Elder Abuse and Its Prevention is the summary of a workshop convened in April 2013 by the Institute of Medicine's Forum on Global Violence Prevention. Using an ecological framework, this workshop explored the burden of elder abuse around the world, focusing on its impacts on individuals, families, communities, and societies. Additionally, the workshop addressed occurrences and co-occurrences of different types of abuse, including physical, sexual, emotional, and financial, as well as neglect. The ultimate objective was to illuminate promising global and multisectoral evidence-based approaches to the prevention of elder maltreatment. While the workshop covered scope and prevalence and unique characteristics of abuse, the intention was to move beyond what is known about elder abuse to foster discussions about how to improve prevention, intervention, and mitigation of the victims' needs, particularly through collaborative efforts. The workshop discussions included innovative intervention models and opportunities for prevention across sectors and settings.

Violence and related forms of abuse against elders is a global public health and human rights problem with far-reaching consequences, resulting in increased death, disability, and exploitation with collateral effects on well-being. Data suggest that at least 10 percent of elders in the United States are victims of elder maltreatment every year. In low- and middle-income countries, where the burden of violence is the greatest, the figure is likely even higher. In addition, elders experiencing risk factors such as diminishing cognitive function, caregiver dependence, and social isolation are more vulnerable to maltreatment and underreporting. As the world population of adults aged 65 and older continues to grow, the implications of elder maltreatment for health care, social welfare, justice, and financial systems are great. However, despite the magnitude of global elder maltreatment, it has been an underappreciated public health problem. Elder Abuse and Its Prevention discusses the prevalence and characteristics of elder abuse around the world, risk factors for abuse and potential adverse health outcomes, and contextually specific factors, such as culture and the role of the community.

Contents

• THE NATIONAL ACADEMIES
• PLANNING COMMITTEE FOR WORKSHOP ON ELDER ABUSE AND ITS PREVENTION
• FORUM ON GLOBAL VIOLENCE PREVENTION
• Reviewers
• Acknowledgments
• I. Workshop Overview
  • 1. Introduction
    • DEFINITIONS AND CONTEXT
    • ORGANIZATION OF THE REPORT
    • REFERENCES
  • 2. Measuring and Conceptualizing Elder Abuse
    • SETTINGS
    • COGNITIVE IMPAIRMENT
    • NEGLECT AND SELF-NEGLECT
    • CONCEPTUALIZING ELDER ABUSE
    • ISSUES WITH PREVALENCE STUDIES
    • REFERENCES
  • 3. Risk Factors and Health Outcomes
    • RISK FACTORS
    • HEALTH OUTCOMES
    • REFERENCES
  • 4. Ethical Considerations
    • BRAIN HEALTH AND FUNCTION: DECISION-MAKING CAPACITY AND COMPETENCY
    • ELDER ABUSE REPORTING
    • HIPAA
    • LONG-TERM CARE
    • MOVING FORWARD
    • REFERENCES
  • 5. Screening and Prevention
    • SCREENING
    • PREVENTION
    • REFERENCES
  • 6. The Way Forward
    • HEALTH POLICY AND PROMOTING AWARENESS
    • MOVING PREVENTION FORWARD
• II. Papers and Commentary from Speakers
  • II.1. UNDERSTANDING ELDER ABUSE IN THE CHINESE COMMUNITY: THE ROLE OF CULTURAL, SOCIAL, AND COMMUNITY FACTORS
    • Introduction
    • Cultural Traditions: Filial Piety
    • Cultural and Linguistic Diversity
    • Prevalence of Elder Abuse
    • Cultural Perceptions of Elder Abuse
    • Perceived Psychosocial Impact of Elder Abuse
    • Help-Seeking Tendency of Elder Abuse
    • Community Support in Nurturing Filial Piety Values and Intergenerational Relationships
    • Community-Based Participatory Research Methodology
    • Meeting the Challenge of Cultural Complexity
    • Conclusion
  • II.2. SEVEN POLICY PRIORITIES FOR AN ENHANCED PUBLIC HEALTH RESPONSE TO ELDER ABUSE
    • Develop Policy to Recognize Elder Abuse as a Public Health Issue
    • Research Priorities Critical to Inform Policy and Practice Relating to Elder Abuse
    • Policy Opportunity: Translate What We Do Know into Practice
    • Resources and Policy: Chicken and Egg
    • Implement Law and Develop Policy Infrastructure
    • Develop a Political Constituency
    • Promote Innovation
  • II.3. ELDER NEGLECT: THE STATE OF THE SCIENCE
    • Elder Neglect Review: The Research Overview
    • Elder Neglect Literature Review
  • II.4. NATIVE ELDER MISTREATMENT
    • Introduction
    • Prevalence and Risk Factors
    • Cultural Conceptions of Abuse
    • Law Enforcement and APS
    • Future Directions
  • II.5. ELDER FINANCIAL ABUSE
    • Introduction
    • The Wells Fargo Advisors Inventory
    • Top Types of Financial Abuse
    • OWN IT
  • II.6. ELDER ABUSE AND ITS PREVENTION: SCREENING AND DETECTION
    • Introduction
    • The CMS Elder Maltreatment and Care Symposium
    • The Elder Abuse Suspicion Index
    • Elder Abuse Screening and Detection
    • Screening and Detection in Community-Dwelling Older Adults
    • Screening and Detection in Institutionalized Older Adults
    • General Issues and Challenges in Elder Abuse Screening and Detection
  • II.7. ELDER ABUSE AND NEGLECT: A ROLE FOR PHYSICIANS
  • II.8. PREVENTING ELDER ABUSE—HOPE SPRINGS ETERNAL
    • Introduction
    • Networks: Demonstrated Leadership
    • Support Groups: A Chance for Human Connection
    • World Elder Abuse Awareness Day
    • Power of Youth
    • Changing the World, One Click at a Time
    • Generating a Conceptual Framework
    • Summary
  • II.9. ELDER ABUSE INTERVENTION: THE SHELTER MODEL AND THE LONG-TERM CARE FACILITY
    • Cost-Effective
    • Highly Adaptable
    • Multifaceted
    • Easily Replicable
    • Partnership
  • II.10. ELDER ABUSE IN ASIA—AN OVERVIEW
    • Prevalence of Elder Abuse in Asia
    • Cultural Considerations
    • Discussions
  • REFERENCES
• Appendixes
  • Appendix A Workshop Agenda
  • Appendix B Speaker Biographical Sketches

Rapporteur: Rachel M. Taylor.

This workshop summary was supported by contracts between the National Academy of Sciences and the Department of Health and Human Services: Administration on Aging, Office on Women's Health; Anheuser-Busch InBev; the Archstone Foundation; the Avon Foundation for Women; BD (Becton, Dickinson and Company); Catholic Health Initiatives; the Centers for Disease Control and Prevention; the Department of Justice: National Institute of Justice; Eli Lilly and Company; the F Felix Foundation; the Fetzer Institute; the Foundation to Promote Open Society; the Joyce Foundation; John E. Fogarty International Center; Kaiser Permanente; LeadingAge; Merck & Co., Inc.; the National Institutes of Health: National Institute on Alcoholism and Alcohol Abuse, National Institute on Drug Abuse, Office of Research on Women's Health; the Robert Wood Johnson Foundation; and Wells Fargo Advisors. The views presented in this summary do not necessarily reflect the views of the organizations or agencies that provided support for the activity.

Suggested citation:

IOM (Institute of Medicine) and NRC (National Research Council). 2014. Elder abuse and its prevention: Workshop summary. Washington, DC: The National Academies Press.

NOTICE: The workshop that is the subject of this workshop summary was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.