--- title: "Elder Abuse Intervention and Education for the First Responder" type: "pdf" year: "2001" canonical: "/projects/474" --- # 01-25 # Table of Contents - [01-25](#01-25) - [Glendale Police Department](#glendale-police-department) - [ELDER ABUSE INTERVENTION AND EDUCATION FOR THE FIRST RESPONDER](#elder-abuse-intervention-and-education-for-the-first-responder) - [Glendale Police Department](#glendale-police-department) - [C.O.P.P.S.](#copps) - [ELDER ABUSE INTERVENTION AND EDUATI i N F IR THE FIRST SPO FR](#elder-abuse-intervention-and-eduati-i-n-f-ir-the-first-spo-fr) - [Glendale Police Department](#glendale-police-department) - [Elder Abuse Intervention and Education for the First Responder](#elder-abuse-intervention-and-education-for-the-first-responder) - [SUMMARY](#summary) - [SCANNING](#scanning) - [ANALYSIS](#analysis) - [RESPONSE](#response) - [Elder Abuse Intervention and Education for the First Responder](#elder-abuse-intervention-and-education-for-the-first-responder) - [Elder Abuse Intervention an. suca iCta for"the first Responder](#elder-abuse-intervention-an-suca-icta-forthe-first-responder) - [ASSESSMENT](#assessment) - [AGENCY AND OFFICER INFORMATION](#agency-and-officer-information) ## Glendale Police Department ### ELDER ABUSE INTERVENTION AND EDUCATION FOR THE FIRST RESPONDER ![img-0.jpeg](https://popdatasets.blob.core.windows.net/popdatasetmdimgs/01-25/img-0.jpeg) ![img-1.jpeg](https://popdatasets.blob.core.windows.net/popdatasetmdimgs/01-25/img-1.jpeg) Submitted to the Police Executive Forum (P.E.R.F.) for the **2001 HERMAN GOLDSTEIN** Award for Excellence in Problem-Oriented Policing ![img-2.jpeg](https://popdatasets.blob.core.windows.net/popdatasetmdimgs/01-25/img-2.jpeg) ![img-3.jpeg](https://popdatasets.blob.core.windows.net/popdatasetmdimgs/01-25/img-3.jpeg) # Glendale Police Department ## C.O.P.P.S. ![img-4.jpeg](https://popdatasets.blob.core.windows.net/popdatasetmdimgs/01-25/img-4.jpeg) ## ELDER ABUSE INTERVENTION AND EDUATI i N F IR THE FIRST SPO FR ![img-5.jpeg](https://popdatasets.blob.core.windows.net/popdatasetmdimgs/01-25/img-5.jpeg) April 10, 2001 Submitted by.: Agent Lisa Muzqutz COmmunity Police PartnerShip # Glendale Police Department ## Elder Abuse Intervention and Education for the First Responder ## SUMMARY The COmmunity Police PartnerShip (C.O.P.P.S.) Unit from the City of Glendale has developed an Elder Abuse Intervention and Education Program designed for the "First Responder." California's population over the age of sixty (60) is one of the fastest growing segments in the state. As adults enter their "golden years", they unfortunately become susceptible to abuse. The lack of transportation, reduction in mobility, the reduced number of social contacts, and some of the mental/physical conditions that accompany the aging process can allow this abuse to go undetected for extremely long periods of time. It is estimated that one out often people over the age of sixty-five (65) is abused in some form, however, only one out of fourteen cases of abuse will ever be reported. Elder abuse can consist of neglect, self-neglect) physical, sexual, psychological and financial abuse. The signs of elder abuse can be difficult to identify, and may only be recognized in retrospect unless the individual has been educated or trained to identify the signs and symptoms of abuse. Often the person who abuses the elder has a special relationship with the victim. Because of the dependence on the special relationship, along with the social and physical consequences of the aging process, elder abuse can be easily concealed from those who only have intermittent contact with the elder. The C.O.P.P.S. Unit developed strong partnerships with public and private agencies to ensure a multidisciplinary approach for the Elder Abuse Intervention and Education Program was attained. The program has educational and outreach components designed to identify elders who are "at risk" of being abused and to recognize the initial signs of potential abuse. The training is designed to provide individuals likely to come into contact with potential victims of elder abuse (first responders) with the basic information to assist in detecting the initial signs of possible abuse and neglect and take action so that the appropriate follow-up procedures are initiated. This training allows the first responder to maximize the use of existing resources (both public and private) in dealing with situations involving elder abuse. In addition to the training program, a public service announcement was developed and aired on local cable to increase public awareness. The reduction in calls for emergency services and the improvement of the quality of life for the older adult was the primary goal of the program, and the goal was achieved. # SCANNING Over the past several years, the Glendale Police Department has been experiencing a multitude of problems ![img-6.jpeg](https://popdatasets.blob.core.windows.net/popdatasetmdimgs/01-25/img-6.jpeg) Conditions Encountered by First Responders of an Elderly Adult related to the older adults in our community. Many of these - problems range from dilapidated housing conditions, older adults living in squalor, conditions of extreme neglect, financial, sexual, psychological, physical abuse and in extreme cases, death. When