Published Work by AGEM Member:  Tony Rosen, MD MPH Associate Professor of Emergency Medicine Department of Emergency Medicine, Division of Geriatric Emergency Medicine Program Director, Vulnerable Elder Protection Team (VEPT) New York-Presbyterian Hospital/Weill Cornell Medical

 

 

Vulnerable Elder Protection Team: Initial experience of an emergency department-based interdisciplinary elder abuse programs
https://doi.org/10.1111/jgs.17967

Summary:

The goal of our work of is to improve identification, intervention, and prevention of elder abuse in health care settings, particularly the Emergency Department. Our research has explored forensic injury patterns in physical elder abuse and health care utilization among elder abuse victims using Medicare claims data and data mining / machine learning approaches. Colleagues and I have developed an Emergency Department-based multi-disciplinary Vulnerable Elder Protection Team (VEPT) to assess, treat, and ensure the safety of elder abuse and neglect victims while collecting evidence and working closely with the authorities. Our work with collaborators also explores the optimal role of prosecutors in elder abuse response.

We believe this work is meaningful for Geriatric Emergency Medicine because: elder abuse and neglect are common and contribute significantly to morbidity and mortality. Despite this, they are dramatically under-recognized and under-reported. An ED visit provides a unique opportunity to identify elder abuse and initiate intervention, as interaction with a healthcare provider after injury or illness may be the older time that an abused older adult ever leaves their home. Unfortunately, emergency providers rarely detect elder abuse. Geriatric Emergency Departments are developing standardized protocols to assess and respond, which has the potential to help these vulnerable older adults.

 

Older adults experience care transition barriers after an ED visit. Through this qualitative analysis, we identified that prominent themes experienced include the abruptness of the discharge process, follow-up care navigation, new limitations hindering performance of baseline activities, and ramifications to caregivers impacting an older adult’s willingness to request or accept assistance. These findings can help improve geriatric emergency care and inform the development of effective emergency department-to-community care transition patient-centered interventions that have been elusive thus far.