Abstract
The Centers for Disease Control and Prevention report 1 in 10 adults over the age of 60 have experienced some form of abuse including neglect and exploitation. However, these statistics are an underestimate. Professionals who interact with the elderly describe being reluctant to report abuse due to a lack of knowledge of elder abuse, the reporting process, and the resources available to support victims. The invisibility of elder abuse has only increased during the 2020 COVID pandemic due to the increased social isolation of older adults and understaffed, overburdened health and social systems. Cross-disciplinary education for healthcare and social service practitioners, law enforcement, court personnel, families, and the older adults themselves is an essential component to identify and prevent elder abuse. This chapter provides an overview of elder abuse and neglect categories, risk factors, and best practice interventions advocated for addressing elder victimization.
TopIntroduction
The Centers for Disease Control and Prevention (2020a) report that 1 in 10 adults over the age of 60 have experienced some form of abuse including neglect and exploitation. However, these statistics are an underestimate as the data is limited to reports made by older adults treated in an emergency department. These statistics do not include older adults treated by other providers, older adults who choose not to report the abuse, or older adults who cannot report because of mental or physical limitations. Reasons older victimized adults do not report abuse include not recognizing that what is happening to them is in fact abuse, wishing to protect the abuser, not knowing how to report abuse, or an unwillingness to seek assistance because they believe there is no help out there and/or they fear retaliation. Professionals who interact with the elderly describe being reluctant to report abuse due to a lack of knowledge of elder abuse, the reporting process, and the resources available to support victims (Schmeidel et al., 2012). This lack of knowledge of abuse, poor reporting process, and lack of available resources also explains the dramatic underreporting of elder abuse (National Center on Elder Abuse, 2018). The invisibility of elder abuse has only increased during the 2020 COVID pandemic due to the increased social isolation of older adults and under staffed, overburdened health and social systems (Makaroun et al., 2020). Cross-disciplinary education for health care professionals, social service practitioners, law enforcement, court personnel, families, and the older adults themselves is widely recommended as an essential component to identify and prevent elder abuse (Dolinsky & Jerin, 2019; Registered Nurses Association of Ontario, 2014; Roberto, 2015; Vognar & Gibbs, 2014).
To support the need for additional training in identifying and addressing elder victimization, this chapter will provide an understanding of elder abuse and neglect and review the best practice strategies used to support victims of elder abuse.
Chapter Objectives
- 1.
Describe the various forms of elder abuse.
- 2.
Summarize the risk factors associated with the victim and the offender.
- 3.
Compare and contrast strategies police, social services, and medical professionals use to assess and intervene in cases of elder abuse.
- 4.
Identify needs for future research to help support elder abuse victims.
Background
The initial approach to elderly victimization was to protect the elderly from themselves (Dolinsky & Jerin, 2019). In 1962, amendments to the Social Security Act sent money to states to establish elder protective service units, not so much to protect the elderly from criminal victimizations, but to protect them from self-neglect (Teaster et al., 2010). In 1965, a second federal government legislative action was passed in the form of the Older Americans Act (OAA) (Government Publishing Office, 1965). This legislation provided additional federal funding to states to deliver services and support to allow the elderly to remain independent. The OAA originally focused on providing assistance to low-income and older individuals living in rural areas, but has since expanded its services to support older Americans who want to live independently (Dolinsky & Jerin, 2019). The OAA act has been reauthorized numerous times since 1965 and includes funding for community service employment for the elderly, nutrition services, health promotion, disease prevention, family caregiver services, and grants to Native Americans. However, less than 0.5% of the total amount of the nearly $2 billion funding in FY 2012 went to the prevention and detection of elder abuse (Dolinsky & Jerin, 2019).
Key Terms in this Chapter
Multidisciplinary Team: Multidisciplinary teams can include a diverse set of professionals spanning across several disciplines including Adult Protective Services, police, geriatricians, psychologists, health care professionals, attorney representation, long-term care ombudspersons, and mental health counselors. The team’s responsibilities include providing expert consultation to service providers and updating team members on new policies, programs, and services.
S.A.L.T. Council: The Triad action group that focuses on senior crime and safety. The council reviews and recommends programs that will provide a community benefit to the senior citizens.
Triad Program: A collaboration between the American Association of Retired Persons (AARP), the International Association of Chiefs of Police (IACP), and the National Sheriff‘s Association (NSA) that uses law enforcement personnel and volunteers to develop and implement crime prevention and education programs for older adults.
Elder Justice Act: The Elder Justice Act was signed into law by President Obama on March 23, 2010, as part of the Patient Protection and Affordable Care Act. It provides federal resources to “prevent, detect, treat, understand, intervene in and, where appropriate, prosecute elder abuse, neglect and exploitation.” Most elder justice programs and activities never received funding through the annual congressional appropriations process. In addition, the authorizations of appropriations for most Elder Justice Act provisions expired on September 30, 2014.
Elder Abuse: Physical, sexual, or psychological abuse, as well as neglect, abandonments, and financial exploitation of an older person by another person or entity, which occurs in any setting (e.g., home, community, or facility), either in a relationship where there is an expectation of trust and/or when an older person is targeted based on age or disability.
Dementia: A term used to describe more than 70 disorders that are the result of degenerative damage to nerve cells within the brain. This damage affects thinking, memory, language, emotions, and the ability to make decisions.
Elder Justice Roadmap: The Roadmap provides a resource for strategic planning to combat elder abuse. It identifies priorities and strategies for public and private engagement at the local, state, and federal levels based on the recommendation of 750 professionals who work with the elderly.