Effect of an elder abuse and self‐neglect intervention on repeat investigations by adult protective services: RISE project

Abstract

BackgroundAdult Protective Services (APS) is the primary agency responsible for investigating elder abuse and self‐neglect (EASN) allegations in the United States. The harms of EASN are well established; however, APS lacks a conceptually derived evidenced‐based intervention phase. RISE is a community‐based intervention designed to complement APS that provides enhanced services and a longer intervention phase. The objective of this study was to test whether exposure to the RISE/APS collaboration was associated with reducing the case outcome of recurrence (repeat investigations) compared to usual care APS only services.MethodsA retrospective observational study (n = 1947) of two counties in Maine where RISE was available to provide enhanced services to persons referred from APS. An extended regression endogenous treatment Probit model using APS administrative data was used to predict case recurrence.ResultsBetween July 2019 and October 2021, 154 cases participated in RISE and 1793 received usual APS only services. 49% of cases in RISE had 2 or more prior substantiated allegations versus 6% for those receiving usual APS care, and 46% of cases in RISE had a recurrence during the observation period versus 6% for usual care group. However, after accounting for the non‐random treatment assignment, RISE was associated with a significantly lowered likelihood of recurrence compared to persons receiving usual care provided by APS (probability of recurrence reduced by 0.55 for the Average Treatment Effect on the Treated and 0.26 for the Average Treatment Effect).ConclusionsA reduction in recurrence carries important implications for APS clients, costs, resources, and workflow. It may also serve as a proxy indicating a reduction in revictimization and harm for EASN victims.

Self‐neglect co‐occurs with and is a risk factor for elder mistreatment: An analysis of Maine Adult Protective Services Administrative Data

“…Adapting and evaluating that intervention (RISE) in health systems caring for these high-risk patients should be considered to examine whether it reduces reinvestigations by APS and or improves health outcomes. 4 ORCID Stuart D. Lewis https://orcid.org/0000-0001-9904-8116…”

“…A "report" constituted any referral to APS that was investigated. 4 Maine APS allegations are physical, emotional, financial, and sexual abuse, neglect, selfneglect, and "exploitation-other" (exploitation-other was excluded as it does not align with the CDC definition of elder mistreatment).…”