TEAM Institute Clinical Division

TEAM has provided medical and mental health assessments for more than 3,000 mistreated older adults that have been referred after Adult Protective Services substantiated reports of abuse, neglect and/or exploitation since it's inception in 1997.  Below is a diagram of the TEAM Institute Clinical Program services.

  

The TEAM clinical assessment process involves:

  • Adult Protective Service investigation
  • Targeted geriatric assessment, including:
    • Mobility
    • Mood
    • Memory
    • Medications
    • Medical and social history
    • Mental health capacity
  • Joint APS and medical team intervention and care planning

This approach has been recognized nationally and replicated in Louisiana and Ohio through funding by the U.S. Department of Justice. In 2014, TEAM expanded its clinical assessment program statewide and now also provides in-home and telehealth assessments.  TEAM faculty also conduct forensic assessments of facility cases by records review.

 

  • Clinical Division

    TEAM Institute Clinical Division

    TEAM has provided medical and mental health assessments for more than 3,000 mistreated older adults that have been referred after Adult Protective Services substantiated reports of abuse, neglect and/or exploitation since it's inception in 1997.  Below is a diagram of the TEAM Institute Clinical Program services.

      

    The TEAM clinical assessment process involves:

    • Adult Protective Service investigation
    • Targeted geriatric assessment, including:
      • Mobility
      • Mood
      • Memory
      • Medications
      • Medical and social history
      • Mental health capacity
    • Joint APS and medical team intervention and care planning

    This approach has been recognized nationally and replicated in Louisiana and Ohio through funding by the U.S. Department of Justice. In 2014, TEAM expanded its clinical assessment program statewide and now also provides in-home and telehealth assessments.  TEAM faculty also conduct forensic assessments of facility cases by records review.

     

  • Education Division

    TEAM Education Division

    TEAM is a multidisciplinary collaboration between the Harris Health System, Adult Protective Services (APS), and the University of Texas Health Science Center at Houston (UTHealth).

    As part of its education outreach, TEAM has provided professional education to social workers, medical students, community agencies, legal/judicial entities, universities, home health agencies, hospice agencies, civic clubs, law enforcement and state and federal governmental agencies about the reality of elder abuse. 

    Members of TEAM have been guest lecturers at Annual APS Conferences in San Antonio, Texas and the Older Adult Conferences sponsored by TEAM during Elder Abuse awareness month each May in Houston. 

    As members of TEAM, APS and UTHealth present annual trainings to law enforcement officers in Houston to help them identify signs and indicators of elder abuse when they are in the field. The officers are educated on the protocol to follow when abuse is identified and needs to be reported.

    TEAM members have given presentations and lectures on Elder Abuse and TEAM involvement to medical students from both McGovern Medical School at UTHealth and Baylor College of Medicine.  As part of the TEAM educational component, workers from APS have taken students from McGovern and Baylor into the field to observed APS clients in the community.  This experience gives students an opportunity to meet with victims of abuse and neglect in the field and to observe how APS identifies abuse and works to alleviate this problem in the community. 

    TEAM has given guest lectures on Elder Abuse to geriatric social work students through the Graduate College of Social Work at the University of Houston-Central Campus.

    Interdisciplinary panels from TEAM have discussed Elder Abuse and case scenarios and solutions with medical students and professors from UTHealth through the Houston Geriatric Educational Center in Houston.

    • In 2000, the Department of Justice (DOJ) funded a curriculum for physicians.  It is available online at no cost.  The curriculum includes both trainer and participant manuals.
    • From 2009 - 2015 Health Resources and Services Administration (HRSA) funded a Houston Geriatric Education Center that trained over 26,000 individuals, with an emphasis in elder abuse.
    • In 2009, the Reynolds Foundation funded a geriatric training grant for four years.  One part of this grant involved training medical teams around Houston to intervene in cases of elder mistreatment.  This grant impacted 13,345 learners.

    If your Houston area-based organization is interested in scheduling a presentation to learn more about these aspects of elder abuse and self-neglect and the services provided by TEAM and Adult Protective Services, please contact Leslie Clark at 713-873-4683 or Leslie.E.Clark@uth.tmc.edu.  

