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Julie Childs
DOJ Elder Justice Initiative
NAELA News Journal - NAELA News Online

Combating Elder Abuse

By Julie Childs, JD, LLM Elder Law
Published June 2019

The Elder Justice Initiative (EJI) has useful online resources available to elder law attorneys. EJI's mission is to support and help to coordinate the Department of Justice's enforcement and programmatic efforts to combat elder abuse, neglect, and financial fraud against America's older adults. Learn more about these online tools.

What is the Elder Justice Initiative 
The Department of Justice’s Elder Justice Initiative (EJI) is housed in the Civil Division’s Fraud Section and supports the Department’s enforcement efforts against nursing homes that fail to provide Medicare and Medicaid eligible beneficiaries with the skilled nursing care to which they are entitled.  The EJI also supports the efforts of state and local prosecutors, law enforcement, and elder abuse professionals in their efforts to combat and prevent elder abuse by developing a wide array of training, resources, tools and information, all of which are housed in the Elder Justice Website. EJI resources are continually expanding and practitioners may find them beneficial as well as they work with older clients.

Overview of the Problem of Elder Abuse
A 2016 U.S. Census report estimated that there are 49,220,000 Americans 65 years and older.1 While this cohort is dynamic and engaged, 1 in 10 older people are abused each year.2

Elder abuse is “an intentional act or failure to act by a caregiver or another person in a relationship involving an expectation of trust that causes or creates a risk of harm to an older adult.”3 According the United Nations, “while the taboo topic of elder abuse has started to gain visibility across the world, it remains one of the least investigated types of violence in national surveys, and one of the least addressed in national action plans.”4


Help for Victims
The EJI provides several scenarios to help the public understand the five types of abuse:

  • Caregiver neglect
  • Financial fraud and exploitation
  • Psychological abuse
  • Physical abuse
  • Sexual abuse
Often several types of abuse occur simultaneously to harm older adults so these scenarios are a good way to see those nuances and find assistance locally.

Training
The EJI webinars and video series are available on the EJI website and YouTube. They provide information for federal, state, and local prosecutors handling elder abuse, neglect, and financial exploitation cases. There is a wide array of webinar topics to choose from ranging from a roundtable discussion with judges from around the country who share their views and experiences from the bench presiding over elder abuse or financial exploitation cases to learning how dementia impacts an elder abuse investigation and how to find and work with expert witnesses

Through a collaboration with the International Association of Chiefs of Police (IACP), the EJI also created a six-part “Roll Call” video series to enable law enforcement to better identify signs of elder abuse and recognize evidence that can lead to the successful prosecution of criminals. 

In 2019, the EJI, in collaboration with the National Center for State Courts (NCSC) and the American Bar Association Commission on Law and Aging, created “Finding the Right Fit: Decision-Making Supports and Guardianship,” a training designed to assist individuals in exploring ways to help someone who may need assistance in making decisions with informal supports, legal options, and/or adult guardianship.

“Finding the Right Fit” is available at no charge on the NCSC and EJI websites and provides a broad overview of decision-making supports and guardianship to provide information and guidance on finding the right kind of supports for someone’s needs.

WHO Quick Facts
• Around 1 in 6 people 60 years and older experienced some form of abuse in community settings during the past year.
• Rates of elder abuse are high in institutions such as nursing homes and long-term care facilities, with 2 in 3 staff reporting that they have committed abuse in the past year.
• Elder abuse can lead to serious physical injuries and long-term psychological consequences.
• Elder abuse is predicted to increase as many countries are experiencing rapidly aging populations.
• The global population of people aged 60 years and older will more than double, from 900 million in 2015 to about 2 billion in 2050.5

Successful aging is based on independence, but the experience of elder abuse diminishes independence and erodes autonomy.

Tools to Fight Elder Financial Abuse 
Elder financial fraud and abuse are growing concerns globally.6 Often the older person’s hard-saved money is stolen by a trusted person such as a family member. Other times a trusted person acting under a power of attorney gains access to savings, property, and control of the older person’s life and abuses that power. Scams targeting older adults are the biggest non-familial elder financial fraud issue.

