Author(s),

Pub. Date

Sample size and demographics

Type(s) of abuse covered§

Selected finding(s)

(page number/s in parentheses)

Dunlop, et al

2000

319 substantiated cases of abused persons aged 60+ in Miami-Dade County, Florida

APS substantiated cases of abuse, neglect, and exploitation

·        Agencies should develop and fund new program initiatives, including specialized shelters, support groups, family counseling and other appropriate services. (119)

·        Professionals in aging field should become familiar with domestic violence and resources. (119)

·        Policies and practices of services should be culturally competent. (118)

Moon and Benton

2000

Interviews of 100 African American, 95 Korean American and 90 white elders age 60 or older living in LA County, CA in 1997.  Purposive and convenience sampling methods were used to find participants.  2/3 participants were female.

Physical, medical, verbal, psychological, financial, and neglect.

·        "[T]he majority of respondents from all 3 groups studied believed that incidents of elder abuse should not be reported to the authorities until they are absolutely sure that abuse has occurred." (300)

·        "Ethnic-specific approach to public outreach and educational efforts may be more effective than a more general approach in increasing the awareness and understanding of elder abuse issues pertinent to each ethnic community." (301)

·        "Public educational outreach efforts for prevention of and intervention in elder abuse should target recent immigrant populations who are not familiar with the American legal and social service systems related to elder abuse." (301)

Phillips, et al

2000

93 cases of women aged 55+ caring for dependent spouse or other elder family member

Verbal and physical abuse; threatened with gun/knife; gun or knife used -- all by the elder for whom they were caring

·        In 27 cases, no victim called police; only 1 sought medical treatment.  (128)

·        Only 29% of caregivers said they were abused while 39% reported specific instances of abuse; this "has important implications for how health professionals discuss abuse with caregivers, and the types of interventions and prevention strategies that are likely to work."  (140)

Brownell, et al

1999

401 cases of abuse of elders 60+ (with 404 identified abusers) known to Elderly Crime Victims Resource Center in New York City;   subanalysis done of 218 abusers for whom mental health status was reported

Physical, psychological, financial abuse and neglect  (one case of sexual abuse was counted as physical abuse)

·        70% of victims accepted services: 28% police intervention; 19% case management; 18% order of protection; 14% referral to District Attorney; 12% health care; 11% lock replacement; 8% mobile crisis services; 8% housing assistance; 7% eviction of abuser; 6% financial management; 2% mental hygiene warrant  (89)

·        "Victims of impaired abusers refused 85% of offered services.. One explanation, requiring further study, is that the victims' desire to stop the abuse is often contingent upon their ability to ensure their abusers receive assistance as well.  If services are offered that only address the victim's well being, it appears the victim will be more likely to refuse them."  (89)

·        "The risk of elder abuse may be most effectively reduced in many cases by addressing the needs of [impaired] abusers." (92)

Hightower, et al

1999

57 domestic violence transition houses, second stage houses and safe houses in Canada

Unspecified

·        ¼ had no clients age 60 + in previous year, and ¾ had fewer than 2 older women in previous year.  Overall estimate is that 2% of women served are 60+. (45-47)

·        35.6% of facilities were fully handicapped accessible. (49)

·        5 of 46 (10.9%) programs provide special programming/outreach for older women. (53)

·        Shelter staff suggested the following:  training for all staff (60.4%); house renovations (41.7%); special equipment (41.7%); access to community support services (41.7%); a trained staff specialist (27.1%); or other (16.7%).  (53)

·        "[A]lmost all of the transition houses clearly supported the admittance of older women abused by partners, family, or unrelated caregivers."  (54)

Lithwick and Beaulieu

1999

128 cases of mistreatment of adults aged 60+ brought to the attention of community service agencies in Quebec

Physical or sexual abuse; psychological abuse; financial and material exploitation; neglect (both active and passive) by family members and acquaintances

·        Interventions received in cases of spouse abuse were: external medical services (44%); homemaker services (41%); in-house medical services (38%); private services (38%); day centers and day respite programs (38%); psychiatric intervention (21%); interim placement (20%); placement of the perpetrator (16%); legal services (15%); placement of the victim (10%); and residence or group home placement (8%).  (103)

