Domestic Abuse in Later Life: Services and Interventions

How can we improve safety and support for older victims of domestic abuse? What services do older victims want? What interventions might they be willing to use?

After completing a local needs assessment, reviewing descriptions of other projects and their results can be a way to create effective programs to meet the needs of victims. A new research review on the topic, prepared by Bonnie Brandl of the National Clearinghouse on Abuse in Later Life/Wisconsin Coalition Against Domestic Violence, and Loree Cook-Daniels, then consultant to the National Center on Elder Abuse, examines twenty-five articles published in the U.S. and Canada between 1989 and 2000 that produced findings related to service use by victims.

The twenty-five studies were:

Allen, M. (1995). Community Response to Problems Faced by Older Battered Women. (Available from the Minnesota Coalition for Battered Women, (651) 646-6177.), 1 - 15. [CANE File No. Z4895]*

Brownell, P. et al. (1999). Mental Health and Criminal Justice Issues Among Perpetrators of Elder Abuse. Journal of Elder Abuse & Neglect, Vol. 11, No. 4, 81-94. [CANE File No. K4212-8]*

Dunlop, et al. (2000). Elder Abuse: Risk Factors and Use of Case Data to Improve Policy and Practice. Journal of Elder Abuse & Neglect, Vol. 12. No. 3/4, 95 - 122. [CANE File No. L4425-28]*

Harris, S. (1996). For Better or for Worse: Spouse Abuse Grown Old. Journal of Elder Abuse & Neglect. Vol. 8, No. 1, 1-33. [CANE File No. J4081-17]*

Hightower, J. et al. (1999). Meeting the Needs of Abused Older Women? A British Columbia and Yukon Transition House Survey. Journal of Elder Abuse & Neglect. Vol 11, No. 4, 39-57. [CANE File No. K4211-10]*

Korbin J., et al. (1991). Abused Elders Who Seek Legal Recourse Against Their Adult Offspring: Findings from an Exploratory Study. Journal of Elder Abuse & Neglect. Vol. 3, No. 3, 1-18. [CANE File No. F3212-10]*

Lachs, M. et al. (1997b). Risk Factors for Reported Elder Abuse and Neglect: A Nine-Year Observational Cohort Study. The Gerontologist, Vol. 37, No. 4, 469 - 474. [CANE File No. J4068-6]*

Le, Q. (1997). Mistreatment of Vietnamese Elderly by Their Families in the United States. Journal of Elder Abuse & Neglect, Vol. 9, No. 2, 51-62. [CANE File No. J4079-7]*

Lithwick, M. et al. (1999). The Mistreatment of Older Adults: Perpetrator-Victim Relationships and Interventions. Journal of Elder Abuse & Neglect, Vol. 11, No. 4, 95 - 112. [CANE File No. K4213-10]*

Moon, A. and Evans-Campbell, T. (1999). Awareness of Formal and Informal Sources of Help for Victims of Elder Abuse Among Korean American and Caucasian Elders in Los Angeles. Journal of Elder Abuse & Neglect, 11(3): 1-23. [CANE File No. K4214-12]*

Moon, A., and O. Williams. (1993). Perceptions of Elder Abuse And Help-Seeking Patterns Among African-American, Caucasian American and Korean-American Elderly Women. Gerontologist, 33, 386-395. [CANE File No. H3282-10]*

Older Women’s Network. (1998). Study of Shelter Needs of Abused Older Women. (Available from the Older Women’s Network at (416) 214-1518 or info@olderwomensnetwork.org.) [CANE File No. Z4896]*

Phillips, L. et al. (2000). Abuse of Female Caregivers by Care Recipients: Another Form of Elder Abuse. Journal of Elder Abuse & Neglect, Vol. 12. No. 3/4, 123 - 144. [CANE File No. L4431-21]*