the police responded to these problems, the criminal or medical necessities would be addressed, however, if no immediate need for police or medical services was present, the officer, feeling discouraged, would leave the incident often real- izing that they would return another time. Through regular bi-monthly meetings with other city and government agencies, \{e.g., Fire, Code Enforcement, Neighborhood Services, City Attorney's Office and Social Services) the C.O.P.P.S. Unit realized that we were responding to similar and oftentimes the same complaints. The agencies would address their specific area of expertise and would often walk away from the problem feeling that it was not resolved and that they would be returning. These responses would sometimes continue on a regular basis until the situation degraded to the point where the situation was in fact emergent and emergency resources were necessary. The lack of communication/coordination between these various agencies contributed to reduction in the quality of life for many of the older adults in our community. Although resources were available to assist in these problems, the first responders were unaware of their existence. The number of problems coming to the attention of the police department were not large, however the impact of each individual case was significant. These net consequences included the loss of resources, physical injury, depression, neglect and an overall reduction in the quality of life for the older adult. According to national statistics the population over the age of 60 is the fastest growing population in California and the United States. It is estimated that one out often persons over the age of 65 are the victims of abuse every year, however only one out of fourteen of these cases are ever reported. Not only was there a concern that current cases of abuse/neglect were not being identified, the demographic trends indicate that this problem will grow significantly in the years to come if something is not done to address this issue. # ANALYSIS The term "Elder Abuse" is used to describe several different situations; neglect (by others), self-neglect, physical, financial, sexual, and psychological abuse. By reviewing information collected from local, county and national records and statistics, elder abuse ranks as one of the most under-reported situations. Elder abuse has been found to be embarrassing and humiliating for the older adult and these feelings are magnified when the suspect is a trusted family member or friend. Due to these factors, neither the victim nor the victim's family or friends want to discuss the problem. The abuse or neglect of an older adult is generally kept behind closed doors and can be described as America's "best-kept frightening little secret". Traditionally, responses to situations involving abuse or neglect of an older adult were incident based. From a law enforcement perspective, a police officer would respond to a situation where someone suspected abuse and assess the situation to determine if criminal activity was occurring or if the person was unable to care for them self. If criminal activity was identified, an investigation would be initiated. If self neglect were involved, action would be taken only when the situation presented an immediate, life-threatening hazard or the person manifested a mental condition which indicated that they were a danger to them self or others. If an agency other than the police depaitrnent was notified, that agency would generally process the incident as ![img-7.jpeg](https://popdatasets.blob.core.windows.net/popdatasetmdimgs/01-25/img-7.jpeg) First Responder/Partner Neighborhood it would any other case within its area of responsibility. For example, if a code enforcement officer received a complaint regarding dilapidated property, a code enforcement investigation would be initiated. Even though situations involving abuse/neglect might be involved, the responding personnel did not have training to identify this as a possible root cause of the problem. Historically, code enforcement and fire personnel are incident driven and deal with each matter in accordance with their agency's established standard operating procedures. Therefore each agency lacked the ability to identify the root problem, and this inability prevented the implementation of a solution to what was a long-term problem. Even though services/resources were in existence that could permanently resolve the situation, they were not effectively utilized. The standard procedures neglected to identify the root cause of the problem and/or potential problems that reached a level that was catastrophic to the older adult. In order to prevent abuse/neglect situations on a long-term basis, the C.O.P.P.S. Unit analyzed several of its own investigations in attempt to find factors that placed older adults at risk of being abused. The analysis included a review of various records maintained by the Glendale Police Department and interviews with older adults that were victims of abuse. The primary factors placing a person at risk were identified as, but not limited to, the following: - Living alone - Being isolated from family or friends - Mental health or physical condition that makes a person dependent upon another (e.g., memory loss thereby