ECHO Elder Abuse Identification and Clinical Management in Primary Care

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ECHO Project

This 5-part ECHO series will equip primary care clinical providers with a framework to address elder abuse in their practice.  Drawing from recent literature, decades of clinical practice and forensic assessment experience, Drs. Mosqueda and Olsen will present foundational information that informs pragmatic response and management plans.  ECHO’s case-based interactive teaching format facilitates participants confidence in translating the content to application in clinical practice.  Effective response strategies may reduce the incidence of mistreatment and mitigate the impact on medical and mental health co-morbidities in effected patients. 

Instructor

Laura Mosqueda, MD, FAAFP, AGSF is a professor (with tenure) of Family Medicine and Geriatrics at the Keck School of Medicine of USC. She is a widely respected authority on elder abuse and care of the elderly and underserved. She is also an expert on medical education curriculum design, development, and implementation. Since joining the Keck School of Medicine of USC, her roles have included: Chair of the Department of Family Medicine, Associate Dean of Primary Care, and Dean. She is the principal investigator of an NIA-funded R01 study to understand the causes of the abuse of people with dementia and is the Director of the National Center on Elder Abuse, a federally funded initiative that serves as the nation’s coordinating body and clearinghouse for information on research, training, best practices, news, and resources. Dr. Mosqueda is also a fellow in the Health and Aging Policy Fellowship Program. As a clinician, researcher, educator, and academic administrator, she has a unique perspective that is informed by her extensive experiences in the community, including her role as a volunteer long-term care ombudsman.

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Bonnie Olsen, Ph.D. is a clinical geropsychologist, working in academic medicine for over 25 years.  She provides cognitive assessment and psychotherapy in a collaborative geriatric primary care setting.  As the Vice Chair for Research in the Department of Family Medicine at the Keck School of Medicine at USC, Dr. Olsen is involved in a number of research and program grants. She is the Principal Investigator on several federally and foundation funded grants focusing on: development of the Judicial Guardianship Evaluation Worksheet to assist judges in probate matters, interprofessional geriatric clinical education, elder abuse identification, prevention and response in emergency departments, and development of elder abuse curriculum for medical residents.  She has remained dedicated to community service throughout her career.  

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Sessions

A Tool to Assess Risk and Plan Next Steps

Friday, Mar. 11, 2022 11 AM to 12 PM (PST)

The AIM model has been used effectively as a framework for many elder abuse responders to understand the conditions and factors associated with risk for abuse as well as provide potential areas for mitigation. Dr. Mosqueda will present the model, the evidence that informs the content, and offer pragmatic strategies to apply the model in clinical practice.

Session Video | Slide | Resources

Diagnosing Abuse in the Context of Dementia 

Friday, Apr. 8, 2022 11 AM to 12 PM (PST)

Persons living with dementia are known to be exceptionally vulnerable to abuse yet present a complex problem for accurate diagnosis.  Dr. Olsen will present best practices and research-informed approaches to determining risk and constructing a plan of care.  Issues of decisional and functional capacity will be addressed as well as the critical role of caregivers in conceptualizing mistreatment.

Session Video | Slide | Resources

Forensic Markers: Discerning Between Accidental and Abusive Injuries

Friday, May 20, 2022 11 AM to 12 PM (PST)

An evolving literature supports specific injury patterns that can help medical providers determine the likelihood that an injury was intentionally caused.  Dr. Mosqueda will review the information pertaining to pressure ulcers, fractures and bruising patterns providing knowledge that supports good clinical decision making.  She will demonstrate use of the Geri IDT (Geriatric Injury Documentation Tool) to accurately record details of wounds so that wounds can be tracked over time and support criminal prosecution when needed.

Resources

Navigating Complex Family Dynamics in Elder Abuse

Friday, Jun. 10, 2022 11 AM to 12 PM (PST)

Perpetrators of elder abuse are most often family members. Understanding common patterns within families that support mistreatment and neglect will help providers develop tailored and realistic interventions.  Dr. Olsen will review a compendium of familial dynamic patterns that are commonly observed in cases of elder mistreatment.  Participants will learn how to recognize and manage these relationships in the clinical setting which will allow providers to focus on the patients’ medical needs and provide clarity regarding appropriate referrals for family caregiver support services.

Preventing Abuse in High Risk Situations: Intervention Strategies

Friday, Jul. 8, 2022 11 AM to 12 PM (PST)

Elder abuse often develops over time, is rarely a single isolated event and usually involves more than one type.  Drs. Mosqueda and Olsen will discuss approaches to clinical decision making regarding if, how and when to intervene.  Case-based review will demonstrate identification of the relevant factors and weighing alternative interventions.  Participation will support more confidence in managing the multiple co-morbidities and psychosocial factors that so often accompany elder abuse and neglect in the clinical setting.

Register

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