The EJI, in partnership with law enforcement associations such as the IACP and The National White Collar Crime Center (NW3C), created an Excel-based financial investigative tool that can help identify patterns of exploitation and develop graphic representations of suspected criminal activity. The objective of the Senior Abuse Financial Tracking and Accounting Tool (SAFTA) is to provide law enforcement with a simplified method for investigating suspicious financial patterns and prosecuting cases of suspected financial exploitation of older adults. It is available to download for free from the EJI and IACP websites.

The Elder Abuse Guide for Law Enforcement (EAGLE) is an online tool designed by the EJI and the National Center on Elder Abuse (NCEA) to help quickly identify, intervene and resolve elder abuse situations. Practitioners may find these aspects particularly helpful:
  • Tools to assist in documenting a case for prosecution
  • ZIP-code-based community resources locator
  • State-by-state penal codes relating to elder abuse
Special Finds
The EJI launched the Multidisciplinary Technical Assistance Center in 2017 to provide guidance and resources to Multidisciplinary Teams (MDTs) working on elder abuse cases. A new dynamic MDT national map shows where all the teams are nationally and the EJI even provides a dedicated MDT expert who is available to consult with teams at no charge.

One of EJI’s best kept secrets is that it hosts the largest peer reviewed elder abuse research database anywhere. Access to practice webinars and curated research allows for a deep dive into the field. With a growing state samples database (which contains examples of pleadings, indictments, etc.), different types of state statutes related to elder abuse, and a catalog of relevant state elder abuse laws, the EJI website is a good resource for prosecutors and practitioners.  

For cases in the news, the daily post of US Department of Justice press releases on elder justice offers a front-line view of the fight. 

Many new additions to the EJI website are planned for 2020 now that the Elder Abuse Prevention and Prosecution Act (EAPPA) was signed by President Trump on October 18, 2017, identifying the need for data on elder abuse. We encourage you to visit us online.

Citations
1 https://www.census.gov/content/dam/Census/library/publications/2018/acs/ACS-38.pdf

2 Acierno, R., Hernandez, M., Amstadter, A., Resnick, H., Steve, K.,Muzzy, W. & Kilpatrick,D. ( 2010). Prevalence and correlates of emotional, physical, sexual, and financial abuse and potential neglect in the United States: The National Elder Mistreatment Study. American Journal of Public Health, 100(2), 292–297. doi:10.2105/AJPH.2009.163089

3 Elder Abuse Surveillance: Uniform Definitions And Recommended Core Data Elements Version 1.0 Compiled by Jeffrey Hall PhD, MSPH, Debra L Karch, PhD, Alex Crosby, MD, MPH  Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Violence Prevention, Atlanta, Georgia, 2016 Available at https://www.cdc.gov/violenceprevention/pdf/EA_Book_Revised_2016.pdf

4 2017 World Elder Abuse Awareness Day Understand and End Financial Exploitation of Older People A Human Rights Issue United Nations Headquarters, New York, 15 June 2017 Available at https://www.un.org/development/desa/ageing/wpcontent/uploads/sites/24/2017/
05/WEAAD2017_MissionStatement_Final.pdf


5 Based on available evidence, WHO estimates that 15.7% of people 60 years and older are subjected to abuse. These prevalence rates are likely to be underestimates as many cases of elder abuse are not reported. Globally the numbers of people affected are predicted to increase as many countries are experiencing rapidly aging populations. World Health Organization 2018 Factsheet on Elder Abuse available at https://www.who.int/news-room/fact-sheets/detail/elder-abuse

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About the Author
Julie E. Childs, JD, LLM is the Director of the Elderjustice.gov website and a Consultant to the Department of Justice’s Elder Justice Initiative in Washington, D.C. The opinions contained herein are those of the author(s) or contributor(s) and do not necessarily represent the views of the U.S. Department of Justice.