Pillemer, K., and D. Finkelhor. (1989). Causes of Elder Abuse: Caregiver Stress Versus Problem Relatives. American Journal of Orthopsychiatry, Vol. 59, No. 2, 179-187. [CANE File No. E2641-9]*

Pillemer, K., and D. Finkelhor. (1988). The Prevalence of Elder Abuse: A Random Sample Survey. Gerontologist, Vol. 28, No. 1, 51-57. [CANE File No. C2155-7]*

Podnieks, E. (1992a). National Survey on Abuse of the Elderly in Canada. Journal of Elder Abuse & Neglect, Vol. 4, No. 1/2, 5 - 58. [CANE File No. A13-28]*

Podnieks, E. (1992b). Emerging Themes from a Follow-up Study of Canadian Victims of Elder Abuse. Journal of Elder Abuse & Neglect. Vol. 4, No. 1/2, 59 - 111. [CANE File No. H3384-27]*

Seaver, C. (1996). Muted Lives: Older Battered Women. Journal of Elder Abuse & Neglect. Vol. 8, No. 2, 3-21. [CANE File No. N4761-10]*

Tomita, S. (1999). Exploration of Elder Mistreatment Among the Japanese. Tatara (ed.), Understanding Elder Abuse in Minority Populations, 119-139. [CANE File No. N4672-13]*

Vinton, L. et al. (1998). A Nationwide Survey of Domestic Violence Shelters’ Programming for Older Women. Violence Against Women, Vol. 4, No. 5, 559-571. [CANE File No. N4892-7]*

Vinton, L. (1992). Battered Women’s Shelters and Older Women: The Florida Experience. Journal of Family Violence. Vol. 7, No. 1, 63 - 72. [CANE File No. H3431-10]*

Vladescu, Dana, et al. (1999). An Evaluation of a Client-Centered Case Management Program for Elder Abuse. Journal of Elder Abuse & Neglect, Vol. 11. No. 4, 5-22. [CANE File No. K4209-10]*

Wolf, R. (1999). Elder Shelters: U.S., Canada, and Japan. (Available from the National Center on Elder Abuse, (202) 898-2586.) [CANE File No. J4893-13]*

Wolf, R. (1998). Support Groups for Older Victims of Domestic Violence: Sponsors and Programs. (Available from the National Center on Elder Abuse, (202) 898-2586.) [CANE File No. J4123-37]*

Wolf, R. and K. Pillemer. (1997). The Older Battered Woman: Wives and Mothers Compared. Journal of Mental Health and Aging. Vol. 3, No. 3, 325-336. [CANE File No. J4067-12]*

Brandl and Cook-Daniels prepared a very brief analysis of the findings, and articulated just a few of the possible implications. These sections of their article are reprinted below.

GENERALIZED FINDINGS

Many older domestic violence victims do not seek services from agencies such as the police and health care professionals (Phillips, 2000; Brownell, 1999; OWN, 1998), and may not tell anyone at all about the abuse (Podnieks, 1992(b)). If they seek services from professionals like emergency department staff, they stand a very good chance of not getting a referral to APS or other DV services (Lachs, 1997(b)). When victims are identified, they frequently refuse offered services (Brownell, 1999; Lithwick, 1999).

Reasons victims may not seek help or refuse offered services include: not seeing themselves as abused (Phillips, 2000); not knowing where to report abuse (Moon, 1999); a desire to obtain services for their abusers rather than themselves (Brownell, 1999; Korbin, 1991); a lack of services or an inability to qualify or a long wait list for services (Hightower, 1999; Allen, 1995); embarrassment or fear (OWN, 1998); and community attitudes (Allen, 1995). Le (1997) suggested increasing public awareness, addressing isolation, and hiring bilingual/bicultural staff as methods to alleviate some fears of reporting. Similarly, Moon (2002) suggests using an ethnic-specific approach to public outreach. Tomita (1999) recommends considering interventions focusing on respite, safety, and group harmony.

