**Annual Annotated Bibliography of Elder Abuse and Neglect Publications\
July 2005 - June 2006**\
\
The following is an annotated bibliography of works published or
appearing in print from July 2005 through June 2006.\
\
Entries are categorized as National Center on Elder Abuse (NCEA)
publications, research, scholarship, books, manuals and training
resources, and hearings. The citations are alphabetized by author\'s
name within the genre categories. A number of international references
have also been included, as they contribute to the advancement of the
study of elder mistreatment and the recognition of elder abuse, neglect
and exploitation as a worldwide societal problem. (International entries
are categorized as research, scholarship, or books and manuals;
abstracts identify the originating country.)\
\
Many readers use the CANE bibliography series to keep abreast of
recently published\
literature in the field. As a convenience, if a citation has previously
appeared in a CANE bibliography, we have indicated this with an asterisk
(\*) after the file number. To access the CANE Bibliography Series visit
the NCEA Web site at:
<http://www.elderabusecenter.org/default.cfm?p=cane.cfm> .\
\
Most of these reference materials may be obtained through your local
university and community libraries or interlibrary loan services. Some
must be ordered directly through the publisher or production company.
When available, contact and pricing information is included with the
abstract. Increasingly, many resources are available online, and the Web
addresses are also included.\*\* If you need assistance in obtaining any
of these materials, please contact the CANE office at <cane-ud@udel.edu>
or (302) 831-3525.\
\
(To search for reference materials from previous years, please visit the
CANE Web site at: <http://db.rdms.udel.edu:8080/CANE> . To access
earlier annual reviews, visit the CANE Bibliography Series

at: <http://www.elderabusecenter.org/default.cfm?p=cane.cfm> .)

\*\*Note: Web addresses may change without notice. If an address
provided is no longer accurate, we recommend using a generic search
engine, such as Google, to find a current link. If you cannot locate the
online publication, contact the CANE offices for assistance.

\*\*\* Although some entries have earlier publication dates, these
references first appeared in print during this time frame. Such entries
are noted by a triple asterisk following the CANE file number.

The National Center on Elder Abuse (NCEA) serves as a national resource
for elder rights advocates, law enforcement and legal professionals,
public policy leaders, researchers, and citizens. It is the mission of
NCEA to promote understanding, knowledge sharing, and action on elder
abuse, neglect, and exploitation.

The NCEA is administered under the auspices of the National Association
of State Units on Aging.

**NCEA Partners**

-   National Association of State Units on Aging (NASUA), Lead Partner

-   American Bar Association (ABA) Commission on Law and Aging

-   Clearinghouse on Abuse and Neglect of the Elderly (CANE) at the
    University of Delaware

-   National Adult Protective Services Association (NAPSA)

-   National Committee for the Prevention of Elder Abuse (NCPEA)

This publication was made possible through the support provided by the
National Center on Elder Abuse. Major funding for the National Center on
Elder Abuse comes from the U.S. Administration on Aging, Department of
Health and Human Services. Grant No. 90-AM-2792.

Opinions or points of view expressed do not necessarily reflect the
official position or policies of the U.S. Administration on Aging.

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**I. Publications by the National Center on Elder Abuse (NCEA)**

1\. Clearinghouse on Abuse and Neglect of the Elderly (CANE) for the
National Center on Elder Abuse (NCEA)

**CANE Bibliography Series**

National Center on Elder Abuse; Washington, D.C.; 2005-2006.

As part of its commitment to the National Center on Elder Abuse (NCEA)
to promote the dissemination of current and relevant research on topics
related to elder abuse, neglect, self-neglect, and exploitation, the
Clearinghouse on Abuse and Neglect of the Elderly (CANE) annually
produces a series of selected annotated bibliographies. Bibliographies
can be accessed online at:
[www.elderabusecenter.org/default.cfm?p=cane.cfm](http://www.elderabusecenter.org/default.cfm?p=cane.cfm)
. The following bibliographies were developed and posted on the NCEA web
site from July 2005 through June 2006:

> [**Elder Abuse: International and Cultural Perspectives - An Update of
> the
> Literature**](http://www.elderabusecenter.org/default.cfm?p=CANE_International060614.cfm)

