Coordinated team action best addresses elder abuse

The Cornell Chronicle reports on a recent publication, co-authored by BCTR director Karl Pillemer, outlining the likely traits of victims and perpetrators of elder abuse and the best approach to addressing the problem. The findings from the review of current research suggests that a team approach is most effective:

As many as one out of 10 people age 60 and older will experience some kind of abuse, most often in the form of financial exploitation, says a new Cornell study. Prevalence rates were previously thought to be 4 percent to 6 percent.

“It’s not that the rate of elder abuse has gone up. It’s that with improved research, we now know definitively that this is a very serious public health problem,” said Karl Pillemer, the Hazel E. Reed Professor in the Department of Human Development and a professor of gerontology in medicine at Weill Cornell Medicine.

“Elder Abuse,” appearing Nov. 11 in The New England Journal of Medicine, pulls together research from 46 studies from around the world. Pillemer is co-author with Mark Lachs, professor of medicine and co-chief of the Division of Geriatric and Palliative Medicine at Weill Cornell Medicine.

A profile of those likely to be abused also has emerged, the authors say. At greatest risk are women and elders with physical or cognitive impairments, low incomes or dementia. Those who live with others, such as a spouse or adult children, are also at higher risk; people who live alone are much less likely to be abused because there is simply less opportunity for abuse. On the other side of the coin, perpetrators tend to have mental illness and abuse substances.

“So you can get a picture of an older woman, who is beginning to experience an impairment, lives with a relative (who is likely to be the abuser) and otherwise is socially isolated, and may have some form of dementia. The perpetrator has their own problems. That is what elder abuse looks like,” Pillemer said.

The abuse can take many forms: physical, sexual, psychological or verbal mistreatment, as well as financial exploitation and neglect. The study found that in nursing homes, there are high rates of violence and aggression toward older adults. In particular, residents abusing other residents is more common than staff mistreating residents.

The findings also suggest that doctors play a crucial role in recognizing abuse and intervening, said Lachs. “A physician may be the only person who ever gets the chance to detect elder abuse, because these people can become so socially isolated with just the abuser that often no one else sees them,” he said. And given the prevalence of the problem, a doctor who is seeing 20 patients per day could see several potential victims of elder abuse per week, he added.

Simply removing the victim from their situation rarely works. Some older people, if they have no other choice, would prefer to rely on an abusive caregiver who is also providing care than have to move out of their home or into a nursing home, Pillemer said. “These cases are often unbelievably difficult to resolve. It’s hard for an agency to resist the temptation to move the person into the nursing home. Usually that’s not what the older person wants, and often it’s not the most appropriate place for them.”

Instead, doctors can be most helpful by spearheading a multidisciplinary team of nurses, social workers, hospitals, police, district attorneys and lawyers to help victims get the services they need. One of the paper’s strongest recommendations is for each city to create this type of team. “It’s a simple intervention, but it turns out to really work wonders,” Pillemer said. “The expression ‘It takes a village’ is true for the prevention of elder abuse.”

 

Experts recommend team approach to thwart elder abuse - Cornell Chronicle
Nursing home residents abusing one another and scammers ripping off the elderly, new study finds - Daily News

Networking event on pain in later life sparks new connections

TRIPLL co-director Elaine Wethington speaking with Information Sciences grad student Alex Adams (l) and Communications associate professor Jeff Niederdeppe (r)

On October 21^st the Translational Research Institute on Pain in Later Life (TRIPLL) hosted a networking event for over 30 invited researchers at the Statler Hotel on Cornell campus.  TRIPLL, an NIH-funded Edward R. Roybal Center, fosters multidisciplinary collaborations among researchers from Weill Cornell Medical College, faculty at Cornell’s Ithaca Campus, Cornell Tech, and the Bronfenbrenner Center for Translational Research (BCTR), with the goal of understanding and treating pain in older adults.

An introduction by TRIPLL director Cary Reid (Weill Cornell Medical College) noted key challenges in the field. “Up to half of all older adults live with chronic pain,” Reid said, “but diagnostic and treatment approaches have yet to catch up to this reality.” To address this concern, Reid highlighted a range of resources offered by TRIPLL to engage new researchers in the field, including pilot funding, webinars, feedback on project proposals, matchmaking with potential collaborators, and access to participant populations.

