The Hawaii Elder Abuse
Prevention Forum
July 25th, 2014
Deborah Merrill, Senior Policy Director
Page 1
introduction & objectives
Page 2
What do people know?
• Violence against animals
• Violence against children
• Domestic Violence
• Elder Abuse
Page 3
Learning Objectives
• Define and distinguish elder abuse and related
phenomenon (e.g. self-neglect and abuse in later life)
• Describe older victims, their abusers and the impact
of elder abuse on them
• Determine what agencies to prevent Elder Abuse
• Identify strategies to respond to possible elder abuse
Page 4
Today we are using:
A broad definition of Abuse
*Abuse – including physical, sexual, psychological,
*Neglect – including by self and others
*Exploitation – including financial and property
Page 5
Growth in Elderly population
From 1990
– Population 65 and older at 30 million
In 2050
– Population 65 and older at 88 million
Page 6
Elder Abuse is an iceberg.
Reported estimates use the number 10%
Page 7
Elder Abuse: Under the Radar
A 2011 study in New York State found that for every one
case of elder abuse that comes to the attention of a
responsible entity…
Another twenty three point five cases never come to light
1 discovered vs. 23.5 hidden
Elder Abuse robs an older person of their independence.
Their life is never the same.
Page 8
Elder Abuse
• Physical, sexual, or psychological abuse, as
well as neglect, abandonment and financial
exploitation of an older person by another
person or entity
• That occurs in any setting (e.g. home,
community, or facility),
• Either
– In a relationship where there is an
expectation of trust; and/or
– When an older person is targeted based
on age or disability
Page 9
Related Phenomena
• Abuse in Later Life (term often used by
domestic violence and sexual assault
advocates (50+)
• Abuse of vulnerable adults (some
statutes/APS – adults aged 18+)
• All crimes against persons age 60 and older
(criminal justice)
• Self-neglect
Page 10
Hawaii state laws???
Who are mandatory reporters?
What is the state definition?
Page 11
Multiple forms of elder abuse often
occur at the same time.
Page 12
Discomfort in Disclosure
• Shame
• Fear
• Embarrassment
• Grief
Page 13
Who are the older victims of
All races, religions, ethnicities, cultures and socio-economic
groups- commonality that they are older and victims
Both men and women, more women are victims of intimate
partner violence
Persons who are socially isolated, age is a contributing factor
Healthy, active
Needing care and with cognitive impairment
In private homes, congregate living arrangements, and facilities
Page 14
Who are the Abusers?
Page 15
• Most older victims are abused by someone
they know and trust or would expect to trust
• Family members
• Spouses or partners
• Caregivers (family, paid staff or volunteers)
• Persons in positions of trust/authority( powers
of attorney, guardians, faith leaders)
• Some target older adults for their age and
perceived or real frailty
• Strangers
Page 16
Victims Living in Facilities are
Abused by:
Caregivers and other facility staff and volunteers
Other residents
Spouses and partners
Family members
Page 17
Victims of abuse are
never the same.
Page 18
Effects of Elder Abuse on
• Mortality: Up to 300% higher mortality rates than
non-abused older people
• Distress: Significantly higher levels of psychological
distress and lower perceived self-efficacy than other
older adults
• Health: Bone or joint problems, digestive problems,
depression or anxiety, chronic pain, high blood
pressure and heart problems
Page 19
Complex Dynamics
• No single dynamic explains elder abuse
• “Depending on the victim-offender relationship and
the type of elder abuse, elder abuse may resemble
domestic violence, child abuse, or fraud or the
phenomenon can stand on its own with the complexity
of the relationships, individual vulnerabilities and
contexts in which it occurs.”
Page 20
Victims Want the Abuse to End
But often maintain a relationship with or protect the
abuser because:
• Fear (of retaliation, death, facility placement, or loss)
• Love/care about the abuser (especially an adult child)
• Economic reasons
• Health concerns
Page 21
What can you do?
• Listen to older adult
• Do not assume cognitive impairment
• What do you do in your work?
• What is Hawaii doing now?
Page 22
Contact information:
Deborah Merrill
Senior Policy Director
202.898.2578 x 122
[email protected]
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For more information, please visit:
Or call us at: 202-898-2583