  • Research Division

    Current and Past Grant Support

    The National Institute of Justice Office for Victims of Crimes:  2014-2016

    • Exploring Elder Financial Exploitation Victimization: Identifying Unique Risk Profiles and Factors to Enhance Detection, Prevention and Intervention

    The U.S. Department of Health and Human Services - Administration on Aging:  2012-2016

    • Intervention to Reduce Medication Non-Adherence in Community-Dwelling Elders Who Self-Neglect

    Albert and Ethel Herzstein Charitable Foundation Geriatric Studies for Junior Faculty Program:  2012-2014

    • Estimating Differential Mortality Rates for Elder Mistreatment and Self-Neglect Types: A Road to More Efficient Service Delivery

    Agency for Healthcare Research and Quality (AHRQ):  2010-2012

    • Multidimensional Assessment of Elder Self-neglect

    National Institute on Aging (NIA):  2009-2011

    • Vitamin D Replacement in Vulnerable Older Adults

    Borchard Foundation Center on Law and Aging: 2009

    • Forensic Markers and Risk Factors for Death Associated with Cases Reported to Adult Protective Services

    National Institutes of Health (NIH):  2005-2008

    • Consortium for Research in Elder Self-Neglect of Texas (CREST)

    TEAM Publications

    Books:

    Brandl B, Dyer CB, Heisler CJ, Otto J, Stiegel L, Thomas R: Elder Abuse Detection and Intervention: A Collaborative Approach.  2006 Springer.

    Chapters

    Chapter editor – “Delirium, Dementia and Other Cognitive Disorders”, Psychiatric Mental Health Nursing, Mosby-Year Book, Inc.

    Dyer CB, Silverman E, Nguyen T, McCullough L: “Ethical Patient Care”, A Casebook for Geriatric Health Care Teams, Cassell, Mezey, and Fulmer eds. January 2002.

    Spencer J, Hersch G, Shelton M, Ripple J, Spencer C, Dyer CB, Murphy K.: "Functional Outcomes and Daily Life Activities of African-American Elders After Hospitalization" Geriatric Issues in Occupational Therapy, Corcoran MA, ed. AOTA Press, Maryland, 2003.

    Dyer CB, Kim LC: "Elder Mistreatment: Abuse, Neglect, & Exploitation" Current Geriatric Diagnosis & Treatment, Landefeld, Palmer, Johnson, Johnston, and Lyons eds. McGraw-Hill, 2004.

    Mehta MM, Dyer CB: “A Practical Approach to Elder Abuse, Neglect, and Exploitation”, Practice of Geriatrics, 4th Edition, 2007.

    Kim L, Dyer CB: “Assessment of older adults in their home.” Handbook of Geriatric Assessment, Gallo, Fulmer, Paveza and Bogner, eds. Jones and Bartlett, Publisher, Inc. 2005.

    Dyer CB, Regev M, Whitmore SP: “Older Adults in Disasters”. Geriatric Education for Emergency Medical Services. AGS and the National Council of State EMS Training Coordinators. American Geriatrics Society and Jones and Bartlett Publishers, Inc., 2007.

    Ostwald, Sharon & Dyer, Carmel (2011) Fostering resilience, promoting health, and preventing disease in older adults (Chapter 3, pp. 48-86) in Introduction to Gerontology (Ed: Ian Stuart-Hamilton), Cambridge, UK: Cambridge University Press.

    Dyer, Carmel & Ostwald, Sharon (2011) Ageing and Health:  Managing co-morbidities and functional disability in older people (Chapter 4, pp. 87-125) in Introduction to Gerontology (Ed: Ian Stuart-Hamilton), Cambridge, UK: Cambridge University Press.

    Reyes-Ortiz CA, Burnett J, Flores DV, Halphen JM, Dyer CB. Medical implications of elder abuse: self-neglect. Clin Geriatr Med. 2014 Nov;30(4):807-23.

    Burnett J, Achenbaum WA, Murphy KP. Early Identification and Prevention of Elder Abuse.  Clin Geriatr Med. 2014 Nov; 30(4):743-759.

    Papers

    Monograph on Elder Abuse and Neglect, the Texas Medical Association, November 1998.

    Dyer CB, Hyman DJ, Pavlik V, Murphy KP, Gleason MS: Elder Neglect: A Collaboration Between a Geriatrics Assessment Team and Adult Protective Services. Southern Medical Journal. 92(2):242-244. 1999.

    Dyer CB, Pavlik VN, Portal B, Hyman DJ, Barth J, Murphy KP, Gleason MS: A Case Study of Abused or Neglected Elders Treated by an Interdisciplinary Geriatric Team. Journal of Elder Abuse and Neglect. 10(3/4):131-139. 1999.

