Elder abuse is a global term referring to the abuse, neglect, and exploitation of adults who are approximately 60 years of age and older. The National Center on Elder Abuse (NCEA) contends that between 500,000 and 5 million older Americans are abused each year. Adult Protective Services (APS) is typically the agency of first report for abuse of elders over 60 years of age in each state in the United States. According to the most recent survey of APS agencies, self-neglect was the most common category of investigated reports (29.4%), followed by caregiver neglect (26.1%) and financial exploitation (18.5%). Researchers estimate that as many as 1 in 14 instances of elder abuse go unreported. From 1996 to 2006, reports of the abuse of older adults increased by approximately 80%. This increase in 10 years’ time highlights the growing need for understanding elder abuse legislation.
States’ provision of protective services for adults emerged from government’s concern for adults who could not manage their own affairs. Protective services were funded in 1975 under Title XX of the Social Security Act, which required funding protective services for all adults 18 years of age and older without regard to income. The legislation placed an emphasis on persons found in situations that included abuse, neglect, and exploitation. Under the Title XX federal mandate, states created APS units in their local social service agencies, either through statute or regulation. Programs included mandatory reporting laws, modeled after child abuse reporting legislation, as well as involuntary interventions, such as emergency orders, and civil commitments.
Congressional involvement in elder abuse prevention spans more than 25 years. From 1978 through 1990, the House Select Committee on Aging held hearings on the problem of elder abuse. The hearings prompted a number of reports documenting the scope of the problem, including Elder Abuse: An Examination of a Hidden Problem (House Select Committee on Aging) and Elder Abuse: A National Disgrace (Rep. Claude Pepper). In 1990, the Subcommittee on Health and Long-Term Care of the House Select Committee on Aging issued Elder Abuse: A Decade of Shame and Inaction.
In an effort to combat elder abuse in nursing homes, the ombudsman program was created in 1972 as a Public Health Service demonstration project. Demonstration projects were carried out in seven states, which were transferred to the Administration on Aging in 1974. In 1978, the U.S. Congress amended the Older Americans Act (OAA; 42 U.S.C. §3001 et seq., as amended), requiring that each state develop a long-term care ombudsman program. Additional statutory requirements for the program were added, with existing requirements strengthened in subsequent OAA amendments.
In 1987, the federal government described elder abuse, neglect, and exploitation in amendments to the OAA under Title VII. Included were definitions of elder abuse in addition to funding for a National Center on Elder Abuse (NCEA) and for elder abuse and awareness activities for states. Subsequent re-authorizations of the Older Americans Act have increased dollars for the NCEA and for states’ elder abuse and awareness efforts, which are carried out by a variety of state-level entities.
Other pieces of legislation, such as the Violence Against Women Act (1994), have provisions for addressing elder abuse, although its focus is primarily on a younger adult population.
The Elder Justice Act
After piecemeal policymaking on elder abuse, Senator John Breaux (D) of Louisiana emerged as a champion for federal legislation on the issue. Named the Chairman of the Senate Special Committee on Aging in 2001, in 2002, Breaux, along with Orin Hatch (R, Utah), first introduced the Elder Justice Act in the Senate. Although the act failed to pass with its first and second years of introduction in Congress, it was reintroduced for a third time on November 16, 2005. With Senator Breaux retiring from office, Senator Hatch introduced the Elder Justice Act (EJA), federal legislation proposed to increase the detection, prevention, and prosecution of elder abuse. The bill was introduced by Representative Peter King (R, New York), chairperson of the House Committee on Homeland Security, in March 2006. The Elder Justice Coalition, a nonpartisan coalition of national, regional, state, and local advocacy groups and concerned citizens, is working to promote public support for the act.
The EJA contains at least six major provisions. First, it establishes an Elder Justice Resource Center, a repository of national data collection, maintenance, and dissemination of information related to elder justice. Second, the EJA includes provision for a steady flow of grants to eligible entities for abuse detection, prevention, and intervention as well as for Centers of Excellence. The national Centers of Excellence are conceived to specialize in research, clinical practice, and training. Third, the act provides for the creation of stationary and mobile forensic centers to promote forensic expertise, particularly for professionals in forensic pathology and geriatrics. Fourth, the act contains language that enables safer long-term care facilities by incentivizing the reporting of elder abuse and training of and criminal background checks for staff. Fifth, technical assistance is provided to law enforcement in order to increase the prosecution of elder abuse. Finally, consistent funding to APS is included via grants to state and local offices.
- Fulmer, T. (Ed.). (2002). Journal of Elder Abuse and Neglect, 14(2/3).
- The Library of Congress (2005). The Elder Justice Act. Retrieved May 30, 2017, from https://www.congress.gov/bill/109th-congress/senate-bill/2010
- National Long Term Care Ombudsman Resource Center. (2001). About Ombudsman Program. Retrieved May 30, 2017, from http://ltcombudsman.org/about/about-ombudsman
- Teaster, P. B., Dugar, T. D., Otto, J. M., Mendiondo, M. S., Abner, E. L., & Cecil, K. A. (2006). The 2004 survey of state Adult Protective Services: Abuse of adults 60 years of age and older. Report to the National Center on Elder Abuse, Administration on Aging. Washington, DC: National Center on Elder Abuse.
- Elder Justice Coalition: http://www.elderjusticecoalition.com/
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