requiring assistance in managing financial affairs or needing transportation due to an inability to drive) - A strong sense of independence - A desire not to be a burden to others + A compulsive need to "hoard" money and property in some cases The factors that appear to place a person at risk of being abused/neglected span a broad range of disciplines. Therefore, the C.O.P.P.S. Unit sought to gain additional insight into the problem and possible solutions through a comprehensive, multi-disciplinary approach. Each agency involved provided services to older adults or had expertise in dealing with physical and mental conditions. The C.O.P.P.S. Unit took the lead in establishing partnerships with the Los Angeles County Department of Mental Health Older Adult Services Unit (G.E.N.E.S.I.S.), Verdugo Hills Hospital Geropsychiatric Unit, the City of Glendale Adult Recreation Center (which has case management services for older adults), the City of Burbank Adult Recreation Center, the Los Angeles County District Attorney's Office, and a consultant with expertise in law enforcement and psychology. Once the partnership was formed, numerous discussions were held with the various subject matter experts. The symposium verified the previously identified factors that appeared to be the root cause(s) of the problem, and confirmed that those most likely to come in contact with older adults at risk of being abused were not adequately trained to identify and evaluate the critical risk factors. Therefore, a high probability existed that situations involving actual abuse or, situations where the older adult was at a high risk of being abused, were not being identified and no action was being taken that would resolve the issue on a long-term basis. Unfortunately, the situation would be left to deteriorate until an emergency response was necessary. The inability to identify the problem at an early stage left the older adult in an untenable situation. In cases of financial abuse, the person in control of the older adult's assets would continue to exhaust those assets until the older adult was left destitute. Psychological abuse would also continue, and possibly escalate, causing additional psychological problems for the older adult and leaving them in a state of constant fear. When physical abuse goes unidentified, it often continues, escalates, and eventually requires medical treatment for serious conditions. In all of these cases, the older adult is left with a feeling of humiliation and a sense that they no longer control their own life. ![img-8.jpeg](https://popdatasets.blob.core.windows.net/popdatasetmdimgs/01-25/img-8.jpeg) Elder Abuse may Include Physical Abuse From a public perspective, the inability to effectively deal with the issue of elder abuse significantly impacts the community in a number of different ways. Dilapidated housing in a neighborhood reduces property values throughout the community and attracts other criminal activity. When a community feels it cannot address an issue, there is a collective sense of helplessness. This can break down the very fibers that hold a community together which then diminishes their ability to work together to resolve other important issues affecting the neighborhood. Financially, the public welfare system has absorbed the cost of supporting the older adult's fundamental needs. However, if a potential problem can be recognized, these older adults would retain their own assets and public assistance would not be required. # RESPONSE In its analysis, the C.O.P.P.S. Unit realized the seriousness of the problem, but recognized that several options were available to deal with the elder abuse quandary. A collaborative approach was implemented. In conjunction with our local mental health agencies, research was conducted on the subject of elder abuse, in addition to exploring what services and resources were currently available in preventing or dealing with elder abuse. The collaborated efforts built strong partnerships with our local and county agencies and other stakeholders. One possible solution evaluated during this process involved requesting the local mental health agencies to expand their outreach to first responders. However, the identified agencies already experienced heavy caseloads, which significantly impacted their ability to expand their outreach resources to a level where it would be effective. It was highly unlikely that these agencies would receive additional funding that would allow for the implementation of specialized outreach teams. Another available option was to essentially leave the existing system in place. However maintaining status quo meant that the problems would not be dealt with at an early stage, and a significant amount of resources ![img-9.jpeg](https://popdatasets.blob.core.windows.net/popdatasetmdimgs/01-25/img-9.jpeg) City of Glendale # Elder Abuse Intervention and Education for the First Responder would have to be devoted to each individual case once it rose to the level of an emergency. Since the older adult population is expected to dramatically increase over the next several years, one would expect these agencies to increase their resources used to resolve these emergent situations. This non-programmatic approach did little to improve the communication among agencies or assist