Elder Abuse and Neglect
Prevention And Intervention
Research has yet to adequately address these aspects of elder mistreatment. One of the most established programs serving mistreated elders is the Elder Abuse Project sponsored by the Victim Services Agency at Mt. Sinai Hospital in New York directed by Risa Breckman (Breckman and Adelman). Breckman is also the codirector of the Elder Abuse Training and Resources Center, which provides training, technical assistance, and case consultation services to organizations through out the country. Rosalie Wolf and Karl Pillemer present four of the best practice models—a multidisciplinary case conference team from San Francisco, a volunteer advocacy program from Madison, Wisconsin, a victim support group from New York City, and a master's degree adult protective services track in social work in Hawaii. They also address some of the common problems faced by community agencies that deal with elder mistreatment cases—the fragmented human services system, the resistance and reluctance of victims to accept services, and the shortage of trained personnel.
Effective intervention in elder mistreatment cases is often difficult to accomplish. First and foremost, since many mistreated elders are competent adults they have the right to refuse assistance even when it is obviously needed. Many of them deny that abuse or neglect is occurring or refuse any assistance offered, often due to embarrassment or fear of retaliation. Only when an older adult is ruled mentally incompetent by a court and a guardian is appointed can intervention be instigated without the elder's consent. Second, in many communities the resources needed for intervention are nonexistent or very limited. Sometimes the only option available is to remove the elder from his or her home. Yet both abuse and neglect also occur in rest and nursing homes. So for some elders the treatment is worse than the original problem. Third, the care of mistreated elders typically requires a multidisciplinary team of health care and human services providers who are well trained regarding the needs of older adults and the needs of abused or neglected elders, and who can address their medical, social, psychological, housing, and legal needs. Fourth, since very little research has been done on elder mistreatment intervention, including which strategies produce the most effective and efficient outcomes, practitioners have little evidence-based information to guide them in caring for these elders. Last, funding has been very limited for instituting or maintaining new initiatives for managing mistreatment cases.
Theoretically speaking, the prevention of elder abuse and neglect will require that ageism be eliminated in our society, and that we restore respect for and honor to our older adults. In addition, it will require that we educate everyone about aging, instill the value of people over material objects, and establish the resources needed to provide quality care for our aged members. Empirically speaking we do not yet know how to effectively prevent or intervene in elder abuse or neglect cases. Very little research has been done on these aspects of elder mistreatment, and there is very little outcome or programmatic evaluation data. Therefore, clinical judgment typically guides prevention and intervention. Until sound research addresses these important aspects of elder mistreatment, this will continue to be the case.
MARGARET F. HUDSON
See also AGEISM; CRIMINAL VICTIMIZATION.
BIBLIOGRAPHY
ANETZBERGER, G. J.; KORBIN, J. E.; and AUSTIN, C. C. "Alcoholism and Elder Abuse." Journal of Interpersonal Violence 9 (1994): 184–193.
BRECKMAN, R. S., and ALDERMAN, R. D. Strategies for Helping Victims of Elder Mistreatment. Newbury Park, Calif.: Sage, 1988.
BURSTON, G. R. "Granny-Battering." British Medical Journal (6 September 1975): 592.
BUTLER, R. N. Why Survive? Being Old in America. New York: Harper & Row, 1975.
DOUGLASS, R. L., and NOEL, C. "A Study of Maltreatment of the Elderly and Other Vulnerable Adults." Final Report to the U.S. Administration on Aging, Department of HEW and the Michigan Department of Social Services. Ann Arbor, Mich.: Institute of Gerontology, University of Michigan, 1980.
FULMER, T. T., and GOULD, C. S. "Assessing Neglect." Abuse, Neglect, and Exploitation of Older Persons. Edited by L. A. Baumhover and S. C. Beal. Baltimore: Health Professionals Press, 1996. Pages 89–99.
HUDSON, M. F. "Elder Mistreatment: Current Research." Elder Abuse: Conflict in the Family. Edited by K. A. Pillemer and R. S. Wolf. Dover, Mass.: Auburn House, 1986. Pages 125–166.
HUDSON, M. F. "Elder Mistreatment: A Taxonomy with Definitions by Delphi." Journal of Elder Abuse and Neglect 3 (1991): 1–20.
