Examining Elder Abuse

More study is needed to fully understand the complex issue impacting older adults,  researcher says in USF lecture.

By Lindsay Peterson

Special to USF News

 

TAMPA, Fla. (Feb. 8, 2013) – Elder abuse is a complex issue covering a broad range of offenses, from physically harming older adults to stealing from them, a noted researcher said during a recent talk that is part of the University of South Florida’s Collaborative on Aging's Distinguished Lectureship Series.

Pamela Teaster, elder abuse researcher and associate dean for research in the College of Public Health at the University of Kentucky, said financial abuse is particularly widespread, with annual financial losses to elder victims topping $2.9 billion.

A policy brief on the topic and her comments can be found here.

More than eight in every 1,000 older adults are abused and/or exploited, Teaster said, but the number of actual cases could be five times higher because of underreporting. Victims are often frail, vulnerable elders, and the abusers are often their own family members, neighbors, and people posing as friends.

In Teaster’s words, elder abuse is a "wicked problem," only barely understood and tough to solve. She’s one of a relatively small number of researchers who have devoted their careers to the subject.

One of the complications is that its solutions vary depending on how the problem is framed and by whom.  A lawyer might call for the jailing of the abusers, said Teaster, while a social worker would favor programs to educate and empower potential victims.

Another aspect of the problem is that so little is known about its full scope. This is largely because it is a relatively new area of research.

All the available data collection methods fall short in some way. Telephone surveys don't capture all victims. Adult Protective Services reports vary by state and include only victims who come forward; many are ashamed to admit it or pressured by perpetrators to keep quiet. Medicare and Medicaid fraud units don’t generally investigate cases under certain dollar thresholds.

Teaster, who helped produced two in-depth elder abuse studies for the MetLife Mature Market Institute, called for more research into the scope of elder abuse and the circumstances in which it occurs. Considering the high dollar losses of financial exploitation, particularly to the Medicare and Medicaid systems, it is a problem that affects all of society, she said.

In particular, she’d like to see a greater research and clinical focus on the loss of financial capacity in older adults and how it makes them vulnerable to exploitation. Loss of financial capacity often occurs very early in the process of cognitive decline in older adults at risk of dementia, before other deficits are detected.

Teaster expressed serious concerns about "consumer-directed care" programs, which give older adults more control over funds to provide for their own home-based care. Without proper safeguards, this could create a whole new class of abuse victims, she said. It will be up to alert family members and care managers to prevent more exploitation by speaking up when they see a problem.

She offered these warning signs of abuse in older adults:  

·         Fear or submissiveness to caregiver; any sign of intimidation by another

·         Isolation from relationships

·         New “best friend” or “sweetheart”

·         Missed appointments, uncharacteristic nonpayment for services

·         Unusual bank activity; significant changes in spending patterns

·         Anxiety about personal finances;  lack of knowledge about financial status

·         Missing belongings or property

·         Sudden changes in financial  management, legal documents

Teaster ended with the words of George Washington Carver: “How far you go in life depends on your being tender with the young, compassionate with the aged, sympathetic with the striving, and tolerant of the weak and strong, because some day in life you will have been all of these.”

The Collaborative on Aging's Distinguished Lectureship Series continues in February and March with three more presentations.

·         On Feb. 8, Martha Bruce, Professor of Sociology in Psychiatry at Weill Medical College of Cornell University, will talk about “Extending the Reach of Evidence-based Practices using Long Distance Implementation Strategies:  Depression Care in Home Healthcare,” in 1023B of the College of Public Health.

·         On March 4, Marie Bernard, Deputy Director of the National Institute on Aging, will speak at 10 a.m. in 1023A in the College of Public Health. Her topic: “Was George Orwell Right? Aging Research and its Implications for Policy.”

On March 22, Joshua Wiener, a Distinguished Fellow and Program Director for Aging, Disability and Long-Term Care at RIT International, in Washington, D.C., will speak at 10: 30 a.m., in 1023B in the College of Public Health. His topic: “Follow the Money: Financial Options for Long-Term Care.”