Today we revisit a topic we last discussed in a 2020 podcast with Laura Mosqueda: elder mistreatment. Our guests today are geriatricians Carrie Rubenstein and Julia Hiner, and Tony Rosen, an emergency medicine doctor. They talk about where we are now, in 2026, with elder mistreatment, including:

• Terminology: elder mistreatment vs. abuse and neglect

• The need to incorporate prevention and solutions into how we talk about mistreatment

• This is not rocket science. Studying elder mistreatment is much harder than rocket science.

• Highlighting the reasons they focus on elder mistreatment, including inspiring words for why this led them to geriatrics and aging research

• Should we screen for elder mistreatment? The US Preventive Services Task Force doesn't see enough evidence to recommend screening. Our guests may differ…

• Which clinicians should assess for elder mistreatment? Hospitalists? ED docs? Primary care providers? Tony published a study in JAGS showing older adults who experienced elder mistreatment were as likely to visit primary care as those who did not, also great accompanying editorial by Mara Rosenberg and Lena Makaroun gets a shout out.

• Early evidence that supporting caregivers can reduce elder mistreatment (in one small study of the COACH intervention, rates of mistreatment were reduced to zero)

• Borrowing from pediatrics: many/most hospitals and emergency departments can call a Child Protective Services Team. Tony is piloting a parallel team for older adults - the Vulnerable Elders Protection Team (see JAGS paper).

• We talk about key members of interdisciplinary teams across sites, systems, and counties. Social workers get a big shout out.

• A one year fellowship in capacity assessment and elder mistreatment at UT Houston, directed by Julia.

• An Elder Abuse Curriculum for Medical Residents and Geriatric Medicine Fellows

• https://pmc.ncbi.nlm.nih.gov/articles/PMC10842324/

Kudos to my son Renn for recording 5 overlapping cello parts on Eleanor Rigby!

-Alex Smith