Closing the Loop: An Environmental Scan of APS-Reporter Feedback Policies and Practices

Abstract Abuse, neglect, and exploitation of older adults are prevalent and underreported in the United States. Pathways to identifying and resolving cases of abuse against older adults depend on mandated and non-mandated reporters bringing attention to these cases through reports to Adult Protective Services (APS). However, existing research points to several barriers to reporting. One significant barrier is a lack of communication from APS to reporters about reports they have made (e.g., whether the report is appropriate for APS, the investigation outcome, and services provided by APS). This lack of reciprocal communication likely serves as a disincentive for future reporting. This study aims to promote improved communication between APS and reporters by examining the legal, ethical, and practical barriers and facilitators to communication at key points in the reporting and response pathways. In this first phase of the project, we conducted an environmental scan of policies and practices related to reporting, investigation, and feedback. Early results from the environmental scan suggest most APS agencies (81%) do not currently provide feedback to reporters. Among those providing feedback, 20% provide feedback only to mandated reporters, and 50% provide only procedural feedback, which focuses on the process of receiving and screening reports for investigation and not on the outcome of the investigation. In the next phase of this study, we will supplement these findings through interviews with APS leaders across the U.S. These early results will begin to fill an important gap in the understanding of feedback loops between APS and reporters.

matched 1:1 on age, sex, race, and census region (n=7654). Cox regression assessed count of prevalent geriatric conditions (dementia, depression, falls, hip fracture, sensory deficits, osteoporosis, orthostatic hypotension, urinary incontinence, frailty, and polypharmacy), and risk for clinical or utilization outcomes (cancer, kidney disease, muscle wasting, hepatitis C, liver disease, myocardial infarction, stroke; hospitalization, nursing home and home health admission) during follow-up between 1/1/2015-12/31/2016. PLWH and PWOH are similar in count of geriatric conditions. Compared to those with none, those having 2+ geriatric conditions were similar across PLWH and PWOH in their risk of ≥1  of NH admission compared to no geriatric conditions. In this study, PLWH use nursing homes less than PWOH despite having a similar number of geriatric conditions and clinical outcomes. Further research to understand this apparent discrepancy will be critical to achieve equity in nursing home access.
These early results will begin to fill an important gap in the

COMPARISON OF OLDER ADULT AND HEALTHCARE PROVIDER BELIEFS ABOUT FALL PREVENTION STRATEGIES Gwen Bergen, Ankita Henry, and Yara Haddad, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States
Older adults reported about 36 million falls in 2018. Although effective strategies are available to minimize fall risk, little is known about older adults' and healthcare providers' awareness of these strategies. This study describes and compares older adults' and healthcare providers' beliefs about fall prevention strategies. Demographic and fallrelated data for older adults were obtained from the 2019 fall cohort of Porter Novelli ConsumerStyles. Similar data from primary care practitioners, nurse practitioners, and physician assistants, were gathered from the 2019 cohort of DocStyles. Percentages and 95% confidence intervals were calculated to compare older adults and providers. Most providers (91.3%) and older adults (85.1%) believed falls can be prevented. High percentages of providers and older adults identified strength and balance exercises (90.7% and 82.8% respectively) and making homes safer (90.5% and 79.9% respectively) as strategies that help prevent falls. More providers reported that Tai Chi (45.7%) and managing medications (84.2%) can prevent falls compared to older adults (21.7% and 24.0% respectively; p<0.0001). Sizable percentages of providers and older adults endorsed less evidencebased strategies including aerobic exercise (70.7% and 58.4% respectively) and being more careful (69.3% and 81.6% respectively). Among older adults, lower endorsement of evidence-based strategies (e.g., Tai Chi, medication management) coupled with higher endorsement of limited evidence-based strategies (e.g., being careful, aerobic exercise) suggest some older adults lack awareness of effective fall prevention interventions. Increased patient and provider communication can increase awareness about the benefits of evidence-based strategies for fall prevention.

COMPARISON OF PHYSICAL ACTIVITY LEVEL FROM OSTEOPOROSIS, PARKINSON AND HEALTHY SUBJECTS
Seong Hyun Moon, 1 Thurmon Lockhart, 1 and Krupa Doshi, 2 1. Arizona State University, Tempe,Arizona,United States,2. MAYO Clinic,Scottsdale,Arizona,United States Lifestyle at the habitation immensely affects the progression of various illnesses, such as Osteoporosis and Parkinson's disease (PD). These disorders lead patients to a sedentary lifestyle and result in significantly less movement compared to the average healthy individual. The combination of these backgrounds escalates the percentage of fall incidents. Quantifying physical activity levels from longitudinal Activities of Daily Living (ADL) data of these disease patients could stipulate intuition of their fall mechanisms. The objective of this study is to compare the osteoporosis, Parkinson's disease, and healthy group's physical activity level from their ADL. For this study total of eighteen subjects participated (healthy=6, osteoporosis=6, PD=6). The result indicated that the dynamic physical activity level for the healthy subject was 13.2%, the osteoporosis subject was 7.9%, and the PD subject was 7.0%. This indicates that there was a significant decline in physical activity level for the PD compared to healthy subjects (P=0.0024*). Also, a comparison between healthy and osteoporosis subjects showed a significant difference (P=0.0066*). Lastly, the physical activity level of PD and osteoporosis subjects did not have a significant difference among them (P=0.6276). The aim of this study was to evaluate the physical activity level of the osteoporosis, PD, and healthy subjects. The systematic approach of collecting physical activity levels with the Inertial Measurement Unit (IMU) device allowed researchers to collect the quantitative data of ADL. In this experiment, healthy subjects were significantly more physically active compared to osteoporosis and PD patients.

COMPARISONS OF FACTORS ASSOCIATED WITH SUICIDAL IDEATION OF OLDER INDIVIDUALS BY HEALTH STATUS
Hyeyeon Sung, 1 Jihun Na, 2 Sungkyu Lee, 1 and Sehyun Baek, 1 1. Soongsil University,Seoul,Seoult'ukpyolsi,Republic of Korea,2. Korea Center on Gambling Problems,Seoul,Republic of Korea This study examined the factors associated with suicidal ideation among older individuals and compared those factors by their objective and subjective health status. Data were obtained from the 13th wave of the Korean Health Panel Survey in 2018. The sample of 6,283 older individuals, who are 55 years and older, was classified into four groups by their objective and subjective health status. Objective health status was measured by the number of chronic health conditions,