The Family Violence Community of Practice newsletter shares ideas and keeps our colleagues informed about practices that improve the justice system’s response in family violence cases. Please contact Madelynn Herman, knowledge management analyst, at mhermann@ncsc.dni.us or (757) 259-1549 with questions, concerns, or suggestions for the Family Violence CoP. 

Table of Contents

The Problem and Meaning of Elder Abuse – by Lynn Levey

National Estimates of Elder Abuse – by Brenda Uekert

Elder Abuse “Before the Court” – by Denise Dancy

Resource Corner – by Madelynn Herman 

Congressional Beat: The Elder Justice Act 

Florida’s Model Training Program   

Prosecuting Elder Crimes in Contra Costa, California 

Rochester’s Innovative Program for Elder Abusers 

In the News: Kentucky says “yes” to family courts

We want your Feedback!

The Problem and Meaning of Elder Abuse     

By Lynn Levey    

Many professionals, both inside and outside of the court system, hold the belief that older women who are victims of domestic violence stay in their situation because they have ‘gotten used to the abuse.’  Ask yourself, ‘do you ever get used to being beaten, berated or bruised?’ 

– Art Mason, Lifespan, Rochester, NY    

Elder abuse is an umbrella term that may include physical, sexual or emotional abuse; financial exploitation; and neglect in providing necessary material items like food, shelter or clothing to avoid physical harm or mental illness. The abuse might also involve withholding medicine or refusing to arrange transportation for doctor appointments. While damage inflicted by physical abuse may be obvious, frequently the abuse is in the form of emotional or psychological abuse, resulting in humiliation, intimidation, and fear. Like intimate partner violence, elder abuse occurs in all kinds of families.      

The elderly are subjected to stereotypes in the media that affect the way the public, justice agencies, and the courts respond to abuse within this population. According to Art Mason of Lifespan in Rochester, New York, “there still exists a great deal of ‘ageism’ when dealing with older victims of domestic violence. False assumptions are made about their reluctance to follow through with charges, their ability to understand things and whether their memory is intact. This type of stereotyping … often leads to dismissal of the seriousness of the situation and patronizing attitude by many.”   

Elder abuse, like intimate partner violence, thrives in silence. While perpetrators of elder abuse may be the victim’s spouse or partner, the perpetrator may be a custodial caregiver, a child or grandchild. Like intimate partner violence, isolation from others is a key component of elder abuse. The elderly must often depend on others for basic necessities like food, shelter and clothing. The person that controls these items has a great deal of power. Threats to withdraw any of these basic items, coupled with the possibility of physical harm, may lead to physical and mental health problems or intensify existing ones.     

Screening for elder abuse should be done regularly by medical personnel and those in contact with the elderly. Physical limitations often make it difficult for elderly people to have meaningful interaction with those outside their immediate living quarters. This not only contributes to social isolation but also reduces the opportunities for others to notice changes in someone’s well-being. It also minimizes the opportunity for someone to ask for help.     

What to look for in an elderly person you know: 

• Unexplained injuries, bruises or burns 

• Excessive fears, withdrawal or agitation 

• Sudden inability to pay bills, buy food or personal items 

• Changes in appetite; unusual weight gain or loss 

• Poor personal hygiene 

• Does not know personal finances 

• Unexplained changes in health   

Do’s for families and friends 

• Respect and honor our elders

• Report suspected abuse/mistreatment or self-neglect 

• Find sources of help and use them 

• Visit regularly to monitor well-being of elderly neighbors and reduce isolation 

• Speak up when something looks or sounds wrong 

• Volunteer to help an elderly person

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National Estimates of Elder Abuse   

By Brenda Uekert   

“It is widely recognized that the risk of harm is a real one. Yet at the same time, far too little is known about what is happening. The nation has not yet begun collecting data on the incidence or prevalence of elder abuse. The statistics are incomplete.”  

—The National Association of Adult Protective Services Administrators   

Each year hundreds of thousands of older persons are abused, neglected and exploited by family members. Many victims are people who are older, frail, and depend on others to meet their most basic needs. Because elder abuse affects a vulnerable population and the abuse often occurs within the family, the crime suffers from a shroud of secrecy. Hence, elder abuse is vastly underreported. The most recent national survey of elder abuse and neglect (conducted in 1996 by the National Center on Elder Abuse) estimated that almost four times as many new incidents of abuse, neglect, and/or self-neglect were NOT reported as those that were reported to and substantiated by Adult Protective Services (APS) agencies.     

