New Montefiore Program Targets Elder Abuse and Neglect

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 www.montefiore.org or www.montekids.org.

SOURCE Montefiore Medical Center

Steven Osborne, sosborne@montefiore.org, or Mike Quane, mquane@montefiore.org,
both of Montefiore Medical Center, +1-718-920-4011