<http://www.elderabusecenter.org/default.cfm?p=CANE_International060614.cfm>

> [**Self-Neglect: An Update of the
> Literature**](http://www.elderabusecenter.org/default.cfm?p=cane_selfneglectupdate.cfm)
>
> <http://www.elderabusecenter.org/default.cfm?p=cane_selfneglectupdate.cfm>
>
> [**Compulsive Hoarding - A Form of
> Self-Neglect**](http://www.elderabusecenter.org/default.cfm?p=cane_hoarding.cfm)
>
> <http://www.elderabusecenter.org/default.cfm?p=cane_hoarding.cfm>
>
> [**Informal Caregiving for Dependent Elders: The Association with
> Elder Abuse, Neglect, and the Well-Being of Older
> Individuals**](http://www.elderabusecenter.org/default.cfm?p=cane_informal.cfm)
>
> <http://www.elderabusecenter.org/default.cfm?p=cane_informal.cfm>
>
> [**Guardianship and other Legal Protections of Vulnerable
> Adults**](http://www.elderabusecenter.org/default.cfm?p=cane_guardianship.cfm)
>
> <http://www.elderabusecenter.org/default.cfm?p=cane_guardianship.cfm>
>
> [**Identifying Elder Abuse: Tools, Techniques and Guidelines for
> Screening and
> Assessment**](http://www.elderabusecenter.org/default.cfm?p=cane_ea_assessment.cfm)
>
> <http://www.elderabusecenter.org/default.cfm?p=cane_ea_assessment.cfm>
>
> [**2004-2005 Year in Review: Research and Scholarship on Elder
> Abuse**](http://www.elderabusecenter.org/default.cfm?p=cane_pubs0604705a.cfm)
>
> <http://www.elderabusecenter.org/default.cfm?p=cane_pubs0604705a.cfm>

2\. S6273-15\*

National Association of State Units on Aging (NASUA) for the National
Center on Elder Abuse (NCEA)

**Domestic Violence in Later Life: A Guide to the Aging Network for
Domestic Violence and Victim Service Programs**

National Center on Elder Abuse; Washington, D.C.; Spring 2006.

As quoted from the introduction: \"As the \'Baby Boom\' generation born
between 1946 and 1964 ages, it is likely more victims of late life
violence and abuse will seek out or be referred to the specialized
services provided by domestic violence programs. This potential calls
for increased collaboration between aging and domestic violence networks
to assure maximum support and safety for victims and survivors of abuse
in later life. The national aging network of State Units on Aging, Area
Agencies on Aging, Tribal and Native organizations, and direct service
providers - especially long term care ombudsman programs, adult
protective services, legal services, and information and
referral/assistance - has a key role to play in speaking out for older
victims. With this Issue Brief we hope to encourage expanded dialogue
and connections with allied partners\...\" The publication provides an
overview of the aging network, established under the Older Americans Act
(OAA), and describes key entities, providers of the four broad
categories of support (access services, elder rights, services in the
community, and in-home services) and the key values underlying the
network. A list of state and national resources is also provided. (Note:
This issue brief is accessible online at:
<http://www.elderabusecenter.org/pdf/publication/nceaissuebrief.agingnetworkguideDV.pdf>
.)

3\. S6149-67\*

National Association of State Units on Aging (NASUA) for the National
Center on Elder Abuse (NCEA)

**Nursing Home Abuse Risk Prevention Profile and Checklist**

National Center on Elder Abuse; Washington, DC; 2005.

This resource was designed to assist nursing home professionals in
assessing the risk of resident abuse and neglect. Three major areas are
considered: facility risk factors; resident risk factors; and
relationship risk factors. Facility risk factors include not only staff
turnover and caregiver stress, but the absence (or inadequacy) of
prevention policies and training initiatives. Resident risk factors
encompass behavioral symptoms related to dementia, and unmet resident
needs. Relationship risk factors address not only issues related to the
presence or absence of family involvement, but also interactions between
residents and staff. Steps for abuse prevention planning are outlined
and include an emphasis on multidisciplinary collaboration. Instructions
for the use and scoring of the checklist are also provided. Finally,
implementation tips generated by Minnesota's pilot testing of the tool
are presented. (Note: This publication is accessible online at:
<http://www.elderabusecenter.org/pdf/publication/NursingHomeRisk.pdf> .)

4\. S6174-00

National Center on Elder Abuse (NCEA)

**NCEA Webcast Archives**

National Center on Elder Abuse; 2005-2006.