All states have some form of elder abuse prevention laws and a reporting system. The reporting process typically involves a phone call to the state elder abuse hotline. The APS agency screens calls for potential seriousness, and if the agency decides the situation possibly violates state elder abuse laws it assigns a caseworker to conduct an investigation. A 2000 survey of APS agencies found that of 396,398 investigations by APS agencies, almost half of those were substantiated.   

Despite the lack of comprehensive and timely studies, various surveys have found considerable consistency in the character of elder abuse. Among the most compelling statistics are the following.   

• A 2000 survey of APS investigations across the US revealed a troubling 61 percent increase over 1996 in the number of elder abuse allegations nationally – and a staggering 300 percent increase since the first national survey in 1986.

• Female elders are abused at a higher rate than males, after accounting for their larger proportion in the aging population. 

• Our oldest elders (80 years and over) are abused and neglected at two to three times their proportion of the elderly population. 

• In almost 90 percent of the elder abuse and neglect incidents with a known perpetrator, the perpetrator is a family member, and two-thirds of the perpetrators are adult children or spouses. 

• Almost half of the substantiated abused and neglected elderly were not physically able to care for themselves.   

The statistics are alarming. In 2001, the the first National Summit on Elder Abuse called it “a crisis requiring full mobilization.”  The Summit, sponsored by the National Center on Elder Abuse, resulted in the adoption of 21 separate recommendations as part of the agenda. Among the priorities:   

• Develop and implement a sustained national strategic communications program to educate the public on elder abuse. 

• Enact a National Elder Abuse Act to raise national awareness and to focus federal resources on elder abuse. 

• Improve the legal landscape for the justice system. 

• Fund the development and implementation of a national elder abuse education and training curriculum.  

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Elder Abuse “Before the Court” 

By Denise Dancy

It is estimated that only 1 out of 14 cases of domestic elder abuse (excluding self-neglect cases) is identified or brought to the attention of authorities.[1] Courts, in particular, can “see” elder abuse in a variety of contexts. But do they recognize the extent of the problem?  

The overt cases of abuse are more readily identifiable, but given the full spectrum of “elder abuse” types and definitions, incidents may go undetected or unsuspected. Systemic ignorance can lead to an escalation of the problem. It becomes incumbent to be able to screen for instances of abuse.   

A variety of risk assessment and screening tools have been developed in recent years.[2] Assessment can fall into three general categories: actual abuse, suspected abuse, and (potential) risk of abuse. They also vary by type of administration. There is considerable variance in the instruments used to identify abuse—and some have been criticized on issues of reliability and validity. 

Ideally, elders at risk of abuse should be screened through Adult Protective Services (APS) or a similar type of agency. Yet, this may not always be practical or timely. An initial screening from the “bench” is entirely appropriate. A streamlined version of one screening instrument has been suggested as a simple (initial) screening tool for elder abuse. It includes the following questions: 

• Are you afraid of anyone in your family? 

• Has anyone close to you tried to hurt or harm you recently? 

• Has anyone close to you called you names or put you down or made you feel bad recently? 

• Does someone in your family make you stay in bed or tell you you’re sick when you know you aren’t? 

• Has anyone forced you to do things you didn’t want to do? 

• Has anyone taken things that belong to you without your okay? 

Potential “high-risk situations” can also be briefly assessed using a “SAVED” protocol[3].  This protocol identifies the following risk factors that may be indicative of abuse or the potential for abuse:  

S - Stress/social isolation
A - Alcohol/other drug abuse
V - Violence (previous history)
E - Emotions (psychiatric illness)
D - Dependency/dynamics in family (or other caregiving situation)   

Issues of mental capacity, consent (willful), and undue influence should also be factored into an elder’s vulnerability to abuse.[4] Incapacity can increase the likelihood of abuse. Courts should consider the relationship between the parties and the “fairness” of any transaction, and determine whether undue influence is a factor in certain cases involving elders.   

Wider implementation of the Recommended Guidelines for State Courts Handling Cases Involving Elder Abuse[5] and the utilization of a simple screening protocol (and referral for a full assessment where appropriate and available) can enhance the court’s awareness and efficacy in identifying and properly adjudicating cases where elder abuse may be involved. It also decreases the likelihood of the court’s unknowing complicity with a phenomenon that continues to grow in frequency as a larger part of our society continues to age - and becomes more vulnerable to elder abuse and “domestic violence in the older generation.”  

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Resource Corner 

By Madelynn Herman    

What are the mandatory requirements for reporting elder abuse? Are there any recommended guidelines for the handling of elder abuse cases in the state courts? Has a training curricula been developed for judges and court staff on elder abuse? Are there any listservs for professionals working in the field of elder abuse?  What is an elder justice center? What is the definition of elder abuse? Are there national statistics on the incidence of elder abuse?   

