Background & History
The population of adults 65 and older in the United States is growing rapidly (U.S. Census Bureau, 2017). Of critical importance to ensuring the well-being of older adults is addressing the public health issue of elder abuse (Weissberger et al., 2019). Elder abuse results in physical, psychological, financial, sexual abuse, neglect, and social consequences to victims, their families, and society. Elder abuse is a growing public health problem in the United States, and statistics show that each year, hundreds of thousands of elders are abused in some manner (Rzeszut, 2017). Statistics show that elders who experience abuse have a 300 percent higher risk of death when compared to those elders who have not been abused. Each state defines elder abuse in its unique way, and thus definitions of elder abuse vary from state to state (Rzeszut, 2017). The problem with many states’ elder abuse statutes is that many of them do not include elder abandonment as a form of elder abuse or instead categorize elder abandonment as a form of Elder neglect. Abuse in nursing homes may also be categorized according to the type of relationship; staff-to-resident abuse, family-to-resident abuse, and resident-to-resident abuse, also called resident-to-resident aggression (Myhre et al., 2020).
According to the National Center on Elder Abuse, elder abandonment is defined as “the desertion of an elderly person by an individual who has assumed responsibility for providing care for an elder, or by a person with physical custody of an elder” (Rzeszut, 2017). Because elder abandonment is sometimes used interchangeably with elder neglect; elder abandonment is rarely reported, and statistics for elder abandonment are hard to come by (Rzeszut, 2017). If elder abandonment was added to every state’s statute, it would increase awareness across the United States and more cases will be brought to the attention of law enforcement or Adult Protective Services (APS) is solely a case of elder abandonment instead of elder neglect.
Statistics show that nearly thirty percent of the adult population in the United States provides care for a member of the elderly community (Myhre et al., 2020). As the elderly population in the United States increases, more and more adult children are becoming caregivers for their aging parents. Statistics in the United States show that family and friends usually become caregivers for the elderly and therefore become the ones responsible for most long-term care for the elderly. Little is known about elder abuse in nursing homes, and compared to research on other forms of interpersonal abuse, research about elder abuse in nursing homes is still in its infancy (Platts-Mills et al., 2020). The Emergency departments (E.D.) are a unique and important setting for screening for elder abuse. In the United States, E.D.s are the primary source of acute, unscheduled care for older adults, with more than 20 million visits annually. Individuals experiencing elder abuse visit the E.D. at approximately three times the rate of non-abused elders.
Areas of Concern
The most reliably measured kind of elder physical abuse form of mistreatment. Screening frequently relied on a modified version of the Conflict Tactic Scale (CTS) based on Pillemer and Finkelhor’s development of the CTS (1988) prevalence analysis. (Pillemer, et al. 2016). Sexual assault, including any form of unsolicited sexual contact. Inflicting any mental suffering is considered emotional abuse. Caregiver neglect is the unwillingness or failure to meet a caregiver’s responsibility to provide for their charges’ fundamental requirements, such as food, clothes, shelter, and medical attention.
Elder abuse is “any knowing, willful, or negligent conduct by a caregiver or any other person that causes injury or a severe risk of harm to a vulnerable adult,” according to the Administration on Aging (Rzeszut, S. M. 2017). Physical, sexual, emotional, and neglectful behaviors are just a few examples of how elder abuse can manifest itself. Elder abuse is viewed as a serious public health issue in the U.S., according to the National Association of Area Agencies on Aging and the Centers for Disease Control and Prevention. Unfortunately, older People in the U.S. are frequently abused due to their high population and frailty. According to statistics, elderly people who have been mistreated have a 300% greater chance of dying than elderly people who have not.
Elder abuse is particularly malicious because, in most situations, the victim relies on the care or shelter of the perpetrator, who is frequently the caretaker. Most elder abusers are the senior’s offspring since carers are frequently family members. The reality supports the common perception in the United States that elder abuse is underreported and that family members frequently commit acts of elder abuse. According to the Elder Justice Coalition, one of the reasons why elder abuse is so common is because it is a “hidden pandemic.”
Perception of Problem & Strengths of Client Population or Community.
Caregiver interventions were among the first models used to prevent elder abuse (Pillemer et al., 2016). These interventions provide services to relieve the burden of caregiving, such as housekeeping and meal preparation, respite care, education, and support groups and are promoted as abuse-prevention strategies. The most widely used intervention across countries is telephone “helplines,” which allow individuals to seek advice and assistance regarding elder abuse. There is considerable case study evidence suggesting that helplines facilitate early intervention to prevent or forestall mistreatment.
Unfortunately, the greatest gap in knowledge about elder abuse lies in prevention, given the pressing nature of the problem (Pillemer et al., 2016). Only approximately Ten intervention studies have been conducted with even minimally acceptable methods, and the results of most of these efforts have been negative or equivocal. No international comparative Studies of prevention programs have been conducted. Further, no information exists on the cost-effectiveness of programs; there is virtually no descriptive data on the costs incurred by elder abuse interventions.
The incidence of elder abuse in institutional settings is not addressed due to a lack of studies; no trustworthy prevalence studies of this mistreatment in nursing homes or other long-term care institutions have been done. The findings of the surveys imply that the extent of elder abuse is so great that social workers and medical experts who work with older people are likely to come across it regularly. The risk of abuse is increased for several subpopulations overrepresented in the elder service system, such as dementia sufferers. Elder abuse incidences will increase overall if prevalence rates stay the same, reflecting a rapidly expanding population of senior citizens. Depending on the rates at which their populations are growing, various nations will experience this spike in incidences of elder abuse in different ways.
