Social Problems of Vulnerable Population

The National Center on Elder Abuse (NCEA) (2012) reports
the United States 2010 Census recorded “the greatest number
and proportion of people age 65 and older in all decennial
census history: 40.3 million, or 13% of the total population….
In 2010, there were 5.8 million people aged 85 or older” (p.
1). By 2040, 1 in 5 Americans will be age 65 or older (Urban
Institute, 2012). A March 2011, U.S. government report
cited elder abuse was on the rise involving multiple types of
abuse (Pham, 2011). Elder abuse (neglect and mistreatment)
is defined as “intentional actions that cause harm or create a
serious risk of harm (whether or not harm is intended) to a
vulnerable elder by a caregiver or other person who stands
in a trust relationship to the elder. This includes failure by
a caregiver to satisfy the elder’s basic needs or to protect the
elder from harm” (NCEA, 2012, p. 1). Types of elder abuse
are shown in the Table. In addition, self-neglect on the part
of the elder which can include refusing needed help in daily
activities, can be self-abusive.

ORDER NOW FOR ORIGINAL, PLAGIARISM-FREE PAPERS

Statistics on types of elder abuse
According to a 2012 report by Statistic Brain (based on
NCEA, Bureau of Justice Statistics), the number of elder
abuse cases in 2010 were 9.5% of the elderly population.
The percentages of elder abuse cases by types reported in
Elder Abuse: Definition, Types and
Statistics, and Elder Abuse (Mistreatment
and Neglect) Laws
Eileen Watson, EdD, MSN, ANP, GNP, LNCC
Professional Practice, Trends, and Issues
Table: Types of Elder Abuse, Definitions, Causations and Signs and Symptoms
Type Definition Causation-Examples Sign/Symptoms
Physical Abuse Non-accidental use of force resulting
in injury, impairment ,or pain
Hitting, slapping, shoving, forcefeeding, restraining by chemical or
physical means
Bruising, burns, broken bones,
lacerations, scars, welts—check
symmetry/asymmetry
Psychological/Emotional Abuse Verbal—Words spoken causing
emotional pain or distress
Nonverbal—Treatment causing
emotional pain or distress
Verbal—threats, yelling, humiliation,
ridicule
Nonverbal—ignoring, isolating, or
terrorizing elder
Withdrawal, evasiveness, refusal
to socialize, unexplainable fear or
suspicion, depression, mumbling
to self
Sexual Abuse Contact without consent (nonconsensual sex act)
Physical sex act, showing elder
pornography, forcing elder to
undress or watch sex acts
Ripped/torn underwear, bleeding
genitals, bruised regions of breasts
or genitals, unexplained venereal
diseases or vaginal infections,
unexplainable vaginal or anal
bleeding
Financial Abuse Unauthorized use of elder’s funds or
property. Sudden change in financial
situations
Illegal taking, misuse, or hiding of
funds, property, assets for another’s
benefit;
Stealing, coercion to change a will
or assuming power of attorney
Forged signatures on checks,
identity theft, large amount of money
withdrawn without explanations,
missing property
Neglect by Caregiver/Abandonment Failure by individual caring for
vulnerable elder to provide food,
water, shelter, protection or health
care. Desertion by caregiver from
vulnerable elder
Physical—failure to provide
preventive health care, safety,
eyeglasses dentures, or hygiene
Emotional—failure to provide social
stimulation
Financial—failure to use available
resources for well-being of elder
Weight loss, thirst, sunken eyes, lack
of assistive devices, bedsores, poor
hygiene, unsanitary living conditions
Note. Adapted from:
Robinson, Benedictis, & Segal. (2013, March). Elderbuse and neglect. Retrieved from: http://www.helpguide.org/mental/elder_abuse_physical_emotional_
sexual_neglect.htm
Administration of Aging (2013). What is elder abuse? Retrieved from: http://www.aoa.gov/AoA_programs/elder_rights/eEA_prevention/whatis EA.aspx
Legal Info. (n.d.) Elder abuse-An overview. Retrieved from: http://www.legalinfo.com/content/elder-abuse
Sellas & Brenner (2011). Elder abuse. Retrieved from: http://emedicine.medscape.com/article/805727-overview
Journal of Legal Nurse Consulting • Fall 2013 • Volume 24, Number 2 • 41
2010 include: neglect (58.5%), physical abuse (15.7%),
financial abuse (12.3%), psychological abuse (7.3%), sexual
abuse (0.04%), all other types (5.1%), and unknown (0.06%)
(Statistic Brain, 2012). Elder abuse occurs in private homes,
long-term care facilities (nursing homes, assisted living
facilities), and hospitals. Approximately 1 out of 14 reported
cases of elder abuse occurred in the victim’s domestic setting
(e.g., home) while physical abuse was identified as the
most common type of abuse in nursing homes. (Elder-law.
law, 2013). Elder abuse statistics report that for every case
of elder abuse reported to authorities, approximately five
case go unreported due to a victim’s loyalty/fear of his/her
abuser; shame for being dependent on the abuser; or being
uninformed/misunderstanding about available services.
Elder abuse laws
Both federal and state laws address elder abuse, neglect, and
financial exploitation (Center for Elders and the Courts
(CEC) (2012).
Federal law
Federal law defines an elderly person as someone age 60 years
and older. This definition came from the Older Americans
Act of 1965 (42 U.S.C. 3001 et seq.). The Omnibus Budget
Reconciliation Act (1987), also known as the Nursing Home
Reform Act, has been cited as the most substantial law
related to elder abuse (Omalacy, 2012). The law “provides
federal statutory protection for residents in certified nursing
facilities….Residents have the right to privacy, information