The newest edition to resources in the NCSC Court Information Database is the Elder Abuse Resource Guide. The Elder Abuse Resource Guide provides answers to the questions posed above. This resource guide was developed specifically for the courts and provides information on the following topics:   

• Elder abuse resources for courts 

• Elder abuse legislation and laws 

• Websites and online reports 

• Elder abuse prevention 

• Elder abuse statistics and definitions 

• A bibliography of law review articles and books on elder abuse    

The NCSC Knowledge and Information Service responds to requests for information from the court community, policy makers, and others. To request information or technical assistance on elder abuse or family violence, see our online request form or call 800-616-6164 or 757-259-1588.

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Congressional Beat: The Elder Justice Act   

In September 2002, United States Senators John Breaux (D-Louisiana) and Orrin Hatch (R-Utah) introduced the Elder Justice Act of 2002. The bill establishes dual Offices of Elder Justice at the Departments of Justice and Health and Human Services. The Offices would be responsible for coordinating disparate federal, state and local elder abuse prevention efforts, while also housing policy experts and coordinating programs to study, detect, treat, prosecute, and most importantly, prevent elder abuse. The bill would also establish new programs to assist victims and provide grants for education and training for law enforcement and prosecutors.  As of February 2003, the bill has been referred to the Senate Committee on Finance.

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Florida’s Model Training Program    

In Florida, an innovative, model training program is being developed to improve court and prosecution response to elder abuse and domestic violence. “All professionals who work in this area have heard the alarming statistics,” says Jean Sherman, Ed.D., R.N. and Director of The Center for Aging and Disabilities at the University of Miami School of Medicine. “Yet, until recently, there has been little concerted effort to train criminal justice professionals about the unique dynamics of successfully prosecuting crimes against the elderly and people with disabilities, or about how to make justice programs truly accessible to these crime victims,” adds Sherman.

The new curriculum, “Take A Closer Look: Obtaining Justice Under the Law for Elders and People with Disabilities,” includes training about frail elders and people with disabilities, both considered “vulnerable adults” under Florida Law. It combines training on abuse, neglect and exploitation of vulnerable adults with domestic violence that occurs in these populations. Training is scheduled to take place from July through December 2003 for criminal court professionals, and in mid-2004 for civil court professionals.   

Under this program, justice professionals in the local State Attorney’s Office―prosecutors, investigators, court officers and victim assistants, etc.―will attend training sessions to expand their existing knowledge and awareness of the needs and challenges of vulnerable adults, so that they can, “take a closer look”, and know the appropriate steps to take to better protect and serve these victimized citizens. When an incident is reported and substantiated, a closer look will enable justice professionals to:

• Identify cases of abuse or domestic violence in elders and persons with disabilities 

• Respond in a way that will safeguard the victim, involving appropriate area services to achieve a coordinated response and an effective intervention and safety/recovery plan 

• Make programs truly accessible by ensuring that impaired victims are provided with any appropriate support services or assistance they may need 

• Acquire the knowledge to do their jobs more effectively with respect to vulnerable adults; find more satisfaction and less frustration in job performance 

• Better coordinate all elements within the justice system to increase the number of successful prosecutions   

The Take a Closer Look Project will use a collaborative community team from the Miami-Dade State Attorney’s Office, the Safespace Foundation, Inc., the ARC of South Florida and the Center on Aging and Disabilities at the University of Miami to develop and deliver a model comprehensive training curriculum. The project will create a model victim needs screening tool for victim counselors to better support older victims and individuals with disabilities. Additionally, the project will create a model assessment tool for use in the Probate Court, to detect elder guardianship wards who are at high risk for abuse.   

Among the many reasons to develop and conduct such training, “It’s the right thing to do,” says Jean Sherman. “Truly, the worth of any society can be judged by the manner in which it treats its most vulnerable members.”   

For more information, contact Jean Sherman, jsherman@med.miami.edu.

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Prosecuting Elder Crimes in Contra Costa, California    

In 2001, Contra Costa’s District Attorney’s Office created the Elder and Dependent Adult Prosecution Unit.  The new unit was made possible by funding through the county’s “Zero Tolerance Initiative” and was established by the Board of Supervisors. Local community-based groups, such as Elder Abuse Prevention and its advocate group, Senior Fraud Fighters, played a major role in advancing the cause. This effort symbolized a partnership between those who advocated on behalf of the elderly and dependent adults and those who advocated for survivors of domestic violence.   

