Enhancing an Elder Abuse Forensic Center Intervention: Promoting Safety, Justice, and Efficiency through the Addition of a Service Advocate (WITHDRAWN)

BACKGROUND/PURPOSE:

Elder mistreatment and self-neglect are significant social problems affecting 11.4% of the population aged 60 and older to their physical, psychological, financial and social detriment. The Elder Abuse Forensic Center (FC) is a model intervention bringing together a multi-disciplinary team of professionals to review severe or difficult-to-resolve cases of mistreatment and assist elder abuse direct-care providers (case presenters) in investigating, resolving, and pursuing justice in their cases. Despite demonstrating effectiveness in reducing one-year case recurrence and increasing appropriate client guardianship and perpetrator prosecution, some clients have unmet needs beyond the crisis-intervention and legal recourses provided by traditional FC member agencies.

The purpose of this pilot study is to analyze the effect of adding a FC-affiliated social worker to the Los Angeles County FC (LACEAFC) as a Service Advocate (SA) to work directly with FC clients, providing wrap-around social and instrumental support and monitoring. Specifically, we hypothesize that inclusion of the SA will enhance FC effectiveness by providing: (1) a new, direct approach to enacting team recommendations, (2) timely feedback to the team about client welfare and recommendation receptivity, and (3) support to existing FC member agencies.

METHODS:

                A case study approach was used to describe the SA role and its preliminary effects on the FC team, processes, and clients. Data was extracted from FC records including meeting minutes, SA case notes, and client case information. Thematic analysis was used to identify key SA activities and the quality and outcome of team and client interactions. Additionally, case summaries were generated for specific cases which received direct services from the SA and outcomes from these cases were compared to similar past cases which received the FC intervention prior to the inclusion of the SA.

RESULTS:

                 The addition of the SA to the LACEAFC has enhanced their ability to serve mistreated and vulnerable older adults and increased opportunities for research within this context.  To-date the SA has assisted 23 FC clients and conducted over 90 home visits, seeing most clients faster than would usually be required by APS protocol. The SA’s conversational and friendly approach was been well-received, resulting in few service refusals. The SA reported back to the FC team with regular client updates and requests for further discussion, resulting in a faster-paced problem-solving process resulting in greater benefit to the client. Although some team members were initially concerned that services would be duplicated, the SA has provided crucial support to member agencies and alleviated some of the case burden usually borne by providers.

CONCLUSIONS:

                The enhanced FC model appears better able to support mistreated and vulnerable older adults and promote their safety and security. The SA serves as a resource to the FC team and those they serve, including case presenters and their clients.

As the FC model is replicated across the country, the inclusion of a SA may enhance program quality, integration, and overall effectiveness. Research on SA implementation may yield greater insight into the geographic locations and service settings that most benefit from the inclusion of a SA.