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March 10, 2023

Elder Abuse Fatality Review Teams

Erica C. R. Costello

The entire PDF in which this article appears can be found here. 

The COVID-19 pandemic has had a staggering effect on the number of reported cases of abuse, neglect, and exploitation involving older adults. Recent studies have found that as many as one in five older adults reported abuse since the beginning of the pandemic, representing an 83.6% increase in cases reported before the start of the pandemic (Chang and Levy, 2021). Sadly, many of these cases may have resulted the premature death of the older adult.

Several states have adopted legislation creating “Elder Abuse Fatality Review Teams,” or EAFRTs, to examine the deaths of older adults caused by abuse or neglect and to prevent similar deaths from occurring in the future.  Similar to child and domestic violence fatality review teams, the purpose of EAFRTs is to look at problems or conduct that may lead to the death of the older adult and make recommendations for improving systemic issues or professional behavior (Burnett, Bitondo Dyer & Heisler, 2021). The first EAFRTs were started in 2001 in Houston, Texas; Orange County, California; Pulaski, Arkansas; and Maine, with initial funding provided by the US Department of Justice, Office for Victims of Crime. EAFRTs have now expanded to include at least 42 functioning teams in various states and communities throughout the country. Id.  

Florida is one of the latest states to adopt legislation allowing for the creation of EAFRTs in the state’s 20 judicial circuits (Mills, 2020). Adopted in 2020, Fla. Stat. § 415.1103 allows the state attorney to initiate an EAFRT to review the deaths of older adults caused by, or related to, abuse or neglect. The statute also allows for a wide range of professionals and entities to be voluntary representatives of the EAFRT, including law enforcement officers, adult protective services workers, medical examiners, county court judges, elder law attorneys, funeral home directors, hospital discharge planners, public guardians, and others. Once initiated, the statute requires the EAFRTs to review the deaths of older adults in their judicial circuit, to identify potential gaps, deficiencies, or problems in the delivery of services which may be related to the deaths, and to develop communitywide approaches or potential changes in laws, rules, and policies to help prevent the deaths of older adults.

A recent study conducted in 2021 found that EAFRTs provided several benefits to the states and communities that have so far established them (Burnett, Bitondo Dyer & Heisler, 2021). Some of the reported benefits of EAFRTs include improved communication, coordination, and collaboration amongst EAFRT representatives. Id.  EAFRT representatives also reported that the teams reduced the amount of “finger pointing” and blaming among team members, improved their knowledge and ability to recognize abuse, increased their awareness about the roles of other organizations, increased their confidence in making referrals, and enhanced their understanding of how the abuse can lead to premature death. Id.

Perhaps the greatest benefit reported by members was attending EAFRT meetings with other representatives.  Indeed, over 82% of EAFRT members reported that they informally shared what they learned from team meetings with other colleagues in their organization or discipline. Id. 74% of EAFRT members also reported that such meetings led to improvements in the interventions provided to victims in their states or communities, including outreach, education, investigation, or other services. Id. Lesser reported impacts from EAFRTs included improving local or state policies to address abuse involving older adults and enacting state statutes to prevent such abuse. Id.

Based on these findings, EAFRTs can play in an important role in the prevention of premature deaths from abuse, neglect, and exploitation following the COVID-19 pandemic.  As the number of reported cases of abuse and neglect involving older adults has significantly increased since the beginning of the pandemic, states and localities can look toward the creation of EAFRTs to help identify system gaps and develop effective interventions for improving services provided to older adults. Such interventions can also assist in decreasing the number of cases of reported abuse and reducing the number cases resulting in the premature death of an older adult.

To support state and communities with the development and establishment of EAFRTs, the ABA Commission on Law and Aging has published, “Elder Abuse Fatality Review Teams: A Replication Manual.” Further resources on EAFRTs can also be found on ABA COLA’s website at:  If you have any questions about EAFRTs, or if you would like to discuss starting an EAFRT in your state or community, please feel free to contact Erica Costello at [email protected].

Works Cited:

Burnett, J., Bitondo Dyer, C., & Heisler, C., Enhancing and Evaluating the Capacity of Elder Abuse Fatality Review Teams to Assist Victim Services, Journal of Elder Abuse & Neglect, pp. 1-16 (2021).

Chang, E. & Levy, B., High Prevalence of Elder Abuse During the Covid-19 Pandemic: Risk and Resilience Factors, 29 American Journal of Geriatric Psychiatry, pp. 1152-1159 (2021).

Mills, R. (June 12, 2020). Deaths of Florida’s elderly who were abused or neglected to get increased scrutiny under new lawNaples Daily News.

ABA Commission on Law and Aging. (2005). Elder Abuse Fatality Review Teams: A Replication Manual.

Erica C. R. Costello

Senior Attorney, ABA Commission on Law and Aging

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