Adult protective services and animal welfare: should animal abuse and neglect be assessed during adult protective services screening?

Past research has examined links among animal abuse, child maltreatment, and intimate partner violence and demonstrated the importance of addressing the needs of both human and animal victims. We hypothesized that there might be a similar link between animal abuse and older adult welfare issues. As a first step in the earlier research was the development of a screening protocol that shed light on the link between domestic violence and animal abuse, we decided to follow a similar route to explore this new topic by asking state government representatives about their experiences, if any, with this topic. Here we report the results of a national survey of state Adult Protective Services agencies regarding their protocols for assessing animal welfare issues in the context of older adult maltreatment. We also describe a model assessment protocol we developed in collaboration with the Utah Division of Aging and Adult Services.     

Competing Values in Serving Older and Vulnerable Adults: Adult Protective Services,Mandated Reporting,and Domestic Violence Programs

State mandatory reporting statutes may directly or indirectly list domestic violence programs as among those that are mandated reporters of cases of suspected abuse, neglect, or exploitation of older individuals and those with disabilities. Domestic violence programs, however, may not consider themselves to be mandated reporters, because the responsibility of reporting abuse may be contrary to their programmatic philosophy. In the Commonwealth of Virginia, the potential conflict between domestic violence programs and Adult Protective Services about the issue of mandated reporting has created tension between these organizations as each entity continues interpreting the issues and policies of mandated reporting through its own lens. The authors draw out some of the reasons for the conflict as well as make recommendations for improving relationships between the two organizations, which will ultimately benefit vulnerable adults who are experiencing abuse.     

Building the adult protective services system of tomorrow: The role of the APS national voluntary consensus guidelines

In 2015, the Administration for Community Living (ACL) established the first federal “home” for Adult Protective Services (APS). This leadership has included working collaboratively with state Adult Protective Service systems to ensure that older adults and adults with disabilities are afforded the same protections against abuse, neglect, and financial exploitation regardless of where in the country they live. As part of that leadership, ACL created draft Voluntary Consensus Guidelines for State APS Systems. ACL undertook a process of public and stakeholder engagement and analyzed the resulting comments to improve upon the initial draft of the draft to arrive at the final version. This article examines the comments, including the concerns raised by the commenters about specific areas of the Guidelines, areas identified for future research, and reflections and opinions on the role of the federal government in guiding the development of the field of adult protection.     

Social support as a mediator of revictimization of low-income African American women

Mediating effects of social support on the link between childhood maltreatment and adult intimate partner violence (IPV) were explored in a sample of 362 low-income, African American women. We examined relations between childhood maltreatment experiences (total maltreatment, sexual abuse, physical abuse, emotional abuse, emotional neglect, and physical neglect) and adult maltreatment (physical IPV and nonphysical IPV). Results of hierarchical multiple regression analyses revealed small, but significant, effects. Further, social support mediated revictimization. Social support fully mediated relations in which the form of childhood maltreatment was different than the form of adult IPV (e.g., the relation between childhood sexual abuse and adult nonphysical IPV), but only partially mediated the relations in which the form of childhood maltreatment was similar to adult IPV (e.g., the relation between childhood emotional abuse and adult nonphysical IPV). Implications for clinical interventions for women with intimate partner violence experiences are discussed.     

State of the science on prevention of elder abuse and lessons learned from child abuse and domestic violence prevention: Toward a conceptual framework for research

ABSTRACT

The goal of this review is to discuss the state of the science in elder abuse prevention. Findings from evidence-based programs to reduce elder abuse are discussed, drawing from findings and insights from evidence-based programs for child maltreatment and domestic/intimate partner violence. A conceptual measurement model for the study of elder abuse is presented and linked to possible measures of risk factors and outcomes. Advances in neuroscience in child maltreatment and novel measurement strategies for outcome assessment are presented.     

Risk factors associated with elder abuse: the importance of differentiating by type of elder maltreatment

Elder abuse research rarely differentiates by the type of elder maltreatment involved when identifying risk factors. The purpose of this study was to compare risk factors across four predominant types of elder maltreatment (financial exploitation, physical abuse, neglect by others, and hybrid financial exploitation [HFE]). Data were collected from two sources: interviews with victims of substantiated elder abuse, responding adult protective services (APS) caseworkers (N = 71), and third-party informants; and a statewide database that contained all substantiated cases over a corresponding 2-year period (N = 2,142). Using chi-square (interview data) and logistic regressions (Adult Services/Adult Protective Services [ASAPS] data), significant differences across the four types of elder maltreatment were found. These two datasets provide converging evidence for the importance of differentiating by type of maltreatment when identifying risk factors for elder maltreatment and for the importance of considering both the elderly victim and the abusive individual when predicting type of elder maltreatment.     