·        In cases of spouse abuse, if one member of the couple was cognitively impaired, it was more likely that the perpetrator would be placed (31%) than if there was no impairment (3%).  (103)

·        Victims placed in a residential setting (10%) all had cognitive impairment.  (103)

·        Victims abused by an adult child were more likely to be placed than those abused by spouse. (102-4)

·        In cases with adult child perpetrators, interventions included homemaker services (46%); private services (41%); external medical services (39%); in-house medical services (36%); placement of the victim (30%); legal services (28%); residence or group home placements (21%); psychiatric intervention (10%); and interim placement (8%).  (103-4)

·        Abuse was stopped or diminished in 60% of all cases: 52% of psychological abuse; 55% of financial abuse; 80% of neglect; 65% of physical abuse.  (103)

·        Services were declined by 58% of victims and 47% of perpetrators.  (104)

Moon and Evans-Campbell 1999

Interviews of 95 Korean-Americans and 90 Caucasian elders age 60 and over in Los Angeles

Awareness of formal or informal sources of help for elder mistreatment or abuse

·        "Only 28% of Korean-Americans, compared to 62% of Caucasians, knew of an agency, organization, or a professional to turn to for help if they were abused or mistreated."  (8)

·        Of the 27 Korean Americans who knew of a professional source of help, 22 named Korean American agencies.  The remaining 5 mentioned the police.  (8-9)

·        "Over one-quarter of Korean Americans (28%) and 3% of Caucasians could not identify a signal source of help, informal or formal, to turn to if they were being abused."  (10)

·        "Most elderly respondents, regardless of ethnicity, would turn to an informal source of help, the police, or a general social service agency providing services to the elderly rather than APS."  (20)

Tomita

1999

Two focus groups of Japanese-Americans (age unclear) and 25 interviews of Japanese Americans in Seattle and Hawaii, aged 65+

Purpose of study was to "capture the Japanese American definitions of mistreatment"  (120)

·        Suggests interventions be focused on "the we-self and not the I-self, perhaps involving third parties to support or carry out professionals' interventions."  (137)

·        Interventions should focus on respite, safety, and group harmony promoted through conflict-avoidance and management techniques.  (137)

Vladescu, et al

1999

26 abused elders (age limit unspecified) served between 1/1/97 and 1/1/99 by Seniors' Case Management program in Hamilton, Ontario; focus group of 3 case managers

Physical, psychological, and financial abuse

·        In 34.6% of cases, the abuse was eliminated; in an additional 30.8% of cases, the situation was improved for victim.  (14)

·        Abuse was eliminated in 27.3% of cases where duration was less than two years, but in 40% of cases where abuse had lasted longer than two years.  (14)

·        34.6% of resolved cases involved the victim relocating away from abuser.  (16)

·        There was no significant relationship between the amount of time the case manager spent on the case and whether or not the abuse was eliminated.  (15)

·        "When information is available and the abused senior is aware of his/her options, ending an abusive situation is chosen over harm reduction."  (13)

·        "[This study] supports a client-centered approach that empowers abused seniors rather than rescuing them."  (20)

Wolf

1999

20 elder shelters in US, Canada and Japan:

10 shelters in operation, 6 being planned and 4 were closed

Unspecified

·        Shelters were of various types: rooms in residential care homes, safe homes, apartments in housing for the elderly, designated floors or areas in building that have other functions, and buildings designed as shelters.  (3)

·        Domestic violence programs were involved in only two of the 20 shelters. (4)

·        Three programs had only 1 bed; the average was 8.  About half the beds were filled.  (4)

·        About two-thirds of the programs admitted only elders who could care for themselves or needed minimal assistance; one third took persons with two or more ADL needs.  (4)

·        Because of limited beds, length of stay, and philosophy, "[t]he [victim's] opportunity for sharing experiences and forming healthy relationships which is such an important feature of the battered women's shelters is lacking."  (6)

·        "As to whether elder shelters are a viable solution, it is too early to say."  (8)