in preventinglsolving problems involving elder abuse. Essentially, leaving the current, dysfunctional system in place would confirm the analysis, and the issue would not be fully addressed. After analyzing the compiled information, the C.O.P.P.S. Unit reached the conclusion that the existing system had all of the elements in place to adequately address the problem. Services were available, but the system for identifying the problem and delivering appropriate services was inadequate. Therefore, the designed response involved a higher coordinative effort of the resources involved in the current system. Using the partnership established with G.E.N.I.S.I.S., work began on developing a tool or protocol to assist the first responder in the early identification and recognition of elder abuse. In part, this development involved a modification of a longer, in-depth assessment tool used by mental health professionals. The goal was not to make the first responder a mental health or social worker, but to enable the first responder to properly assess a situation and coordinate an appropriate response to the problem. Another goal in the development of the protocol was to ensure the ease of its use, without sacrificing accuracy. Ultimately, the accuracy in identifying and assessing the problem would allow the first responder to set in motion a response that was most appropriate to the type of problem identified. This would in turn lead to ![img-10.jpeg](https://popdatasets.blob.core.windows.net/popdatasetmdimgs/01-25/img-10.jpeg) an improvement in the quality of life for the older adult and reduce the likelihood that the use of emergency resources would be required in the future. A pilot protocol was developed and used by members of the Glendale Fire Paramedics and the Mental Health Section of Verdugo Hills Hospital. During a one-month test period, the results confirmed that the protocol, in conjunction with our education program, proved to be a valuable tool in the field. These two groups found that using the assessment protocol made it easier to deal with older adults, assess the situation, and deliver the proper assistance. The paramedic group indicated that widespread use of the assessment protocol would lead to a reduction in future calls for service because the situation would now be addressed in a comprehensive manner instead of in the traditional, fragmented approach. Using the information gained through the evaluation forms and interviews with fire and mental health professionals, adjustments were made to the assessment ![img-11.jpeg](https://popdatasets.blob.core.windows.net/popdatasetmdimgs/01-25/img-11.jpeg) First Responder/Partner Fire Paramedics protocol and educational program. The next step in this process was designed to broaden its use and maximize the use of existing resources. Initially, this involved training medical, mental health and social services personnel who typically receive referrals from the first responders. Secondly, an eight-hour seminar was developed to reach as many first responders as possible. The C.O.P.P.S. Unit, in conjunction with Verdugo Hills Hospital's Geropsychiatric Team and G.E.N.E.S.I.S., identified the 24 -hour hotlines, medical, mental health, and social services personnel contacted by first responders for assistance. These organizations were given instruction on the assessment protocol, the information provided to first responders, and the types of assistance a first responder might be seeking when contacting one of these referral resources. During this training, members of these organizations stated they could use the assessment protocol as a preliminary assessment tool as well. This unexpectedly fulfilled an unmet need by allowing these agencies to make an initial assessment more efficiently. In addition to the development of the assessment protocol, the C.O.P.P.S. Unit developed an 8 -hour seminar that focused on the recognition of elder abuse and appropriate intervention techniques for the first responder. The initial part of the curriculum consisted of an introduction on the topic of elder abuse and the consequences that may arise if not properly identified and proactively addressed. The first responders were instructed on the proper use of the assessment protocol. Additionally, equal importance was given to ensuring that a proper assessment was made in critical situations. The curriculum also included a discussion of medical issues as they related to the older adult, since both psychological and medical issues can impact an older adult's ability to provide for themselves. Once the older adult becomes mentally or physically impaired, they potentially become dependent and susceptible to abuse by unscrupulous individuals. A basic understanding of medical and psychological issues by the first responder is essential in order to identify an individual who is being abused or is at risk of being abused. Once the first responder properly identifies abuse, he/she must consider the legal requirements imposed upon them and the various methods available in dealing with the situation. Therefore, the curriculum also included education on elder abuse statutes and information that, if collected or documented by the first responder, would aid in stopping the abuse and prosecuting of the person committing the abuse. In closing, the curriculum also emphasized the various referral services that are available to the first responder that might prevent abuse in "high risk" situations and provide support for the older adult. The entire curriculum emphasized the need for the first responders to coordinate the various services that offer a successful solution to the problem. This multi-disciplinary curriculum was developed by the C.O.P.P.S. Unit along with Los Angeles County Department of Mental Health and legal professionals who were intimately involved in the process and part of the # Elder Abuse Intervention an. suca iCta for"the first Responder partnerships established at the early stages of this process. The curriculum was submitted to the California Commission on Peace Officer Standards and Training (P.O.S.T.) for training certification. After weighing the need for statewide elder abuse interdiction, approval was given for continuing education/training credit for Iaw enforcement professionals. Prior to implementing this project, one other obstacle had to be overcome. Although numerous people expressed support for this unique concept, funding was not available from traditional sources. The C.O.P.P.S. Unit applied for city grants and presented financial proposals to county and state officials and several grant resources. However, elder abuse was not the "area of interest" for most foundations. Eventually, the C.O.P.P.S. Unit and its partners were able to garner the support of Los Angeles County Supervisor Michael Antonovich who was able to assist in providing some of the funding for this program. The remainder of the funding and resources were obtained through the generosity of businesses within our local community. With everyone's combined efforts, preparation for our 8 -hour seminar commenced. Invitations were sent to all fire, police and code enforcement agencies in Los Angeles County, as well as several social service organizations, which netted an overwhelming response. Arrangements for the seminar were extensive and included preparing a reference/resource binder, a PowerPoint presentation, speeches, curriculum, and a facility in which to hold the seminar. ![img-12.jpeg](https://popdatasets.blob.core.windows.net/popdatasetmdimgs/01-25/img-12.jpeg) First Responders Training conference In order to gather and maintain a high interest level, we worked closely with the Los Angeles District Attorney's Office, Los Angeles County Mental Health Department and a consultant with expertise both in law enforcement and psychology to produce an informative and useful seminar. During the last quarter of the calendar year 2000, the initial planning culminated in a seminar wherein the curriculum was presented to 180 participants representing law enforcement, fire, paramedics, code enforcement, and social service agencies throughout Los Angeles County. Furthermore, each participant received an assessment protocol and a binder containing both educational and resource material. Additionally, the C.O.P.P.S. Unit developed a public service announcement and a "Caring Caller Program." The public service announcement was aired on Glendale's cable station and viewed by neighboring cities. The service announcement portrayed the verbal abuse of an older adult and reached out to the community to contact the Glendale Police Department for assistance in suspected cases. The Caring Caller Program, which was designed in conjunction with the City of Glendale Parks, Recreation and the Community Services Department, has volunteers designated to call seniors who are homebound and enjoy a caring phone call. Each volunteer calls the same senior each week during their shift and checks on the senior's well being and provides companionship to the senior. # ASSESSMENT In order to assess the effectiveness of the training conference each participant was given an evaluation form to complete. The evaluation asked the participants to evaluate not only the conference itself, but to give an indication of the usefulness of the information presented in the seminar. Generally speaking, the evaluations indicated that the conference was well organized and the vast majority of the participants found the information useful in their professional capacity. Furthermore, most participants felt that the assessment protocol provided an easy, useful and standardized method to assess situations involving older adults. They further recommended that additional seminars be given to further disseminate this information. A second evaluation form was mailed to conference participants. The results indicated that the information provided was useful and was actually being used in the field to identify and resolve problems. Most of the responses, again, voiced the opinion that the training was extremely valuable, the training program should be expanded, and would recommend the program to other co-workers. Since the seminar, the C.O.P.P.S. Unit continues to maintain contact with its partnered agencies to determine if the goals of identifying at risk older adults and providing appropriate services to prevent or stop cases of abuse are being met. As a result of our combined efforts with the seminar, Los Angeles County Department of Mental Health indicated changes in their operations have been made. Both