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2000
Volume
12 Number 1
The
First National Study of Elder Abuse and Neglect: Contrast
With Results from Other Studies, by Cynthia Thomas, PhD
with commentaries by Terry Fulmer, PhD; RN, FAAN; Paula
Mixson, MA; Chris Phillipson, PhD; and James J. Callahan,
PhD
ABSTRACT.
The National Elder Abuse Incidence study (NEAIS), conducted
in 1994-1999 under the sponsorship of the US Administration
for Children and Families and the Administration on Aging,
was designed to obtain national estimates of both reported
and unreported cases of elder abuse and neglect for 1996.
This article contrasts the methods and results of this
study with several previous studies to assess the reasons
for differences in estimates. These differences include
whether the study was designed to measure prevalence or
incidence, the inclusiveness of the definitions, eligible
age range, and methods of data collection. Future studies
should combine incidence and prevalence and incorporate
a sample design that will allow estimates for several
age ranges and definitional subsets to meet different
public policy requirements.
Key
words: estimates of elder abuse, incidence and prevalence,
sentinel approach
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Older
Self-Neglecters: Interpersonal Problems and the Maintenance
of Self-Continuity, by Susanna D. Bozinovski, PhD
ABSTRACT:
This qualitative study using the grounded theory method
explores the nature of self-neglect among older persons
who have been involved with Adult Protective Services.
Two basic social psychological processes were identified
which explain much of the self-neglecting behavior exhibited
by older persons. These include preserving and protecting
self and maintaining customary control. These two processes
comprise the overarching process of Maintaining Continuity.
Interpersonal problems of these older self-neglecters
are a main source of threat to identity and sense of personal
control. It is the quest for continuity that accounts
for many of the interactional activities between these
persons and others including their caseworkers, family
members, neighbors, and others. Viewed in this way, continuity
goes beyond being just an adaptive strategy. It is a motivating
force and also a continuous life goal.
Key
words: Self-neglect, adult protective services, aging,
continuity, self, grounded theory
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The
Quality of Data Collection by an Interview on the Prevalence
of Elder Mistreatment, by Hannie C. Comijs, PhD; Wil Dijkstra,
PhD; Lex M. Bouter, PhD; and Johannes H. Smit, PhD
ABSTRACT:
The aim of the present study was to investigate the quality
of the interview process that was used to obtain data
on the prevalence of elder mistreatment in order to improve
the quality of this process in future research studies.
Audiotapes of interviews with 143 victims of elder mistreatment
were transcribed into verbatim protocols that were subsequently
coded and analyzed. The results of the present study show
that despite the fact that all interviewers were carefully
selected, intensively trained, and supervised during the
interview period, 4.2% of the questions were skipped,
and in 4.4% of the interactions no usable answer was obtained.
However, in all of these cases the interviewer did register
an answer, the validity of which is questionable. Considerable
differences were found between interviewers with respect
to their performance and also between the various questions.
Finally, suggestions are made to improve interviewer behavior.
Key
words: elder mistreatment, prevalence, question-answer
sequence, interaction coding
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Elder
Abuse In Costa Rica, by Nancy Gilliland, PhD and Lillyana
Picado, E., MSc
ABSTRACT:
This paper describes how the problem of domestic elder
abuse in Costa Rica is being perceived and acted upon
by direct service providers and other professionals in
the field of aging. Costa Rica is a small Central American
democracy in which the family is the central institution
and sense of filial obligation is strong. In this cultural
context elder abuse often takes the form of overprotection
by family members who deprive elders of their autonomy.
Although they suffer from this loss, elders frequently
do not define it as abuse, making it difficult for professionals
to intervene. A more serious concern was abandonment of
elders by families (with or without intent to harm) since
there are few facilities or resources to accommodate such
elders. Over all we found a mixture, sometimes in the
same person, of resignation in the face of a phenomenon
that may come inevitably with modernization and committed
activism. We illustrate the latter by describing the efforts
of two Costa Rican organizations to prevent elder abuse.
Key
words: elder abuse, Costa Rica, developing society,
abandonment, filial obligation
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Elder
Abuse: Some Caucasian-American Views, by Margaret F. Hudson,
PhD, RN; Cherry Beasley, MSN, RN; Ruth H. Benedict, MSN,
RN; John R. Carlson, MS; Beverly F. Craig, EdD, RN; Carolyn
Herman, PhD, RN; and Shirley C. Mason, EdD, RN
ABSTRACT:
To gain a greater understanding of what "elder abuse"
means to the American public, a random sample of adults
from seven culturally diverse counties in North Carolina
was interviewed. Caucasian-Americans from five different
counties and regions of the state were represented in
the sample. The Caucasian-American groupsÕ responses were
compared with each other and with those of a panel of
elder mistreatment experts. There were areas of agreement
and disagreement. The relevance of the findings is discussed
in relation to research, practice, education, and policy.
