Module 8 Nursing Responses to Elder Mistreatment An IAFN Education Course Multidisciplinary Team Approaches to Elder Mistreatment

By the end of this module, participants will be able to: Describe multidisciplinary team approaches to elder mistreatment (EM) Discuss ways nurses can work with first responders to maximize patient care and safety in EM cases Identify nursing partners in health care settings and the community, as well as their respective roles, in responses to EM Learning Objectives 2

Why Work Together? Working in isolation from others in the community who respond to elder mistreatment can lead to “inconsistent, overlapping and inappropriate responses and services for victims and interventions for perpetrators” B. Brandl, C. Bitondo Dyer, C. Heisler, J. Marlatt Otto, L. Stiegel & R. Thomas, Elder abuse detection and intervention: A collaborative approach,

Discussion Questions With whom do you work within your practice setting or your health care system on EM cases? Describe how. Who do you work with from outside agencies/systems on EM cases? Describe how. Why do you work together? Benefits? Challenges? What strategies have helped overcome challenges? 4

What are multidisciplinary team approaches to elder mistreatment? When professionals and agencies within and across systems agree to work together at some level to respond to individual cases of EM or to more broadly address the problem 5

For example: Agencies are mandated by state law to form more coordinated responses to EM One or more professionals is motivated to coordinate within/across systems to improve responses to EM Recognition of limits of what individual agencies can do working in isolation Reasons to Work Together 6

How specifically do responders work together? 7 Vary in… o Levels of formality and permanence o Membership o Type of structure to support coordinated effort

Examples of Ways Nurses Work with Other Responders Activate involvement of other professionals as per state law if they detect EM Participate in case reviews of EM cases and provide input as nursing professionals. Clarify roles of nurses in situations of EM across practice settings Educate professionals involved in EM cases about health care and safety needs of patients and coordinate follow-up interventions (keeping in mind confidentiality requirements) 8

Key Responders: Healthcare Physicians, nurse practitioners, physician assistants Nurses, nurse specialists, nurse managers/supervisors Social workers Discharge/care transition planners EMS/Paramedics/firefighters Chaplains Medical examiners and coroners Other health professionals Medical management staff 9

Key Responders: Community  Adult protective services (APS)  Long term care ombudsmen  Long term care facility administrators  Law enforcement  Prosecution  Civil attorneys  Victim advocacy/assistance services  Wide range of other professionals/organizations 10

Identifying Other Community Resources For example: Senior housing Adult day care Transportation Faith-based organizations Community mental health organizations 11

What systems and professionals were involved in this case review? What effect could the review process potentially have on the patient? On the nursing staff? On the hospital? What community agencies should be involved in this case? What have you learned from this illustration that you can apply in your practice setting? Case: Mrs. Schmidt 12