What We Know From Elder Abuse Research And Practice Evidence
What We Know from Elder AbuseResearch and Practice EvidenceNational Adult Protective Services Association ConferenceAugust 19, 2019Storm Ervin & Erica Henderson, Urban Institute
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AcknowledgementsThis work was produced by the Center for Victim Research (CVR) undergrant number 2016-XV-GX-K006, awarded by the Office for Victims ofCrime, Office of Justice Programs, U.S. Department of Justice. Theopinions, findings, and conclusions or recommendations expressed inthis presentation are those of the contributors and do not necessarilyrepresent the official position or policies of the U.S. Department ofJustice.VictimResearch.org
Road Map for Today’s Talk1. Goals and process for CVR’s evidence reviews2. Findings from CVR’s Elder Abuse review3. Group discussions and activity4. Share-out and Q&AVictimResearch.org
Goals of CVR’s Reviews Assess state of the field in victimization response for differentSystemvictimization topics Systematically synthesize the best available evidence fromresearch and practice Help service providers and researchers understand what thefield needsVictimResearch.org
Framework for EvidenceSystemBestAvailableResearchWhat WeKnow fromPracticeCVRSynthesesContext ofWhat WeKnowModified from: Puddy, R. W. & Wilkins, N. (2011). Understanding Evidence Part 1: BestAvailable Research Evidence. A Guide to the Continuum of Evidence of Effectiveness, CDCVictimResearch.org
Questions to Answer1. Number of victims (prevalence)2. Risk factors3. Harms and consequences4. Prevention and intervention services5. Policy, practice, and research implicationsVictimResearch.org
For more aboutCVR’s methodology,see our websitehereVictimResearch.org
Inclusion Criteria1. Standard screening criteria for both research and practice evidence: Available in English Produced in 2000 or later Within the victimization scope identified by the review team during Step 12. Further inclusion criteria by evidence type:ResearchPeer-reviewed research employingqualitative, quantitative, and mixedmethods approaches. PracticeMultiple perspectives or consensusRepeatedly cited ( 3 times)Government agency, nongovernmental organization orcredentialed expertVictimResearch.org
Findings from CVR’s Elder AbuseReview
DefinitionAny intentional ornegligent act thatcauses harm orserious risk of harmto an older person Physical abuseEmotional abuseSexual abuseFinancial (or material)exploitation Neglect AbandonmentVictimResearch.org
Scope Abuse committed by a "person oftrust" “Person of trust" could be someonewith a personal relationship, such asfamily or friend, or a legal/contractualrelationship, such as caretaker oraccountant Excludes self-neglect and fraud/scamscommitted by strangers Search results Yielded 300 research articles Yielded 351 practice itemsThis Photo by Unknown Author is licensed under CC BY-NC-NDVictimResearch.org
Elder Abuse Self-Reported on National SurveysNational Elder Mistreatment Study:n 5,77711%Self- report(Acierno et al., 2010)National Social Life Health and AgingProject (NSHAP)n 3,005Wave 1: 23.5%Self- report(Schafer & Koltai, 2014)VictimResearch.org
Elder Abuse Self-Reported by Type of Abuse4.6%EMOTIONAL, PSYCHOLOGICAL, OR VERBALMISTREATMENT9.0%5.2%FINANCIAL EXPLOITATION3.5%5.1%NEGLECT1.6%PHYSICAL MISTREATMENT0.2%0.6%SEXUAL MISTREATMENTNational Elder Mistreatment Study (n 5,777)NSHAP (n 3,005)VictimResearch.org
Elder Abuse Reported to Social ServicesChicago Health and Aging Project1993-2010 n 6,1392.3%Reported to social servicesElder Abuse Reports in 17 states0.86%Reported to social services(Jogerst et al., 2003)(Dong, Simon, & Evans, 2012)VictimResearch.org
