ELDER ABUSE, ETHNICITY, AND HEALTHCARE SETTINGS

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DESCRIPTION (applicant s abstract): Dr. Michael Rodriguez, MD, MPH, has developed expertise in the area of intimate partner abuse among ethnically diverse populations. Through mentoring relationships, structured integrated activities, and development of a research program, Dr. Rodriguez will advance his independence in conducting patient-oriented clinical research. Elder mistreatment is a significant health and social problem affecting all racial, ethnic, and socioeconomic groups. Although cultural values influence attitudes about mistreatment, little research has focused on understanding mistreated elders' perspectives on mistreatment. Furthermore, identification and management of elder mistreatment in health care settings are impeded by the lack of effective, culturally appropriate screening tools. In focus groups with mistreated Latino, African-American, and non-Latino Caucasian elders, Dr. Rodriguez will examine perceptions of mistreatment and identify factors that facilitate or hinder patient-provider communication about mistreatment. Similarly, focus groups with cognitively impaired elders, care givers, health care providers, and adult protective services workers will examine their perspectives on the definition of elder mistreatment and factors facilitating its identification in health care settings. A survey instrument will be developed using results from focus groups, current literature, and expert advice, and will include screening questions, established measures of abuse and neglect, patient preferences for health care interventions, demographic, and descriptive data. The survey will be administered to an ethnically diverse, clinic-based sample of elderly patients, and resulting data will provide information on risk factors for eider mistreatment and the utility of the screening questions. The goals of this study are to: (1) examine mistreated elders' perceptions of mistreatment and the role of health care providers in addressing elder mistreatment; (2) examine care givers, health care providers, and adult protective service workers perspectives on mistreatment and how health care providers can help victims; (3) identify risk factors for elder mistreatment; and (4) begin development of a screening tool for use in health care settings.