Shelly L. Jackson

Risk factors associated with elder abuse: the importance of differentiating by type of elder maltreatment.

Elder abuse research rarely differentiates by the type of elder maltreatment involved when identifying risk factors. The purpose of this study was to compare risk factors across four predominant types of elder maltreatment (financial exploitation, physical abuse, neglect by others, and hybrid financial exploitation [HFE]). Data were collected from two sources: interviews with victims of substantiated elder abuse, responding adult protective services (APS) caseworkers (N = 71), and third-party informants; and a statewide database that contained all substantiated cases over a corresponding 2-year period (N = 2,142). Using chi-square (interview data) and logistic regressions (Adult Services/Adult Protective Services [ASAPS] data), significant differences across the four types of elder maltreatment were found. These two datasets provide converging evidence for the importance of differentiating by type of maltreatment when identifying risk factors for elder maltreatment and for the importance of considering both the elderly victim and the abusive individual when predicting type of elder maltreatment.

Exploring gender differences in trauma exposure and the emergence of symptoms of PTSD among incarcerated men and women

Our study examines gender differences in traumatic exposure and associated posttraumatic stress disorder (PTSD) symptoms reported by a 266 male and female inmates. In our sample, 94.7% of the inmates had experienced at least one traumatic event identified in Trauma History Questionnaire – Modified. Male inmates reported higher rates of witnessing harm to others in childhood (22.4%) and adolescence (43.25) and female inmates, higher rates of interpersonal sexual trauma in childhood (31.2%), adolescence (35.3%), and adulthood (27.7%). Women showed higher rates of PTSD (40.2%) when compared to men (12.5%), as measured by the total PTSD score of the Impact of Event Scale – Revised. The combined trauma types explained 12% and 16% of the total PTSD score in the female and male samples, respectively. In the female model, interpersonal sexual trauma was a significant predictor of PTSD symptoms; whereas in the male model, interpersonal nonsexual trauma was a significant predictor. We discuss these findings as they inform our understanding of gender differences in trauma response and psychiatric morbidity in adulthood.

Impact of parental consent and notification policies on the decisions of adolescents to be tested for HIV

Restrictions have been placed on the ability of adolescents to obtain human immunodeficiency virus (HIV) testing independent of their parents. Although some states have given adolescents the right to consent to HIV testing independently, many states have remained silent on the issue or have compromised these rights by providing for parental consent or notification when adolescents seek testing. This article examines existing policies and explores whether policies that require adolescents to obtain parental consent, or that permit or mandate parental notification, may deter them from obtaining needed HIV testing.

The shifting conceptualization of elder abuse in the United States: from social services, to criminal justice, and beyond

A variety of forces have shifted the conceptualization of elder abuse over time to where it is almost unrecognizable when compared to its original conceptualization. The field has adopted or embraced whatever social problem is in vogue in an attempt to elevate elder abuse to a recognizable social problem that to date has eluded the field. This paper traces the various influences on the shifting conceptualizations of elder abuse and how those conceptualizations have shaped societys response. The paper concludes by suggesting that multiple conceptualizations can and must co-exist, a framework which is consistent with the multidisciplinary team approach becoming prevalent in the field.

APS investigation across four types of elder maltreatment

Purpose – Little empirical attention has been given to adult protective services (APS) investigations and the clients involved in those investigations. The purpose of this study was to explore aspects of the APS investigation of and response to reported elder maltreatment, the perceptions of elderly victims and their refusal of services, and to compare findings by the type of maltreatment involved (financial exploitation, physical abuse, neglect, and hybrid financial exploitation).Design/methodology/approach – Data were collected from two sources over a two‐year period: in‐depth interviews with 71 APS caseworkers and 55 of the corresponding elderly victims who experienced substantiated elder maltreatment; and a statewide database that contained 2,142 substantiated cases of elder abuse.Findings – Many aspects of the APS investigation and response differed by the type of maltreatment involved. While elderly victims were generally cooperative and satisfied with the APS intervention, 38 percent would have pre...

How Case Characteristics Differ across Four Types of Elder Maltreatment: Implications for Tailoring Interventions to Increase Victim Safety

Purpose: The purpose of this study was to determine whether case characteristics are differentially associated with four forms of elder maltreatment. Method: Triangulated interviews were conducted with 71 APS caseworkers, 55 victims of substantiated abuse whose cases they managed, and 35 third party persons. Results: Pure financial exploitation (PFE) was characterized by victim unawareness of financial exploitation and living alone. Physical abuse (PA) was characterized by victim’s desire to protect the abusive individual. Neglect was characterized by isolation and victim’s residing with the abusive individual. Hybrid financial exploitation (HFE) was characterized by mutual dependency. Implications: These differences indicate the need for tailoring interventions to increase victim safety. PFE requires victims to maintain financial security and independence. PA requires services to meet the needs of abusive individuals. Neglect requires greater monitoring when elderly persons reside with another person. HFE requires the provision of services to both members of the dyad.

