Elder mistreatment is experienced by 10% of older adults and is much more common among older adults with dementia. It is associated with increased rates of psychological distress, hospitalization and death and, in the US, costs billions of dollars each year. Though elder mistreatment is relatively common and costly, it is estimated that less than 10% of instances of elder mistreatment are reported. Given these data, there is a great need for research on interventions to mitigate elder mistreatment, and a practical model or framework to use in approaching such interventions. While many theories have been proposed, adapted and applied to understand elder mistreatment, there has not been a simple, coherent framework of known risk factors of the victim, perpetrator, and environment that applies to all types of abuse. In this paper we present a new model to examine the multidimensional and complex relationships between risk factors. This model is informed by theories of elder mistreatment, research on risk factors for elder mistreatment and 10 years of experience of faculty and staff at an Elder Abuse Forensics Center who have investigated more than 1000 cases of elder mistreatment. We hope this model, the Abuse Intervention Model (AIM), will be used to study and intervene in elder mistreatment.

Background: Group visits have the potential to help patients identify their health care values and engage in the emotionally and cognitively challenging task of advance care planning (ACP) in a resource-efficient manner by providing a forum for social learning and social support.Objective: To evaluate the feasibility and acceptability of disease-specific group visits for patients with heart failure and their caregivers.Design: Feasibility trial of a 90-minute group visit held for 10 separate groups and led by a trained facilitator using the video-based PREPARE for Your Care ACP tool.Setting:/Subjects: Older adults with recent hospitalization for heart failure (n = 36; median age, 74 years) and their caregivers (n = 21).Measurements: Pre-and post-visit surveys and a postvisit telephone interview assessing perceived value and acceptability; structured nonparticipant observations to assess process and feasibility.Results: Mean scores from the postgroup visit evaluation showed that participants reported that they felt comfortable discussing ACP in a group (4.59), understood the information covered (4.70), and were able to identify and clarify their health care values (4.43). Interview and observation data demonstrated that participants were able to identify and clarify their preferences by listening and learning from a diverse range of perspectives in the group and that the disease-focused nature of the group visit created a supportive space for participants to share their experiences.Conclusions: Disease-focused ACP group visits were feasible to conduct and acceptable to participants, underscoring their value as an efficient intervention to engage patients and caregivers in the otherwise time-and resource-intensive task of ACP.