Protecting Vulnerable Elders

Launched in April 2017, is addressing the needs of older adults suffering from mistreatment, usually at the hands of caregivers or family members.

Like child abuse and domestic violence, elder abuse is vastly under-reported. But there鈥檚 a difference. Elder abuse research and infrastructure are less well-developed and less well-funded than other types of interpersonal mistreatment, says Dr. Anthony Rosen, an Associate Attending Physician, Associate Professor of Emergency Medicine and founder of the VEPT at 日本av色情片. His goal, and that of his teammates, is to bring elder abuse out of the shadows and into the full light of day. And to protect our vulnerable elders, save lives and grow the team鈥檚 impact, locally and nationally.

Elder mistreatment can take the form of physical, sexual, verbal or emotional abuse; financial exploitation; or outright neglect. Physical abuse in particular can be devilishly difficult to detect, even in the Emergency Department, where the VEPT is housed.听

Says Dr. Rosen, 鈥渢here鈥檚 an art to distinguishing between an injury caused by an accident and one caused by intentional violence. Falls in particular are very common among older adults, and they鈥檙e the reason given by abusers for injuries caused by their own mistreatment of a vulnerable elder.听

鈥淥ur research has found that abuse victims tend to have injuries to the face, jaw, teeth or neck but no injuries to their extremities,鈥 he continues. 鈥淭hat makes sense: If you fall down the stairs, you can certainly have facial injuries, but not without injuries to your arms and legs. Elder abuse victims are also more likely to have injuries to the left cheek, which stands to reason, given that most abusers鈥攁nd most people鈥are right-handed. We鈥檝e also found that neck injuries are common in physical abuse but almost never occur in falls.

Why is the VEPT housed in the Emergency Department?

In the Emergency Department (ED), victims of abuse or neglect can receive care and connect with both hospital and citywide resources, Dr. Rosen says. In fact, 鈥渁 visit to the ED for acute injury may be the only time a victimized elder leaves their home.

Who are the members of the team?

鈥淥ur team consists of 2 physicians and 2 advanced practice providers, meaning that a medical provider is always accessible,鈥 he says. 鈥淲e also have 2 expert social workers, who are actually at the heart of our program. An inpatient geriatrician is available to provide care throughout a vulnerable elder鈥檚 hospitalization. And we also have a program coordinator who manages the day-to-day operations of the program.

鈥淎dditionally,鈥 he continues, 鈥渨e collaborate closely with other departments as needed, including security, ethics, geriatrics, patient services, legal, psychiatry and radiology.鈥

The VEPT works with several community partners as well, including Adult Protective Services (APS) and the Center for Elder Abuse Solutions (CEAS), housed in the Division of Geriatric and Palliative Medicine at 日本av色情片.

Dr. Rosen鈥檚 mentor, Dr. Mark Lachs, has been a behind-the-scenes VEPT member and leader all along. Passionate about the disenfranchised elderly, Dr. Lachs is the Irene F. and I. Roy Psaty Distinguished Professor of Clinical Medicine and an attending geriatrician at 日本av色情片, whose contributions to research and clinical practice continue to inform the team鈥檚 work, both within and beyond the institution.

Has the VEPT been growing?

The short answer is a resounding 鈥測es.鈥 In 2019, just 2 years after its founding, 鈥渨e secured funding from the New York State Office of Victim Services (OVS) to expand our program beyond the ED and to respond to inpatient consults,鈥 says Dr. Rosen. 鈥淲e also launched a telemedicine version of our program. Our funding was renewed in October 2022, and we鈥檙e currently piloting an outpatient consultation program with the Cornell Center on Aging. We鈥檙e also strengthening our relationship with APS.鈥

Positive outcomes

Dr. Rosen and his colleagues have been carefully tracking the impact of the VEPT program: We were encouraged that out of the total number of older patients determined to be at high or moderate risk for mistreatment, 75 percent were discharged with a change in their housing situation or with new or additional home services. These improvements suggest an increase in short-term safety for vulnerable older adults, and we are currently examining longer-term outcomes.

Additionally, 鈥providers in the ED have reported that the VEPT made them more likely to consider and assess elder mistreatment. They鈥檝e also expressed the view that there鈥檚 merit in establishing a VEPT program in EDs at other institutions across the country.鈥

In January 2021, 鈥渙ur colleagues at the University of Colorado launched the Vulnerable Elder Services, Protection and Advocacy Team, which is partly modeled on our VEPT program. We鈥檙e excited at the prospect of supporting and replicating similar programs at other institutions. One critical element is to show how these programs can be funded and sustained.鈥

The Concerned Persons Helpline

The Elder Abuse Helpline for Concerned Persons is a non-emergency service that provides information, support and resources. Services are free and confidential.

A concerned person can be a friend, family member or neighbor living in New York State who suspects that a vulnerable elder may be suffering from mistreatment. The Helpline is open for business between 9:00 a.m. and 5:00 p.m. Eastern Time on Monday through Friday.听

The Elder Abuse Helpline offers the following services to concerned persons:

  • supportive counseling to ease uncertainty, anxiety, and stress
  • discussion of concerns and needs
  • guidance to help plan next steps
  • information and education about elder abuse, neglect and exploitation
  • appropriate and timely referrals

If you鈥檙e concerned about a vulnerable elder鈥攁 friend, family member or neighbor鈥攃all 844-746-6905 or email the Helpline鈥檚 staff at cease_helpline@med.cornell.edu.听

Learn more about the and visit here for听more information about the .

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