“Promising new approaches to treat pain may come from wide variety of fields,” said TRIPLL co-director and interim BCTR director Elaine Wethington. She continued, “for this event we reached out to researchers in social, behavioral, economic, environmental, biological, communication, and information sciences. Basic scientists can sometimes feel daunted when trying to extend their work to clinical settings and patient populations. TRIPLL provides the guidance and resources to help secure study participants.”

Current and past TRIPLL pilot investigators spoke about the support TRIPLL gave them, helping them secure local and federal support for their research.

The midlife crisis myth

Elaine Wethington

Do a significant number of people experience stress about aging in midlife, leading to sudden life changes and sports car purchases? They do not, according to a new study. A recent post on psychologytoday.com explains that there is no evidence that people experience greater stress or more major life changes in midlife as opposed to other ages. BCTR acting director Elaine Wethington is referenced in the post, further clarifying another factor that may lead to belief in the myth of the midlife crisis:

Cornell University sociologist Elaine Wethington talks about the midlife crisis as a case of “expected stress.” You think everyone will have a midlife crisis so you feel you have to fit into the mold. If you don't, you think there's something wrong with you.

Worried about a midlife crisis? Don't. There's no such thing. - Psychology Today

Pillemer in the NY Times on blooming in later life

Karl Pillemer

A recent New York Times article dispels the myth that a person's best creative, professional, or even physical accomplishments are necessarily confined to the younger years. Many are finding success and satisfaction in their 60s and later, perhaps due to experience gained and an openness to try new things in the later stages of life.

BCTR director Karl Pillemer, a gerontologist whose Legacy Project gathers wisdom from elders, is quoted in the article:

We absolutely have to revamp this idea of a linear pattern of accomplishment that ends when you’re 50 or 60. There are simply too many examples of people who bloom late, and it’s the most extraordinary time of their life...There was this feeling of somehow ‘getting it right’ at 50 or 60 or older.

Finding success, well past the age of wunderkind - New York Times

New book: “Thirty Lessons for Loving” by Karl Pillemer

30 Lessons for Loving: Advice from the Wisest Americans on Love, Relationships, and Marriage uses data and stories from the most detailed survey of long-married people ever conducted to show the way to lifelong, fulfilling relationships. Author and incoming BCTR director Karl Pillemer presents this sage advice from the oldest and wisest Americans on everything from finding a partner, to deciding to commit, to growing old together. The new book, out in January, follows the success of Pillemer’s 30 Lessons for Living, which offered life advice across various areas (work, family, money,etc.). Pillemer is also Hazel E. Reed Professor in the Department of Human Development and Professor of Gerontology in Medicine at the Weill Cornell Medical College.

In an article in Cornell Alumni Magazine, Pillemer explains why advice from this group is so important and can be so helpful to younger generations,

They're looking back from the finish line; it's no longer a mystery how things are going to turn out. These are people who've been through just about everything that keeps young people awake at night, and they're still doing okay. They're living examples that a lot of what we worry about is actually resolvable—that with resilience, drive, and flexibility, you can still be happy, even though bad things sometimes happen to you.

The book is already garnering media attention, including an interview on CBS This Morning (video below). Pillemer will give a book talk on 30 Lessons for Loving on Wednesday, February 25th at 4:00pm in Room 160 Mann Library, Cornell campus.

The book trailer:

Pillemer on CBS This Morning:

Secrets to a successful marriage from 700 retirees - CBS This Morning
Heart to heart - Cornell Alumni Magazine
It's never to late for love, according to gerontology research - Cornell Chronicle
Inside Cornell: Karl Pillemer's "30 Lessons for Loving" - CornellCast
The love advice that shocked expert Karl Pillemer - Huffington Post
Romantic advice from highly experienced practitioners - Sarasota Herald Tribune
Hundreds of retirees share secrets to a happy marriage - USA Today
Forget 'gray divorce': Here's how to make love last - The Wall Street Journal

TRIPLL’s National Institute on Aging funding renewed

The BCTR's Translational Research Institute for Pain in Later Life (TRIPLL) has received a five-year, $1.95 million renewal grant from the National Institute on Aging. In this next phase, TRIPLL adds a focus on behavior change science, applying insights from psychology, sociology, economics, and communications to develop optimal pain management techniques. TRIPLL investigators also plan to explore how new communication tools, including social media and smartphones, can be harnessed to manage pain.

TRIPLL co-director Karl Pillemer notes,

In spite of how widespread chronic pain is among older adults, there are relatively few tested interventions to help people reduce their pain. Our new focus is exciting because we hope to translate findings into more effective interventions by deepening our understanding of human behavior and decision-making.

