What Services Are Available to Stop Abuse?
A variety of health and social services are available to address the underlying causes of abuse, stop it, and reduce the likelihood that it will occur again. Still other services treat the emotional, physical, and financial effects. Some of these services are federally funded and available in every community, while others are specific to certain communities. Below is a list of services that are frequently needed by victims. Instructions for finding out what services are available in your community, and how to access them, are provided on the How do I find services in my community? page.
Mental health assessments are often needed to determine if an older person is capable of meeting his or her own basic needs, making decisions about services, offering testimony, and protecting him or herself against abuse. Assessments of alleged abusers' mental status are sometimes needed to determine if they pose a danger to others and are in need of treatment.
Counseling for victims or vulnerable adults can help them assess their options, plan for their safety, resolve conflicts, and overcome trauma. Group or individual counseling may be available from private therapists, health maintenance organizations, or mental health clinics. In abuse cases, counseling typically focuses on the following issues:
- Educating victims about resources and options
- Breaking through denial and shame
- Safety planning (planning what to do if abuse occurs)
- Building support networks
- Traumatic or post traumatic stress
- Family counseling to resolve or mediate conflicts and address tensions or stresses that give rise to abuse or neglect
Legal assistance is needed in many abuse cases. Legal services are provided by private attorneys, programs operated by local or state bar associations, or subsidized legal aid programs. The Older American's Act established a network of free legal services for persons over the age of 60. These programs are becoming increasingly adept at handling elder abuse cases. The following interventions may be needed in abuse cases:
- Lawsuits to recover assets or property
- Annulments of bogus marriages
- Restraining orders to restrict contact between perpetrators and victims
- Guardianship (called conservatorship in some states) is a process by which courts assign responsible persons or agencies to act on behalf of people who are unable to protect themselves or their interests as a result of physical or cognitive impairments. Guardians may be family members or professionals from public or private guardians or in private practice. Some communities have programs that use volunteers to serve as, or monitor, guardians.
- Prosecution of offenders
- Assistance with obtaining restitution
When abuse or neglect is related to the stresses associated with care giving, risk can be reduced by providing services that reduce the older person's dependency and isolation and provide relief to caregivers. Support services include:
Daily money management. Financial abuse frequently may occur when an older person has lost the ability to manage his or her finances. Arranging for trustworthy people to help can reduce this risk. The help may be informal, where the money manager simply helps the elder with simple tasks like paying bills, or it may involve formal transfers of authority, including representative payeeship, power of attorney, or guardianship.
- Support groups for caregivers address the emotional demands and stresses of providing care. They also provide instruction and guidance in meeting the older person's needs and handling difficult behaviors. They may relieve the tensions, resentments, and stresses that give rise to abuse and neglect.
- Respite programs give caregivers a break. Respite care comes in many forms. Attendants, professionals, or volunteers may come to the older person's home to provide a few hours of relief to the caregiver, or the older person may come to an agency. Some communities offer extended respite care of several days or longer.
- Home delivered meal programs. Programs deliver nutritious meals to seniors in their homes.
- Attendants assist vulnerable people with their daily activities, including bathing, shopping, and preparing meals.
- Adult day health centers provide an array of services, including nursing care; physical, occupational, and speech therapy; and socialization to frail seniors.
- Friendly visitors make home visits to isolated seniors.
- Telephone reassurance programs can make routine "check in" calls to isolated seniors or provide telephone counseling to seniors who are in emotional distress.
Case management is an approach to providing services to individuals who have multiple and changing care needs. Case managers, who may work for public or private agencies or be in private practice, provide the following services:
- Comprehensive assessments of the older person's general health, mental capacity, and ability to manage in the home and community
- Develop "care plans," often in consultation with other professionals from several disciplines, for meeting clients' service needs
- Arrange for needed services
- Respond to problems or emergencies
- Conduct routine re-assessments to detect changes in the person's health or ability to manage, and anticipate problems before they occur
Victim witness assistance
Victim witness assistance programs, which are usually located within prosecutors' offices, help victims whose cases are in the criminal justice system. They provide:
- Information to victims about the court process and the status of their cases
- Advocacy on behalf of victims. Victim advocates inform courts about victims' special needs for protection or assistance, their preferences and concerns regarding what happens to perpetrators, etc.
- Information about and assistance with compensation, restitution, and community services
Domestic violence programs provide an array of services for battered women. Some offer special services for older women or can accommodate older women's special needs. Domestic violence services include:
- Counseling for victims and abusers
- Crisis lines
- Support groups
Services for Abusers
Some situations can be remedied by providing services to abusers. Abusers who are dependent on their victims for money or a place to live may benefit from job training or placement, financial assistance, counseling in independent living, or mental health or substance abuse treatment. While it is difficult to convince some abusers to accept treatment voluntarily - particularly mental health, domestic violence, or substance abuse treatment - these services are often mandated by courts or offered as conditions of probation or as alternatives to prosecution.
Stopping neglect and self-neglect
Determining what interventions are appropriate in neglect cases depends on many factors, including the caregivers' willingness to improve care, the families' resources, and the willingness of the elder to accept help. Caregivers who are willing and able to improve the care they provide can be assisted by support services. A caregiver whose motive for providing care is self-interest may need to be replaced by a responsible person. Mental health services may also be needed, particularly in self-neglect cases.