The prevalence of undiagnosed geriatric health conditions among adult protective service clients.

PURPOSE: We sought to determine the prevalence of remediable health conditions from in-home geriatric assessments of referred adult protective service (APS) clients suffering elder mistreatment. DESIGN AND METHODS: We used a retrospective cohort study of 211 APS clients (74% female; age, M = 77 years) in two central New Jersey counties. RESULTS: Dementia was the most frequent diagnosis (62% prevalence) and was positively correlated with occurrences of financial exploitation (R =.199; p =.01) and caregiver neglect (R =.174; p =.03) among female APS clients. Depression (37% prevalence), hypertension (36%), involuntary weight loss (34%), pain (32%), and falling (26%) all appeared equally distributed, though urinary incontinence (23% prevalence) was strongly correlated with circumstances of caregiver neglect (R =.31; p =.003). IMPLICATIONS: This new effort to link APS workers with geriatric clinicians conducting in-home health assessments proved effective for identifying a high prevalence of remediable health conditions among APS clients suffering various manifestations of elder mistreatment.

Interventions from home-based geriatric assessments of adult protective service clients suffering elder mistreatment.

OBJECTIVES: To describe the interventions for adult protective service (APS) clients referred for geriatric assessment. DESIGN: Retrospective cohort study. SETTING: In-home geriatric assessments conducted in two New Jersey counties. PARTICIPANTS: Two hundred eleven APS clients; 74% female; mean age 77. MEASUREMENTS: Cognition, affect, nutrition, prevalence of selected medical diagnoses and functional conditions, and categories of interventions. RESULTS: Home health agency services were initiated for 46% of APS clients suffering from all forms of mistreatment. Institutional placements (36%) and guardianship interventions (36%) were correlated with caregiver neglect, especially in female APS clients and those diagnosed with dementia. Urgent medications (25%) were prescribed across all mistreatment classifications, and acute hospitalization (20%) was correlated with circumstances of physical abuse. CONCLUSION: An in-home geriatric assessment service was able to contribute at least one relevant intervention for 81% of referred APS clients to collaboratively help mitigate elder mistreatment circumstances.