current (Wave II) social support appears to be both consistently and powerfully protective against most negative outcomes.