2003

Volume 15 Number 1

Domestic Violence and Stalking Among Older Adults: An Assessment of Risk Markers by Jana L. Jasinski, PhD and Tracy L. Dietz, PhD

ABSTRACT. There is limited empirical evidence regarding the extent to which older adults are physically abused by their spouse or partner, and the risk factors associated with such abuse. Much of what does exist focuses on either caregiver abuse or abuse occurring in institutional settings. Moreover, there is virtually no information on stalking victimization among older adults. The current study used the National Violence Against Women Survey to examine physical abuse and stalking victimization among a sample of adults ages 55 and older (N = 3,622). Similar to research conducted with younger samples, women age 55 and older were significantly more likely than men to be both stalked and physically assaulted. Significant racial differences also emerged with respect to intimate partner physical violence, but not stalking. Specifically, African-American and Hispanic respondents were more likely to be victims of intimate partner violence compared to White respondents. Income, however, was not significantly associated with either stalking or physical assault victimization.

Key words: stalking, domestic violence, elder, older adult, victimization

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Elder Abuse in Connecticut's Nursing Homes by Priscilla D. Allen, MSW, PhD; Kathy Kellett, MA; and Cynthia Gruman, MSW, PhD

ABSTRACT: This study investigates abuse and neglect concerns from the nursing home resident's perspective in the state of Connecticut through a retrospective case record review. Complaints tracked from July 1998 through July 2000, using the Connecticut Ombudsman Reporting System, totaled 3,443 and were combined with related data from all of the state's nursing homes (N = 261). Within the total number of complaints, analysis centered on the subcategories of abuse, gross neglect, exploitation (n = 269), and care (n = 791). Findings show that 69% of Connecticut's nursing homes had accounts of care complaints and 47% had one or more accounts of abuse. Identifying abuse and care concerns in Connecticut's nursing homes may lead to the exposition of additional patterns related to abuse and care in other institutional settings and merits further exploration of staffing characteristics in relation to abuse.

Key words: elder abuse, elder neglect, long-term care, nursing home consumers, Ombudsman Program, quality of care.

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Elder Sexual Abuse Within the Family by Holly Ramsey-Klawsnik, PhD, LMFT, LCSW

ABSTRACT: Suspected elder sexual abuse cases investigated by the Massachusetts Elder Protective Services Program between 1993 and 2002 were qualitatively analyzed using clinical consultation records. Cases that involved perpetrators who were family members of their victims inform this discussion of elder sexual abuse within the family. The cases fall into two groups: marital sexual abuse and incestuous abuse. Three patterns of marital cases were observed: (1) long-term domestic violence, (2) recent onset of sexual abuse within a long-term marriage, and (3) sexual victimization within a new marriage. Incestuous elder abuse involved cases perpetrated by adult children, other relatives, and quasi-relatives. Clinical dynamics observed in all types of cases are discussed. Selected cases illustrate abuse dynamics, problems confronting victims, and perpetrator characteristics. The range of abusive behaviors observed, etiological and contributing factors, and forensic markers of elder sexual abuse are discussed.

Key words: elder abuse, elder sexual abuse, family violence, domestic violence, marital abuse, incestuous abuse, rape, victims, perpetrators, Protective services

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Required Elder Abuse Education for Iowa Mandatory Reporters by Gerald J. Jogerst, MD; Jeanette M. Daly, RN, PhD; Jeffrey Dawson, ScD; Margaret F. Brinig, JD, MA, PhD; and Gretchen A. Schmuch, MSW

ABSTRACT: Elder abuse is a societal problem that influences all members of the community. By 1993 each state had enacted laws addressing elder abuse in domestic and institutional settings (Tatara, 1995). These laws take many different forms, and in 44 states and the District of Columbia, contain sections regarding the designation of mandatory reporters of elder abuse and neglect. Health care professionals and law enforcement personnel frequently are listed as mandatory reporters. Iowa is the only state that requires education for its mandatory reporters. The purpose of this paper is to compare the investigation and substantiation rates for elder abuse allegations before and after July 1988 when Iowa statute (§ 235B.1 IA CO) was revised to ensure training of mandatory reporters. The investigation and substantiation rates were analyzed using two-sample t-tests for comparisons of four time periods and compared to investigation rates for Texas and Wisconsin. There were no significant differences in investigation rates for the four time periods and no significant increase in investigation rates over time for Iowa. Many different state agencies are involved in implementing and enforcing this expensive and complicated endeavor of required education for mandatory reporters. Unfortunately, this education has not impacted investigation or substantiation rates for elder abuse.

Key words: Mandatory education, elder abuse, mandatory reporter, adult protective services (APS)

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Elder Abuse and Neglect Among Rural and Urban Women by Keren Patricia Dimah, MPA, MPH and Agber Dimah, PhD

ABSTRACT: Unlike urban older women, rural older women have inadequate health care and limited access to aging network services. Rural women who are part of dysfunctional family relationships are particularly disadvantaged in that they may not be able to gain access to preventive services due to isolation. Indeed, geographic and social isolation, family obligation, and caregiver stress are deemed leading contributory factors to family violence in rural settings. This study examined six forms of substantiated elder abuse, a form of family violence, among rural and urban women. Chi-square analysis and proportions were used to examine differences between 7,178 rural and 7,614 urban female victims, as were demographic characteristics of abusers. More rural women were represented in physical abuse (÷2 = 10.906; P = .001), emotional abuse (÷2 = 25.951; P < .001), and deprivation (÷2 = 3.662; P = .056) categories than urban women. Urban women were represented in the passive neglect category (÷2 = 8.186; P = .004) than rural women. Approximately 88% of rural women compared to 86% of urban women were willing to accept intervention services following abuse. Abusers were mostly non-caregivers and offspring with no legal responsibility to the victims. Since elder mistreatment permeates every segment of society, intervention programs should be distributed equitably.

