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Interventions from Home-Based Geriatric Assessments of Adult Protective Service Clients Suffering Elder Mistreatment

Authors

  • John M. Heath MD, AGSF,

    1. From the *Department of Family Medicine, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, New Brunswick, New JerseyDepartment of Geriatrics, College of Medicine, Florida State University, Tallahassee, FloridaNew Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey§School of Social Work, Rutgers, State University of New Jersey, Piscataway, New Jersey.
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  • Fred A. Kobylarz MD, MPH,

    1. From the *Department of Family Medicine, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, New Brunswick, New JerseyDepartment of Geriatrics, College of Medicine, Florida State University, Tallahassee, FloridaNew Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey§School of Social Work, Rutgers, State University of New Jersey, Piscataway, New Jersey.
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  • Merle Brown PhD, APN,

    1. From the *Department of Family Medicine, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, New Brunswick, New JerseyDepartment of Geriatrics, College of Medicine, Florida State University, Tallahassee, FloridaNew Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey§School of Social Work, Rutgers, State University of New Jersey, Piscataway, New Jersey.
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  • Susan Castaño MSW, LCSW

    1. From the *Department of Family Medicine, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, New Brunswick, New JerseyDepartment of Geriatrics, College of Medicine, Florida State University, Tallahassee, FloridaNew Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey§School of Social Work, Rutgers, State University of New Jersey, Piscataway, New Jersey.
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Address correspondence to John Heath, MD, One RWJ Place, Box 19, New Brunswick, NJ 08903. E-mail: Heathjm@UMDNJ.edu

Abstract

Objectives: To describe the interventions for adult protective service (APS) clients referred for geriatric assessment.

Design: Retrospective cohort study.

Setting: In-home geriatric assessments conducted in two New Jersey counties.

Participants: Two hundred eleven APS clients; 74% female; mean age 77.

Measurements: Cognition, affect, nutrition, prevalence of selected medical diagnoses and functional conditions, and categories of interventions.

Results: Home health agency services were initiated for 46% of APS clients suffering from all forms of mistreatment. Institutional placements (36%) and guardianship interventions (36%) were correlated with caregiver neglect, especially in female APS clients and those diagnosed with dementia. Urgent medications (25%) were prescribed across all mistreatment classifications, and acute hospitalization (20%) was correlated with circumstances of physical abuse.

Conclusion: An in-home geriatric assessment service was able to contribute at least one relevant intervention for 81% of referred APS clients to collaboratively help mitigate elder mistreatment circumstances.

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