In an effort to promote the use of promising practices and to foster
collaboration among the entities that address elder mistreatment, the
NCEA produces an ongoing series of webcasts on a broad range of topics.
Archives of the webcasts can be accessed from the NCEA web site at:
<http://www.elderabusecenter.org/default.cfm?p=eventsandwebcasts.cfm> .
The following webcasts were presented from July 2005 through June 2006:

> [**Strategies for Reaching Isolated and Underserved Victims of Elder
> Abuse**](http://www.visualwebcaster.com/event.asp?id=32817)
>
> April 27, 2006\
> <http://www.visualwebcaster.com/event.asp?id=32817>\
> \
> **[World Elder Abuse Awareness Day: Promoting Local National, Global
> Awareness and Effective
> Action](http://www.visualwebcaster.com/event.asp?id=33068)\
> **April 12, 2006\
> [http://www.visualwebcaster.com/event.asp?id=33068](http://visualwebcaster.com/event.asp?id=33068)\
> \
> [**New Data on Elder Abuse: What We\'ve Learned from the 2004 Survey
> of State APS**](http://www.visualwebcaster.com/event.asp?id=31874)
>
> February 16, 2006\
> <http://www.visualwebcaster.com/event.asp?id=31874>\
> \
> [**Elder Abuse Fatality Review Teams: Issues and
> Answers**](http://www.visualwebcaster.com/event.asp?id=31371)
>
> December, 6 2005\
> <http://www.visualwebcaster.com/event.asp?id=31371>

5\. S6136-45

Teaster, P. B., Dugar, T., Mendiondo, M., Abner, E., & Cecil, K. of the
Graduate Center for Gerontology, University of Kentucky, and Otto, J. of
the National Adult Protective Services Association (NAPSA), prepared for
the National Center on Elder Abuse (NCEA)

**Abuse of Adults Age 60+: The 2004 Survey of Adult Protective
Services - Abuse of Adults 60 Years of Age and Older**

National Center on Elder Abuse (NCEA); Washington, D.C.; February 2006.

This report, a follow up of the NCEA\'s *2000 Survey of State Adult
Protective Services*, describes the findings of the 2004 national survey
of APS data regarding reported and substantiated cases of elder abuse
and neglect from fiscal year 2003. Data was collected from all 50
states, Guam, and the District of Columbia. A total of 565,747 reports
of elder and vulnerable adult abuse were made to APS during fiscal year
2003, representing a 19 percent increase since the 2000 survey; 191,908
cases of abuse across 42 states were substantiated; and self-neglect was
the most commonly reported type of mistreatment, followed by caregiver
neglect and financial exploitation. While all states participated in the
study, only 29 states were able to separate cases involving victims aged
60 and over from vulnerable adults younger than 60. (Note: The entire
report is accessible at:
[http://www.elderabusecenter.org/pdf/2-14-06%20FINAL%2060+REPORT.pdf](http://www.elderabusecenter.org/pdf/2-14-06 FINAL 60+REPORT.pdf)
. The fact sheet summarizing highlights of the study is online at:
[http://www.elderabusecenter.org/pdf/2-14-06%2060FACT%20SHEET.pdf](http://www.elderabusecenter.org/pdf/2-14-06 60FACT SHEET.pdf)
. The web cast seminar highlighting the findings of this report, which
includes a PowerPoint presentation, can be accessed at:
<http://www.visualwebcaster.com/event.asp?id=31874> .)

6\. S6248-67

Wood, E., of the American Bar Association Commission on Law and Aging,
prepared for the National Center on Elder Abuse (NCEA)

**The Availability and Utility of Interdisciplinary Data on Elder Abuse:
A White Paper for the National Center on Elder Abuse**

National Center on Elder Abuse (NCEA); Washington, D.C.; May 2006.