Key words: abused women, domestic violence, elder mistreatment, rural older adults

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Volume 15 Number 2

Mandatory Reporting: Relationships of APS Statute Language on State Reported Elder Abuse by Jeanette M. Daly, RN, PhD; Gerald J. Jogerst, MD; Margaret F. Brinig, JD, MA, PhD; and Jeffrey D. Dawson, ScD

ABSTRACT: Forty-four states and the District of Columbia have laws providing that individuals who assume the care or custody of the elderly are considered mandatory reporters and must report suspected abuse. A mandatory reporter is a person required by law to report allegations and/or suspicions of abuse. Thirty-eight state statutes specify a penalty for mandatory reporters who do not report when they should. The purpose of this study is to evaluate the relationship of state adult protective service wording of mandatory reporting on the rates of reported, investigated and substantiated domestic elder abuse. Higher investigation rates were associated with a mandatory reporting requirement. Description of mandatory reporter, penalty for failure to report abuse allegations, and time to report an abuse allegation did not result in a significant difference in report, investigation, and substantiation rates. Legislation is associated with aspects of adult protective service practice. The requirement that mandatory reporters report an abuse allegation is an important component of adult protective services legislation.

Key words: mandatory reporting, elder abuse, adult protective service investigator

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“Like a Wounded Bird”: Older Battered Women's Life Experiences with Intimate Violence by Eli Buchbinder, PhD and Tova Winterstein

ABSTRACT: Intimate violence against older battered women has been neglected by researchers as well as by practitioners and advocates. The aim of this paper is to describe and analyze the experiences and perceptions of older battered women in coping with and surviving the violence. Qualitative in-depth interviews were conducted with twenty older battered women prior to group intervention. The analysis of interviews revealed four major themes: (1) Experiencing the self from two opposite poles: heroines or fools; (2) Giving up the self for the sake of family members; (3) Children as meaningful others: Friends or foes? (4) Lost in time between a painful past and a trap-like future. These findings are discussed in terms of women's overall existential experience. Some implications for future intervention are suggested

Key words: old battered women, domestic violence, elder abuse, wife abuse

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Expert Panel Recommendations on Elder Mistreatment Using a Public Health Framework by Eben M. Ingram, PhD

ABSTRACT: Elder mistreatment is a widespread and growing problem resulting in a variety of negative societal and health outcomes for a major segment of the population. A public health approach provides a framework for conceptualizing and implementing intervention efforts for the prevention of future and reduction of existing elder mistreatment. The Centers for Disease Control and Prevention convened a panel of experts to advise the agency on developing a comprehensive agenda for the protection of the nation's vulnerable elders in the area of elder mistreatment. This document presents an explanation of the public health approach and a summary of recommendations made by the expert panel.

Key words: elder abuse, elder mistreatment, neglect, primary prevention, public health

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Services and Programming for Older Abused Women: The Ohio Experience by Bonnie S. Fisher, PhD; Therese Zink, MD, MPH; Stephanie Pabst, Med; Saundra Regan, MGS; and Barbara Rinto, MPA

ABSTRACT: Over the last ten years, a growing body of literature has examined services for older women who are abused. This article describes the results from a statewide survey of Ohio's domestic violence (DV) centers' programs and services for older women. Surveys were mailed to all Ohio DV centers in spring 2002, with a follow-up mailing and phone calls, yielding a 73% response rate. Seventy-eight percent had sheltered as least one woman over 55 years old during 2001. Other programs were serving some older women as well. While less than half of the centers educated their staff and volunteers about the needs of older women, 57% had provided training to aging agencies about DV. More collaboration and cross training with aging agencies was recommended to better meet the needs of older women.

Key words: older women, domestic violence, elder abuse

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Ethical Issues in Distinguishing Sexual Activity from Sexual Maltreatment Among Women with Dementia by Jennifer Hagerty Lingler, MA, MSN, CRNP

ABSTRACT: A report from the National Center on Elder Abuse (NCEA) defines sexual abuse as nonconsensual sexual contact of any kind with an elderly person. While such forces as ageism, sexism, and hypercognitivism uniquely situate women with dementia as at risk for sexual maltreatment, autonomy-centered bioethical approaches may, like the NCEA, fail to differentiate between coercive and assentual forms of “nonconsensual” sexual activity. This critical analysis brings to light the complexity of sexual ethics in the context of cognitive impairment. The author argues, from a relationship-centered perspective, that although women with dementia are particularly vulnerable to abuse certainly some, if not most, sexual activity between loving spouses may be morally permissible even when one partner has dementia and cannot consent.

Key words: Dementia, older women, sexual ethics, sexual maltreatment, feminist ethics, trust.

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