    Dyer CB, Goins A: The Value of Interdisciplinary Teams in the Management of Elder Abuse and Neglect. Generations, 24(2):23-27, 2000.

    Dyer CB, Pavlik VN, Murphy KP, Hyman DJ: The high prevalence of depression and dementia in elder neglect. Journal of the American Geriatric Society, 48(2):205-208, 2000.

    Vicioso B, Dyer CB: Elder mistreatment – What should dentists know? Texas Dental Journal, October 2000.

    Discussion Elder Justice: Medical Forensic Issues Concerning Abuse and Neglect. National Institute of Justice, Washington, D.C., October 18, 2000. Available: http://www.ojp.usdoj.gov/nij/elderjust

    Pavlik VN, Festa NA, Hyman DJ, Dyer CB: Quantifying the problem of abuse and neglect in adults-analysis of a statewide database. Journal of the American Geriatrics Society, 49:45-48, 2001.

    Harrell R, Toronjo C, Pavlik VN, Hyman DJ, McLaughlin J, Dyer CB: How geriatricians identify elder abuse and neglect. Am J of Med Sci, 323(1):34-38, 2002.

    Heath JM, Dyer CB, Kerzner LJ, Mosqueda L, Murphy C: Four models of medical education about elder mistreatment. Acad Med, 77(11):1101-1106, 2002.

    Dyer CB, Connolly MT, McFeeley P: The medical forensics of elder abuse and neglect in elder mistreatment: Abuse, neglect and exploitation in an aging America. Bonnie and Wallace eds. National Academic Press, pp. 339-381, 2002.

    Fisher JW, Dyer CB: The hidden health menace of elder abuse. Postgrad Med, 113(4):21-24,30, 2003.

    Fulmer T, Dyer CB, Connolly MT, Guadango L: Progress in elder abuse assessment instruments. J Am Geriatr Soc 52(2):297-304, 2004.

    Jogerst GJ, Brady MJ, Dyer CB: Elder abuse and law: New science, new tools. J. Law Med Ethics, 32(4 Suppl):62-63, 2004.

    Dyer CB, Heisler CJ, Hill CA, Kim LC: Community approaches to elder abuse. Clin Geriatr Med, 21(2):429-447, 2005.

    Dyer CB, Pavlik VN, Toronjo C, Cunningham M, Poythress EL, Searle N, Hyman DJ: The Key Elements of Self-Neglect. Journal of Abuse and Neglect. 17(4):1-10, 2005.

    Dyer CB: Neglect Assessment in Elderly Persons, invited editorial. J Gerontol A Biol Sci Med Sci., Aug 60(8):1000-1, 2005.

    Brandl B, Dyer CB, Heisler CJ, Otto J, Stiegel L, Thomas R Enhancing Victim Safety Through Collaboration. Journal of Care Management, 13(4):64-72, 2006.

    Smith SM, Mathews Oliver SA, Zwart SR, Kelly PA, Goodwin JS, and Dyer CB: Nutritional status assessment of the self-neglecting elderly. J Nutrition.136(10):2534-41, 2006.

    Dyer CB, Prati LL. Self-Neglect: On the CREST of New Discoveries: Introduction. J Elder Abuse Negl 2006;18(4):1-3.

    Poythress EL, Burnett J, Naik AD, Pickens S, Dyer CB. Severe Self-Neglect: An Epidemiological and Historical Perspective. J Elder Abuse Negl 2006; 18(4):5-12.

    Dyer CB, Kelly PA, Pavlik VN, Lee J, Doody RS, Regev T, Pickens S, Burnett J, Smith SM. The Making of a Self-Neglect Severity Scale, J Elder Abuse Negl 2006; 18(4):13-23.

    Burnett J, Coverdale J, Pickens S, Dyer CB. What is the Association Between Self-Neglect, Depressive Symptoms and Untreated Medical Conditions? J Elder Abuse Negl 2006; 18(4):25-34.

    Burnett J, Regev T, Pickens S, Prati LL, Aung K, Moore J, Dyer CB. Social Networks: a profile of the elder who self-neglect. J Elder Abuse Negl 2006; 18(4):35-49.

    Pickens S, Burnett J, Naik AD, Holmes HH, Dyer CB. Is Pain a     Significant Factor in Elder Self-Neglect? J Elder Abuse Negl 2006; 18(4):51-61.

    Aung K, Burnett J, Smith SM, Dyer CB. Vitamin D Deficiency associated with Self-Neglect in the Elderly. J Elder Abuse Negl 2006; 18(4):63-78.

