There is comprehensive public awareness and concern for elder abuse (EA) and mistreatment, yet few proven interventions to prevent it or stop its many manifestations. To promote overall elder justice, NIH convened experts from a range of research fields to integrate existing research and practice on other issues into future elder abuse interventions.
The Intervention and Prevention Strategies Panel made the following suggestions:
- Future interventions target the elder abuse dyad (the initiator and the victim or potential victim);
- Interventions screen those at risk for elder abuse;
- Interventions take multi-disciplinary, multi-dimensional approaches to elder abuse;
- Elder abuse interventions build upon existing programs including senior-target events, shelters and helplines.
Panelists described their own work and collaborated to paint a vision for future elder abuse interventions:
- Jeanne Teresi, PhD, a psychiatric researcher and research administrator.
- Elizabeth Skowron, PhD, a researcher and professor of counseling psychology;
- David Burnes, PhD, who studies social work;
- Mary Ann Dutton, PhD, a trauma researcher and clinical program administrator; and
- Laura Mosqueda, MD, a professor of geriatrics and director of the National Center on Elder Abuse.
Elder Mistreatment Direct Response Programs, including Adult Protective Services (APS), work directly with elder abuse victims to prevent reoccurrence. Burnes shared strategies that target cognitively-intact adults. For example, senior services are voluntary, unlike child protective services. Older adults can accept or refuse any of the offered services. Currently, refusal rates are common, so when researchers design new interventions, they should consider ways to include APS agencies and their respective programming. He also noted the decisions older individuals make may not reduce abuse risks - for example, choosing to remain at home even when home is the site for mistreatment or abuse. Such are the constraints that involve seniors and researchers who develop interventions for them. This and similar constraints lead David Burnes to recommend issue-specific interventions rather than broader "elder abuse prevention" curricula.
Mosqueda described her team’s abuse intervention model that looks at three dimensions of risk:
- the victim or at-risk person,
- the caregiver, and
- their specific context or setting.
This model facilitates identifying modifiable risk factors so intervention strategies can address one or multiple dimensions as needed. Mosqueda emphasized that interventions designed for medical or social-service settings must complement these settings as multiple regulations limit physicians’ and case workers’ time and abilities.
Interventions from other fields
Dutton said to name the abuse is to start an intervention. She said that a nurse, case worker or physician who provides someone with an opportunity to describe abuse also provides an opportunity to initiate positive change. She said that screening reduces intimate partner violence (IPV) rates partly because such questions demonstrate that certain behaviors are wrong, or because it gives someone sufficient validation to seek help. Though screening provides an opportunity, it is important to link screening to effective interventions.
Skowron listed components of effective parenting programs that prevent the occurrence of child abuse and acknowledged that few programs successfully prevent re-occurrences. This likely relates to the fact that parents who abuse or neglect their children have complex risk factors, which parallel those seen in people who commit elder abuse, including mental health problems and uncontrollable emotional reactivity. Her research examines the peripheral nervous system in abusive and neglectful mothers to understand how interventions can prevent re-occurrence. She believes similar approaches can prevent home-based elder abuse, though the types of abuse may differ among children, elders, and the caregivers.
Panelists and participants described other related interventions that have adaption potential for elder abuse, including parent-child interaction therapy, social and emotional learning, social marketing campaigns, home visits, mindfulness, bystander intervention, and caregiver training. Participants concurred that interventions should promote optimal health and wellbeing for all family members so elders can maintain active, goal-driven lives.
Archived video of NIH’s Multiple Approaches to Understanding and Preventing Elder Abuse and Mistreatment workshop.
Information page of NIH's Elder Abuse and Maltreatment workshop.
The Connector's NIH Elder Abuse Research Workshop Overview.
Photo Credit: Fotolia/ Kenishirotie