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New Montefiore Program Targets Elder Abuse and Neglect
Date:4/10/2008

Victims Evaluated; Physicians Trained to Identify Abuse

NEW YORK, April 10 /PRNewswire-USNewswire/ -- Montefiore Medical Center has launched a clinical, educational and research initiative to tackle the growing problem of elder abuse and neglect with the support of a one-year, $150,000 grant from the Caring Commission of UJA-Federation of New York, with the potential for an additional $300,000 over the next two years.

"There are about 140,000 elderly in the Bronx and many of them are vulnerable to elder abuse and neglect due to social isolation, cognitive impairment and/or physical frailty," says Laurie Jacobs, MD, chief of Geriatric Medicine at Montefiore. "Our goals are to provide better care for the victims of abuse, to train our physicians and care givers to identify abuse and to track the frequency and types of elder abuse for policy purposes."

Geriatric Consultation Team

The grant-supported initiative was recently launched when Montefiore established a special consultative team to help physicians and other clinicians evaluate suspected older adult victims of abuse and to help link them to community-based services for social and legal assistance. The team, under the direction of Karin Ouchida, MD, a geriatrician, has been called in on a referral basis for over a dozen cases at Montefiore's inpatient and outpatient facilities, and for patients in the community.

"Victims of elder abuse and neglect are often isolated, and physicians are among the only people they may trust or confide in," says Dr. Ouchida. "Most physicians have not been trained to identify elder abuse and neglect, and need to acquire the skills to elicit relevant information not only about their patients' physical condition, but also about attendant quality of life issues."

Training Physicians to Recognize Abuse

To address this educational gap among physicians, the initiative trained Montefiore's geriatric and geriatric psychiatry attendings and fellows to identify and evaluate elder abuse and neglect. Through their participation on the consultation team, these physicians can provide critical recommendations for the care and management of both victims and caregivers. Programs will soon be underway to train residents and other health care personnel as well. This April, monthly workshops to train medical students from the Albert Einstein College of Medicine will begin. Ultimately, the program will train all 180 medical students who rotate through Montefiore each year.

Abuse vs. Neglect: Tracking Frequencies

"Serious elder mistreatment may be missed if too narrowly defined as physical abuse," says Ouchida. "While we treat frail elders who are victims of threats or physical violence from caregivers with mental health or substance abuse problems, these cases are typically outnumbered by those involving neglect. At the heart of many neglect cases lies a critical mismatch between a patient's basic needs for nourishment, medications and hygiene and the caregiver's ability to meet those needs. An elderly woman who cared for her demented husband for twenty years may no longer be able to provide adequate support and supervision when her own cognitive and physical impairments worsen. In this example, the solution is not to assign blame but to provide assistance to both parties."

To get a handle on the frequency and types of elder abuse and neglect, Montefiore researchers will be tracking the cases they identify, with the aim of expanding services in the Bronx and advocating for improvements in policy.

Montefiore's Division of Geriatrics

Montefiore's Division of Geriatrics is uniquely qualified to undertake this project since it provides service across a broad spectrum of geriatric care: medical home visits, ambulatory care, long term care and acute care. Along with its partner, the Albert Einstein College of Medicine, it also has very robust education and training programs in geriatric medicine for physicians at all levels of training. In addition, the physicians are engaged in clinical research activities centered on many of the problems the elderly face such as medication management, clinical decision-making, osteoporosis, and home safety.

National and New York City Statistics

The National Elder Abuse Incidence Study found that over 550,000 adults aged 60 and over experienced abuse or neglect in domestic settings in 1996, yet only 21 percent were reported to and substantiated by Adult Protective Service agencies. The Department for the Aging estimates there are 50,000 cases of elder abuse each year in New York City.

Montefiore Medical Center encompasses 124 years of innovative medical "firsts," pioneering clinical research, outstanding patient care, dedicated community service and ground-breaking social activism.

A full-service, integrated delivery system caring for patients in the New York metropolitan region and beyond, Montefiore is a 1,122-bed medical center that includes: three hospitals -- the Henry and Lucy Moses Division, the Jack D. Weiler Division and The Children's Hospital at Montefiore; a large home healthcare agency; the largest school health program in the US; a 21-site medical group practice integrated throughout the Bronx and Westchester; and a care management organization providing services to 179,000 health plan members.

The medical center is ranked by the prestigious Leapfrog Group among the top one percent of all U.S. hospitals based on its strategic investments in sophisticated and integrated healthcare technology.

Montefiore's distinguished centers of excellence include cardiology and cardiac surgery, cancer care, tissue and organ transplantation, children's health, women's health, surgery and the surgical subspecialties. Montefiore, the University Hospital for the Albert Einstein College of Medicine, is a national leader in the treatment of diabetes, headaches, obesity, cough and sleep disorders, geriatrics and geriatric psychiatry, neurology and neurosurgery, adolescent and family medicine, HIV/AIDS and social and environmental medicine, among many other specialties. For more information, please visit our websites http://www.montefiore.org or http://www.montekids.org.


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SOURCE Montefiore Medical Center
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