The Impact of Relationship Dynamics on the Detection and Reporting of Elder Abuse Occurring in Domestic Settings

There is a keen desire to increase the detection and reporting of elder abuse. The purpose of this study was to describe the circumstances under which abuse is detected and reported and to identify the relationship dynamics that might be impacting detection and reporting decisions. Interviews were conducted with 71 Adult Protective Services (APS) caseworkers, 55 of their elderly clients, and 32 third-party adults. Detection and reporting are distinct but related acts. The temporal relationship between detection and reporting generally differed depending on the nature and quality of the relationship between (a) the victim and offender and (b) the victim and reporter. Efforts to increase reporting may benefit from taking into consideration these relationship dynamics. A range of individuals detected and reported elder abuse, including victims, under a range of circumstances, reinforcing the value of public efforts to increase awareness of elder abuse.     

Profiles of adult survivors of severe sexual,physical and emotional institutional abuse in Ireland

Adult survivors of institutional abuse were interviewed with a comprehensive assessment protocol which included the Childhood Trauma Questionnaire, the Institutional Child Abuse Processes and Coping Inventory, the Structured Clinical Interviews for Disorders of the Diagnostic and Statistical Manual of Mental Disorders IV axis I disorders and personality disorders, the Trauma Symptoms Inventory, a Life Problems Checklist, the Experiences in Close Relationships Inventory and the Kansas Marital Satisfaction Scale. Profiles were identified for subgroups that described severe sexual (N = 60), physical (N = 102), or emotional (N = 85) abuse as their worst forms of maltreatment. Survivors of severe sexual abuse had the most abnormal profile, which was characterised by higher rates of all forms of child maltreatment and higher rates of post‐traumatic stress disorder, alcohol and substance abuse, antisocial personality disorder, trauma symptoms and life problems. Survivors of severe emotional abuse were better adjusted than the other two groups. The profile of survivors of severe physical abuse occupied an intermediate position between the other two groups. A thorough assessment of abuse history and current functioning should be conducted when providing services to adult survivors of institutional abuse, since this may have important implications for the intensity of services required. Survivors of severe sexual abuse may require more intensive services. Copyright © 2009 John Wiley & Sons, Ltd.     

Retirement:

Stressful life events have been proposed as a possible cause of elder abuse. This study investigates the influence of retirement status on marital conflict and physical violence using a nationally representative sample of 1238 respondents aged 55 years and older. No significant differences were found between retired men and women compared to their nonretired counterparts on measures of depression, stress, marital conflict, and violence. Future research should examine other life events, such as serious illness of one partner or changes in living situation, that might have a more significant impact on marital discord in later life.     

Letter From the Editors

ABSTRACT

In this article we explore older persons’ definitions of and explanations for elder abuse in the Netherlands by means of interviews with older persons. A qualitative study was conducted based on semistructured interviews with 35 older persons who had no experience with abuse. Our findings show that older persons participating in our study define elder abuse foremost as physical violence that is performed intentionally. The study participants explain elder abuse as a result of the dependency and vulnerability of older persons, of changing norms and values, and of changes in the position of older persons in society, which result in disrespect toward older persons and a lack of social control and responsibility. The older persons’ explanations for the occurrence of abuse mainly focus on societal changes; older persons seem to regard elder abuse primarily as a societal problem. This understanding of, and explanation for, elder abuse may influence their detection and reporting behavior, as they may tend to acknowledge only severe cases of intentional physical violence that leave clear and therefore physically detectable evidence.     

Describing the context and nature of emotional maltreatment reports in children

The circumstances leading to reports of emotional maltreatment are potentially unique from those of other abuse types. This study utilized data from the National Child Abuse and Neglect Data System (NCANDS), which is a federally sponsored effort requiring the submission of case-level data on all children who were subject to maltreatment investigations by state child welfare agencies. The central aims of this study were to examine case-level characteristics of sole occurrences of emotional maltreatment Child Protective Service (CPS) reports in an effort to address how caregiver and child risk correlates affect the substantiation of these allegations. A cluster analysis was performed to explore how the risk assessment factors grouped together; secondarily, the cluster groupings were examined in a logistic regression model to measure factors associated with substantiation of these abuse reports. Four unique clusters emerged, with one cluster absent any risk assessment factors entirely and another cluster solely composed of domestic violence. Caregiver risk factors with the highest odds of predicting report substantiation included caregiver substance abuse, domestic violence, and caregiver learning disabilities.     