As quoted from the Executive Summary: \"There is wide consensus that
currently a clear picture of the incidence and prevalence of elder abuse
in the United States is sadly lacking - and that such a picture \'is
essential if social policy is to be created to impact prevention and
treatment\' (National Institute on Aging, 2005). While the National
Center on Elder Abuse (NCEA) has collected and analyzed state adult
protective services data, the penumbra of additional data elements that
might be available through health care, long term care, criminal
justice, fiduciary, and legal services networks has remained largely
unexplored. Therefore, the NCEA sought the development of a white paper
examining such data elements, their scope and limitations, and outlining
their potential use by the U.S. Administration on Aging (AoA), other
federal agencies, and elder abuse professionals and advocates. In
response, the American Bar Association Commission on Law and Aging (ABA
Commission) conducted exploratory research on a wide range of possible
data sources. This white paper presents and evaluates the results.
(Note: This report is accessible online at:
<http://www.elderabusecenter.org/pdf/publication/WhitePaper060404.pdf>
.)

**II. Research**

The following publications use a scientific method to obtain results.
The results are usually quantifiable, and the methodology can be
replicated and tested for validity and reliability.

7\. S6165-52\*

Age Concern New Zealand

**Age Concern Elder Abuse and Neglect Prevention Services - An Analysis
of Referrals for the Period: 1 July 2002 to 30 June 2004**

Age Concern New Zealand, Inc.; Wellington, NZ; November 2005.

This is an analysis of over 1200 cases of elder abuse and neglect
reported to Elder Abuse and Neglect Prevention services (EANP) from July
2002 through June 2004. Among the findings, the majority of abusers (70
percent) are family members (or extended family members, known as
whanau) typically sons or daughters, regardless of the client\'s living
situation; older perpetrators (aged 65 and up) are more likely to be
husbands; family violence occurs even when elders are living in
residential care facilities, with two-thirds of all residential client
abuse being attributed to family/whanau members; psychological abuse,
including verbal intimidation and harassment, is the most frequently
experienced type of abuse, followed by material or financial abuse. The
researchers note that these statistics are based on reported cases only,
and that international studies suggest that this only represents the
\"tip of the iceberg.\" (Note: This report is available online only at
<http://ageconcern.org.nz/files/file/EANP_final.pdf> .) (New Zealand)

8\. S6425-11

Anme, T., McCall, M. & Tatara, T.

**An Exploratory Study of Abuse Among Frail Elders Using Services in a
Small Village in Japan**

Journal of Elder Abuse & Neglect; Vol. 17 (2), 1-20; 2005.

This exploratory study was designed to measure the incidence of elder
abuse and factors associated with mistreatment among frail elderly
service users in a small Japanese community. Seventy-eight participants,
aged 60 and older, receiving one or more support services (such as adult
day care, short-term nursing home care, visiting nurse, rehabilitation,
etc.) were interviewed by health and social services professionals
regarding sociodemographic information, cognitive and physical health
status, functional needs, role conflict, caregiver burden, family
support, and the kinds and frequency of abuse experienced. Separate
interviews were conducted with caregivers. Fourteen participants (17.9
percent) were found to have been abused. The most common type of abuse
identified was emotional or psychological abuse (50 percent), followed
by neglect (42 percent) and financial abuse (35.7 percent). Nearly
two-thirds of the abusive caregivers were daughters-in-law. Abusers were
typically younger than non-abusers, experienced more health problems
than non-abusers, and received comparatively less family support.
Victims were more likely to have demonstrated behavioral problems than
elders who were not mistreated, and they had greater needs for
assistance. Cultural issues are also considered. (Japan)

9\. S6180-11\*

Arai, M.

**Elder Abuse in Japan**

Educational Gerontology; Vol. 32 (1), 13-23; 2006.

In traditional Japanese culture, the Confucian principle of filial piety
implies that care for elderly parents becomes the responsibility of the
oldest son; however, in reality this responsibility falls upon his wife,
who becomes the caretaker for not only her in-laws but her aging spouse
as well. Conflicts arising from the clash of traditional and modern
influences are believed to contribute to elder abuse and neglect. One
hundred women and 46 men, aged 19 to 60, were asked to provide examples
of elder abuse and neglect, and to rank them according to degree of
severity. Among the findings, the type of abuse most commonly viewed as
extreme in nature was physical abuse, followed by neglect, blame, and
psychological abuse. Physical abuse also accounted for nearly 25 percent
of the examples described as moderate in degree, followed closely by
neglect (21 percent of examples given), economic abuse (15 percent), and
emotional abuse (12 percent). Psychological neglect and psychological
abuse were perceived as the most common forms of mild mistreatment,
although examples of verbal, emotional, physical abuse and neglect were
also provided. (Japan)

10\. S6298-25\*\*\*

Bachman, R., Lachs, M. & Meloy, M.

