October 31, 2019

Elder Abuse Then and Now (1979-2019)

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(The pdf for the issue in which this article appears is available for download: Bifocal, Vol. 41, Issue 2.)

Special 40th Anniversary Issue

Elder Abuse  

1979

  •  Congress amended the Social Security Act in 1974 to require all states to establish adult protective services units (APS) for adults aged 18 and older.
  •  The U.S. House of Representatives held hearings and sponsored investigations about elder abuse throughout the middle to late 1970s.
  •  “Caregiver stress” was thought to be the primary cause of elder abuse.  As a result, models that relied upon recognition and reporting of elder abuse by health care providers were developed to identify and help victims.  Helping victims often involved removing them from their home and placing them in a nursing home.

2019

  •      Every state had an APS program by 1981.  States may choose to devote some of their Social Service Block Grant funds to APS. Federal APS funding has been authorized but never appropriated.
  •     The National Center on Elder Abuse (NCEA) was authorized by the Older Americans Act in the late 1980s, and funding has been appropriated since then for its activities, which include information dissemination, research, technical assistance, and training.
  •     The U.S. Senate, House, and Government Accountability Office have conducted myriad hearings and studies on elder abuse issues.
  •     Congress has enacted two key pieces of elder abuse legislation—the Elder Justice Act (EJA) in 2010 and the Elder Abuse Prevention and Prosecution Act (EAPPA) in 2017—but funding for the activities and programs authorized has never been appropriated. (Some authorized activities, such as the federal Elder Justice Coordinating Council, have been funded by federal agencies in other ways.  Amendments to the Violence Against Women Act have authorized dedicated funding for training about abuse of women in later life and persons with disabilities, and those funds have been appropriated.
  •    Judicial training and development of bench tools and other resources for judges has expanded.
  •    There is substantially greater training and involvement of criminal justice system professionals.  However, the lack of dedicated federal funding means that involvement may vary widely from community to community and may not continue if key individuals leave their jobs.
  •    Books, scholarly journal articles, news stories, and other articles and publications about elder abuse have increased exponentially.
  •   There is growing use of civil remedies including civil protection orders, actions to recover homes and personal property, and removals of abusive guardians or agents under a power of attorney.
  •   Multidisciplinary responses have developed and are widely regarded as best practices, with increasing support from federal, state, and local government agencies and philanthropies.  These responses include multidisciplinary or interdisciplinary teams, task forces, coordinating councils, elder abuse fatality review teams, forensic centers, and more.
  •   Multiple research agendas have been developed, including the National Academy of Sciences groundbreaking report, Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America (2003).
  •  Important research has been funded by various federal government agencies (primarily the Department of Justice) and a few foundations.  Research focused first on the extent of the problem, then on development of tools for detecting elder abuse, and is beginning to shift toward outcomes for victims.  Perspectives about the manifestations of elder abuse and theories about its causes have broadened significantly.
  •   While tragic, several cases involving allegations of elder abuse against high-profile individuals such as Brooke Astor, Mickey Rooney, Harper Lee, Casey Kasem, and Stan Lee have raised awareness of the problem among the public, a wider array of professionals, and policy makers.

Selected Commission Contributions Over the Years

  •    Developed Recommended Guidelines for State Courts Handling Cases Involving Elder Abuse (1995).  The ABA adopted the recommendations as Association policy in 1996.  This work has informed efforts in the 2000s to change court practices, such as establishment of elder protection courts and elder justice centers.    
  •    Developed Elder Abuse in the State Courts – Three Curricula for Judges and Court Staff (1997). 
  •   As a partner in the National Center on Elder Abuse, helped implement the National Policy Summit on Elder Abuse held in December 2001.  Led by the Commission, the ABA adopted the Summit’s law-related recommendations as Association policy in 2002.  This policy has enabled the ABA to advocate for enactment of the EJA, EAPPA, and other relevant legislation. 
  •   For AARP’s Public Policy Institute, we analyzed the abuse-related provisions of the Uniform Power of Attorney Act (UPOAA) and prepared a report comparing existing state provisions with the UPOAA provisions.  This report has helped inform state AARP advocates and others, including legislative and bar association study committees, about the benefits of state enactment of the UPOAA.
  •   The Managing Someone Else’s Money guides we produced for the Consumer Financial Protection Bureau have been distributed to more than 1.5 million people, adapted in whole or part by at least nine states, and translated into Spanish. 
  •   Produced Legal Issues Related to Elder Abuse: A Pocket Guide for Law Enforcement and distributed almost 25,000 hard copies to police departments, sheriffs’ agencies, prosecutors, judges and court staff, and community corrections agencies.
  •   With help from the National Adult Protective Services Association, provided seed funding to demonstration sites to establish the earliest elder abuse fatality review teams and produced Elder Abuse Fatality Review Teams: A Replication Manual (2005).  A recently concluded project, conducted with program evaluators at the University of Texas Health Science Center at Houston, allowed us to update and expand the replication manual, conduct a team inventory, develop a library of team documents and other resources, and collect and analyze team outcomes.

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