Table of Contents

About This Course

1. Introduction to Elder Abuse
2. The Basics of Elder Abuse
3. Substance Use and Other Risk Factors
4. Screening and Assessment
5. Intervention and Treatment
6. Preventing Elder Abuse

Supplements
Case Studies
References
Resources

Out of the Shadows
Uncovering Substance Use and Elder Abuse

Checklist for Starting or Revitalizing Teams

The following recommendations are presented as guidance to groups that are starting teams as well as to existing teams that wish to enhance their performance. The list is not exhaustive, and not all items are applicable to all teams.

Defining or Reassessing Teams' Objectives

During the early stages of developing or revitalizing teams, it is helpful to talk to a wide range of stakeholders, key players, and other interested parties, including groups or individuals that are likely to raise objections and opposition to starting a new team or that declined to participate on an existing team. These discussions can identify needs or concerns, prevent duplication of efforts, generate support, identify potential sources of monetary and in-kind support, and anticipate obstacles. Factors to consider include:

• If there is another elder abuse team (or teams) in the community, will a new team complement or compete with the existing one(s)?
• Are there alternatives to creating a new team? For example, could an existing team expand its membership, focus, and case review criteria to meet newly identified needs (e.g., by adding additional members)? What are the benefits and drawbacks of doing so?
• If the team is not new, is it achieving its stated objectives? Have additional needs been identified that could be addressed through modifications in, or additions to, the teams' objectives?

Team Leadership

Teams' leadership, which includes facilitators, chairpersons, or lead agencies, may be mandated by law or dictated by resource consideration. However, to the extent that teams have discretion in selecting leaders, they should consider the following:

• Impartiality. Different disciplines, individuals, or agencies may have biases about how abuse should be handled. People in positions of leadership should be respectful of alternative points of view, committed to interdisciplinary exchange, and free of conflicts of interest.
• Demonstrated leadership.
• Expertise in elder abuse prevention, including an understanding of the roles that various disciplines play in abuse prevention.
• Resources, including staff support, that a lead agency or person can contribute.
• Influence. Depending on the team's objectives, it may be helpful to have leaders who have leverage with policy makers, access to needed information, or who are in positions of leadership in key organization or disciplines.

Membership

Being clear and specific about members' roles on teams and what is expected of them can reduce confusion, misunderstanding, or even conflict. Factors to consider include:

• Will agencies or individuals (or both) be eligible for membership?
• If membership is by agency:
  1. What key agencies in the community should be included?
  2. What role will agency representatives play? For example, will they be responsible for keeping other agency staff apprised of pertinent issues discussed at meetings such as new services or developments in the field of elder abuse?
  3. Will the team have input into how agency representatives are chosen?
• What disciplines are critical? Which are desirable?
• Which of the following categories/types of members will be included?
  1. Employees of public agencies
  2. Employees of private, non-profit agencies
  3. Professionals in private practice
  4. For-profit organizations, including hospitals, nursing homes, financial institutions, private care management or home care agencies, etc.
  5. Volunteers, including retired professionals
  6. Representatives from professional associations or advocacy groups
  7. Others, including clergy, policy makers, ethicists, etc.
• Consideration in selecting members. The skills, expertise, and experience required of members depend on teams' goals and objectives. They may include:
1. Professional skills and knowledge:
• Clinical expertise in relevant areas
• Knowledge of resources
• Familiarity with special populations including underserved cultural communities
2. Administrative skills and authority:
   • Skills in systems change, including legislative advocacy
   • Authority to institute changes within their organizations, negotiate agreements, commit resources, etc.
   • Skills in program and resource development
   • Familiarity with local, State, and Federal administrative structures, regulations, leadership, and funding streams
   • Access to information (e.g., coroners and departments of health can provide information that is critical to death review teams)
3. Personal/professional traits:
   • Commitment to interdisciplinary exchange
   • Appreciation of diverse points of view
   • Follow through
• Will there be categories of membership that reflect different levels of commitment, privileges, and terms? For example, will all members have the right to present cases? Do term limits apply to all or some members?
• What will be the terms and requirements of membership (length of terms, will terms be renewable, grounds for termination, etc.)?
• Are there ways that interested non-members can benefit from, or contribute to, the team (e.g., by receiving minutes or newsletters or serving in an advisory capacity)?
• Who is responsible for replacing members whose terms have expired or who cannot meet their commitments?

Case Reviews

Teams should be clear about the goals of the review process, how cases are chosen, and anticipated outcomes. Factors to consider include:

• What criteria will be used in selecting cases? Specifically:
  1. Who can present?
  2. What types of abusive situations will be discussed (e.g., will the team review self-neglect, abuse in nursing homes, fatalities, etc.)?
  3. Will the team review cases of abuse involving younger disabled adults as well as elders?
  4. Will presenters be encouraged to invite other professionals involved in a case to attend case reviews?
  5. Will the team be available to assist members in planning investigations? Will the team only review "open cases"?
• What measures will be taken to protect clients' privacy and confidentiality?
• Who will receive minutes, and what will they include?
• Who is expected to provide follow-up?
• Will the team be apprised of case outcomes or dispositions?

Other Activities and Objectives

Teams may have multiple goals and objectives, which may change as new needs are identified. Since activities like planning training events or legislative advocacy are extremely time consuming and can divert attention away from core activities, teams may need to develop processes for responding to needs they identify. They should consider if these needs will be:

• Discussed by the group (if so, will this be done during regular meetings or will additional meetings be scheduled?)
• Assigned to subcommittees
• Referred to other appropriate organizations

Redefining Goals and Revitalizing Teams

Occasionally, teams may need to reassess their goals and objectives, membership categories, processes, procedures, or administration. The need to do so may be in response to the following:

• An event, such as the passage of a new law, the allocation of new resources, or retrenchments in services or funding
• Identified unmet needs
• Formation of a new team, creating a need to clarify or redefine the role of an existing team, negotiate agreements, or educate the community about changes

Next Steps

Once goals, objectives, and processes are established or revised, they should be formalized through:

• New or revised materials such as policy and procedure manuals, membership agreements, confidentiality agreements, case review guidelines, etc.
• Education and outreach to the public and professionals. Avenues for reaching these groups include memos, press releases, announcements at professional forums, training programs, etc.

Source: National Center on Elder Abuse, National Committee for the Prevention of Elder Abuse. (2003). Elder abuse prevention teams: A new generation. Washington, DC: National Center on Elder Abuse.