Key
words: elder abuse, caucasian-american, meaning, definition,
types.
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Volume
12 Number 2
Undoing
Undue Influence, by Mary Joy Quinn, RN, MA
ABSTRACT:
Undue influence has long been recognized within the
legal profession and the courts, usually within the context
of will contests. The field of elder abuse and neglect
is now beginning to focus on the issue as practitioners
try to understand the actions of seemingly competent and
capable elders who give away major assets or gifts sometimes
to virtual strangers. Undue influence frequently accompanies
other types of elder abuse and neglect, usually occurring
when a close personal relationship exists. This paper
describes the dynamics of undue influence, outlines the
profiles of victims and abusers, and offers intervention
and prevention strategies.
Key
words: competency, trust, manipulation, threats, financial
abuse
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Elder
and Dependent Adult Fraud: A Sampler of Actual Cases to
Profile the Offenders and the Crimes They Perpetrate, by
Judith B. Sklar, JD
ABSTRACT:
Fraud targeted at elder and dependent adults is largely
committed by four different groups of perpetrators, each
targeting its own unique assortment of crimes at this
vulnerable group of victims. The purpose of this article
is to profile these four offender groups, identify the
various crimes being committed, and provide some preventative
tips and investigative tools to combat this growing area
of fraud. The profiles of the offender groups are compiled
from summaries of actual cases that were prosecuted by
the Santa Clara County District AttorneyÕs Office.
Key
words: victims, power of attorney, prosecution, elder
abuse, theft
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Notes
From The Field: Observations In Working With Forgotten Victims
Of Personal Financial Crimes, by Debbie L. Deem, MS, MSW
ABSTRACT:
This paper focuses on the forgotten victims of financial
crimes. It describes the scope and nature of financial
crime, the impact of this type of crime, and the need
for services to assist victims and their families. It
further describes promising approaches to meeting the
service needs of financial crime victims and ensuring
equal access and protections to members of this underserved
group.
Key
words: elder abuse, perpetrators, fraud, courts, restitution,
fiduciary abuse specialist team
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Forgotten
Victims Of Financial Crime And Abuse: Facing The Challenge,
by Lisa Nerenberg, MSW, MPH
ABSTRACT:
This article summarizes the proceedings of four roundtable
discussions, which were sponsored by the National Center
on Elder Abuse, and held in conjunction with a conference
on financial crime and abuse. The discussions focused
on four components of the legal system: local law enforcement,
federal investigative and regulatory agencies, the civil
justice system, and victim witness assistance programs.
Participants were asked to describe their role in preventing
financial crime and the challenges they face in doing
so.
Key
words: criminal justice system, civil justice system,
victim witness assistance, restitution, investigative
agency, elder abuse, undue influence, mental capacity
Volume
12 Number 3/4
Sexual
Abuse of Older Adults: Preliminary Findings of Cases in
Virginia, by Pamela B. Teaster, PhD; Karen A. Roberto, PhD;
Joy O. Duke, MS; and Myeonghwan Kim, MS
ABSTRACT:
Aggregated data from APS case files of sexually abused
adults in Virginia aged 60 years and older were collected
from July 1, 1996 - June 30, 1999, yielding a total of
42 substantiated cases for the three years of collection.
Data reveal demographic trends; ability to care for self;
type, pattern, and place of abuse; information on witnesses
and alleged offenders; and case resolution and outcomes.
Results show that the majority of cases (n = 40) concerned
women over 70 years of age residing in facilities; offenders
were men (n = 40). Most cases were not prosecuted. Implications
of these data are discussed.
Key
words: sexual abuse, older adult, adult protective
services, elder abuse, outcomes
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Adult
Protection Services Laws: A Comparison of State Statutes
From Definition to Case Closure, by Jini L. Roby, JD, MSW
and Richard Sullivan
ABSTRACT:
While legislative efforts at the federal and state levels
have represented a dramatic change in the last three decades,
there is a great range and variations in the laws addressing
elder abuse, leading to difficulty in generating comparison
data, and coordinating program creation and implementation
across state lines. This article examines the legislative
variations on the topics of definitional issues, reporting
statutes, investigative methods, temporary and permanent
court interventions, and protective services provided
under the laws of all fifty of the United States and the
District of Columbia. Further, it examines the current
elder abuse literature and makes suggestions toward legislation
compatible with it. The bulk of the statutory data include
those available in 1998 but many statutes which became
effective in 1999 are also included. All jurisdictions
are referred to as "states," including the District of
Columbia which is technically a federal district.
Key
words: statutes, legislation, adult protective services,
intervention, laws, elder abuse, financial exploitation.
