Multidisciplinary teams (MDTs) are among the most common and enduring interventions used to prevent elder abuse, neglect, and exploitation in the United States. This paper traces the evolution of MDTs, drawing from the author’s experience in developing one of the country’s first teams and examining their development through to the present day. It explores the roles of team members, which typically include Protective Services (APS) workers, who are designated as the first responders to investigate and follow up on reports in most states; medical professionals, including doctors, nurses, emergency medical care providers, and allied medical professionals, who provide expertise on the risk factors and physical signs of abuse and its harm; Long-Term Care Ombudsmen, who help MDTs understand residents’ perspectives and rights; and mental health providers, including psychologists, psychiatrists, social workers, counselors, and therapists, who assess, diagnose, and treat mental, emotional, or behavioral disorders, trauma, depression, anxiety, and relationship issues.

Legal professionals on MDTs include civil attorneys who provide expertise in legal protections and remedies, including advance directives, restraining orders, and lawsuits to recover misappropriated property. Law Enforcement, including local, state, and national officials, explain their roles in abuse prevention, which include conducting investigations, making arrests, issuing warnings and citations, enforcing restraining orders, conducting background checks on alleged abusers, checking on the well-being of vulnerable people, and accompanying workers on home visits when safety is at risk. Prosecutors elaborate on the evidence needed to prove cases and the standards of proof for various crimes and the punishment they carry. Victim advocates provide a link between victims and the criminal justice system to ensure that their rights are respected. Those with special training in domestic violence provide expertise in the dynamics of power and control, which come into play when abuse occurs in intimate relationships or families. This includes recognizing patterns of coercion, isolation, and emotional manipulation. Advocates also assist clients secure protective orders, develop safety plans, access emergency shelters, and evaluate their options. The author discusses the diverse perspectives that team members bring to the review process, highlighting how these enrich discussions yet sometimes reflect conflicting viewpoints.

In the 40 years that MDTs have existed in the U.S. new variations have emerged in response to new forms of abuse and the collective knowledge about the problem. Teams that will be discussed include financial abuse specialist teams (FASTs), fatality review teams, forensics team. New innovations include teams that specifically focus on systemic barriers to resolving cases, and teams that focus on nursing homes and other long term care facilities.

The paper also provides a brief overview of research on MDTs’ effectiveness in achieving desired outcomes, while acknowledging the inherent challenges in evaluating their nuanced benefits for victims, team members, and the broader field of abuse prevention. It concludes with recommendations for how MDTs can effectively navigate today’s challenges in public policy and funding and how the MDT model can be replicated.