Elder Abuse Detected by Medical Professionals2012 Nationwide EmergencyDepartment DataN 6,723,667.025%*using weighted prevalence(Evans et al., 2017)Medicare Primary andConsumer DemonstrationN 724 older adults withphysical impairment7.5%(Friedman et al., 2015)VictimResearch.org
Elder Abuse Detected by Medical Professionals by Type of AbuseEMOTIONAL, PSYCHOLOGICAL, OR VERBAL MISTREATMENT2.2%FINANCIAL EXPLOITATION1.4%NEGLECT3.7%PHYSICAL MISTREATMENTSEXUAL MISTREATMENT0.7%0.1%Medicare Primary and Consumer Demonstration (n 724)VictimResearch.org
Demographic Risk Factors Gender (women) Mixed evidence on age Minority sexualorientation and gender(LGBT) Race (people of color)Photo by Shutterstock/755584399VictimResearch.org
More Risk FactorsSocialPhysical/Mental Isolation and Loneliness Physical Health Impairment Low Socioeconomic Status Cognitive Impairment (e.g.Alzheimer’s dementia) Dependency on others forcare Mental/ behavioral health issues(e.g. substance abuse)VictimResearch.org
Harms and VictimResearch.org
lSupportTrainingVictimResearch.org
Services and InterventionsAdult Protective ServicesLaw EnforcementReporting andInvestigatingLong-Term Care OmbudsmenCivil Attorneys andProsecutionVictimResearch.org
Services and InterventionsFinancial Abuse SpecialistTeamsMedical Intervention sponsesForensic CentersElder Fatality Review TeamsVictimResearch.org
Services and InterventionsLong-Term Care OmbudsmenArea Agencies on AgingAdvocacy andSupportVictim ServicesSystem-Based & Faith-BasedAdvocacyVictimResearch.org
Barriers to Accessing ServicesThis Photo by Unknown Author is licensedunder CC BY-SA-NC Physical and cognitive limitations Shame and embarrassment Fear of retaliation Dependence on abuser Self-blame Lack of awareness Cultural norms/responsesVictimResearch.org
Services for Vulnerable Older AdultsLGBT Self-help andpeer-basedsocialsupport Partnershipswith LGBTserviceprovidersNativeAmericans RestorativejusticeLatinx CommunitybasedadvocatesAsian PacificIslandersAfricanAmericans Religiousinstitutions Communitybasedorganizations ReligiouscommunitiesVictimResearch.org
Key Legislation Elder Justice Act (2010)Older Americans Act (1965)Older Americans Reauthorization Act (2016)Violence Against Women Reauthorization Act (2013)Mandatory Reporting LawsPower of Attorney and Guardianship LawsVictimResearch.org
Where the Field Needs to Grow Include input from olderadults in all efforts Improve policies andoversight of substituteddecision-making Identify and evaluate othereffective interventions andprogramsThis Photo by Unknown Author is licensed under CC BYVictimResearch.org
Where the Field Needs to Grow Increase research andprevention around cognitiveincapacity Increase research, culturallyappropriate training,resources, and evidencebased victim services fordiverse racial and ethnicpopulationsThis Photo by Unknown Author is licensedunder CC BY-NC-NDVictimResearch.org
Selected References Acierno, R., Hernandez, M. A., Amstadter, A. B., Resnick, H. S., Steve, K., Muzzy, W., & Kilpatrick, D. G. (2010). Prevalence and correlates ofemotional, physical, sexual, and financial abuse and potential neglect in the United States: The National Elder MistreatmentStudy. American journal of public health, 100(2), 292-297. Burgess, A. W., & Phillips, S. L. (2006). Sexual abuse, trauma and dementia in the elderly: A retrospective study of 284 cases. Victims andOffenders, 1(2), 193-204 Dong, X., Simon, M., De Leon, C. M., Fulmer, T., Beck, T., Hebert, L., Dyer, C.B., Paveza, B., & Evans, D. (2009). Elder self-neglect and abuseand mortality risk in a community-dwelling population. Jama, 302(5), 517-526. Dyer, C. B., Pavlik, V. N., Murphy, K. P., & Hyman, D. J. (2000). The high prevalence of depression and dementia in elder abuse orneglect. Journal of the American Geriatrics Society, 48(2), 205-208. Friedman, L. S., Avila, S., Tanouye, K., & Joseph, K. (2011). A case–control study of severe physical abuse of older adults. Journal of theAmerican Geriatrics Society, 59(3), 417-422 James, B. D., Boyle, P. A., & Bennett, D. A. (2014). Correlates of susceptibility to scams in older adults without dementia. Journal of elderabuse & neglect, 26(2), 107-122. Roberto, K. A., Teaster, P. B., & Duke, J. O. (2004). Older women who experience mistreatment: Circumstances and outcomes. Journal ofWomen & Aging, 16(1-2), 3-16 Wong, J. S., & Waite, L. J. (2017). Elder mistreatment predicts later physical and psychological health: Results from a national longitudinalstudy. Journal of elder abuse & neglect, 29(1), 15-42VictimResearch.org
