The Impact of A Multidisciplinary Team after Elder Abuse and Neglect

by Anne P. DePrince  & Leslie Hasche

Community-coordinated responses and multidisciplinary teams have become common responses to domestic violence and sexual assault across the United States. These approaches focus on collaboration across community (e.g., shelters and legal advocacy programs) and criminal justice (e.g., prosecuting attorney and police) agencies to respond to victimization.[1]

More recently, multidisciplinary teams have evolved for responding to older adult maltreatment. Unfortunately, relatively less research has been available on the impact of such team responses to older adult maltreatment, leaving communities without data to inform their efforts.

In collaboration with the Denver Forensic Collaborative for At-Risk Adults (DFC) and graduate student researchers from the TSS Group, we set out to test the impact of multidisciplinary team response to older adult maltreatment.

Denver’s multidisciplinary team brings together representatives from criminal justice offices (police, prosecution), city government offices (e.g., environmental health, housing), Adult Protective Services, as well as medical, mental health and community-based organizations. Together, the team discusses cases and collaborates to put together an action plan for individual cases. Action plans might include a victim advocate calling the older adult to offer services; a police officer and Adult Protective Services caseworker visiting the older adult’s home together; or a referral to environmental health for an inspection of a home.

To test the impact of Denver’s multidisciplinary response to older adult maltreatment, this research compared cases that were discussed by the team in person to those that weren’t. The cases that weren’t discussed by the team in person still got attention from agencies across Denver that serve older adults. The difference was in whether the team met together to discuss and make a plan for the case.

Our research focused on outcomes for cases of alleged abuse, neglect, and/or financial exploitation that involved an older adult over age 60 and a perpetrator in a position of trust, such as a caregiver or family member. The majority of cases had come to the attention of law enforcement through a police report.

Next, we asked victim advocates to describes cases and outcomes. We discovered that cases reviewed by the multidisciplinary team had a better prognosis than other cases. In particular, the advocates thought the older adults were less likely to need their offices’ services in the future. Victim advocates also reported higher across-agency coordination as well as engagement with more types of services for the cases reviewed by the DFC relative to other cases. However, criminal justice advocates tended not to have any more contact with older adults just a few months later. This make sense because most cases were not prosecuted, but raises questions about how multidisciplinary teams can engage with older adult victims over time.

These findings, recently publishedin the Journal of Elder Abuse and Neglect, are in line with the larger literature on community-coordinated responses.

This project also highlighted unique challenges faced by older adults who are victims of abuse, neglect, and/or exploitation.

For example, we found that older adults with allegations of abuse reported to law enforcement were facing considerable mental health challenges and unmet service needs. When taking into account that the most common abusers were family members or close others, the study results point to the need to coordinate across criminal justice, mental health, and aging service sectors to mitigate abuse and unsafe environments as early as possible.

Bottom Line:

In the face of limited resources, many communities are likely to involve multidisciplinary teams in response to cases that have already come to the attention of the police. Our research suggests that this is a good investment of resources, helping teams to collaborate to serve older adult victims.

However, our work also suggests that older adults who come to the attention to multidisciplinary teams through police reports already face significant mental health challenges and service barriers. Therefore, communities may also want to consider resources that allow teams to play a role in prevention as well as in longer-term follow-up of older adult victims.

Acknowledgements

This work was supported by the National Institute of Justice [Grant #2013-MU-CX-0032]. The views expressed are those of the authors and do not necessarily represent the views or the official position of the National Institute of Justice or any other organization.

Thank you to the Denver Forensic Collaborative for At-Risk Adults for their collaboration to make this work possible, particularly Denver City Attorney’s Office (especially Linda Loflin Pettit), Denver District Attorney’s Office (especially Maro Casparian), Denver Human Services-Adult Protective Services and Denver Police Department; and the Traumatic Stress Studies Group

[1] e.g., Allen, Bybee, & Sullivan, 2004; Fanslow & Robinson, 2010; Goodman & Epstein, 2005; Klevens, Baker, Shelley, & Ingram, 2008; DePrince, Belknap et al., 2012; DePrince, Labus, Belknap, Buckingham, & Gover, 2012).