HUDSON, M. F., and CARLSON, J. R. "Elder Abuse: Expert and Public Perspectives on it's Meaning." Journal of Elder Abuse and Neglect 9 (1998): 77–97.
HUDSON, M. F., and CARLSON, J. R. "Elder Abuse: Its Meaning to Caucasians, African-Americans, and Native Americans." Understanding Elder Abuse in Minority Populations. Edited by T. Tatara. Washington, D.C.: Taylor and Francis, 1999. Pages 187–204.
O'MALLEY, H.; SEGARS, H.; PEREZ, R.; MITCHELL, V.; and KNUEPFEL, G. M. Elder Abuse in Massachusetts: A Survey of Professionals and Paraprofessionals. Boston, Mass.: Legal Research and Services for the Elderly. 1979.
PEDRICK-CORNELL, C., and GELLES, R. "Elder Abuse: The Status of Current Knowledge." Family Relations 31 (1982): 457–465.
PHILLIPS, L. R. "Abuse and Neglect of the Frail Elderly at Home: An Explanation of Theoretical Relationships." Journal of Advanced Nursing 8 (1983): 379–392.
PILLEMER, K. A. "The Dangers of Dependency: New Findings on Domestic Violence Against the Elderly." Social Problems 33 (1985): 146–158.
PILLEMER, K. A., and FINKELHOR, D. "The Prevalence of Elder Abuse: A Random Sample Survey." The Gerontologist 28 (1988): 51–57.
PILLEMER, K. A., and MOORE, D. W. "Abuse Patients in Nursing Homes: Findings from a Survey of Staff." The Gerontologist 29 (1989): 314–320.
PODNIEKS, E. "National Survey on Abuse of the Elderly in Canada." Journal of Elder Abuse and Neglect 4 (1992): 5–57.
REINHARZ, S. "Loving and Hating One's Elders: Twin Themes in Legend and Literature." In Elder Abuse: Conflict in the Family. Edited by K. A. Pillemer and R. S. Wolf. Dover, Mass.: Auburn House, 1986. Pages 25–48.
STEARNS, P. J. "Old Age Family Conflict: The Perspective of the Past." In Elder Abuse: Conflict in the Family. Edited by K. A. Pillemer and R. S. Wolf. Dover, Mass.: Auburn House, 1986. Pages 3–24.
STEINMETZ, S. K. "The Politics of Aging, Battered Parents." Society (July/August 1978): 54–55.
STEUER, J., and AUSTIN, E. "Family Abuse of the Elderly." Journal of the American Geriatrics Society 28 (1980): 372–376.
SUMNER, W. G. Folkways: A Study of the Sociological Importance of Usage, Manners, Customs, Mores, and Morals. New York: The New American Library, 1960.
TATARA, T. "Understanding the Nature and Scope of Domestic Elder Abuse with the Use of State Aggregate Data: Summaries of Key Findings of a National Survey of State APS and Aging Agencies." Journal of Elder Abuse and Neglect 5 (1993): 35–37.
TAKAMURA, J. C., and GOLDEN, O. The National Elder Abuse Incidence Study: Final Report. Washington, D.C.: National Center on Elder Abuse, 1998.
WOLF, R. S. "Major Findings From the Three Model Projects on Elder Abuse." In Elder Abuse: Conflict in the Family. Edited by K. A. Pillemer and R. S. Wolf. Dover, Mass.: Auburn House, 1986. Pages 218–238.
WOLF, R. S.; GODKIN, M. A.; and PILLEMER, K. A. Elder Abuse and Neglect: Final Report from Three Model Projects. Worcester, Mass.: University Center on Aging, University of Massachusetts Medical Center, 1984.
WOLF, R. S., and PILLEMER, K. A. "What's New in Elder Abuse Programming? Four Bright Ideas." The Gerontologist 34 (1994): 126–129.
ELDER MISTREATMENT
See ELDER ABUSE AND NEGLECT
Additional topics
Medicine EncyclopediaAging Healthy - Part 2Elder Abuse and Neglect - Definitions And Types Of Abuse And Neglect, Incidence And Prevalence, Victim And Perpetrator Characteristics, Prevention And Intervention