**Reducing Injury Through Self-Protection by Elderly Victims of
Violence: The Interaction Effects of Gender of Victim and the
Victim/Offender Relationship**

Journal of Elder Abuse & Neglect; Vol. 16 (4), 1-24; 2004.

Although crime statistics suggest that older individuals are less likely
to be victims of violent crimes than younger individuals, when
victimized they appear to sustain more serious injuries than younger
victims. In this study, data from robbery and assault cases (excluding
sexual assault) reported in the National Crime Victimization Survey
(NCVS, 1992 through 2000) is analyzed to understand the general effect
of self-protective behaviors on the risk of injury; whether the type of
self-protective behavior has an impact; and whether the effects of such
behaviors vary by the type of offender involved. Physically
self-protective measures included physically attacking or threatening
the offender, using or threatening to use a weapon against the attacker,
chasing the attacker or running away from the scene. Nonphysical
resistance included stalling, arguing or reasoning with the offender,
trying to get attention from others, calling the police, or screaming or
yelling. Of significance, male and female elders who physically resisted
known offenders (intimates and acquaintances) were more likely to
sustain injuries than those who either did not resist or resisted
nonphysically. Those who resisted nonphysically were more likely to
avoid injury than those who resisted physically or took no
self-protective action. However, when attacked by a stranger, victims
who took no action were at greatest risk for injury, followed by those
who resisted physically. Results suggest that nonphysical
self-protective behaviors decreased the risk of injury with both known
and unknown offenders, but appeared particularly effective when dealing
with offending strangers.

11\. S6436-11\*

Bartels, S., Miles, K., Van Citters, A., Forester, B., Cohen, M. & Xie,
H.

**Improving Mental Health Assessment and Service Planning Practices for
Older Adults: A Controlled Comparison Study**

Mental Health Services Research; Vol. 7 (4), 213-223; December 2005.

**Evidence-based practice**

This control study measured the effectiveness of an intervention process
designed to improve routine screening of a number of problem areas for
geriatric clients: substance abuse; dangerousness and suicide risk; and
caregiver burden and risk for elder abuse and neglect. A
multidisciplinary team developed a quality improvement toolkit that
incorporated standardized assessment, decision and support mechanisms,
and service planning to be implemented by non-physician, home health
care and community mental health providers. Forty-four clinicians from
13 agencies working with 100 clients were assigned to either the control
or intervention group. Baseline assessments revealed only 20 to 25
percent of all clinicians were routinely screening for various safety
issues such as caregiver burden and risk for mistreatment. Following the
intervention, medical record reviews indicated that over 90 percent of
the clinicians using the toolkit routinely screened for caregiver
burden, risk for abuse and neglect, and other safety factors, while the
control group showed no improvement. The intervention group demonstrated
improvement in all screening areas. (Note: A description of this
project, including the instruments utilized, is accessible online at:
<http://www.rwjf.org/portfolios/resources/grantsreport.jsp?filename=035254.htm&iaid=144#contents>
.)

12\. S6422-14

Beaulieu, M. & Leclerc, N.

**Ethical and Psychosocial Issues Raised by the Practice in Cases of
Mistreatment of Older Adults**

Journal of Gerontological Social Work; Vol. 46 (3/4), 161-186; 2006.

In this qualitative study, 16 social work practitioners working with
older, mistreated adults were interviewed regarding ethical issues and
other dilemmas encountered through their psychosocial practice.
Complexities arise not only in response to the needs of the client, but
also because the practitioner is often working with the abuser within a
family context. The following five themes emerged: the need for ethical
reflection and self-awareness; the need to evaluate the victim\'s
capacity to make decisions on his or her behalf; confidentiality versus
collaboration among practitioners and across agencies; social versus
family responsibilities; and balancing competing values in practice. The
practice continuum of psychosocial intervention ranges from negative
autonomy (when the victim refuses the practitioner\'s proposals) to
extreme measures (taken when the practitioner makes urgent decisions
without the absolute consent of either the victim or abuser). Excerpts
from the interviews illustrate the practical aspects of these issues.
(Canada)

13\. S6452-11

Bezerra-Flanders, W. & Clark, J.

**Perspectives on Elder Abuse and Neglect in Brazil**

Educational Gerontology; Vol. 32 (1), 63-72; 2006.