Intimate partner violence and child abuse: a child‐centred perspective

A substantial body of literature assessing the impact of intimate partner violence on children and associations between intimate partner violence and child abuse now exists. Central to knowledge about these areas of practice and research is a robust, child‐centred consideration of some of the more challenging conceptual issues they give rise to. In this paper, we aim to stimulate debate by presenting a critical, child‐centred perspective on the intersection between intimate partner violence and child abuse. Initially, we provide the context for the review by presenting a brief overview of the literature. We then consider three central issues from a child‐centred perspective. We discuss the language used to describe children forced to live with intimate partner violence, and the importance of hearing children's perspectives on their experiences of such conflict. Finally, we consider similarities and differences between the intimate partner violence and child abuse fields from a child‐centred viewpoint. We conclude that increasing conceptual clarity around these issues will enhance research in the field, and ultimately improve interventions designed to protect children forced to live with intimate partner violence. Copyright © 2009 John Wiley & Sons, Ltd.     

Childhood abuse and psychiatric impairment in a sample of welfare to work women

Since 1996, individuals who participate in welfare programs are mandated to find employment. Welfare recipients may have difficulty transitioning to the work force due to impairments in psychosocial functioning. Examples include mental health and substance use disorders, medical problems, academic and learning difficulties, and lack of resources such as childcare and transportation. In addition, many welfare recipients have histories of abuse and violence, which further complicate their job finding efforts given the documented relationship between past maltreatment and psychiatric impairment. An area unexplored is the relationship between a history of childhood abuse and psychiatric impairment in Welfare to Work (WtW) recipients. We evaluated the relationships among demographics, personality pathology, substance abuse, cognitive functioning, and histories of childhood abuse in a group of 158 WtW recipients in order to assess predictors of psychiatric impairment. Results suggest that participants with higher levels of psychiatric impairment also had higher levels of interpersonal problems related to personality pathology, higher drug and alcohol use impairment, and endorsed more severe histories of childhood abuse. Personality pathology, alcohol use severity, and self-reported childhood abuse emerged as the best predictor of psychiatric impairment in this WtW sample. These results have implications for identifying individuals at risk for unsuccessful transition into the work force and for the development of effective rehabilitation strategies that considers the unique needs of women in WtW programs.     

Is Elder Abuse and Neglect a Social Phenomenon? Data from the First National Prevalence Survey in Israel

This article discusses findings from the First National Survey on Elder Abuse and Neglect in Israel, conducted during 2004–2005 under the sponsorship of The Association for Planning and Development of Services for the Aged in Israel (ESHEL) and the National Insurance Institute. The goals were to examine the prevalence and severity of various forms of abuse and neglect from the victims' perspective, to examine correlates and predictors, and to develop profiles of elders at risk. Data were collected through personal interviews from a national representative sample of community urban dwellers age 65 and older, using cluster sampling techniques and sampling proportionately both Arab and Jewish elders. The sample was composed of 392 males and 650 females, 89% were Jews and 11% were non-Jews. The instrument included sociodemographic data, health and activities of daily living (ADL), a measure of safety, and a battery to examine seven types of abuse (physical, emotional, verbal, limitation of freedom, financial exploitation, sexual, and neglect). Findings indicate that 18.4% of the respondents were exposed to at least one type of abuse during the 12 months preceding the interview, the highest form being verbal abuse followed by financial exploitation. The rates were quite similar between Jews and Arabs. Women were more exposed to physical violence and Arab women were the most vulnerable. Physical, emotional, verbal, limitation of freedom, and sexual abuse occurred mostly among partners. The rates of physical, sexual, and limitation of freedom abuse, however, were relatively low. Financial exploitation was mostly inflicted by adult children. Partners as perpetrators had more chronic health problems and physical and mental disabilities. Children as perpetrators were unemployed, had various mental health problems, and were substance abusers, often in a process of separation or divorce and tended to live with the victims. Neglect in answering primary needs was found among 20% of the sample, regarding the 3 months preceding the interview. This high rate might be related to elders tending to avoid seeking help or sharing their needs with their families. When victims sought help it was mostly from medical and health services. The findings thus corroborate that elder abuse and neglect is a social problem in Israeli society and has to be addressed in policy discourse and service developments.     

