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Elder Abuse

Elder abuse is the physical, sexual, psychological, or financial abuse or neglect of older people who may be unable to defend or fend for themselves. The incidence of elder abuse is expected to increase as the size of the older population grows, further straining the social service and criminal justice systems charged with protecting that population.

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Elder abuse takes many forms that can occur in conjunction with one another. Neglect and psychological abuse, for instance, are often associated with financial exploitation.

Types of Elder Abuse

Typea Description Examples
Physical abuse Use of physical force against an older adult that may result in bodily injury, physical pain, or impairment. Striking with an object, hitting, pushing, shoving, etc.
Sexual abuse Nonconsensual sexual contact of any kind with an older adult. Unwanted touching, rape, sodomy, coerced nudity, etc.
Psychological abuseb Infliction of anguish, pain, or distress on an older adult through verbal or nonverbal acts. Verbal assaults, insults, threats, intimidation, humiliation, and harassment.
Financial exploitation Illegal or improper use of an older adult’s funds, property, or assets. Cashing an older adult’s checks without authorization. Forging an older adult’s signature. Misusing or stealing an older adult’s money or possessions.
Neglect Refusal or failure to fulfill any part of a person’s obligation or duties to an older adult. Refusing or failing to provide an older adult with such necessities as food, water, clothing, shelter, personal hygiene, medicine, comfort, personal safety, and other essentials.

Excerpted from GAO-11-201
Source:National Center on Elder Abuse.
aFederal and state law may define these terms differently.
bPsychological abuse can also be referred to as verbal or emotional abuse.
 

Elder Financial Exploitation is a Widespread and Increasing National Problem

Elder financial exploitation has been described as an epidemic with society-wide repercussions. Those who can use or develop a position of trust to take advantage of an older person, include (but are not limited to):

  • family members;
  • home care workers;
  • financial advisors;
  • legal guardians; or
  • strangers peddling mail, telephone, or Internet scams.

Losses from this type of abuse are rarely recovered and can leave older adults without the resources needed to support themselves. While federal agencies are supporting state and local governments in combating elder financial exploitation, addressing it calls for a more coordinated and deliberate approach governmentwide. The Elder Justice Coordinating Council, authorized by the Elder Justice Act of 2009, can be the vehicle for defining and implementing this strategy.

How Local Programs Combat Elder Abuse

There is an Adult Protective Services (APS) Program in each state to identify, investigate, resolve, and prevent elder abuse. However, these programs face challenges:

  • caseloads are growing and cases are becoming more complex, but resources are not keeping pace;
  • insufficient collaboration between APS and local law enforcement can impede investigation of allegations; and
  • inadequate administrative data systems make it difficult to track case outcomes and assess service effectiveness.

Federal elder justice activities, such as programs that promote collaboration across social service and law enforcement systems, have helped address some APS challenges, but stronger federal leadership in this area is needed.

In fiscal year 2015, the Administration for Community Living (ACL) within the Department of Health and Human Services received its first appropriation dedicated to the enhancement of state APS programs. In the following year, the APS-dedicated appropriation continued to support state efforts to test improvements in APS practice, services, data collection, and reporting. It also funded further development and implementation of ACL’s National Adult Maltreatment Reporting System (NAMRS), which compiles data from state APS agency information systems in order to provide consistent, accurate national information on the exploitation and abuse of older adults and adults with disabilities. This system was created in response to a GAO recommendation for significant, on-going technical assistance to states to facilitate their participation in a national APS data collection effort.

Federal Agency Programs that Combat Elder Abuse

Certain federal agencies whose missions correspond to the state and local social service, criminal justice, and consumer protection systems are positioned to contribute to state and local efforts.

Figure 1:  Federal Agencies with Missions That Involve Combating Elder Financial Exploitation 

Federal Agencies with Missions That Involve Combating Elder Financial Exploitation

Excerpted from GAO-13-110
aJustice also plays a consumer protection role. Specifically, two of Justice's strategic objectives are to (1) prevent and intervene in crimes against vulnerable populations; uphold the rights of, and improve services to, America's crime victims; and (2) combat corruption, economic crimes, and international organized crime.
 

Figure 2 provides an overview of federal agencies’ responsibilities with regard to combating international and interstate financial crimes—crimes that often target older adults and are particularly difficult for local law enforcement authorities to address.

Figure 2: Federal Agencies’ Responsibilities in Combating International and Interstate Financial Crimes

Federal Agencies’ Responsibilities in Combating International and Interstate Financial Crimes

Excerpted from GAO-13-110
aU.S. Attorneys also participate in the investigation of cases, either alone or in cooperation with other agencies
Note: Consumer Financial Protection Bureau (CFPB), Federal Trade Commission (FTC), Securities and Exchange Commission (SEC), Federal Bureau of Investigation (FBI)

Combating Abuse: Federal Fiduciaries and State Court-Appointed Guardians

When an older adult who receives cash benefits from the Social Security Administration (SSA) or the Department of Veterans Affairs (VA) is not capable of managing his or her own finances, each agency assigns a fiduciary to make sure benefits are used in the older adult’s best interest. Similarly, state courts appoint a guardian or conservator to handle the finances of older adults the court determines to be incapacitated.

  • The number of incapacitated older adults is likely to grow as the population ages, signaling greater demand for individuals willing and able to serve as federal fiduciaries and guardians.
  • As the number of fiduciaries and guardians grows, it will be important to find better ways to monitor their performance to prevent financial exploitation.

Sharing certain information SSA maintains on the performance of its fiduciaries could better ensure that state courts appoint suitable guardians.  Moreover, federally funded pilots evaluating the feasibility, cost, and effectiveness of promising oversight practices could help improve federal and court monitoring of fiduciary and guardian performance.

Looking for our recommendations? Click on any report to find each associated recommendation and its current implementation status.

More Reports

Elder Justice: More Federal Coordination and Public Awareness Needed
http://gao.gov/products/GAO-13-498

GAO-13-498: Published: Jul 10, 2013. Publicly Released: Jul 10, 2013.
Older Americans Act: Options to Better Target Need and Improve Equity
http://gao.gov/products/GAO-13-74

GAO-13-74: Published: Nov 30, 2012. Publicly Released: Dec 11, 2012.

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    • Kay Brown
    • Director, Education, Workforce, and Income Security
    • BrownKE@gao.gov
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