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On March 29, 2007 the Elder Justice Act was introduced in the House by Representatives Rahm Emmanuel (D-IL) and Peter King (R-NY) as H.R. 1783 and in the Senate by Senators Orrin Hatch (R-UT) and Blanche Lincoln (D-AR) as Bill S.1070. It aims to protect seniors by: 1) Boosting funding for the long-term care ombudsman program, which serves as an advocate for the elderly and disabled in long term care; 2) It also establishes an adult protective services grant program and forensics centers that are charged with developing expertise on elder abuse; 3) It elevates the importance of elder justice issues by creating a coordinating council of federal agencies that will make policy recommendations and submit reports to Congress every two years; 4) It requires the Departments of Labor and Health and Human Services to take a proactive role in funding initiatives aimed at improving training programs and working conditions for long-term care professionals as a strategy for increasing the number of such workers during the coming years.
"Our nation has for far too long turned its back on the shame of elder abuse," said Herb Kohl, Chairman of the Senate Special Committee on Aging. "Congress has held hearings on the devastating effects of elder abuse for a quarter of a century. We are finally saying enough is enough. Elder Abuse is unacceptable and we are going to act to stop it." The National Center on Elder Abuse, says studies have estimated that between 3 and 5 percent of the elderly population have been abused, that may be as many as 5 million victims every year.
In a 2004 Survey of State Adult Protective Services, findings show a 19.7 percent increase in the combined total of reports of elder and vulnerable adult abuse and neglect and a 15.6 percent increase in substantiated cases in the four years since the last survey was conducted in 2000.
Who are the victims of abuse?Older women, according to the survey, are far more likely than men to suffer from abuse or neglect. In 2003, two out of every three (65.7%) elder abuse victims were women (15 states reporting).
In 20 of the states, more than two in five victims (42.8%) were age 80 or older.
The majority (77.1%) of victims, according to reports from 13 states, were Caucasian.
What are the types of abuse and who are the perpetrators?
In 2003, slightly more than half (52.7%) of the alleged perpetrators of elder abuse or neglect were female (11 states reporting). Three out of every four alleged offenders (75.1%) were under 60 (7 states reporting). Most alleged perpetrators in 2003 were adult children (32.6%) or other family members (21.5%). Spouses/intimate partners accounted for 11.3% of the total (11 states responding).
Twenty-one of the states (40.4%) maintain an abuse registry or database of alleged perpetrators, while 31 (59.6%) do not.
As reported by 19 states, types of maltreatment substantiated included:
Self neglect (37.2%)
Caregiver neglect (20.4%)
Financial exploitation (14.7%)
Emotional/psychological/verbal abuse (14.8%)
Physical abuse (10.7%)
Sexual abuse (1%)
Other (1.2%)
The three most common sources of reports of elder abuse and neglect allegations were family members (17%), social services workers (10.6%), and friends and neighbors (8%), according to APS data from 11 states. Senior citizens who suffer from physical or mental abuse are three times more likely to die within three years than those free of abuse, according to a new review of data on elder abuse. A substantial number of older persons -- from 2 to 10 percent of the elderly population -- are physically or mentally abused.
Karl Pillemer, professor of human development in the College of Human Ecology at Cornell, has collaborated with Dr. Mark S. Lachs, co-chief of the Division of Geriatrics and Gerontology at the Weill Cornell Medical College in New York City, on a detailed review in The Lancet (Vol. 364, Oct. 2: pp. 1192-1263) on the risk factors, screening, clinical manifestations, diagnosis and treatment of elder abuse.
"This vastly unrecognized and under treated problem compromises the quality of life for millions of older people worldwide," says Pillemer. "A busy physician, who might see 20 to 40 elderly patients a day, might encounter a case of possible elder abuse every day, but because of a lack of time, resources and a general lack of recognition of the problem, many cases go undetected and untreated, putting our elderly at heightened risk of physical and mental harm, and even death." The Cornell gerontologists call for a multidisciplinary team approach to assess the situation and develop solutions that are tailored to the individual victim's needs and problems. Lachs and Pillemer assert that elder abuse directly affects quality of life, and helping patients resolve an abusive situation is one of the most gratifying experiences for physicians and other health-care professionals.
The research was supported, in part, by a National Institute on Aging Mentoring Award in Patient Oriented Research in Aging and an Edward R. Roybal Center grant, also from the National Institute on Aging.
Q&A From National Center on Elder Abuse1. What is elder abuse? Elder abuse is a term referring to any knowing, intentional, or negligent act by a caregiver or any other person that causes harm or a serious risk of harm to a vulnerable adult. The specificity of laws varies from state to state, but broadly defined, abuse may be:
Physical Abuse - Inflicting, or threatening to inflict, physical pain or injury on a vulnerable elder, or depriving them of a basic need.
Emotional Abuse - Inflicting mental pain, anguish, or distress on an elder person through verbal or nonverbal acts.
Sexual Abuse - Non-consensual sexual contact of any kind.
Exploitation - Illegal taking, misuse, or concealment of funds, property, or assets of a vulnerable elder.
Abandonment - The desertion of a vulnerable elder by anyone who has assumed the responsibility for care or custody of that person.
Elder abuse can affect people of all ethnic backgrounds and social status and can affect both men and women.
2. What are the warning signs of elder abuse? While one sign does not necessarily indicate abuse, some tell-tale signs that there could be a problem are:Bruises, pressure marks, broken bones, abrasions, and burns may be an indication of physical abuse, neglect, or mistreatment.
