Uncovering the Causes, Contexts, and Consequences of Elder Mistreatment in People with Dementia

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ABSTRACT The primary objective of the parent project is to investigate the underlying mechanisms that lead to elder mistreatment (EM) among people living with Alzheimer’s Disease and related dementias (ADRD). Applying the Abuse Intervention Model as a theoretical framework, the project identifies EM risk and protective factors among persons living with ADRD (the potential victim), their care partner (CP; potential perpetrator), and the context in which they are situated.5 As originally proposed, study recruitment procedures relied heavily on clinical recruitment of people living with ADRD and their CPs in dementia care clinics. The COVID-19 pandemic drastically affected clinical operations, healthcare utilization patterns, and likelihood of patient research participation, resulting in overall low study enrollment, an underrepresentation of Black participants, and potential sample biases. The proposed supplemental activities will enable expansion of community-based recruitment through inclusion of additional sites and types of organizations and by fully utilizing our enlarged target geographic area throughout Southern California. Though initially ancillary to clinical recruitment efforts, the project seeks to establish community-based referral strategies as the study’s primary referral source. Aim 1: Expand use of community-based referral strategies to recruit a diverse study sample. Piloted as a potential approach to bolster recruitment efforts in response to clinical recruitment challenges, community-based referral strategies have yielded much-needed participant volume and sample diversity. Efforts to recruit study participants from caregiving organizations and adult day health care centers will be expanded to include sites throughout the vast Southern California region. Recruitment will also be broadened to initiate work with faith-based communities, older adult housing sites, retiree organizations, senior centers, and academic gerontology/geriatrics programs. Organizations serving racially diverse groups and populations with low socioeconomic status will be prioritized to facilitate greater recruitment of groups underrepresented in our preliminary sample. Aim 1a: Implement culturally tailored recruitment approaches to engage Black people living with ADRD and their CPs in research. Recruitment partnerships will be strengthened and expanded with Black-serving organizations and those serving geographic areas with high proportions of Black residents. Connections will also be strengthened and established with churches and other faith-based communities to build trust and rapport with prospective Black participants. Aim 2: Collect data on characteristics of individuals living with ADRD and their CPs, their caregiving relationship, and the environment in which they interact. Research interviews will be conducted with newly recruited study participants to systematically collect data on potential risk factors for EM. Interviews will be conducted with expediency and efficiency to accommodate the high volume of participants being interviewed within a limited time frame.