on medical changes, the right to voice grievances without
discrimination, and accommodation of physical, emotional
and social needs” (Omalacy, 2012). The Elder Justice Act of
2009, enacted in 2010 as part of the Patient Protection and
Affordable Care Act (H.R. 3500: P.L. 111-148), coordinates
elder abuse protection and abuse programs with the Office
of the Health and Human Services (CEC, n.d.). Vulnerable
Rights Protection Program (1992) promotes the “passage by
the states of legislation to prevent elderly abuse and neglect,
and provide services to the elderly by providing federal
funding for qualifying state programs” (Best, 2012, p. 1).
State laws
All states have laws relating to elder abuse and neglect.
State law is the primary source of remedies, sanctions, and
protection relating to elder abuse (CEC, n.d.). All states have
Adult Protective Services (APS) or Elder Protective Services
(EPS) statutes that authorize and regulate services for elder
Abuse (Omalacy, 2012). In most states, the first agency to
respond to a report of elder abuse is Adult Protective Services
(APS). The role of APS is to investigate abuse cases, intervene,
and offer services and advice (Robinson, Benedictis, & Segal,
2013). All 50 states have statutes establishing a Long Term
Care Ombudsman Program and are administered by a state
or local council on aging (CEC, n.d.).
Abuse of elders is a criminal offense in all 50 states. Laws
differ by state, but all have systems for reporting suspected
abuse. For example, in January 2013, a California law, AB40,
Elder and dependent adult abuse: reporting. (2011-2012)
was passed to resolve a conflict between federal and state laws
related to elder abuse reports. “When abuse occurs in a nursing
home, employees are required by law to file a report with the
police or the long-term care ombudsman. When reports go
to the ombudsman, strict federal confidentiality rules prevent
the ombudsman from sending the report to law enforcement
for a criminal investigation. The new law requires long-term
care facilities to report suspected abuse that results in serious
injury within two hours to police” (Perkes, 2013, p. 1). All
healthcare providers along with members of the general
public need to be aware of the risk factors, warning signs, and
effects of elder abuse.
References
Aging (2013). What is elder abuse? Retrieved from: http://www.
aoa.gov/AoA_programs/elder_rights/eEA_prevention/whatis
EA.aspx
Professional CertifiCate in
LegaL Nurse CoNsuLtiNg
online Program
www.extension.uCr.edu/lnC
CLiMB tHe LaDDer
oF suCCess.
Being an r.N. is
just the first step.
Learn more online.
42 • Journal of Legal Nurse Consulting • Fall 2013 • Volume 24, Number 2
Sellas, M. & Brenner, B. (2011). Elder abuse. Retrieved from:
http://emedicine.medscape.com/article/805727-overview
Statistic Brain (2012, Sept. 12). Elderly abuse statistics. Retrieved
from: http://www.statisticbrain.com/elderly-abuse-statistics
Urban Institute (2012). The U.S population is aging. Retrieved
from: http://www/urban.org/retirement_policy/agingpopulation.
cfm
U.S. Department of Commerce, U.S. Census Bureau. (2011).
The older population: 2010 (PublicationC2010BR-09).
Washington, D.C. Author
Best, K. ( 2012) Federal laws on elderly abuse. Retrieved from :
http://www.ehow.com/list_7230466_federal-laws-elderly-abuse.Social Problems of Vulnerable Population
html
Center for Elders and the Courts (CEC) (n.d.). Elder abuse laws.
Retrieved from: http://www.eldersandcourts.org/elder-abusebasics/elder-abuse-laws.aspx
Elder-law.law (2012). What are the elder abuse statistics?
Retrieved from: http://elder-law.laws.com/elder-abuse-statistics
Laws.com (2013). What are the elder abuse statistics? Retrieved
from: http://elder-law.laws.com/elder-abuse-statistics
Legal Info. (n.d.) Elder abuse-An overview. Retrieved from:
http://www.legalinfo.com/content/elder-abuse.
National Center on Elder Abuse (NCEA) (2012). Statistics/data:
America’s growing elderly population. Retrieved from: http://
ncea.aoa.gov/library/data/index.aspx
Omalacy, R. (2012). Laws regarding elder neglect. Retrieved from:
http://www.ehow.com/list_7437958_laws-regarding-elderneglect.html
Perkes, C. (2013, Jan.). Local voices praise new health law.
Retrieved from: http://www.ocregister.com/articles/law382380-abuse-elder.htm
Pham, S. (2011, Mar.). Government report finds elder abuse
on the rise. Retrieved from: http://newoldage.blogs.nytimes.
com/2011/03/03/government-report-finds-elder-abuse-on-therise
Robinson, Benedictis,& Segal. (2013, March). Elderbuse and
neglect. Retrieved from: http://www.helpguide.org/mental/
elder_abuse_physical_emotional_sexual_neglect.htm.
Eileen Watson, EdD, MSN, ANP, GNP, LNCC is
an Associate Professor of Nursing at California State
University Long Beach, California where she teaches
the course Legal Issues in Health Care. She has been
an independent contractor since 1989, specializing in
plaintiff and defense medical malpractice. She serves as
an expert witness for the California Board of Registered
Nursing. She is an adult/geriatric nurse practitioner as
well as a civil litigation paralegal. She is a national speaker
and author in the areas of informed consent, advance
directives and elder abuse. She can be contacted at eileen.Social Problems of Vulnerable Population
watson@csulb.edu
Copyright of Journal of Legal Nurse Consulting is the property of American Association of
Legal Nurse Consultants and its content may not be copied or emailed to multiple sites or
posted to a listserv without the copyright holder’s express written permissio