    Naik AD, Pickens S, Burnett J, Lai JM, Dyer CB. Assessing Capacity in the Setting of Self-Neglect: Development of a novel screening tool for decision making capacity. J Elder Abuse Negl 2006; 18(4):79-91.

    Pickens-Pace, S., Naik, A., Burnett, J., Kelly, P.A., Gleason, M., Dyer, CB. “The Utility of the KELS Test is Associated with Substantiated Cases of Elder Self-neglect”. J Am Acad Nurse Prac 2007;19(3):137-142.

    Dyer CB, Pickens S, Burnett J. “Vulnerable elders: When it is no longer safe to live alone”. JAMA, 2007 September 26;298(12):1448-50.

    Dyer CB, Goodwin JS, Vogel M, Regev T, Pickens-Pace S, Burnett J, Baum GP, Kelly PA. Characterizing Self-neglect: A Report of Over 500 Cases Seen By a Geriatric Medicine Team. Amer J Public Health, 2007 Sept; 97(9):1671-6.

    Franzini L, Dyer CB. “Health care costs and utilization of vulnerable elders reported               to adult protective services for self-neglect”, Journal of the American Geriatrics Society. 2008;56(4):667-76.

    Naik NA, Burnet J, Pickens S, Dyer CB. Impairment in instrumental activities of daily living and the geriatric syndrome of self-neglect. Gerontologist. 2008 Jun;48(3):388-93.

    Naik NA, Lai JM, Kunik M, Dyer CB. Assessing capacity in suspected cases of self-neglect. Geriatrics. 2008 Feb;63(2):24-31.

    Naik AN, Teal CR, Pavlik VN, Dyer CB, McCullough LB. Conceptual Challenges and Practical Approaches to Screening for Capacity for Self Care and Protection in Vulnerable Adults. Journal of the American Geriatrics Society 2008, S266-270.

    Dyer CB, Franzini L, Watson M, Sanchez L, Prati L, Mitchell S, Wallace R, Pickens S. Future research: a prospective longitudinal study of elder self-neglect. J Am Geriatr Soc. 2008 Nov;56 Suppl 2:S261-5. Review.

    Kelly PA, Dyer CB, Pavlik V, Doody R, Jogerst G. Exploring self-neglect in older adults: preliminary findings of the self-neglect severity scale and next steps. J Am Geriatr Soc. 2008 Nov;56 Suppl 2:S253-60. Review.

    Dyer CB, Marcus M, Burnett J. Introduction: the consortium for research in elder self-neglect. J Am Geriatr Soc. 2008 Nov;56 Suppl 2:S239-40.

    Naik AD, Dyer CB, Kunik ME, McCullough LB. Patient Autonomy for the Management of Chronic Conditions: A two-component re-conceptualization. American Journal of Bioethics. 2009,9(2):23-30. IF 3.93.

    Naik AD, Dyer CB, Kunik ME, McCullough LB. Response to Commentaries on Patient Autonomy for the Management of Chronic Conditions: A two-component re-conceptualization. American Journal of Bioethics. 2009,9(2):W3-W5.

    Dong X, Simon M, Mendes de Leon C, Fulmer T, Beck T, Hebert L, Dyer C, Paveza G, Evans D. Elder self-neglect and abuse and mortality risk in a community-dwelling population. JAMA. 2009 Aug 5; 302(5):517-26.

    Burnett J, Cully J, Achenbaum WA, Dyer CB, Naik A. Assessing Self- Efficacy for safe and independent living: a cross-sectional study in vulnerable older adults. Journal of Applied Gerontology. First Published April 22, 2010 Online.

    Burnett J, Dyer C, Naik A. Convergent validation of the Kohlman Evaluation of Living Skills (KELS) as a screening tool of older adults’ capacity to live safely and independently in the community. Archives of Physical Medicine and Rehabilitation, 2009;90(11):1948-1952.

    Culberson J, Ticker R, Burnett J, Marcus M, Pickens S, Dyer CB: Prescription Medication Use Among Self-Neglecting Elderly; Journal of Addictions Nursing; 2011; 22:63-68.

    Pickens SN, Halphen JM, Dyer CB: Elder Mistreatment in the Long Term Care Setting; Annals of Long-Term Care: Clinical Care and Aging. 2011; 19[8]:30-35.

    Turner A, Burnett J, Hochschild A, Zulfiqar A, Dyer CB. A High Proportion of Medication Non-Adherence in a Sample of Community-Dwelling Older Adults with Adult Protective Services Validated Self-Neglect; Drugs and Aging, Drugs Aging. 2012 Sep; 29(9):741-9.