Services that were often accepted by victims or that potential victims said they would use were: police intervention; case management; orders of protection; health care; homemaker services; individual counseling; peer support groups; and a 24-hour help line (Brownell, 1999; Lithwick, 1999; OWN, 1998; Podnieks, 1992a and 1992b).

Several researchers recommended using strategies (such as an empowerment model) and interventions (such as peer counseling, help lines and support groups) used for younger battered women (Dunlop, 2000; Wolf, 1997; Harris, 1996; Pillemer, 1989 and 1988). Several studies suggest collaboration with domestic violence advocates (Dunlop, 2000; Wolf, 1998; Harris, 1996).

Yet, domestic violence programs serve very few older women (Hightower, 1999; Vinton 1998 and 1992). Those that offer special programming aimed at older women tend to serve more (Vinton, 1998; Seaver, 1996). Shelters specifically for abused elders are rare, and two-thirds of them will not serve an elder who needs more than minimal assistance (Wolf, 1999). Two researchers were not sure elder-specific shelters were a good idea (Wolf, 1999; OWN, 1998).

Two studies found that APS-type services are effective in reducing or eliminating abuse in the majority of cases studied (Lithwick, 1999; Vladescu, 1999). Several studies recommended support groups (Dunlop, 2000; Podnieks, 1992b). Peer support groups were found to be somewhat to very successful in helping victims gain skills to cope with their situations (Wolf, 1998; Seaver, 1996).

POTENTIAL IMPLICATIONS

Both the domestic violence and adult protective services systems offer approaches, services, and referral networks that are useful to elders who are victims of domestic violence. Each system brings strengths: the domestic violence field knows better how to run emergency shelters and peer support groups, while the adult protective services system is better equipped to help impaired elders and link elders with services designed for their age group (to name but four areas). More cross-training and collaborative efforts should take place between the two systems to ensure that both do a better job of providing services to older victims of domestic violence.

Far more attention needs to be paid to developing and providing services to abusers. Because of how longstanding relationships between elders and their abusers are likely to be and because of ties of love and feelings of responsibility, many abused elders appear to be less concerned about helping themselves than helping their abusers. Therefore, assisting victims to find help for their abusers may well be key to providing services to the victims.

Because many victims do not seek help and because those that do are sometimes not identified as victims of domestic violence, public and professional education efforts should be stepped up to ensure that more abuse victims are identified and assisted in ending the abuse and/or gaining additional coping skills.

Finally, more funding needs to be made available to ensure existing services are available and accessible to those who need them (many shelters, for instance, are not accessible to older women who use assistive devices such as wheelchairs or walkers) and to create more services such as peer support groups and individual counseling for both victims and abusers.

MORE DETAILS AVAILABLE

The research review itself also contains a discussion of the limitations of studies on domestic violence in later life and a chart that briefly summarizes each article’s author(s) and year of publication, sample size and demographics, type(s) of abuse covered, and selected findings, often in quotes and always with an associated page number.

The article is currently published on the Web in two formats: html (which creates what looks like a web page) and .pdf, which can only be opened and read with an Adobe Acrobat reader (available free from the website). The National Center on Elder Abuse is also developing a printed version of this and several other research reviews; AAR will let its readers know how to obtain a copy when it’s available. For now, the articles are available on the WordBridges website:

Services and interventions
www.WordBridges.net/ElderAbuse/Research/2002-09-08R.html (html) or
www.WordBridges.net/ElderAbuse/Research/2002-09-08R.pdf (Adobe Acrobat format)

*NOTE:
CANE - The Clearinghouse on Abuse and Neglect of the Elderly - is the nation's largest computerized collection of elder abuse resources and materials. Single copies of articles in its holdings can be ordered from CANE for $.20 per page. The digits following the hyphen in the file number indicate how many pages the article has.

CANE
Department of Consumer Studies
University of Delaware
Newark, DE 19716

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