TRIPLL, based in New York City, is one of 12 national Edward R. Roybal Centers for Translational Research on Aging. TRIPLL unites social and psychological scientists at Cornell’s Ithaca campus, Weill Cornell Medical College researchers, and community-based health care partners.

Funding renewed for aging and pain research center - Cornell Chronicle

Talks at Twelve: Karl Pillemer

Talks at Twelve: Karl Pillemer, Thursday, October 23, 2014

Resident-to-Resident Elder Mistreatment in Nursing Homes: Findings from the First Prevalence Study
Karl Pillemer, Human Development, Cornell University

Thursday, October 23, 2014
12:00PM-1:00PM
Beebe Hall, 2nd floor conference room

This talk is open to all. Lunch will be served. Metered parking is available in the Plantations lot across the road from Beebe Hall.

Over the past two decades, a growing body of research has addressed abuse experienced by older persons in long-term care facilities. This literature has focused primarily on mistreatment of residents by staff; but preliminary research and clinical experience suggest that residents are at much greater risk of aggression from other facility residents. In his talk, Karl Pillemer will report findings from the first large-scale study of Resident-to-Resident Elder Mistreatment (R-REM), which identified incidents of R-REM in 10 long-term care facilities (1903 residents) over a 2-4 week observation period. Using multiple methods, the study provides the prevalence rate of overall R-REM and specific subtypes: physical, verbal, sexual and others, as well as main correlates of R-REM.

Karl Pillemer, Ph.D., a sociologist and gerontologist, is the Hazel E. Reed Professor of Human Development in the College of Human Ecology and a Professor of Gerontology in Medicine at Weill Cornell Medical College. He has a career-long interest in issues related to elder abuse and neglect, including conducting the first prevalence studies of elder mistreatment in the community and in nursing homes. He also has a program of research on the quality of care in nursing homes, examining how staff characteristics and environmental factors affect the delivery of care and resident outcomes. Dr. Pillemer has developed and evaluated a number of intervention programs aimed at improving care provided by staff, and is the co-principal investigator of an NIH-funded study of resident-to-resident elder mistreatment in nursing homes.

Overcoming older African Americans’ reluctance to participate as research subjects

Myra Sabir, former Bronfenbrenner Life Course Center postdoctoral fellow and assistant director, is the primary author of a recent article in The Journal of Aging Studies on the difficulties of recruiting older African Americans as research subjects. The BCTR's Karl Pillemer is co-author.

The paper's abstract:

Well-known trust-building methods are routinely used to recruit and retain older African Americans into scientific research studies, yet the quandary over how to overcome this group's hesitance to participate in research remains. We present two innovative and testable methods for resolving the dilemma around increasing older African Americans' participation in scientific research studies. Certain specific and meaningful experiential similarities between the primary researcher and the participants, as well as clear recognition of the elders' worth and dignity, improved older African Americans' willingness to adhere to a rigorous research design. Steps taken in an intervention study produced a potentially replicable strategy for achieving strong results in recruitment, retention and engagement of this population over three waves of assessment. Sixty-two (n = 62) older African Americans were randomized to treatment and control conditions of a reminiscence intervention. Sensitivity to an African American cultural form of respect for elders (recognition of worth and dignity), and intersections between the lived experience of the researcher and participants helped dispel this population's well-documented distrust of scientific research. Results suggest that intentional efforts to honor the worth and dignity of elders through high level hospitality and highlighting meaningful experiential similarities between the researcher and the participants can improve recruitment and retention results. Experiential similarities, in particular, may prove more useful to recruitment and retention than structural similarities such as age, race, or gender, which may not in themselves result in the trust experiential similarities elicit.

An intensely sympathetic awareness: Experiential similarity and cultural norms as means for gaining older African Americans' trust of scientific research - Journal of Aging Studies

Boomers pioneer new retirement housing trends

A recent article on Yahoo! Finance reports that, according to the National Association of Home Builders, almost one fourth of remodelers surveyed last year were doing work so that boomers could age in place. The BCTR's Elaine Wethington, co-director of the Translational Research Institute on Pain in Later Life, was quoted in the article,

For many, the desire to age in place stems from the difficulty boomers have had in caring for their own elderly parents who lived far away. Such long-distance relationships have left many adult children feeling “stressed and powerless,” says Elaine Wethington, a sociology professor who directs the Translational Research on Aging Center at Cornell University. By remaining close to their own kids, boomers are hoping to make things easier as they age.

Boomers pioneer new retirement housing trends - Yahoo! Finance