Self-neglect, the inability to provide for oneself the goods or services to meet basic needs, is three times more common than physical abuse or caregiver neglect. Over the past decade our academic geriatrics team has successfully collaborated with Adult Protective Services (APS) to intervene in cases of vulnerable, at-risk elders who self-neglect. Despite the great successes of this collaboration, there is no empirical evidence citing the effectiveness of coupling the Comprehensive Geriatric Assessment Intervention (CGAI) with APS intervention versus APS intervention alone in the management and remediation of elder self-neglect. We plan to conduct a randomized clinical trial (RCT) to test if CGAI and APS intervention is superior to APS intervention alone. Specifically, we plan to recruit 100 APS substantiated cases of elder self-neglect, ages 65 or older, and randomly assign them to either the CGAI and APS intervention group or the usual APS intervention group. Data related to self-neglect status, social, physical, medical and cognitive status and health care utilization and mortality will be collected at baseline and again at 6 months. We intend to test the hypothesis that this approach will improve the quality of care and outcomes provided to these seniors by state protective service agencies.

Public Health Relevance

We can anticipate a sharp rise in the geriatric syndrome of self-neglect in upcoming years due to the burgeoning of our elder population. This study could provide the evidence to link already existing Comprehensive Geriatric Assessment and Intervention (CGAI) teams with local Adult Protective Services workers. Based on our experience of working with APS over the last ten years we believe that the procedures of a CGAI team can easily be integrated into any APS operation, both regionally and nationally, and can reverse the cycle of elder self-neglect, thus improving public health outcomes for our vulnerable elderly population.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Research Project (R01)
Project #
5R01HS017440-02
Application #
7901562
Study Section
Health Care Quality and Effectiveness Research (HQER)
Program Officer
Mullican, Charlotte
Project Start
2009-08-01
Project End
2012-07-31
Budget Start
2010-08-01
Budget End
2012-07-31
Support Year
2
Fiscal Year
2010
Total Cost
Indirect Cost
Name
University of Texas Health Science Center Houston
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
800771594
City
Houston
State
TX
Country
United States
Zip Code
77225