The role of capacity assessments in elder abuse investigations and guardianships.

Capacity evaluations of older adults assist in determining whether a situation should be considered elder/dependent adult abuse and which type of intervention is warranted. Capacity evaluations must integrate multiple sources of data and focus on functional abilities. Understanding the legal standard underlying the capacity needed for a specific decision is key in making a clinical opinion relevant in legal settings. Capacity evaluations for guardianships help to identify preserved abilities and make recommendations to enhance decisional and functional capacities that promote the dignity and independence of older adults.

Elder abuse forensic centers.

Elder abuse forensic centers present a new model of multidisciplinary collaboration on elder abuse cases. The "clients" of a forensic center are Adult Protective Services (APS), law enforcement, and the Long-term Care Ombudsman. Centers take the basic multidisciplinary team model and add a geriatrician and a psychologist. Additionally, forensic center team members make home visits with APS and others for the purposes of conducting psychological or medical evaluations, lessening the burden of multiple interviews for the alleged abuse victims, and gathering evidence for possible prosecution. The challenges and successes of the four California forensic center teams are discussed.

Geriatricians and psychologists: essential ingredients in the evaluation of elder abuse and neglect.

This article describes the clinical work that three sets of geriatricians and psychologists provided in three elder abuse forensic centers in California. After a brief history of how the clinical services in each program developed, the contributions of geriatricians and psychologists within these elder abuse teams are detailed through the use of several case anecdotes. Beyond providing physical and psychological evaluations, geriatricians and psychologists provide consultations and education to other professionals and to elder abuse victims and their caregivers. These clinical teams emphasize the importance of conducting home visits and functional assessments, working with interdisciplinary team members, and providing expert testimony.

Trauma healing in refugee camps in Guinea: a psychosocial program for Liberian and Sierra Leonean survivors of torture and war.

From 1999 to 2005, the Minneapolis-based Center for Victims of Torture (CVT) served Liberian and Sierra Leonean survivors of torture and war living in the refugee camps of Guinea. A psychosocial program was developed with 3 main goals: (a) to provide mental health care, (b) to train local refugee counselors, and (c) to raise community awareness about war trauma and mental health. Utilizing paraprofessional counselors under the close, on-site supervision of expatriate clinicians, the treatment model blended elements of Western and indigenous healing. The core component consisted of relationship-based supportive group counseling. Clinical interventions were guided by a 3-stage model of trauma recovery (safety, mourning, reconnection), which was adapted to the realities of the refugee camp setting. Over 4,000 clients were provided with counseling, and an additional 15,000 were provided with other supportive services. Results from follow-up assessments indicated significant reductions in trauma symptoms and increases in measures of daily functioning and social support during and after participation in groups. The treatment model developed in Guinea served as the basis for CVT's ongoing work with survivors in Sierra Leone and Liberia. ((c) 2006 APA, all rights reserved).