Older Women's Network

1998

106 women aged 50+ suspected of being victims of domestic abuse (58% voluntarily disclosed abuse) and 134 stakeholders in Canada

Physical, emotional, financial and sexual abuse; neglect

·        Seven programs for older battered women are briefly discussed. (11-13)

·        Older abused women are most likely to turn to family, friends, and cultural/faith groups. (25)

·        No need to establish separate facilities for older women; existing shelters should play a role. (39)

·        Older women most wanted peer support groups, 24-hour multilingual crisis line. (27)

·        Embarrassment and fear are primary reasons women 50+ don't use shelters. (31)

Vinton

1998

428 domestic violence shelters in the U.S., surveyed about services to women 60+

Unspecified

·        2/3 had sheltered at least one woman 60+ in previous year; 13.6% had sheltered 10+. (565)

·        61 programs (14.8%) said they had specialized programming for older victims:  outreach (34%); individual interventions (19%); educational materials featuring older couples (18%); staff/volunteer training (16%); support groups for older women (9%).  (567-8)

·        "[S]helters that offered special programming were significantly more likely" to have sheltered more than 10 older women.  (568)

·        76.2% of the shelters were handicapped accessible; 60.3% stored but did not dispense medications; an additional 25.7% both stored and dispensed medications.  (564)

Wolf

1998

30 support groups for older battered women in U.S. and Canada

Unspecified

·        Similarities in programming whether the group was sponsored by DV or aging services. (23)

·        Half of the aging services-sponsored and one of the DV-sponsored groups were open to men, although few participated/stayed.  (11)

·        All but one DV-sponsored group accepted persons abused by non-spouse relatives and victims of financial exploitation.  (15)

·        Group leaders felt "very" to "somewhat" successful at improving participants' self-esteem, abuse awareness, feelings of personal growth, and coping ability.  Also helped participants develop safety plans, decrease isolation, problem-solve, decrease dependency, reduce anxiety, and know how to obtain an order of protection.  (18)

·        Groups had as few as 2 or 3 members.  (22)

·        "As state policy, a partnership should be encouraged among a state's domestic violence coalition, the state unit on aging, adult protective services agency and victim assistance programs so that the experience and skills in these areas can be tapped for the benefit of abused elders."  (26)

Lachs, et al

1997 (b)  

182 victims of physical abuse aged 60+ from New Haven, Connecticut

EPS-substantiated cases of physical abuse

·        114 of 182 had been seen 628 times at hospital emergency depart. (ED) within 5 years of EPS case, with a median of 3 visits/elder. (448)

·        37.8% of 111 community-dwelling elders had at least one ED visit rated "high probability" of being abuse related, yet only 9.1% of all the ED visits were referred to EPS.  (451)

Le

1997        

20 Vietnamese age 60+, living in a house headed by an adult child, at least somewhat dependent on child, in Southern California

Verbal, emotional, financial and physical abuse

·        Recommendations include address post traumatic stress disorder, provide respite care, emergency shelter, increase public awareness, address isolation, fund in-home care, promote education on intergenerational issues, hire bilingual/bicultural staff, encourage seniors to take responsibility for their lives, and alleviate the fear of reporting.  (61)

Wolf and Pillemer

1997

73 abused women aged 60+ from New York City, San Francisco, Honolulu, and Madison, WI.  22 were abused by husband, 51 by children (review of written case assessment data)

Physical abuse, psychological abuse, neglect, financial exploitation

·        "For dependent victims of spouse and parent abuse, the shelter movement provides a model: reducing the dependency of the victim on the perpetrator through temporary shelter, group and individual counseling, legal advocacy, social service referral, transitional housing and health care." (8)

·        "Decreasing the dependency of the perpetrator on the victim is a second approach - especially for adult children.  A much more comprehensive program for perpetrators is needed than what is available today." (9)

Harris

1996

5168 couples 19+ from the 1985 U.S. National Family Violence Resurvey, separated into under 60 (4476) and 60+ (842)

