Development and Spanish translation of the Weinberg Center Risk and Abuse Prevention Screen (WC-RAPS).

Barriers for enhanced detection, identification, and reporting of elder abuse include the paucity of appropriate, valid, easily administered screening tools. This article describes the qualitative methods used in the development of the Weinberg Center Risk and Abuse Prevention Screen (WC-RAPS), and of its Spanish version. Focus groups and cognitive interviews were instrumental in identifying problematic items, underscoring potential response errors, and informing about putative causes for divergent interpretations of item-intent. Seven of the 11 original items were modified, a double-barreled item was segregated into two, one item deleted, and three additional items included to create the final 13 WC-RAPS items. The multi-step approach implemented for the Spanish conversion evidenced deviation from the original intended meaning for one item. The readability for English and Spanish versions was also assessed. Screening for elder abuse, if implemented systematically can be instrumental in identifying unrecognized abuse and preventing reoccurrence.

Methodological approaches to the analyses of elder abuse screening measures: Application of latent variable measurement modeling to the WC-RAPS.

While several elder abuse screens exist, few measure risk and none target long-term support services. The aims were to examine the psychometric properties of the Weinberg Center Risk and Abuse Prevention Screen (WC-RAPS), comparing approaches to modeling self-reported risk and abuse in relation to reported Adult Protective Services contacts. METHODS: The sample (n = 7,035), admissions to managed long-term care (79%) and short-term rehabilitation (20%), was primarily (66%) female, with mean age 77.6 (SD = 9.10); 7% each were African American and Latino and 12% Asian. Latent variable models were used to examine measurement properties of six indicators of abuse and five of risk. RESULTS: Good model fit and stable subscale measurement models were observed across analyses. Reliability was >0.80 across methods, and concurrent criterion validity estimates were as expected. CONCLUSION: Evidence supported the reliability and concurrent criterion validity of the risk and abuse subscales in an ethnically diverse cohort.

Medical Cannabis in the Skilled Nursing Facility: A Novel Approach to Improving Symptom Management and Quality of Life.

Throughout the millennia, the cannabis plant has been utilized as a recognized therapy for pain relief and symptom management. Following the Prohibition-era stigmatization and criminalization of all forms of cannabis of the early 20th century, there has been a recent nationwide and worldwide resurgence in interest and use of the cannabinoid compounds extracted from the cannabis plant, that is, medical cannabis. Although at the Federal level, cannabis remains a Schedule I substance, 31 states have already decriminalized possession and use of medical cannabis for specific diagnoses. It is noteworthy that many of these indicated diagnoses are prevalent in the skilled nursing facility (SNF). This creates regulatory concerns as SNFs and other healthcare facilities must maintain compliance with Federal laws, while balancing the individual resident's rights to utilize medical cannabis where indicated. The authors developed an innovative program that affords their residents the ability to participate in a state-approved medical cannabis program while remaining compliant with Federal law. As medical cannabis use becomes more widespread and accepted, clinicians providing medical care in healthcare facilities will encounter residents who may benefit from and request this alternative therapy. Studies examining older adults that are utilizing medical cannabis legally have demonstrated significant decreases in prescription medication use, most notably a reduction in opioid analgesic usage. As such, medical cannabis should be viewed as an additional option in the clinician's toolbox of therapeutic interventions for symptom relief.

An elder abuse shelter program: build it and they will come, a long term care based program to address elder abuse in the community.

This article describes how The Hebrew Home for the Aged at Riverdale (the Hebrew Home), a non-profit geriatric care center, has established one of the nation's first long term care based elder abuse prevention and intervention programs for elderly living in the community. This program, known as the Weinberg Center for Prevention, Intervention and Research in Elder Abuse (the "Weinberg Center"), received start-up funding in the form of a matching grant challenge from the Weinberg Foundation of Baltimore, which has a history of funding innovative geriatric programs throughout the United States. Utilizing the Hebrew Home's extensive integrated service model, a multidisciplinary team works with a network of private and governmental agencies. This model was designed based upon the needs of this population as described in the nascent research, evaluation of the few programs in existence, and the emerging state of elder abuse as a matter of public policy. The goals are to increase public awareness, intervene to make the home safe, and provide a secure and fulfilling short or long term shelter. Research in prevalence and efficacious use of the shelter is being conducted.