Transcript Rescue and Rehabilitation for Victims of Elder Mistreatment

The Safety Action Plan
Rescue and Rehabilitation for Victims of Elder Mistreatment
Thomas Price, MD
Chief of Medicine, Wesley Woods Geriatric Center
Emory Center for Health in Aging
Assistant Professor, Emory University School of Medicine
Division of Geriatric Medicine and Gerontology
Elder Mistreatment
 Abuse, Neglect and Exploitation
 Up to 10% of older adults (>65) annually
 1.2:100 for total population
 2003: 1-2 million cases in USA
 DeKalb County, Georgia
 Estimated 3200 cases/year
 In 2009: 40 Investigated, 22 Tried
Results of Environmental Scan
 Georgia
 Vulnerable Adult Senate Study Committee
 Department of Human Services/DAS
 DeKalb County
 Courts, Area Agency on Aging
 Police (city, county, university) and fire rescue
 Emory
 Emergency Med, Psychiatry, Hospital Med, Rehab,
Hospital Admin, University/School of Medicine
Approach to the Problem
 Identify Victims (Police, EMS)
 Case management (VALARI)
 Medical Eval (Wesley Woods Hospital)
 Shelter (Wesley Woods Center facilities)
 Rehabilitation (Wesley Woods Clinic/Psych)
 Reenter Community (APS, DAS, AAA)
 Prosecution of crimes (Court MDT)
Target Population
 Older persons suspected of being victims of elder
mistreatment in DeKalb county identified by first
responders (Police, EMS)
 Victims entered into system by FRS
 Cases managed by VALARI volunteer corps
Process and Outcome Measures
 Case Review Form
 Demographics of victims
 Identification of risk factors/associations
 Targeted interventions
 Absolute number of cases investigated in DeKalb
(increase)
 Outcomes of protected elders
 Prosecution rate compared to others
Timeline
Georgia State Task Force on Abuse, Neglect and Exploitation Starts
Task Force creates rescue concept
2005
2006
2007
2008
2009
2010
VALARI formed
VSAP start date
9/20/2010
(tentative)
First VALARI MDT meeting
First Draft of VSAP
Emory/DeKalb MOU
signed
Emory and DeKalb Co Meet
Implementing the Program
 Buy in achieved (so far)
 DeKalb Co/Emory agreement signed 5/2010
 Program described in Emory’s annual report
 Press coverage
 Emory Healthcare to support costs of beds, care if
indigent patient (community svc) per agreement
 DeKalb Co and APS collaboration – 30 day sheltering
Facilitators (Allies and Supporters)
 Practice Change Fellows!
 DeKalb County Solicitor General’s Office
 Office of Victim’s Assistance (Betsy Ramsey)
 State Senator Ronald Ramsey (D – 43rd)
 James Bulot PhD (Georgia DHS/DAS Director)
 Albert Blackwelder (COO, Wesley Woods)
 Mark S. Lachs MD (Director, NYC Center)
 Ted Johnson MD (Chair, Emory Geriatrics)
 Wayne Alexander MD (Chair, Emory Medicine)
 Debra Houry MD (Director, Emory Center for Injury
Control)
Barriers
 Alternate physicians needed for covering program
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(24/7 call)
May need clinic space for rapid assessment
Kit bag development
Case review form development
Financial sustainability (limits sustainability and
scope)
Statewide implementation pressure
Effect of the Multidisciplinary Team
MDT
Begins
Sustaining the Program
 Goals
 Rescue and rehabilitate victims of elder mistreatment
 Demonstrate effectiveness and impact of the program
 Seek funding as an Elder Justice Center
 Collaboration with Emory CIC, Georgia State Univ, etc
 Research product (EU – Center for Health in Aging)
 Seek state funding (mandated centers?)
 State legislation for these programs
 GA Senate Resolution 57 (Ramsey) has established a
committee to investigate need and funding for the program
What I Am Learning
 Working with politicians and (other elected
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officials)
Value of sweat (and tuchus) equity
National search for expert content mentor (Lachs)
Partnerships with non-MDs vital (lawyers, nurses,
sociologists/SW, etc)
Coordinate with diverse agencies (government
and otherwise)
Collaborate: take some ideas and farm out others