Protecting Our Elders: Recognizing and Preventing Elder Abuse and Neglect was the focus of the 21st Annual Selenia E. and Joseph C. Valley, Sr. Conference held on September 14, 2007 at the University of Houston Hilton Hotel and Conference Center. Speakers informed attendees about the importance of preventing, recognizing, and reporting elder abuse which is also known as the hidden crime because it is underreported. The conference was sponsored by the Selenia E. and Joseph C. Valley, Sr. Memorial Trust Fund for Gerontological Nursing. The trust was established in 1986 to help improve nursing care of the elderly through education and clinical training. Each year the conference is devoted to providing public and professional education to those who care for the older adult population.

Carmel Bitondo Dyer, MD, AGSF, FACP, Director, Geriatric Medicine Division at the University of Texas Medical School at Houston was the keynote speaker. In her presentation titled Elder Mistreatment: Recognition and Treatment, Dr. Dyer defined the various forms of elder mistreatment including abuse, neglect, self-neglect and financial exploitation. She indicated that while 80% of child abuse cases and 50% of domestic violence cases are reported, only 20% of elder mistreatment

-Carmel Bitondo Dyer, MD, AGSF, FACP, Gerontological
Professional of the Year, and Charlene James, MPH,
Community Advocate of the Year-

cases are reported. She urged healthcare professions to be more vigilant in looking for signs of elder mistreatment. Healthcare professionals should recognize victim as well as perpetrator risk factors, and be able to detect signs of mistreatment when older adults arrive for care in local clinics, hospitals, other healthcare settings, or when conducting visits in the home. Effective collaboration between healthcare professionals, law enforcement, Adult Protective Services, faith communities, ombudsmen and other agencies help to identify vulnerable older adults and provide them with needed services. The Texas Elder Abuse Mistreatment (TEAM) Institute is an example of an interdisciplinary team that works to identify and assess victims of elder mistreatment.

The following session focused on the importance of screening tools used to detect elder mistreatment as well as the components of geriatric assessments. Speakers were Sabrina Pickens, MSN, APRN-BC and Tziona Regev, LCSW. While many screening tools are available to detect elder mistreatment, finding the right tool can be challenging given that some tools are specific to certain aspects of elder mistreatment and others are costly. Comprehensive geriatric assessments are effective tools for identifying cognitive, emotional and functional status, as well as helping determine the best intervention for older adults at risk of elder mistreatment.

The Awards Luncheon honored Gerontological Professional of the Year, Carmel Bitondo Dyer, MD, and Director of the Geriatric Medicine Division at the University of Texas Medical School at Houston. Community Advocate of the Year was Charlene James, MPH, former Director of the Harris County Area Agency on Aging.

The afternoon panel titled Partners in Protecting Our Elderly addressed the issue of elder mistreatment in the community and the role of Adult Protective Services (APS). Elder mistreatment in long-term care, the role of the ombudsman, and the need for estate planning in order to protect one’s assets were addressed as well. Charlene James, MPH served as the moderator and panelists included Jim Barnes of APS; Diane Persson, PhD, Director of the Harris County Long-Term Care Ombudsman Program; and Gina Patterson, JP, MSW of Locke, Liddell and Sapp, LLP. Mr. Barnes indicated that APS will investigate elder mistreatment in the community, and work to reduce or eliminate further risk or harm to the individuals involved. In many instances with the involvement of APS older adults are able to access the appropriate services, support and assistance needed to continue living independently in the community. For individuals residing in long-term care facilities, ombudsmen serve as advocates who fight for their rights. Ombudsmen serve as OARS. They Observe, Act upon and Report elder mistreatment in long-term care facilities. Among the top three complaints in long-term care are unanswered call lights, poor quality food and lack of appropriate staff. Gina Patterson spoke of the importance of estate planning prior to illness and the need to have a durable power of attorney, medical power of attorney, and advance directives.

