RESUMEN
Telecommunication assisted forensic assessments of capacity and mistreatment by geriatricians with expertise in elder abuse and self-neglect are helping to meet the demand for such forensic services for Adult Protective Services (APS) clients in remote and underserved areas of Texas. The use of synchronous audiovisual assisted interviews instead of in-person interviews with clients to provide capacity assessments has become more important with the arrival of the COVID-19 pandemic. There is growing interest in establishing similar programs in other states using geriatrician faculty from medical schools to serve the clients of their state Adult Protective Services agencies. The arrangement between APS and the geriatricians at McGovern Medical School in Houston, Texas is novel. The structure of the arrangement is important for the success of the program. Legal, ethical, and practical considerations are discussed in this article, including approaches to the Health Insurance Portability and Accountability Act, physician liability, state law, and resource limitations. It is hoped that sharing how one such collaboration has addressed these important issues will suggest approaches for the structuring of similar programs.
Asunto(s)
COVID-19 , Abuso de Ancianos , Medicina Legal , Evaluación Geriátrica/métodos , Telemedicina , Anciano , COVID-19/epidemiología , COVID-19/prevención & control , Control de Enfermedades Transmisibles/métodos , Abuso de Ancianos/diagnóstico , Abuso de Ancianos/ética , Abuso de Ancianos/legislación & jurisprudencia , Abuso de Ancianos/prevención & control , Medicina Legal/ética , Medicina Legal/legislación & jurisprudencia , Medicina Legal/métodos , Humanos , Innovación Organizacional , Evaluación de Programas y Proyectos de Salud , SARS-CoV-2 , Telecomunicaciones/organización & administración , Telemedicina/ética , Telemedicina/legislación & jurisprudencia , Telemedicina/métodos , Estados Unidos/epidemiología , Poblaciones VulnerablesRESUMEN
New York City is currently experiencing an outbreak of COVID-19, a highly contagious and potentially deadly virus, which is particularly dangerous for older adults. This pandemic has led to public health policies including social distancing and stay-at-home orders. We explore here the impact of this unique crisis on victims of elder mistreatment and people at risk of victimization. The COVID-19 outbreak has also had a profound impact on the organizations from many sectors that typically respond to protect and serve victims of elder mistreatment. We examine this impact and describe creative solutions developed by these organizations and initial lessons learned in New York City to help inform other communities facing this pandemic and provide guidance for future crises.