Department of Pathology awarded MDHHS grant to enhance the protection and safety of older adults in Michigan

Dr. Joyce deJong and Abigail Grande
Joyce deJong, DO, left, and Abigail Grande, MPH

The Department of Pathology at WMed has been awarded a 2023 Prevent Elder and Vulnerable Adult Abuse, Exploitation, and Neglect Today (PRVNT) grant by the Michigan Department of Health and Human Services (MDHHS).

The funding, which totals more than $129,000, was awarded in October to a research team that includes principal investigator Abigail Grande, MPH, Quality and Research Manager for the Office of the Medical Examiner within the Department of Pathology, and co-principal investigator Joyce deJong, DO, Chair of the Department of Pathology. The grant application submitted by Grande and Dr. deJong underwent a rigorous review during a highly competitive process with only four grants awarded statewide.

Grande said the funding from MDHHS will allow the Office of the Medical Examiner and the Department of Pathology to continue – and expand upon – work that began in late 2021, when researchers led by Christine Pink, PhD, assistant professor in the Department of Pathology, were awarded their first PRVNT grant, which totaled more than $146,000.

The initial round of funding helped launch and support the formation of elder death review teams in several Michigan counties – Berrien, Calhoun, Kalamazoo, and Muskegon, as well as one team for both Grand Traverse and Leelanau counties. The six counties are among 13 in the state of Michigan that are currently served by the Office of the Medical Examiner, which is housed at the medical school’s W.E. Upjohn M.D. Campus. In addition to the elder death review teams, the Department of Pathology also put in place an elder death review project manager, a role that is currently held by Catherine Emerson, JD, a former prosecutor who created and directed the Elder Justice Program for the state of Michigan from 2012 to 2015.

“We established multiple teams and began looking for abuse or neglect, or patterns in those communities in terms of the causes of death,” Dr. deJong said. “That first year, we also went through and identified gaps in the system and how to address them to improve the overall care of elderly and vulnerable adults.”

The latest PRVNT grant from MDHHS will provide funding to continue supporting the elder death review teams, as well as allow for the addition of a new team in Barry County.

The multidisciplinary teams are made up of representatives from engaged agencies within each county, including the Office of the Medical Examiner, law enforcement, prosecutors, and Adult Protective Services, as well as the state’s Long Term Care Ombudsman Program and Department of Licensing and Regulatory Affairs, among other agencies. The teams systematically review elder deaths reported to the Office of the Medical Examiner, combing for any obvious signs of elder abuse and neglect, as well as more subtle signs or elements characteristic in each county to foster the improvement of prevention and intervention strategies. The teams work to identify gaps in death investigation methods and discover commonalities with the use of statistical analysis to identify patterns of variables most frequently experienced in each county and use that information to reduce the number of elder abuse cases, particularly those resulting in death.

“With an aging population in Michigan and nationwide, this is something that does – and will continue to – require more attention,” Dr. deJong said. “It’s a public health issue.”

Grande and Dr. deJong said the implementation of the elder death review teams in the six counties over the past year has resulted in some tangible successes. Reviews by the teams during the first year of grant funding led to criminal charges in four cases, as well as the initiation of 17 investigations by the Department of Licensing and Regulatory Affairs.

Moreover, Grande said communication between – and within – agencies in each of the counties has improved immensely and the teams have identified potential gaps that, if addressed, could enhance the protection and safety of older adults. Those gaps include the need for Michigan laws pertaining to elder care to be updated; training for medical examiner investigators to better identify elder abuse and neglect at the time of a death, as well as the recommendation that all adult care facilities be licensed, regulated, and subject to oversight.

Funding from the 2023 PRVNT grant runs through September 30, 2023. In that time, Grande said she and Dr. deJong will focus on the continued growth of the elder death review teams and work to make each team sustainable for the future. Additionally, Grande said they hope to secure more funding to develop elder death review teams in all remaining counties served by the Office of the Medical Examiner.

“We’ve really developed this pilot program that can be replicated in counties and states beyond our office and the state of Michigan,” Grande said.