G.E.N.I.S.I.S. and the 24-hour hotline have realized an increase in referrals from first responders as a result of our seminar. The Los Angeles County Department of Mental Health is pleased with the results and firmly states that an increase in the number of older adults at risk of being abused are being identified and are receiving needed services from mental health, law enforcement, and community based programs. Verdugo Hills Hospital is located within our community and provides specialized services to older adults. In terms of evaluating this program, Verdugo Hills Hospital indicated they have received an increase in the number of referrals (many from Glendale Police and Fire Departments), which has prompted the provision of appropriate mental health and medical services to more individuals at an earlier stage. This has reduced the amount of time spent by local law enforcement and fire personnel dealing with specific situa- ![img-13.jpeg](https://popdatasets.blob.core.windows.net/popdatasetmdimgs/01-25/img-13.jpeg) Community Partners tions, improved the quality of life for many older adults, and dealt with situations at an earlier stage thereby preventing cases of abuse. At this stage in the process, the C.O.P.P.S. Unit has provided training to all personnel in both the Police and Fire Departments (note - Code Enforcement Inspectors were able to attend the initial seminar). In addition to providing this program within our own jurisdiction, the C.O.P.P.S. Unit and the Los Angeles County Department of Mental Health have received requests from the Los Angeles County Sheriff's Department, County of Ventura, Port Hueneme Police Department, Arcadia Police Department, Monrovia Police Department, Seal Beach Police Department, Manhattan Beach Police Department, and Hermosa Beach Police Department to train their personnel so that the respective departments can obtain the benefits provided to those who have already participated in this program. Based upon the review of the evaluations and anecdotal information provided after implementing this program, it appears that the basic goals of the program have been met. Older adults who were at risk of being abuse or who in fact are being abused have been identified and the appropriate services have been contacted. This has resulted in a reduction in the amount of time first responders must devote in dealing with this issue and has improved the quality of life for the older adults involved. Based upon requests to continue and expand the program, the C.O.P.P.S. Unit in conjunction with its partners, are pursuing funding sources (both public and private) to accommodate the expansion of this program. The expansion of the program will benefit a wider segment of the community and permit a system for dealing with the issue of elder abuse with the goal of being in place as the older adult population continues to grow. # AGENCY AND OFFICER INFORMATION Since its introduction to the Department in 1994, under Police Chief James Anthony, community policing was raised to the forefront in policing efforts in the City of Glendale. Two line level officers were assigned to develop community policing. Since that time, and with the encouragement of our current Chief of Police Russell K. Siverling, the C.O.P.P.S. Unit has been increased to include twelve Police Officers, three Community Service Officers, and two Sergeants. This community-oriented team is committed to developing long-term solutions to community problems. As is its charge, the C.O.P.P.S. Unit identified a growing city-wide problem and decided to create the Elder Abuse Intervention and Education for the First Responder Program. Using the SARA Model, the C.O.P.P.S. Unit created partnerships with city and local government agencies and relied upon county and private funding sources. The C.O.P.P.S. Unit committed two Police Officers and one Community Service Officer to perform the numerous tasks required to implement the city-wide program. Once the Elder Abuse Intervention and Education for the First Responder program was developed, training was provided for all ranks within the Police and Fire Departments and Code Enforcement personnel in the City of Glendale (subsequently, the program expanded to include Los Angeles County). All participants were instructed on the identification of older adults being abused or at the risk of being abused and were given a resource binder and a pocket assessment protocol tool to assist them in the field. After assessing the program and interviewing the partners involved with its development, the C.O.P.P.S. Unit has determined the basic goals of the program have been met. The Unit concluded that the program reduced the amount of time first responders devote to dealing with older adult issues and has improved the quality of life for the older adults in the City of Glendale and communities of Los Angeles County. | Name: | Lisa Muzquiz | | :-- | :-- | | Position/Rank: | Community Police Partnership/Agent | | Address: | 140 N. Isabel | | City/State: | Glendale, California 91206 | | Telephone: | $(818) 548-4015$ | | Fax: | $(818) 409-7013$ | | E-mail: | lmuzquiz. ci.glendale. ca. us | ![img-14.jpeg](https://popdatasets.blob.core.windows.net/popdatasetmdimgs/01-25/img-14.jpeg) Average annual growth rate (in percent) of the elderly population