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NORC at the University Chicago

Evaluation of the Administration of Aging’s Program to Prevent Elder Abuse

Evaluation of pilot interventions to prevent elder mistreatment
  • Client
    The Office of the Assistant Secretary for Planning and Evaluation (ASPE)
  • Dates
    September 2012 - July 2016

Challenge

Millions of older Americans are vulnerable to abuse, neglect and exploitation.

 

Enacted as part of the Patient Protection and Affordable Care Act in March of 2010, the Elder Justice Act represents the most comprehensive federal elder abuse prevention law to date, calling national attention to the millions of vulnerable older Americans who are victims of abuse, neglect, and exploitation.

Solution

A mixed methods approach was used to evaluate the process of elder abuse prevention interventions.

 

The Office of the Assistant Secretary for Planning and Evaluation (ASPE), Department of Health and Human Services contracted NORC to design and conduct an evaluation of pilot interventions to prevent elder mistreatment through the Elder Abuse Prevention Interventions Program.

 

The purpose of the project was to study the development and implementation of state grantees' elder abuse interventions, analyze administrative data, and report findings on the characteristics of victims and perpetrators of elder abuse or those at-risk, use of prevention services, and outcomes.



All pilot projects shared common goals and requirements, including:

  • designing a selective and/or indicated preventive intervention,
  • targeting people at high risk of elder abuse,
  • establishing key stakeholder partnerships,
  • providing local and state-level Adult Protective Services (APS), administrative data, and
  • collecting a core set of data elements.

 

Beyond these five objectives, grantees were afforded broad discretion in developing prevention interventions tailored to their specific communities and contexts. NORC used a mixed methods approach to conduct the process and outcome evaluation of five elder abuse prevention interventions.

 

Using the grantee’s administrative data, NORC developed a core set of data elements on client characteristics, program activities, and outcome measures. To examine the implementation and infrastructure, NORC conducted site visits to learn about the theoretical or clinical basis of the prevention intervention; implementation of the core components of the intervention; partnerships; context; facilitators and barriers; service utilization; state and local data collection systems; and project replicability and lessons learned.

Results

All grantees used multiple components and interventions to address victims and elders-at-risk.

 

Given the complex and multi-dimensional nature of elder abuse, each grantee developed a prevention intervention that addressed victims and elders at-risk or care recipients:

  • screening for elder abuse in primary care settings, applying preventive measures, and involving APS,
  • using multi-disciplinary teams to intervene in cases of financial exploitation,
  • testing a multi-component model for primary and secondary prevention of abuse of older people with dementia,   
  • mobilizing supports for at-risk and victimized elders, and   
  • increasing medication adherence among older adults with a substantiated report of self-neglect and decreasing social isolation.

 

Core components were implemented as intended. Each prevention intervention was standardized through manuals and protocols for implementation.  While delivery methods and service duration varied, home visits were a common delivery element across grantees. As the prevention interventions varied, so did the outcomes, resulting in increased referrals to APS for care coordination, halting financial exploitation, decreased vulnerability, and access to social supports.

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