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A
variety of health and social services are available to address
the underlying causes of abuse, stop it, and reduce the
likelihood that it will occur again. Still other services
treat the emotional, physical, and financial effects. Some
of these services are federally funded and available in
every community, while others are specific to certain communities.
Below is a list of services that are frequently needed by
victims. Instructions for finding out what services are
available in your community, and how to access them, are
provided on the How do I find
services in my community? page.
Mental
health assessments are often needed to determine if
an older person is capable of meeting his or her own basic
needs, making decisions about services, offering testimony,
and protecting him or herself against abuse. Assessments
of alleged abusers' mental status are sometimes needed to
determine if they pose a danger to others and are in need
of treatment.
Counseling
for victims or vulnerable adults can help them assess their
options, plan for their safety, resolve conflicts, and overcome
trauma. Group or individual counseling may be available
from private therapists, health maintenance organizations,
or mental health clinics. In abuse cases, counseling typically
focuses on the following issues:
- Educating
victims about resources and options
- Breaking
through denial and shame
- Safety
planning (planning what to do if abuse occurs)
- Building
support networks
- Co-dependency
- Traumatic
or post traumatic stress
- Family
counseling to resolve or mediate conflicts and address
tensions or stresses that give rise to abuse or neglect
Legal
assistance is needed in many abuse cases. Legal services
are provided by private attorneys, programs operated by
local or state bar associations, or subsidized legal aid
programs. The Older American's Act established a network
of free legal services for persons over the age of 60. These
programs are becoming increasingly adept at handling elder
abuse cases. The following interventions may be needed in
abuse cases:
- Lawsuits
to recover assets or property
- Annulments
of bogus marriages
- Restraining
orders to restrict contact between perpetrators and victims
- Guardianship
(called conservatorship in some states) is a process by
which courts assign responsible persons or agencies to
act on behalf of people who are unable to protect themselves
or their interests as a result of physical or cognitive
impairments. Guardians may be family members or professionals
from public or private guardians or in private practice.
Some communities have programs that use volunteers to
serve as, or monitor, guardians.
- Prosecution
of offenders
- Assistance
with obtaining restitution
Support
Services. When abuse or neglect is related to the stresses
associated with care giving, risk can be reduced by providing
services that reduce the older person's dependency and isolation
and provide relief to caregivers. Support services include:
Daily
money management. Financial abuse frequently may occur when
an older person has lost the ability to manage his or her
finances. Arranging for trustworthy people to help can reduce
this risk. The help may be informal, where the money manager
simply helps the elder with simple tasks like paying bills,
or it may involve formal transfers of authority, including
representative payeeship, power of attorney, or guardianship.
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Support groups for caregivers address the emotional demands
and stresses of providing care. They also provide instruction
and guidance in meeting the older person's needs and handling
difficult behaviors. They may relieve the tensions, resentments,
and stresses that give rise to abuse and neglect.
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Respite programs give caregivers a break. Respite care
comes in many forms. Attendants, professionals, or volunteers
may come to the older person's home to provide a few hours
of relief to the caregiver, or the older person may come
to an agency. Some communities offer extended respite
care of several days or longer.
- Home
delivered meal programs. Programs deliver nutritious meals
to seniors in their homes.
- Attendants
assist vulnerable people with their daily activities,
including bathing, shopping, and preparing meals.
- Adult
day health centers provide an array of services, including
nursing care; physical, occupational, and speech therapy;
and socialization to frail seniors.
- Friendly
visitors make home visits to isolated seniors.
- Telephone
reassurance programs can make routine "check in" calls
to isolated seniors or provide telephone counseling to
seniors who are in emotional distress.
Case management is an approach to providing services
to individuals who have multiple and changing care needs.
Case managers, who may work for public or private agencies
or be in private practice, provide the following services:
- Comprehensive
assessments of the older person's general health, mental
capacity, and ability to manage in the home and community
- Develop
"care plans," often in consultation with other professionals
from several disciplines, for meeting clients' service
needs
- Arrange
for needed services
- Respond
to problems or emergencies
- Conduct
routine re-assessments to detect changes in the person's
health or ability to manage, and anticipate problems before
they occur
Victim
witness assistance programs, which are usually located
within prosecutors' offices, help victims whose cases are
in the criminal justice system. They provide:
- Information
to victims about the court process and the status of their
cases
- Advocacy
on behalf of victims. Victim advocates inform courts about
victims' special needs for protection or assistance, their
preferences and concerns regarding what happens to perpetrators,
etc.
- Information
about and assistance with compensation, restitution, and
community services
Domestic
violence programs provide an array of services for battered
women. Some offer special services for older women or can
accommodate older women's special needs. Domestic violence
services include:
- Shelters
- Counseling
for victims and abusers
- Crisis
lines
-
Support groups
Services
for Abusers. Some situations can be remedied by providing
services to abusers. Abusers who are dependent on their
victims for money or a place to live may benefit from job
training or placement, financial assistance, counseling
in independent living, or mental health or substance abuse
treatment. While it is difficult to convince some abusers
to accept treatment voluntarily - particularly mental health,
domestic violence, or substance abuse treatment - these
services are often mandated by courts or offered as conditions
of probation or as alternatives to prosecution.
Stopping
neglect and self-neglect
Determining
what interventions are appropriate in neglect cases depends
on many factors, including the caregivers' willingness to
improve care, the families' resources, and the willingness
of the elder to accept help. Caregivers who are willing
and able to improve the care they provide can be assisted
by support services. A caregiver whose motive for providing
care is self-interest may need to be replaced by a responsible
person. Mental health services may also be needed, particularly
in self-neglect cases.
Last
Updated March 2003
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