The idea that this study includes individuals who hold leadership roles in several nursing homes and towns in Norway is a strength that might improve the applicability of its findings (Myhre et al., 2020). With individuals from two different nations and a combined depth of research expertise, the research team brought a variety of viewpoints and conversations to the data analysis process. This enhances the reliability of our results and the legitimacy of the study.
Leaders & Key Informants
For this case, the key informants and leaders comprise a range of people with knowledge and data about elder abuse in the United States. The primary Key informants are the victims of elder abuse, the caregivers, the long-term care Ombudsman Program, and the aging disability services. The leaders include the lawyers in cases of elder abuse, the National Centre on Elder Abuse (NCEA), and the states’ strategies in charge of the elderly American Citizens well being formed in October 2000 at the national symposium on elder fraud and abuse (Teaster et al., 2020). These strategies are sponsored by the U.S. Department of Justice and the U.S. Department of Health & Human Services (Teaster et al., 2020). The data from the three interviewed victims of elder abuse reports that they did not report the abuse initially due to fear of the stigmatization that comes with suing family members since their primary caregivers were their children and relatives.
The main reason elder abuse cases are on the rise despite the law prohibiting elder abuse and forming different programs to deal with elder abuse is that the people in charge of ending the abuse are participating in the abuse. Besides, the authorities in charge of caring for the elders and dealing with cases of abuse lack active oversight; therefore, most reported cases take longer to solve while other issues are not looked into( Weissberger et al., 2022). For this reason, the only way to mitigate or control the abuse is by creating an active oversight and financing the programs put forward by the nation to mitigate elder abuse. Elders should be reminded of their rights and educated on forms of abuse such that whenever a case a rise, they can easily report it to the relevant authorities. The caregivers in charge of elders should be educated and advised on the need to give quality care to the elder. The government should support them financially and make healthcare for the elderly affordable and accessible.
Despite its widespread effect, only a fraction of these cases reaches the attention of Adult Protective Services (APS) (Roepke-Buehler, Dong MD, 2015). APS agencies investigate elder abuse cases and intervene when cases are substantiated to resolve abusive situations. The types of elder abuse cases that APS handles are diverse and include abuse from a perpetrator (physical, emotional, and sexual abuse; financial exploitation; neglect) and self-neglect. For conceptual clarification, the Administration on Aging and the Elder Justice Act include abuse from a perpetrator and self-neglect under the umbrella construct of elder abuse. Most elder abuse cases reported to APS are cases of self-neglect. Given the complex psychosocial and individual-level mechanisms underlying various types of abuse, it is essential to examine elder abuse as a global construct according to its specific subtypes. Data from the NCEA and Ombudsman programs all relate to one common point: there are few oversights and accountability measures in these programs to ensure active and quality service delivery; therefore, most cases go unsolved. Therefore the primary way to solve these cases is by creating strong oversight of the authorities in charge of elders’ well-being.
Weissberger, G. H., Goodman, M. C., Mosqueda, L., Schoen, J., Nguyen, A. L., Wilber, H., Gassoumis, Z. D., Nguyen, C. P., & Han, S. (2019, July 31). Elder Abuse Characteristics Based on Calls to the National Center on Elder Abuse Resource Line. Journal of Applied Gerontology, 39(10), 1078–1087. https://doi.org/10.1177/0733464819865685
Rzeszut, S. M. (2017, July). The Need for a Stronger Definition: Recognizing Abandonment as a form of Elder Abuse Across the United States. Family Court Review, 55(3), 444–457. https://doi.org/10.1111/fcre.12295
Myhre, J., Saga, S., Malmedal, W., Ostaszkiewicz, J., & Nakrem, S. (2020, March 12). Elder abuse and neglect: an overlooked patient safety issue. A focus group study of nursing home leaders’ perceptions of elder abuse and neglect. BMC Health Services Research, 20(1). https://doi.org/10.1186/s12913-020-5047-4
Pillemer, K., Burnes, D., Riffin, C., & Lachs, M. S. (2016, March 18). Elder Abuse: Global Situation, Risk Factors, and Prevention Strategies. The Gerontologist, 56(Suppl 2), S194–S205. https://doi.org/10.1093/geront/gnw004
Roulet Schwab, D., & Wangmo, T. (2017, September 20). Perceptions of Elder Abuse From Community-Dwelling Older Persons and Professionals Working in Western Switzerland. Journal of Interpersonal Violence, 36(1–2), NP135–NP161. https://doi.org/10.1177/0886260517732345
Karl Pillemer, PhD, David Burnes, Ph.D., Catherine Riffin, Ph.D., Mark S. Lachs, MD, MPH, Elder Abuse: Global Situation, Risk Factors, and Prevention Strategies, The Gerontologist, Volume 56, Issue Suppl_2, April 2016, Pages S194–S205, https://doi.org/10.1093/geront/gnw004
Weissberger, G. H., Lim, A. C., Mosqueda, L., Schoen, J., Axelrod, J., Nguyen, A. L., … & Han, S. D. (2022). Elder abuse in the COVID-19 era is based on calls to the National Center on Elder Abuse resource line. BMC geriatrics, 22(1), 1-9.
Teaster, P. B., Lindberg, B. W., & Zhao, Y. (2020). Elder abuse policy, past, present, and future trends. In Advances in Elder Abuse Research (pp. 53-71). Springer, Cham.