The unit began with a prosecutor and an investigator, on loan from the Sheriff’s Office. In addition to their regular duties, the team initiated training for law enforcement and a public education campaign. An increase in the caseload led to an expansion of the unit, and a second prosecutor and investigator were added in 2002. The specialized unit handles homicide, serious battery, robbery, false imprisonment, and a variety of financial crime cases. The unit participates in a multidisciplinary team that includes Adult Protective Services, Elder Abuse Prevention, law enforcement agencies, hospital staff, Aging and Adult Services.  This group meets monthly to review difficult cases.      

According to Deputy District Attorney Phyllis Redmond, “one of the goals for the future of the unit is to provide enhanced advocacy and support for our victims who are often in great need of services.” The unit strives to enhance the relationship between the District Attorney’s Office and local community partners. Ms. Redmond added, “The Zero Tolerance Initiative has provided not only funding but a mindset of positive action in cases involving elder and dependent abuse.”  

For more information, contact: Phyllis Redmond, predm@da.co.contra-costa.ca.us.

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Rochester’s Innovative Program for Elder Abusers   

Lifespan, a non-profit agency in Rochester New York, offers a psycho-educational program for those who abuse the elderly. The program, called Stop Elder Abuse and Mistreatment Program, or SEAM, is a 16-week program that covers aging awareness, the myth of entitlement, issues of power and control, and taking responsibility for one’s actions.     

SEAM holds perpetrators accountable for their actions, which may include financial exploitation, physical abuse and neglect, sexual mistreatment, and verbal abuse. Referrals are made by the courts, adult protective services, probation and others in the legal or medical community. The program is not limited to spouses or by gender.

According to Program Director Art Mason, SEAM “presents a ‘third alternative’ to many older victims of domestic violence who have been told by numerous professionals or friends, that their only two choices are to cut all ties to the perpetrator or to learn to live with the situation.” SEAM works to honor the wishes of the victim while also monitoring the situation for further signs of abuse. Mason also noted that “most older people have had little, if any, exposure to the court system. Many hold the system in awe or are very intimidated by it. It is incumbent upon us to make that interaction as positive as possible so they can get their issues addressed and their safety protected.”     

The refrain is a familiar one: when victims are asked what they want, they often say they want the abuse to stop. The SEAM program offers innovation, victim safety, and accountability for abusers.     

For more information on this program contact Art Mason at Lifespan: 585-244-8400 Ext. 110. 

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In the News: Kentucky says “yes” to family courts   

On November 8, 2002, Kentuckians made an historic decision. By ballot, they informed their government that they believe Kentucky should amend the state’s constitution to initiate family courts.    

The general election ballot in Kentucky asked voters: “Are you in favor of Family Courts in Kentucky by amending the Kentucky  Constitution to allow the Supreme Court to designate a division of circuit court as a Family Court?” Voters overwhelmingly supported the amendment, with 76 percent voting yes and 24 percent voting no.

For 10 years, Kentucky operated a family court pilot project in a handful of locations. There was a question, however, as to the constitutionality of the family courts, and many believed that the courts should not be expanded statewide until the state constitution could be amended to provide for them. 

According to Chief Justice Joseph E. Lambert of Kentucky, there is a lesson to be learned. “Citizens want improved courts, and when they are properly educated, respond enthusiastically.”  

Virtually all major newspapers in Kentucky endorsed the amendment before the election, and it was passed overwhelmingly in both houses of the Kentucky General Assembly. The amendment also received the support of the Kentucky Education Association, the Kentucky Farm Bureau Federation, the Kentucky State AFL-CIO, the Kentucky Association of School Superintendents, the Jefferson County Teachers Association, several Kentucky chapters of the NAACP, any many other organizations.

In an op-ed piece published by several Kentucky newspapers, Chief Justice Lambert wrote, “Where court involvement in family matters is necessary, courts should do more than merely decide who wins and who loses. With dedicated judges, competent and well-trained support staff, and helping professionals, family courts are making an otherwise dreadful ordeal a survivable experience.”

For more information on family courts, the National Center for State Courts recommends the following publications, both available online at www.ncsconline.org.   

• "How Are Courts Coordinating Family Cases?" by Carol Flango, Victor E. Flango, and H. Ted Rubin
• “Integrating Criminal and Civil Matters in Family Courts: Performance Areas and Recommendations” by Brenda Uekert 

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We want your Feedback! 

The Family Violence Community of Practice would like to hear from you.  Do you have any suggestions on topics we should address in the newsletter?  Are you interested in low cost web-based training opportunities?   What are your training needs?   Just drop us a note so that we can better address the needs of the court community and those who serve the families affected by domestic violence.  Contact: Madelynn Herman (mherman@ncsc.dni.us).    

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