    Burnett J, Achenbaum A, Flores DV, Hayes L, Kao D, Hochschild A, Halphen, JM & Dyer CB. Improving Clinical Surveillance and Prevention Efforts in Elder Self-Neglect. Aging Health. 2012; 8(6): 1-9.

    Burnett J, Mitchell RA Jr., Cloyd EA, Halphen JM, Diamond PM, Hochschild AE, Booker JA, & Dyer CB. Forensic Markers Associated with Elder Mistreatment and Self-neglect: A Case-Control Study. Academic Forensic Pathology, 2013:3(4) a-b.

    Pickens, S., Ostwald, SK., Pace Murphy, K., Diamond, P., Burnett, J., Dyer, CB. Assessing Dimensions of Executive Function in Community-Dwelling Older Adults with Self-Neglect. Journal Clinical Nursing Studies. 2014; 2(1):17-29.

    Halphen JM, Burnett J. Elder Abuse and Neglect: Appearances Can Be Deceptive. Psychiatric Times. August 2014;31(8): 14-16.

    Burnett J, Dyer CB, Booker J, Flores DV, Green CE, Diamond PM. Community-Based Risk Assessment of Elder Mistreatment and Self-Neglect: Evidence of Construct Validity and Measurement Invariance Across Gender and Ethnicity. Journal of the Society for Social Work and Research. 2014 Sept; 5(3):291-319.

    Flores DV, Burnett J, Booker J, Dyer CB. Uncomfortably Numb: Substance Use Associated With Elder Mistreatment. Drug and Alcohol Dependence. 2015 Jan 1; 146:e279

    Lee J, Burnett J, & Dyer CB. Frailty in Self-Neglecting Older Adults: A Secondary Analysis. Journal of Elder Abuse and Neglect. (In Press)

    Hansen M, Flores DV, Coverdale JH, Diamond PM & Burnett J. Correlates of Depression in Community-dwelling Older Adults with Adult Protective Services Substantiated Self-Neglect. Journal of Elder Abuse and Neglect. 2016; 28:1, 41-56.

    Burnett J, Jackson SL, Sinha A, Aschenbrenner AR, Xia R, Murphy KP & Diamond PM. Differential Mortality across Five Types of Substantiated Elder Abuse. Journal of Elder Abuse and Neglect. 2016; 28:2, 59-75.

  • Elder Justice

    The Harris County Elder Abuse Fatality Review Team (EFFORT) Fatality Review Division

    EFFORT was formed in 2001 with a small grant from the American Bar Association to the TEAM Institute.  EFFORT operates under the auspices of the Texas Health and Safety Code (Chapter 672) and is a subcommittee of the Harris County Domestic Violence Coordinating Council.  EFFORT focuses on the analysis of deaths of elderly that are the result of or related to elder abuse or neglect.  The purpose is to identify systemic problems and help inform adult protective services, law enforcement, prosecutors, health care providers, government, and others to improve effectiveness in preventing these deaths and prosecuting offenders.    EFFORT members are representatives from the medical community, the legal community and agencies who are responsible for adult fatality investigations.

    • Criminal prosecutor involved in prosecuting crimes involving family violence
    • Attorney from Department of Aging and Disability
    • Adult protective services attorneys and supervisors
    • Homicide detectives and other police officials
    • Medical examiner
    • Medical forensic professionals, such as a forensic nurse specialist or a death scene investigator
    • Elder abuse and neglect specialist including APS, physicians, and nurses
    • Public health professional
    • Representative of family violence shelter/center providing services to the county
    • Victim witness advocate in the county prosecutor’s office
    • Representative from the community supervision and corrections department
    • Designated representative(s) from the Harris County Domestic Violence Coordinating Council Adult Violent Death Review Team (AVDRT)
       

    The goals of the EFFORT are to:

    • Bring together an interdisciplinary team (IDT) composed of representatives from the above groups to present and examine fatality cases related to elder abuse or neglect. 
    • Conduct formal, confidential, and systematic evaluation and analyses of cases of elder death resulting from suspected abuse or neglect occurring in Houston and Harris County.  The flow of each case through the various agencies is examined to identify areas for improvement or ways to strengthening agency contacts and interagency responsiveness.
    • Evaluate policies, protocols and practices to identify gaps in service within agencies and the community.
    • Build a database for analysis of aggregate population data of deceased persons and perpetrators.
    • Disseminate information on prevention strategies through an annual quantitative and qualitative report to the AVDRT and as required to the Texas Department of Protective and Regulatory Services and to the community-at-large.
    • Promote cooperation, communication and coordination among agencies involved in responding to unexpected deaths.
    • Develop an understanding of the causes and incidence of deaths caused by interpersonal violence in Houston/Harris County where the review team is located.
    • Advise the legislature, appropriate state agencies and local law enforcement agencies on changes to law, policy or practice that will reduce the number of deaths attributed to violence.
    • Identify research questions that need investigation to inform decision making to end violence against elders.
    • Identify interventions that are applicable to informing health professionals and the public about violence against elders.

    Houston's Financial Abuse Specialist Team (FAST) Financial Abuse Division

    The FAST team is a group of professionals from various disciplines who meet regularly to discuss cases of financial abuse, develop educational material, train frontline workers and community members and provide consultation on specific cases of elder financial exploitation. The FAST team uses the varied backgrounds, training, expertise and philosophies of these different professions to explore best course of action for each case.

    • Medicine
      • Conduct comprehensive medical assessments to determine health care needs
      • Perform capacity evaluations
      • Refer to appropriate resources
    • Social Work
      • Conduct psychosocial assessments of clients to determine appropriate services
      • Develop a holistic care plan and suggest interventions
      • Advocate on behalf of older adults
    • Real Estate
      • Advise team on reverse mortgages, legalities of taking homes away from older adults
    • Law Enforcement
      • Provide expertise to team and Adult Protective Services (APS) about what legal consequences or charges may be pertinent
      • Investigate allegations of abuse and/or refer to APS
      • Educate team on law enforcement-related issues including various penalties or violations
    • Banking
      • Provide information about direct deposit, fraud prevention and verification of transactions
      • Analyze financial status and needs of the client
      • Educate the team on various topics related to financial institutions
    • Financial Investors
      • Provide information about scams and schemes related to annuities, investments and wealth management
    • Long-Term Care Ombudsman
      • Act as liaison between the FAST team, APS and local social service agencies
      • Provide information regarding client rights to receive care through long-term care facilities, community-based organizations or through in-home care facilities
      • Investigates complaints of abuse, neglect or exploitation of older adults living in long-term care facilities
    • Mental Health Professionals
      • Examine each case to determine possible mental health diagnoses for both the victim and potential abuser
      • Provide recommendations and referral to available community resources
    • Clergy
      • Provide advice from a religious perspective
      • Resources and information about services or support that places of worship might be able to provide
    • Housing/Unsanitary Living Conditions
      • Provides information on current housing standards
      • Has the capability to condemn uninhabitable properties
    • Consultants
      • Members of all disciplines can choose to participate as consultants and/or attend all monthly meetings

TEAM Institute logoTexas Elder Abuse & Mistreatment

The Texas Elder Abuse and Mistreatment Institute (TEAM) is a 17-year multidisciplinary collaboration between academic medicine geriatric health care specialists and the Texas Department of Family and Protective Services, Division of Adult Protective Services (APS). Its mission is to improve the lives of abused and neglected vulnerable adults through evidence-based multidisciplinary clinical assessment and care planning. As the first formal collaboration between a medical school and a state APS program, the TEAM Institute has provided multidisciplinary clinical assessments and short- and long-term care plans for more than 2000 abused and neglected older adults. The TEAM Institute multidisciplinary clinical team comprises members from geriatric medicine, nursing, social work, APS and physical and occupational therapy working together to provide comprehensive care plans.

Historically, the TEAM Institute clinical services were limited to in-home, face-to-face medical and mental health capacity assessments of APS clients living locally near Houston, Texas. Through a statewide virtual services program called the Forensic Assessment Center Network (FACN), the TEAM Institute services have been extended to APS clients across Texas. This expansion will improve APS investigations and client outcomes through increased access to geriatric health care specialists. This new program has helped overcome geographic boundaries and shortages of specialty care providers by implementing telemedicine mental health capacity assessments, assessments of abused and neglected older adult’s mobility, mood, memory, medications, and medical and social history as well as client staffing consults with APS caseworkers. In addition, the FACN also includes forensic assessments of facility based abuse cases and employee misconduct registry reviews to assist with the determination of abuse and protection of older adults against future abuse.

TEAM Institute organization chart

For more information about TEAM Institute, contact Leslie Clark at Leslie.E.Clark@uth.tmc.edu or 713-873-4683.