The session titled The Faces of Abuse and Neglect highlighted the experience of one family’s struggle with their loved one who had Alzheimer’s and was being exploited financially by strangers. Tziona Regev, LCSW invited two sisters to speak about the challenges they faced in trying to help their father after the death of their mother. The sisters worked with APS and TEAM to ensure that their father received the medical care he needed, as well as with law enforcement to end the financial exploitation. The sisters indicated that ultimately theirs was a success story which they wanted to share in order to prevent other families from a similar experience.

The conference concluded with an interactive session led by Thomas Cole, PhD, Director, McGovern Center for Health, Humanities and the Human Spirit at the University of Texas Health Science Center at Houston. The title of his presentation was Hope for the Future. Dr. Cole led the discussion by asking students from North Harris County Montgomery Community College what led them into the profession. Many different factors have served to inspire and motivate the students to become healthcare professionals. Dr. Cole commented that they represented hope for the future of older adults. Regardless of the setting where older adults reside, whether living in their own homes in the community or in long-term care, we as healthcare professions need to be vigilant to ensure that they are living in an environment free from abuse and that their needs are being met.

COA Honors and Accomplishments
 

Geriatric Resource Nurse Program is underway at the UTSON
 

“Hydrate!” said the nurses presenting an innovative strategy to their colleagues at a local hospital. The nurses, trained to be geriatric resource nurses, were teaching their somewhat skeptical colleagues a technique for dealing with the elderly. But challenging stereotypical notions is what the Geriatric Resource Nurses project does.

In the project, nurse participants gain a working knowledge of best geriatric practices and interact with COA’s faculty. In a typical workshop, Dr. Bergstrom may be instructing on pressure ulcer prevention, Dr. Ostwald on stroke survival, Dr. Carroll on conflict resolution, Dr. Rapp on malnutrition, Dr. Fay on normal physiological changes and Dr. Wasserman on defining measurable outcomes. In addition, Dr. Kwon assists participants to use the website’s discussion board and provides web links to viable resources. Also, participants perform a needs assessment and implement a clinical project on the unit where they work. One such clinical project was organizing hourly nursing visits to help take care of elder’s needs toward reducing the number of falls in the unit.

Dr. Vaunette Fay directs the project currently beginning its second year of HRSA funding. The program helps today’s nurses learn how to better care for the increasing number of older patients seen in the health care system due to the aging of America. The workshops permit nurses to interactively gain geriatric content while learning to be leaders.

And the participants? They come from acute or skilled care, long term care, home health, hospice, and the like. For additional information, visit the website at http://www.geroresourcenurse.org/grn/index.htm

Director's Corner
 

This has been an exciting Summer and early Fall for the COA family. The discovery and dissemination of knowledge is central to our mission and we have several important advances. First, we have successfully competed for funding from the National Institutes of Health, National Institute for Nursing Research and National Institute for Aging, and from Health Resources and Service Administration. Please notice the titles of grants by Drs. Nancy Bergstrom and Mary Pat Rapp, Dr. Gayle Hersch, and Drs. Carmel Dyer (School of Medicine), Dr. Ostwald and colleagues elsewhere in this edition.

Second, our students and alumni are expanding our capability to generate and disseminate knowledge through publications (see reference to Dr. Josie Lujan and Dr. Ostwald’s publication) and by joining the COA faculty. Dr. Mary Pat Rapp is now housed in the COA and Dr. Connie Sixta is an Adjunct Faculty member who will continue to work with Dr. Ostwald.

Third, we just completed the 21st Annual Valley Conference. A report of the conference is presented elsewhere. We were able to address the issue of abuse and neglect of the elderly for health care professionals and community advocates. We also acknowledged the contributions of Dr. Carmel Dyer as Gerontological Professional of the Year and Mrs. Charlene Hunter James as Community Advocate of the Year.

We thank you for all of the support you have given to our faculty, students, and Center on Aging colleagues.

Nancy Bergstrom, PhD, RN, FAAN

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