Russian Perspectives on Elder Abuse: An Exploratory Study

ABSTRACT

The purpose of this exploratory study was to analyze Russian perceptions of elder abuse as reflected in their examples of abusive behavior from an adult child to an aging parent. Also of interest was the possibility of gender differences in the Russian perspectives on elder abuse. The convenience sample consisted of 21 Russian participants (10 males, 10 females, and one without gender identified), who provided examples of extreme, moderate, and mild abuse from an adult child towards an aging parent. Most examples of extreme abuse were forms of physical violence. Typical examples of moderate abuse were instances of psychological aggression–particularly verbal aggression–and neglect. The most common examples of mild abuse were verbal aggression and neglect. One-way analyses of variance revealed statistically significant gender differences in the number of references to psychological aggression in general and to verbal aggression in particular in the examples of moderate abuse, with females giving more examples than males.     

Self-Neglect: Implications for Prosecutors

ABSTRACT

Historically, the view of elder mistreatment in the United States has been similar to that of child abuse and has been detrimental to the understanding of elder mistreatment. Until recently, there was little understanding of the complexity of elder mistreatment and the legal system lacked appropriate laws with which to handle this growing problem. Over the last two decades, legislation, laws, and criminal codes of conduct have been developed to tackle the problem of elder mistreatment. However, little knowledge or understanding of the public health problems and legal implications related to the most common form of elder mistreatment referred to Adult Protective Services (APS), elder self-neglect, is available. The growth of this national problem has expanded the role of the legal system and pushed the development of interdisciplinary research with the intent of defining and understanding the problem of self-neglect and with the ultimate goal of expanding intervention strategies. The Consortium for Research in Elder Self-Neglect of Texas (CREST) is the leader in this field and the pilot study suggests numerous medical and legal implications for both intervention and future research.     

Older Women's Perceptions of Elder Maltreatment and Ethical Dilemmas in Adult Protective Services: A Cross-Cultural,Exploratory Study

In this study, older African American, Latina, and Caucasian women from varying socioeconomic backgrounds participated in eight focus groups that examined their perceptions of elder maltreatment and three ethical dilemmas within adult protective service work: mandatory reporting, involuntary protective services, and criminalization of elder maltreatment. Participants espoused a broad and inclusive view of elder maltreatment. In responding to illustrative case scenarios, participants strongly favored protection over freedom by supporting mandatory reporting and involuntary protective services. Criminalization of elder maltreatment also was supported. This article presents results of each scenario and broad themes across the study, with attention paid to areas of consistency and difference across ethnicity and socioeconomic categories.     

Abuse and Neglect Experienced by Aging Chinese in Canada

The traditional values of Chinese culture promote care and respect toward older adults. While it appears to be ironic to discuss issues of abuse and neglect in the Chinese culture, research findings in Chinese societies do indicate the occurrences of such problems. However, little research on the abuse and neglect of older Chinese in Western societies has been available. This study aims to examine the incidence of abuse and neglect and the associated correlates based on data collected from a random sample of 2,272 aging Chinese 55 years and older in seven Canadian cities. The findings show that 4.5% of the participants reported experiencing at least one incident of maltreatment or neglect within the past year. The most common forms of neglect and abuse experienced by the aging Chinese include being scolded, yelled at, treated impolitely all the time, and ridiculed. Close family members such as spouses and sons are those that most commonly maltreat older Chinese. Those who were more likely to report at least one incident of maltreatment or neglect were older adults living with others; they tended to have no education, more access barriers, more chronic illnesses, less favorable mental health, and a higher level of identification with Chinese cultural values. The findings implied that the face value of respect and care received by older people in Chinese culture should not be taken for granted. Culturally appropriate precautionary steps are needed for prevention and early problem identification.     

Physical Abuse of Older Adults in Nursing Homes: A Random Sample Survey of Adults With an Elderly Family Member in a Nursing Home

Few empirical studies have focused on elder abuse in nursing home settings. The present study investigated the prevalence and risk factors of staff physical abuse among elderly individuals receiving nursing home care in Michigan. A random sample of 452 adults with elderly relatives, older than 65 years, and in nursing home care completed a telephone survey regarding elder abuse and neglect experienced by this elder family member in the care setting. Some 24.3% of respondents reported at least one incident of physical abuse by nursing home staff. A logistic regression model was used to estimate the importance of various risk factors in nursing home abuse. Limitations in activities of daily living (ADLs), older adult behavioral difficulties, and previous victimization by nonstaff perpetrators were associated with a greater likelihood of physical abuse. Interventions that address these risk factors may be effective in reducing older adult physical abuse in nursing homes. Attention to the contextual or ecological character of nursing home abuse is essential, particularly in light of the findings of this study.