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Most
Successful Intervention Strategies For Abused Older Adults,
by Daphne Nahmiash, PhD and Myrna Reis, PhD
ABSTRACT:
In this Project CARE study, intervention plans for 83
cases, with a total of 473 strategies, are analyzed in
a qualitative content analysis method. The 473 strategies
are designed and implemented by an abuse-trained, multidisciplinary,
health and social service agency, home care team. Each
strategy is rated by the team for its acceptance/refusal
by clients and levels of success. The most accepted and
successful strategies for abused older adults are concrete:
nursing and other medical care and homemaking assistance,
followed by empowerment strategies, such as support groups
for abused older adults, information about rights and
resources and volunteer buddy/advocates. Less successful
strategies for abused persons are referrals to general
community activities and programs. For caregiver abusers,
the most successful and accepted interventions involve
individual supportive counseling to reduce anxiety, stress
and depression and education and training. Abuser-oriented
strategies are most accepted and successful in the study.
Thus, it would seem pertinent for intervenors to focus
services and strategies on abusers and not only on abused
older adults, in particular offering them supportive individual
counseling to reduce anxiety, stress, and depression.
For abused care receivers, home-based services can offer
the necessary support to move out of their abuse situation
with the help of volunteers and support group activities.
Key
words: abuse, seniors, caregivers, intervention strategies,
empowerment, supportive counseling.
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Perceptions
of Adult Protective Services Workers of the Support Provided
By Criminal Justice Professionals in a Case of Elder Abuse,
by B.E. Blakely, PhD and Ronald Dolon, PhD
ABSTRACT:
This paper summarizes results of a 1997 survey of adult
protective services workers in 43 states. The survey yielded
ratings of police and victim assistants in detecting and
treating elder abuse and estimates of the likelihood that
criminal justice professionals would provide ten forms
of assistance in a case of elder abuse. Respondents also
reported the most helpful services supplied by criminal
justice professionals, the services that were most difficult
to obtain, and overall ratings of criminal justice professionals
in cases of elder abuse. Findings provide insights about
relationships between adult protective services workers
and criminal justice professionals.
Key
words: Elder abuse, domestic violence, police, victim
assistant, arrest, protective orders
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Elder
Abuse: Risk Factors and Use of Case Data to Improve Policy
and Practice, by Burton D. Dulop, PhD; Max B. Rothman, JD,
LLM; Katherine M. Condon, MA; Kellye S. Hebert, MA; and
Iveris L. Martinez, MA
ABSTRACT:
Countering the generally reactive community approach to
prevention and treatment of elder abuse, this study employs
analysis of local elder abuse case data to estimate the
incidence of elder abuse, neglect, and exploitation and
to measure the risk factors, including co-location of
other forms of abuse, that predict elder abuse in Miami-Dade
County, Florida. The authors also compare the model of
intervention used in Florida and elsewhere to best practice
models that incorporate elements of domestic violence
treatment. They present a series of specific recommendations
for improving local abuse data-collection, analysis, and
training so that local policy-makers, planners, and practitioners
can make proactive, community-specific, culturally-sensitive
preventive efforts effective. The findings and recommendations
have direct relevance for policy and practice in any community
in the United States.
Key
words: elder abuse, risk factors, intrafamily violence,
intervention, prevention
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Abuse
Of Female Caregivers by Care Recipients: Another Form Of
Elder Abuse, by Linda R. Phillips, Ph.D., RN, FAAN; Esperanza
Torres de Ardon, MS, RN; and Guillermina Solis Briones,
RN, A/GNP, MS
ABSTRACT:
This paper focuses on the abuse of aging, caregiving women
(55 years or older) by the spouses or parents for whom
they provide care. Data presented were derived from a
study of the dynamics of family caregiving focusing on
Mexican American and Anglo caregiving dyads. Analysis
focused on identifying correlates of abuse from a group
of variables that represented the structure and context
of caregiving. Data suggest the problem is not trivial
and the interactional context of caregiving is the most
promising aspect for explanation, intervention and prevention.
Key
words: Cross-cultural caregiving; Hispanic caregiving;
Elder abuse; Caregiver abuse.
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PRACTICE
ISSUES
Experiences
And Needs Of Adult Protective Services Case Managers When
Assisting Clients Who Have Companion Animals, by Barbara
W. Boat, PhD and Juliette C. Knight, MA
ABSTRACT:
Enhancing the safety and quality of life of adults
who require protective services must frequently include
consideration of their companion animals. Six Adult Protective
Services case managers reported on their experiences with
clients who had pets. Issues discussed included clientsÕ
neglect of themselves and their pets, attachment to and
loss of pets, abuse and threats to harm a pet, collecting
or hoarding of animals, and staff encounters with aggressive
animals. The case managers made recommendations concerning
agency procedures, staff training and useful support services
to offer staff and clients when companion animals are
present.
Key
words: Adult protective services, animal pets, attachment
to pet
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