Protecting Older Americans: A History of Federal Action on Elder Abuse,Neglect, and Exploitation

ABSTRACT

Congressional hearings on elder abuse began over a quarter century ago. However, federal legislative and departmental activity for addressing the problem has been slow and lacks coordination and comprehensiveness. In addition, federal funding to combat elder abuse represents only a small percentage of that spent on such other abused populations as children and women. The barriers and challenges to addressing elder abuse are identified along with existing programs at the federal level. The article concludes with a discussion of state and local initiatives which show promise for effectively preventing or treating this problem.     

Addressing the measurement challenge in elder abuse interventions: need for a severity framework

ABSTRACT

The field of elder abuse is evolving toward an emphasis on intervention research. However, researchers currently rely on binary approaches to measure elder abuse phenomena, which fail to capture changes in problem status over the course of intervention. This commentary develops a case for severity as a framework to operationalize and measure elder abuse in intervention research and practice. A severity framework provides enhanced elder abuse measurement responsiveness and aligns with the dominant client-centered, harm-reduction clinical approach to intervening with elder abuse cases.     

S 333 IS–108th Congress, 1st Session: To Promote Elder Justice,and for Other Purposes

ABSTRACT

The sample for this exploratory qualitative study of Greek perceptions of elder abuse consisted of 43 Greek participants from urban centers and 28 Greeks from a small island village. Participants were asked to provide examples of extreme, moderate, and mild abuse from an adult child toward his/her aging parent. Half of the examples of extreme abuse were various forms of physical aggression. Predominant examples of moderate abuse were psychological abuse and neglect, and at the mild level neglect was the most highly cited category. The most frequently mentioned specific types of elder mistreatment were verbal abuse, psychological neglect, physical neglect, and hitting. There were no gender differences in the kinds of examples that participants gave or the severity they attributed to their examples. Females were more often presented as victims of abuse than males. A negative correlation was found between age and the number of physical abuse examples given overall, and as types of severe abuse.     

Times of Transition: Elder Abuse and Neglect in Israel

ABSTRACT

The present paper addresses the advancement of research, policies, legislation, and practice experiences designed to deal with the phenomenon of elder abuse and neglect in Israel in times of transition. The paper presents a short overview of the demographic scene, reflecting population characteristics and needs that impact care giving as well as elder abuse and neglect. The developments of scientific knowledge and its accumulation, especially the empirical data from the first national survey on elder abuse and neglect are discussed. Further, legislative developments relating to four generational laws and the advancement of policies and innovative practice experiences are described and analyzed. Finally, future challenges in the field are identified.     

Decision-Making and Adult Protective Services Workers: Identifying Critical Factors

ABSTRACT

The decision-making process of Adult Protective Service (APS) workers is under-explored in the field of elder abuse. Yet, it is critical in assuring the protection of elders from physical abuse. This article identifies 10 major critical factors used by APS workers in New Hampshire when intervening in substantiated cases of elder physical abuse. The qualitative methodological framework utilized a literature review, two focus groups, 15 individual face-to-face interviews, and a modified Delphi method of analysis. The findings identify the strengths and flaws in the decisional process and suggest considerations for further study.     

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.     

Experience of elder abuse among older Korean immigrants

ABSTRACT

Studies on the scope and nature of Asian American elder abuse conducted with older immigrants are extremely limited. The overall purpose of this study was to examine the extent and type of elder abuse among older Korean immigrants, and to investigate critical predictors of elder abuse in this population. The sample consisted of 200 older Korean immigrants aged 60 to 90 years who resided in Los Angeles County in 2008. One of the key findings indicated that 58.3% of respondents experienced one or more types of elder abuse. Logistic regression indicated that the victims’ health status and educational level were statistically significant predictors of the likelihood of experiencing abuse. The present study, although limited in sample size, measures, sampling methods, and population representation, has contributed to this important area of knowledge. It is recommended that future studies conduct research on elder abuse with more representative national samples that can measure the extent of abuse and neglect more accurately.     

Depression and Elder Abuse and Neglect Among a Community-Dwelling Chinese Elderly Population

ABSTRACT

Our recent survey of an elderly cohort in mainland China suggests that elder abuse and neglect are common. Unfortunately, there is minimal knowledge about the risk factors for elder abuse and neglect among this population. We aimed to examine depression as a risk factor for elder abuse and neglect among Chinese elderly. A cross-sectional study was performed in a major urban medical center in NanJing, China. Depression was assessed using the Geriatric Depression Scale and direct questions were asked regarding abuse and neglect experienced by the elderly since the age of 60; 412 patients completed the survey. The mean age of the participants was 70 and 34% were female. Depression was found in 12% of the participants and elder abuse and neglect was found in 35% of the participants. After multiple logistical regression, feeling of dissatisfaction with life (OR, 2.92; 95% CI, 1.51–5.68, p < 0.001), often being bored (OR, 2.91; CI, 1.53–5.55, p < 0.001), often feeling helpless (OR, 2.79; CI, 1.35–5.76, p < 0.001), and feeling worthless (OR, 2.16; CI, 1.10–4.22, p < 0.001) were associated with increased risk of elder abuse and neglect. Multiple logistic regression modeling showed that depression is independently associated with elder abuse and neglect (OR, 3.26; CI, 1.49–7.10, p < 0.003). These findings suggest that depression is a significant risk factor associated with elder abuse and neglect among Chinese elderly.     