Unexplained withdrawal from normal activities, a sudden change in alertness, and unusual depression may be indicators of emotional abuse.
Bruises around the breasts or genital area can occur from sexual abuse.
Sudden changes in financial situations may be the result of exploitation.
Bedsores, unattended medical needs, poor hygiene, and unusual weight loss are indicators of possible neglect.
Behavior such as belittling, threats, and other uses of power and control by spouses are indicators of verbal or emotional abuse.
Strained or tense relationships, frequent arguments between the caregiver and elderly person are also signs.
Most important is to be alert. The suffering is often in silence. If you notice changes in personality or behavior, you should start to question what is going on.
3. What is self-neglect and what are the signs? Tragically, sometimes elders neglect their own care, which can lead to illness or injury. Self-neglect can include behaviors such as:Hoarding
Failure to take essential medications or refusal to seek medical treatment for serious illness
Leaving a burning stove unattended
Poor hygiene
Not wearing suitable clothing for the weather
Confusion
Inability to attend to housekeeping
Dehydration
Self-neglect accounts for the majority of cases reported to adult protective services. Oftentimes, the problem is paired with declining health, isolation, Alzheimer's disease or dementia, or drug and alcohol dependency.
In some of these cases, elders will be connected to supports in the community that can allow them to continue living on their own. Some conditions like depression and malnutrition may be successfully treated through medical intervention. If the problems are severe enough, a guardian may be appointed.
4. What makes an older adult vulnerable to abuse? Social isolation and mental impairment (such as dementia or Alzheimer's disease) are two factors that may make an older person more vulnerable to abuse. But, in some situations, studies show that living with someone else (a caregiver or a friend) may increase the chances for abuse to occur. A history of domestic violence may also make a senior more susceptible to abuse.5. Who are the abusers of older people? Abusers of older adults are both women and men. Family members are more often the abusers than any other group. For several years, data showed that adult children were the most common abusers of family members; recent information indicates spouses are the most common perpetrators when state data concerning elders and vulnerable adults is combined.
The bottom line is that elder abuse is a family issue. As far as the types of abuse are concerned, neglect is the most common type of abuse identified. Review our Fact Sheet for more information about who abuses.
6. Are there criminal penalties for the abusers? Although there are variations across the country, in most states there are several laws that address criminal penalties for various types of elder abuse. Laws vary state to state. Some states have increased penalties for those who victimize older adults. Increasingly, across the country, law enforcement officers and prosecutors are trained on elder abuse and ways to use criminal and civil laws to bring abusers to justice.7. How many people are suffering from elder abuse? It is difficult to say how many older Americans are abused, neglected, or exploited, in large part because surveillance is limited and the problem remains greatly hidden. Findings from the often cited National Elder Abuse Incidence Study suggest that more than 500,000 Americans aged 60 and over were victims of domestic abuse in 1996.
This study also found that only 16 percent of the abusive situations are referred for help - 84 percent remain hidden. While a couple of studies estimate that between 3 percent and 5 percent of the elderly population have been abused, the Senate Special Committee on Aging estimates that there may be as many as 5 million victims every year.
8. Who do I call if I suspect elder abuse? Each one of us has a responsibility to keep vulnerable elders safe from harm. The laws in most states require helping professions in the front lines -- such as doctors and home health providers -- to report suspected abuse or neglect. These professionals are called mandated reporters. Under the laws of eight states, "any person" is required to report a suspicion of mistreatment. Wisconsin is not one of these states. Wisconsin has voluntary reporting.9. What should I expect if I call someone for help? When making the call, be ready to give the elder's name, address, contact information, and details about why you are concerned.
You may be asked a series of questions to gain more insight into the nature of the situation.
Are there any known medical problems (including confusion or memory loss)?
What kinds of family or social supports are there?
Have you seen or heard incidents of yelling, hitting, or other abusive behavior?
You will be asked for your name, address, telephone number, etc., but Wisconsin will take the report even if you do not identify yourself.
10. How can elder abuse be prevented? Educating seniors, professionals, caregivers, and the public on abuse is critical to prevention. On an individual level, some simple but vital steps to reduce the risk:Take care of your health.
Seek professional help for drug, alcohol, and depression concerns, and urge family members to get help for these problems.
Attend support groups for spouses and learn about domestic violence services.
Plan for your own future. With a power of attorney or a living will, health care decisions can be addressed to avoid confusion and family problems, should you become incapacitated. Seek independent advice from someone you trust before signing any documents.
Stay active in the community and connected with friends and family. This will decrease social isolation, which has been connected to elder abuse.
Know your rights. If you engage the services of a paid or family caregiver, you have the right to voice your preferences and concerns. If you live in a nursing home or board and care home, call your Long Term Care Ombudsman. The Ombudsman is your advocate and has the power to intervene. All states have adult protective and long-term care ombudsman programs, family care supports, and home and community care services that can help older adults with activities of daily living.
11. How can I help stop elder abuse? Knowing the warning signs of abuse is a first step toward protecting elders. Some specific tips:
Become a community "sentinel" - Keep a watchful eye out for loved ones, friends, or neighbors who may be vulnerable.
Speak up if you have concerns. That means even if you are not sure. You have a right to question.
Be involved. Volunteer with older adults in your community. Support initiatives to increase and strengthen adult protective services in your state.
Please contact your federal representatives and have them co-sponsor and support H.R. 1783 and S.1070. These are important Bills for the health and welfare of our seniors.
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