Elder abuse prevention through enhanced caregiver support: a qualitative case study of the COACH intervention

The Comprehensive Older Adult and Caregiver Help (COACH) intervention, evaluated in a randomized controlled trial (RCT) by [Author(s)] et al. (2024), achieved an unexpected outcome: during the three months after the intervention, no caregivers in the treatment group self-reported elder mistreatment (EM), compared to 23.1% in controls, despite no significant reduction in measured caregiver risk factors such as burden, depression, or anxiety. To explore factors that may have contributed to this outcome, we conducted a case study with three COACH care coaches and their supervisor, supplemented by 100 post-visit notes and six pages of supervisory meeting notes. Thematic analysis identified three elements perceived as central to COACH's impact: tailored, person-centered support; care navigation and resource provision; and culturally responsive, iterative caregiver education. Findings suggest that relational support may mitigate EM risk even when measured risk factors do not change, underscoring the need for theory-informed frameworks to guide caregiver-focused prevention strategies.