All Elder Abuse Perpetrators Are Not Alike The Heterogeneity of Elder Abuse Perpetrators and Implications for Intervention

The tendency to label all elder abuse perpetrators as the “bad guys” has diminished our ability to respond effectively. A review of the literature demonstrates that elder abuse perpetrators are in fact heterogeneous with important differences across types of abuse. A reformulation of perpetrator interventions away from a singular emphasis on prosecution to meaningful alternatives that utilize criminal justice and/or therapeutic approaches tailored to the needs of the case is needed. These interventions must incorporate the needs of both victims and perpetrators, take into consideration the type of abuse involved, acknowledge the variations in perpetrator culpability, and recognize the continuum of complexity among these cases. Without addressing these nuances, intervention and prevention efforts will be futile if not harmful.

A Systematic Examination of Smoke-Free Policies in Multiunit Dwellings in Virginia as Reported by Property Managers: Implications for Prevention

Purpose. In most states, smoking has been curtailed to some extent in public buildings, workplaces, and restaurants. The next frontier for smoke-free policies is the multiunit dwelling industry. However, the extent to which smoke-free housing currently is available is unknown. The purpose of this study was to measure the market for smoke-free housing in Virginia and to identify barriers to adopting smoke-free policies. Design. Telephone interviews were conducted with property managers of rental apartments, townhouses, senior housing, and public housing in four Virginia cities. Setting. Four cities in Virginia. Subjects. Two hundred sixty-three property managers in four cities in Virginia (approximately 75 property managers per city). Measures. Property managers were administered a brief telephone survey. Results. Only 33.8% of property managers reported some type of smoke-free policy, with only 15% of those policies prohibiting smoking in residential units. Most property managers without a smoke-free policy were not considering adopting such a policy for a variety of reasons. Conclusion. The availability of smoke-free multiunit dwellings is severely lacking. This study identified a number of science-based and legal misperceptions that may prevent the adoption of smoke-free policies. Correction of these misperceptions is warranted to increase the availability of smoke-free housing. Such policies will be useful in creating environments that support good health practices while simultaneously protecting tenants from exposure to secondhand smoke.

Five-year all-cause mortality rates across five categories of substantiated elder abuse occurring in the community

ABSTRACT Elder abuse increases the likelihood of early mortality, but little is known regarding which types of abuse may be resulting in the greatest mortality risk. This study included N = 1,670 cases of substantiated elder abuse and estimated the 5-year all-cause mortality for five types of elder abuse (caregiver neglect, physical abuse, emotional abuse, financial exploitation, and polyvictimization). Statistically significant differences in 5-year mortality risks were found between abuse types and across gender. Caregiver neglect and financial exploitation had the lowest survival rates, underscoring the value of considering the long-term consequences associated with different forms of abuse. Likewise, mortality differences between genders and abuse types indicate the need to consider this interaction in elder abuse case investigations and responses. Further mortality studies are needed in this population to better understand these patterns and implications for public health and clinical management of community-dwelling elder abuse victims.

Enhancing the Safety of Elderly Victims After the Close of an APS Investigation

Purpose. The purpose of this study was to test whether particular actions on the part of adult protective services (APS), the elderly victim, and/or society’s response to abusive individuals, are associated with the continuation of abuse after the close of an APS investigation and thereby compromise victim safety. Method. Interviews were conducted with 71 APS caseworkers, 55 of the elderly victims of substantiated abuse, and 35 third-party persons. Results. A small proportion of elderly victims continue to experience abuse after the close of an APS investigation. Elderly victims were more likely to experience continued abuse when they chose to have ongoing contact with their abusers, vis-à-vis cohabitation or otherwise, and when their abusers experienced no consequences. Although continuation of abuse did not differ by the type of maltreatment involved, reasons for the cessation of abuse, and other safety indicators, did. Implications. To enhance victim safety, greater monitoring may be warranted in cases wherein elderly victims continue to have contact with their abuser and when abusive individuals experience no consequences. To further enhance victim safety, abusive individuals must be incorporated into an overall strategic response to elder abuse. A potential avenue for facilitating victim safety while maintaining victim autonomy is to understand their motivations for desiring continued contact with their abuser and developing interventions based upon such knowledge.