RISE

A new more just, holistic, and person-centered approach to 

elder mistreatment and self-neglect

The RISE Model is a new way to approach elder mistreatment and self-neglect designed to reduce harm, respect autonomy, restore relationships, and advance justice in a more holistic and flexible way than the usual systems are structured to do.  Check out the new RISE website here!

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“RISE” integrates methods that have had promising results in other fields and adapts them to the unique challenges and circumstances of individuals and families who run into trouble in aging. The goals of RISE include to:

Repair harm —Restorative justice approaches aim to reduce harm, promote healing, and help those involved in conflict work toward meaningful accountability and transformational change

Inspire change —Motivational interviewing helps people feel that change is possible

Support connection —Teaming is used to build more consistent formal (like Meals on Wheels) and informal (like neighbors) supportive networks around people in need

Empower choice —Supported and interdependent decision-making assists people with cognitive impairment to achieve their goals

The RISE model works at four levels: 

    Relational 

    Individual 

    Social 

    Environmental 

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Factors that distinguish RISE from most other interventions include that:

• It is grounded in theory and methods in which the RISE advocates are trained

• Advocates work not only with older people, but also (if the older person wishes) with people alleged to cause them harm, with others in their lives, and on the relationships among them

• Advocates can stay involved in cases longer than most formal system responders are usually able to, allowing advocates more time to build trusting relationships with and social support around older people, families, and concerned others

• Advocates work in a truly client-centered way

• Advocates are based in a community non-profit, but work alongside formal systems; and

• Advocates’ work is part of an ongoing research project, so they and their colleagues are committed to ongoing data collection and evaluating the efficacy of their work.

Maine’s original RISE program

The two-county Maine pilot study

In 2018, the US Department of Health and Human Services, Administration for Community Living (ACL) awarded Maine’s Adult Protective Services program (APS) $1.28 million to fund the Community & Adult Protective Services Trial of Novel Enhanced Services—or the “CAPSTONES study”—to compare outcomes of APS clients who worked with RISE advocates (in randomly selected Maine counties, Cumberland (the most urban) and Aroostook (the most rural)) versus clients who did not. The RISE advocates, who are employed by the Elder Abuse Institute of Maine and work under the umbrella of the Elder Service Connections Program, began working with clients referred to them by APS in July 2019.  In the first two years of the project, Advocates handled more than 200 cases.

Expanding RISE from two counties to all 16 of Maine’s counties

Phase I CAPSTONES data collection ended in June 2021. APS workers had positive views of the program and believed that it reduced the number of cases that were referred for re-investigation. (Data analysis later found this hunch to be correct.) Clients and advocates also had positive responses to RISE. Based on these early positive results, Maine’s Department of Health and Human Services and APS program used COVID-19 relief funds to expand RISE from 2 counties to the entire state (16 counties), beginning in July 2021.

Funding for RISE included among Maine’s permanent healthy aging programs

In 2023, Maine’s Governor's budget proposed that RISE be funded as a permanent healthy aging program in Maine.

Expanding RISE to other issues, systems, and locations

Expanding RISE to Canada

In 2023, the Canadian government funded creation of a new free-standing RISE program in Toronto, Canada. The program currently is under construction. (Canada does not have an APS program.) Researchers will collect data about this new freestanding RISE program.

​Expanding RISE to New Hampshire

In 2022, ACL awarded a grant to expand RISE to NH where advocates will work on cases referred by APS.

Developing a RISE substance use component, including specialized expertise and training

Given pervasive substance use issues attending elder mistreatment and self-neglect cases, ACL funded a project to develop and pilot test specialized expertise and training in substance use as a part of delivering RISE services, to be studied in Maine and New Hampshire.

Expanding RISE to criminal financial exploitation cases

The RISE team also is working with partners in Maine and King County, Washington to adapt RISE to financial exploitation cases in the criminal justice system to provide an expanded, more person-centered range of options in such cases designed to advance healing, reduce harm and conflict, promote opportunities for restoration of relationships when appropriate, advance justice and provide alternatives to incarceration.