Financial exploitation. Physical abuse. Psychological Abuse. Abandonment. Neglect. All are aspects of elder abuse, increasingly common nationwide, with approximately 120,000 older adults victimized in their own homes each year in NYC alone – and 96% of these cases go unreported.
The cases are heartbreaking and complex, requiring innovative solutions. As a result, the Center for Elder Abuse Solutions (CEASe), formerly known as the New York City Elder Abuse Center (NYCEAC) was launched in 2009 to improve the way professionals, organizations, and systems respond to elder abuse, neglect, and financial exploitation and to support Concerned Persons in the lives of Older Adults who are abused or neglected. It accomplishes this through an unprecedented level of collaboration and coordination with local and national government and non-profit agencies. Now, through CEASe, these organizations provide a streamlined and rapid response to elder abuse cases. In addition, the depth and breadth of expertise and resources of the participating agencies reduce fragmentation of systems and minimizes gaps or overlap of services. CEASe also supports the concerned persons in the lives of abused older adults through the Concerned Persons Helpline. CEASe works to educate key decision-makers and elected officials about elder abuse and seeks to improve legislation to better protect the safety and well-being of New York City’s older adults.
Prior to the launching of CEASe, formerly NYCEAC, in 2009, elder abuse cases in NYC were largely handled by individual workers siloed within their own organizations and systems, and Concerned Persons were without support or recommendations on resources to help themselves and the older adults in their lives CEASe has implemented an effective paradigm for collaboration and coordination between governments and non-profit agencies and organizations.
This need to develop a systematic, collaborative response to the growing number of complex elder abuse cases in was the impetus for the development of the CEASe. Although elder abuse centers have been created in other parts of the United States over the past decade, it seemed that no single center model could be directly transposed to the NYC environment, unique in its size, complexity, and diversity. Thus, in April 2008, the Weill Cornell Medical College’s Division of Geriatrics and Palliative Medicine in partnership with the Harry and Jeanette Weinberg Center for Elder Abuse Prevention at the Hebrew Home at Riverdale (The Weinberg Center) and the New York City Elder Abuse Network (NYCEAN), initiated the NYC Elder Abuse Center Planning Project.
First, a multidisciplinary Advisory Council was formed, comprised of 25 members from a broad range of non-profit and government organizations, including criminal justice, academia, social services, health care, domestic violence, banking, aging services, mental health, and advocacy. Then, the Advisory Council conducted extensive research to determine the CEASe’s priorities, identify stakeholders’ interests and needs, and create a structure for it.
This research utilized a five-pronged strategy intended to build on the success of other models of elder abuse service while soliciting ideas and creating as broad a consensus as possible among the local elder abuse community. An additional benefit to this multi-faceted approach was that we successfully engaged strategic stakeholders important for future partnership development. (Weill Cornell Medical College’s Institutional Review Board approved this research.) The five planning methods utilized were:
- Concept Mapping. Concept mapping is a qualitative and quantitative consensus-building methodology in which a broad group of stakeholders with an interest in a particular topic are identified, their views elicited, and their ideas prioritized for implementation. In response to a prompt (which in this case was, “The most important goal of a New York City Elder Abuse Center to combat elder abuse is….”), the group “brainstorms” to create as many unique ideas relevant to the prompt as possible. These are then sorted by the group into discrete idea areas and then ranked in terms of priority and feasibility. ( Click here for a copy of the concept map.)
- Site Visits to Relevant Centers. Members of the Advisory Council made site visits to existing elder abuse and child advocacy centers throughout the country to see what activities and components of those centers had relevance to the creation of an elder abuse center.
- One-on-One Interviews with Major Stakeholders. Major stakeholders, pioneers, and opinion leaders in NYC were interviewed directly by members of the Advisory Council to solicit their input (e.g. government officials, leaders from the fields of aging, and domestic violence.) These interviews typically lasted in excess of one hour.
- Survey of the Existing Elder Abuse Case Coordination and Review Team. Members of an on-going monthly Manhattan-based case discussion group, the Elder Abuse Case Coordination and Review Team (EACCRT), were surveyed via an online process to solicit their specific opinions about the mission and function of a putative CEASe.
- Review of the literature. An extensive literature search was conducted and national elder abuse listservs were queried to identify best practices and models.
The Advisory Council synthesized and analyzed the data gathered. Utilizing a democratic and transparent process, the Advisory Council determined the CEASe’s structure, governance, priorities, activities, and funding needs.
Since opening in 2009, CEASe has grown from an idea to an organization with 20 staff members. We help older victims of all types of abuse and their families through our EMDTs and case consultation services (funded primarily by Lifespan of Greater Rochester, Inc. and the NYS Office for Victim Services), which are now available in all 5 boroughs of NYC, and through our Elder Abuse Helpline for Concerned Persons. We develop innovative programs when there is a gap we believe we can fill. For example, we created a semi-structured interview tool called the Interview for Decisional Abilities, currently in use by Adult Protective Services in NYC, California and Massachusetts, that helps caseworkers other information about their clients’ decisional-abilities. We provide professional education on elder mistreatment and engage professionals and the public through social media focusing on pertinent issues in the elder justice field and we conduct research and are involved in policy work and writing thought pieces as well, many of which can be found here.
We also seek to scale programs that we think can have a positive impact in other communities and can be sustained. For example, we have partnered with the NYS Office for the Aging and Lifespan of Greater Rochester, Inc. to raise money from the NYS Office for Victim Services and the state legislature to bring EMDTs to all 62 NY State counties (urban, suburban and rural)
In conclusion, the Center for Elder Abuse Solutions is forged by a highly collaborative and thorough planning process. This involved an extensive literature review, consultations and site visits, and an intensive, democratic decision-making approach in which hundreds of ideas from members of the local elder-serving community were considered and prioritized. From this planning process emerged the NYC Elder Abuse Center, which is now the Center for Elder Abuse Solutions.
As it moves forward, CEASe will continue to utilize a collaborative approach to problem-solving to overcome obstacles and plan for the future. We are confident that CEASe will continue to positively impact the prevention of and response to elder mistreatment and will continue to serve as a significant resource for elder abuse technical assistance, innovative best practices, multidisciplinary training, research, and policy development, both locally regionally, and nationally.
For more information about the Center for Elder Abuse Solutions, please contact:
Lisa Rachmuth, LMSW
Executive Director, CEASe
Weill Cornell Medicine
Division of Geriatrics and Palliative Medicine