School of Nursing and Center on Aging and the Life Course, Purdue University, West Lafayette, Indiana, USA.
Schools of Nursing and Industrial Engineering and Regenstrief Center for Healthcare Engineering, Purdue University, West Lafayette, Indiana,USA.
Gerontologist. 2022 Oct 19;62(9):1359-1368. doi: 10.1093/geront/gnac040.
Adult Protective Services (APS) are the frontline agencies investigating elder mistreatment and providing/coordinating postinvestigation services. Yet, their effectiveness in reducing different types of mistreatment in relation to services is unknown. This study aimed to address the knowledge gap by identifying services provided by mistreatment type, and examining the associations of services with mistreatment reduction.
A pretest-post-test design was implemented using the Identification, Services, and Outcomes (ISO) Matrix to assess mistreatment levels during case investigation and at case closure after services were provided. San Francisco and Napa APS participated in a 6-month data collection.
The 4 most prevalent types of mistreatment were examined: emotional, physical, financial abuse, and neglect by others. On average, level of mistreatment decreased across mistreatment types after APS intervention. Care/case management, mental health, and other services were most common, while specific services differed depending on type of mistreatment. Care/case management services were associated with physical and emotional abuse reduction, legal services further correlated with emotional abuse reduction; financial planning services were associated with financial abuse reduction; care/case management and other services were associated with neglect reduction.
This is the first study to address APS services by mistreatment type and the outcomes of services. Adoption of the ISO Matrix by APS programs opens the possibility of research and practice collaboration in APS outcomes research using a standardized approach.
成人保护服务（APS）是调查虐待老年人并提供/协调调查后服务的一线机构。然而，其在减少与服务相关的不同类型虐待方面的效果尚不清楚。本研究旨在通过确定按虐待类型提供的服务，并检查服务与虐待减少之间的关联来解决这一知识空白。
采用识别、服务和结果（ISO）矩阵的预测试后设计，在进行案例调查期间和提供服务后案例结案时评估虐待水平。旧金山和纳帕 APS 参与了为期 6 个月的数据收集。
研究检查了 4 种最常见的虐待类型：情感、身体、财务滥用和他人忽视。平均而言，在 APS 干预后，各种类型的虐待程度都有所降低。护理/案件管理、心理健康和其他服务最为常见，而具体服务则因虐待类型而异。护理/案件管理服务与身体和情感虐待的减少相关，法律服务与情感虐待的减少进一步相关；财务规划服务与财务滥用的减少相关；护理/案件管理和其他服务与忽视的减少相关。
这是第一项按虐待类型和服务结果来探讨 APS 服务的研究。APS 计划采用 ISO 矩阵为 APS 结果研究采用标准化方法进行研究和实践合作开辟了可能性。
