Research priorities for elder abuse screening and intervention: A Geriatric Emergency Care Applied Research (GEAR) network scoping review and consensus statement.

The Geriatric Emergency Care Applied Research (GEAR) Network (1) conducted a scoping review of the current literature on the identification of and interventions to address elder abuse among patients receiving care in emergency departments and (2) used this review to prioritize research questions for knowledge development. Two questions guided the scoping review: What is the effect of universal emergency department screening compared to targeted screening or usual practice on cases of elder abuse identified, safety outcomes, and health care utilization?; and What is the safety, health, legal, and psychosocial impact of emergency department-based interventions vs. usual care for patients experiencing elder abuse? We searched five article databases. Additional material was located through reference lists of identified publications, PsychInfo, and Google Scholar. The results were discussed in a consensus conference; and stakeholders voted to prioritize research questions. No studies were identified that directly addressed the first question regarding assessment strategies, but four instruments used for elder abuse screening in the emergency department were identified. For the second question, we located six articles on interventions for elder abuse in the emergency department; however, none directly addressed the question of comparative effectiveness. Based on these findings, GEAR participants identified five questions as priorities for future research - two related to screening, two related to intervention, and one encompassed both. In sum, research to identify best practices for elder abuse assessment and intervention in emergency departments is still needed. Although there are practical and ethical challenges, rigorous experimental studies are needed.

Financial Shocks and Financial Well-Being: What Builds Resiliency in Lower-Income Households?

Households in the U.S. regularly experience unexpected negative income or expense shocks, and low- and moderate-income households experience these shocks at disproportionately high rates. Relatively little is known about the impact these shocks have on households' subjective sense of financial well-being, and how access to different types of liquidity (e.g., liquid assets, credit cards, social resources, and income flows) can mitigate the impact of these shocks on subjective financial well-being. To address these gaps in the literature, this paper uses data from a two-wave survey administered to 3,911 low- and moderate-income tax filers in 2018. Applying a difference-in-difference analysis, we find that the experience of an income shock between survey waves was associated with a large decline in subjective financial well-being, while the experience of an expense shock was associated with a more modest decline. Relatively liquidity-constrained households tended to be more negatively impacted by shocks than their counterparts, though not all sources of liquidity were equally as effective in buffering households against shocks. The findings of this paper point to the need for policymakers and program administrators to develop tools that can facilitate access to different types of liquidity to offset different financial risks for households.