Five-year all-cause mortality rates across five categories of substantiated elder abuse occurring in the community

ABSTRACT

Elder abuse increases the likelihood of early mortality, but little is known regarding which types of abuse may be resulting in the greatest mortality risk. This study included N = 1,670 cases of substantiated elder abuse and estimated the 5-year all-cause mortality for five types of elder abuse (caregiver neglect, physical abuse, emotional abuse, financial exploitation, and polyvictimization). Statistically significant differences in 5-year mortality risks were found between abuse types and across gender. Caregiver neglect and financial exploitation had the lowest survival rates, underscoring the value of considering the long-term consequences associated with different forms of abuse. Likewise, mortality differences between genders and abuse types indicate the need to consider this interaction in elder abuse case investigations and responses. Further mortality studies are needed in this population to better understand these patterns and implications for public health and clinical management of community-dwelling elder abuse victims.     

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.     

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.     

Rosalie Wolf Memorial Lecture: A logic model to measure the impacts of World Elder Abuse Awareness Day

ABSTRACT

This commentary discusses the need to evaluate the impact of World Elder Abuse Awareness Day activities, the elder abuse field’s most sustained public awareness initiative. A logic model is proposed with measures for short-term, medium-term, and long-term outcomes for community-based programs.     

An Overview of Elder Abuse and Neglect in Australia

ABSTRACT

Only relatively recently has the issue of elder abuse come to prominence in Australia. Until the late 1980s it was a hidden problem with little knowledge of its presence. Attention was drawn to elder abuse after the publication of a number of reports and research projects, allowing the development of responses at national and state levels. This paper gives an overview of the development of elder abuse as a social, legal and medical issue in Australia, and describes the diverse range of responses from the national, state and territory governments.     

The Vulnerability for Elder Abuse Among a Sample of Custodial Grandfathers: An Exploratory Study

ABSTRACT

Older adults have been known to make sacrifices in their caregiving roles. Gerontology literature on custodial grandparents has primarily focused on grandmothers and the challenges they face when they assume primary care for grandchildren. Little is known about the risks that older men face when they become custodial grandparents. This article highlights types and warning signs of abuse, exploitation and neglect. Exploratory study was undertaken with a racially diverse group of custodial grandfathers to fill a gap in the literature about the vulnerability for elder abuse, exploitation and neglect as expressed by older Black, Latino and White custodial grandfathers. To provide a more inclusive understanding of elder abuse, areas of vulnerability were identified for consideration by practitioners, educators and researchers. The implications of this research point to the need to rethink elder abuse assessment, prevention and intervention strategies with older men.     

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.     

Implicit Theories of Elder Abuse in a Sample of European-American Descent

ABSTRACT

The purpose of this exploratory study was to examine implicit theories of elder abuse in a sample of men and women of European-American descent. Seventy-six participants, ranging in age from 17 to 79, filled out an open-ended qualitative survey asking them to give examples of behaviors considered in their culture to be extremely abusive, moderately abusive, and mildly abusive in the context of an adult child-older adult parent dyad. Results indicated that various types of physical aggression and neglect (with an emphasis on physical neglect) were the most common examples of extreme abuse. Psychological aggression was the most common example of moderate abuse, and forms of psychological abuse and neglect were the most frequent examples of mild abuse. Gender differences were found, with females more often mentioning examples of neglect than males. Sexual and economic abuse did not seem to be commonly identified forms of mistreatment in implicit theories of elder abuse.     

Financial Abuse of Elders and Dependent Adults: The FAST (Financial Abuse Specialist Team) Approach

ABSTRACT

The Financial Abuse Specialist Team, a partnership of professionals from diverse disciplines, volunteer their time to review cases of financial elder abuse and facilitate comprehensive service delivery. The team also advocates for legislative reform, educates the community about the problem, and trains professionals in how to recognize, prevent, and resolve financial elder abuse.     

The effect of a family-based intervention with a cognitive-behavioral approach on elder abuse

ABSTRACT

Elder abuse may become a health issue in developing countries, including Iran. The purpose of this investigation was to study the effectiveness of Family-Based Cognitive-Behavioral Social Work (FBCBSW) in reducing elder abuse. In a randomized clinical trial in Iran, 27 elders participated in intervention and control groups. The intervention groups received a five-session FBCBSW intervention and completed the Domestic-Elder-Abuse-Questionnaire (DEAQ), which evaluates elder abuse at baseline and follow-ups. Repeated measures of analysis of variance (ANOVA) and the Wilcoxon test were used to analyze the data. The repeated measures ANOVA revealed that FBCBSW was successful in reducing elder abuse. The Wilcoxon test indicated that emotional neglect, care neglect, financial neglect, curtailment of personal autonomy, psychological abuse, and financial abuse significantly decreased over time, but there was no statistically significant difference in physical abuse before and after the intervention. The findings from this study suggest that FBCBSW is a promising approach to reducing elder abuse and warrants further study with larger samples.     

Notes on Newspaper Accounts of Male Elder Abuse

SUMMARY

Law enforcement press releases and other print-media miscellany detailing accounts of male elder abuse involving insurance fraud, false allegations by perpetrators, and abuse inflicted by care-givers, spawned interest in a more systematic review. That review was accomplished principally by accessing two search engines, with news articles from 1986 to the present. A review of these media accounts transformed the initial “insurance fraud” category into a broader one classified as “economic exploitation.” That same review also resulted in three distinctive categories of caregiver abuse. This article provides abbreviated case accounts within each category, and concludes with brief notes on several themes derived from the reported accounts.