Who do you partner with in the community, in the state, on a nationallevel to address elder abuse? How do services in your community adapt to serve culturally, socially,and economically diverse older adults? What is working well to prevent and respond to elder abuse in yourpractice? What overarching barriers do practitioners face in addressing elderabuse?VictimResearch.org
Thank earchCenter for Victim arch
Framework for Evidence System Modified from: Puddy, R. W. & Wilkins, N. (2011). Understanding Evidence Part 1: Best Available Research Evidence. A Guide to the Continuum of Evidence of Effectiveness, CDC CVR Syntheses Best Available Research What We Know from Practice Context of What We Know
are victims of abuse. 1 › 1 in 10 persons over the age 60 are victims of elder abuse. 2 › Victims of elder financial abuse in U.S. lose close to 3 Billion each year. 3. 1. National Center of Elder Abuse:2005 Elder Abuse Prevalence and Incidence. 2 . National Institute of Justice: Elder Abuse as a Criminal Problem. 3
of elder abuse. These lists are just a starting point. There are other indicators for each type of elder abuse. Also, state laws may define more or fewer types of elder abuse, use different definitions, and include other crimes that might be charged. Be aware that many elder abuse victims ex
3. General public outreach on a variety of issues including elder abuse. New York City Department for the Aging and Elder Abuse (DFTA) DFTA has released several articles and held informational meetings about preventing Elder Abuse, including: 1. Elder Abuse & Crime - DFTA. 2. DFTA Launches 'Providing Options to Elderly Clients Together' Clinical
Elder Abuse: Speakers Notes Power Point Presentation (for a general audience) Slide 1 - Elder Abuse - A Community Issue We live in an aging society. People 85 and older represent the fastest growing segment of the population. As the number of elderly Canadians continues to grow, so will the cases of elder abuse. Elder abuse is not
5.0 Elder Triple Screen Rule Information The Elder Triple Screen Rule was developed by Dr. Alexander Elder. Dr. Elder, once a psychiatrist in New York City, is a professional trader and a world-class expert in technical analysis. He is also the author of two best-selling trading books Trading for a Living and Come into My Trading Room. The .
(1) The elder or dependent adult in . 11. (2) The persons in . 66. (3) The home of the elder or dependent adult. (4) The job or workplace of the elder or dependent adult. (5) The vehicle of the elder or dependent adult. (6) Other (specify): b. If the court orders the person in . 2. to stay away from all the places listed above, will he or she .
Elder Abuse Important Facts about Elder Sexual Abuse 70% of reported sex abuse occurs in nursing homes. Only 30% of victims of elder sexual abuse report it to authorities The abuser is the primary caregiver 81% of the time Elderly women are six times more likely than men to be sexually abused Types of Sexual Abuse Elder Abuse
Prevention of Elder Abuse and the Journal of Elder Abuse & Neglect . Rosalie S. Wolf 1997 Elder Abuse and Neglect, An Update in Reviews in Clinical Gerontology, 7, 177-182. Decade: 1990s Phase: Diversification Major characteristic: . Susan Johnson Created Date:
