Four models of medical education about elder mistreatment

The authors describe four models of incorporating elder-mistreatment curricular content and collaboration with adult protective service (APS) community service agencies into geriatrics medical education. Geriatrics education programs at four academic health centers-the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School; the University of California, Irvine College of Medicine; Hennepin County Medical Center, Minneapolis, Minnesota; and Baylor College of Medicine Geriatrics Program at the Harris County Hospital District, Houston, Texas-were surveyed and information collated. All programs incorporated direct interactions between learners and APS workers into their teaching programs. Learners were fellows, residents, and medical students. While two programs provided direct patient care, two others restricted learners to consultant roles, supporting the APS service providers with medical input. In addition to directly meeting curricular training needs of elder abuse and neglect, clinical cases provided valued learning experiences in applied clinical ethics, the role of physicians with community-based programs, the interaction between the medical and legal professions in cases of financial exploitation, and assessment of elder individuals' decision-making capacity. In two programs APS workers also contribute to the assessment of trainees' humanistic competencies. The authors conclude that APS community service agencies can successfully be incorporated into medical training programs to address a wide range of curricular goals.