Physical violence

·        "Paternalism and medicalization may be appropriate responses for other types of elder abuse but are clearly inappropriate for the majority of older couples represented by the data." (27)

·        APS workers should be encouraged to develop working relationships with domestic violence services already in existence. (27)

Seaver

1996

132 women aged 50+ who have attended older abused women's program in Milwaukee, Wisconsin

Unspecified

·        Program includes weekly support group, volunteer mentors, shelter, community education, and case management.  (14)

·        39% of women in the program freed themselves from abuse; 5% are working on it; and 56% are still in the abusive situation.  (16)

·        Women who left abusive mates were of all ages, including 4 women over age 80.  (17)

·        "Those most likely to stay in abusive relationships were themselves disabled or had highly dependent spouses/adult children."  (17)

·        "Access to state or non-state resources is critical for older women because of the likelihood they are neither employed nor have a pension.  Social Security, Medicare, and public housing have been crucial to the present cohorts of older women."  (19)

·        Most visible impact of program was through the support group.  (18)

Allen

1995

4 forums, 88 total  participants, in MN.  46 participants were battered women/ battered women's advocates; the rest were a  professionals to provide services to seniors

Unspecified

·        Two broad categories of barriers emerged: the first was lack of resources such as financial, housing, and health-related concerns.  The second was community attitudes about violence against women and attitudes held by the religious community, helping professionals, family, and society at large.  (7)

·        Education was listed more often than any other single recommendation.  Education for people working in the media, churches, senior centers, schools, extension programs, medical and health care professions, the aging network, law enforcement, and social services would facilitate the best use of the limited resources currently available.    (15)

Podnieks 1992 (a)

Random sample telephone survey of 2008 persons 65+ living in community settings in Canada

Physical abuse; neglect; psychological abuse; financial exploitation

·        Victims felt the following services would be helpful to them: individual counseling (21%), self-help groups for victims (18%), emergency shelters (12%), household help (5%), medical help (1%) and English language assistance (1%).  (48)

Podnieks

1992 (b)

42 elder abuse victims in Canada identified through Podnieks, 1992(a) study

See Podnieks, 1992(a)

·        This study found "abused elder people will talk about their mistreatment, and for some it can be very therapeutic.  In this survey they revealed that they had not previously discussed their maltreatment with anyone."  (107)

·        Service recommendations include peer counseling, telephone counseling, alternative living options, and prevention. (103)

Vinton

1992

25 battered women's shelters in Florida; "older" was defined as 60+

Unspecified

·        Only 2% of women using shelters and .3% of other service users were 60+  (percentage of  women in Florida 60+: 27%).  (68)

·        Only 2 of 25 had special programming. (69)

Korbin et al

1991

29 people aged 60+ who "seeking legal recourse as a result of maltreatment by an adult offspring" in Cuyahoga County, Ohio over a two-year period; 7 were interviewed

Physical or sexual abuse and financial exploitation

·        Compared to elders physically abused by adult offspring who chose NOT to prosecute, the prosecutors were significantly younger (mean age 66.7 vs. 77.5) and more likely to be African-American (62.1% vs. 9.1%). (5-6)

·        Six of 7 interviewees said they sought legal action after a specific violent incident more severe or frightening than previous ones.  (11)

·        Elders often chose the formal legal system because that's how they could access help for the abuser.  (12)

·        More communities should employ elder victim specialists, who understand old people and can help them through the criminal justice system if their abuser is prosecuted. (15)

Pillemer and Finkelhor 1989

Random sample of 2020 community dwelling people aged 65+ in Boston, MA; 46 abused elders were reinterviewed and compared to 215 controls

Physical assault; psychological abuse; or neglect

·        "Victims would benefit from services similar to those offered to younger battered women."  (186)

Pillemer and Finkelhor 1988

Random sample of 2020 community dwelling people aged 65+ in Boston, MA; 46 abused elders were reinterviewed and compared to 215 controls

Physical assault; psychological abuse; or neglect

·        Service providers to elderly and elderly themselves need to learn more about spouse abuse (57).

·        Services need to be tailored to spouse abuse among elderly, like shelters or safe apartments and support groups (57).