This study was designed to identify perceptions held by Brazilians
regarding elder abuse and neglect. Seventy participants completed the
*Cross-Cultural Perspectives on Abuse* survey either on the Internet or
during a personal interview. Forty-four percent of those surveyed either
did not feel comfortable responding to abuse items or had no awareness
of abuse towards elders. Forty-one percent of the participants provided
examples of mild elder abuse, 41 percent provided examples of moderate
abuse, and 48 percent provided examples of extreme abuse. Of the
examples provided, extreme mistreatment was most frequently
characterized as neglect and abandonment; moderate was most frequently
characterized as psychological abuse and psychological neglect; and mild
was most commonly psychological neglect and verbal abuse. Older
participants provided more examples of mistreatment than younger
participants. The significance of psychological abuse and abandonment
appears to reflect cultural norms and economic difficulties prevalent
throughout the country. (Brazil)

14\. S6480-26

Brinig, M., Jogerst, G., Daly, J., Dawson, J. & Schmuch, G.

**Lawmaking by Public Welfare Professionals**

Whittier Journal of Child and Family Advocacy; Vol. 5; Fall 2005.

Part of a larger research project conducted by the University of Iowa on
elder abuse throughout the U.S., this study analyzes the effect of
bureaucratic characteristics of adult protective services programs (APS)
upon investigation and substantiation rates of elder abuse at the local
level. In addition to providing data on elder abuse reports,
investigations and substantiation, 1,409 APS investigators representing
forty-four states and the District of Columbia completed questionnaires
regarding the bureaucratic structure of their APS programs.
Characteristics analyzed included whether or not abuse screens were
used; whether investigators dealt with only elder abuse cases; full-time
equivalents investigating child and elder abuse allegations;
participant\'s opinion as to whether or not elders were benefited by the
intervention; the department\'s training curriculum; minimum educational
requirement for investigators; percentage of investigators with greater
than the minimum educational requirement; and educational discipline.
Participants who believed that elders were \"better off\" following
intervention demonstrated higher investigation and substantiation rates.
Programs where investigators addressed only elder abuse cases also
appeared to be associated with higher investigation and substantiation
rates. The authors suggest that this model of evaluating program
efficiency could be generalized to other areas of public welfare.

15\. S6456-8

Brownell, P. & Heiser, D.

**Psycho-Educational Support Groups for Older Women Victims of Family
Mistreatment: A Pilot Study**

Journal of Gerontological Social Work; Vol. 46 (3/4), 145-160; 2006.

**Evidence-based practice**

This study, conducted through the Fordham University Graduate School of
Social Service, evaluated a group intervention for older women who had
experienced mistreatment by family members. The intervention, based upon
the model program of NOVA House, an elder shelter in Manitoba, Canada,
consisted of eight two-hour weekly support group sessions incorporating
the use of video, discussion and exercises. It was designed to increase
participants\' social networks and enhance self-esteem, decrease
depression and anxiety, and decrease feelings of guilt. Participants
were women aged 69 to 83 who had experienced some form of mistreatment
in later life (most commonly by adult sons, followed by spouses). They
were solicited through various social service programs in which they
were enrolled. Women were randomly assigned to the intervention group
(n=9) or to the control group (n=6) and continued to receive previously
initiated supportive services. Baseline measures indicated that
participants of both groups demonstrated high levels of self-esteem, low
levels of depression, and had supportive social networks. Post test
outcome measurements revealed no significant changes among participants
of either group in terms of self-esteem, depression, or social supports,
although all but one intervention participant reported positive benefits
resulting from the treatment. Researchers suggest a number of factors
(small sample size; the fact that women were relatively high functioning
at baseline; that they were previously and concurrently engaged in
additional support services; and the relatively short length of the
treatment intervention) that may have had an impact upon outcomes.

16\. S6465-6

Burgess, A., Brown, K., Bell, K., Ledray, L. & Poarch, J.

**Sexual Abuse of Older Adults: Assessing for Signs of a Serious Crime**

American Journal of Nursing/AJN; Vol. 105 (10), 66-71; October 2005.

This study was designed to identify barriers to reporting sexual abuse
of older adults and to identify the signs and symptoms of elder sexual
abuse. Data was gathered and analyzed from a convenience sample of 125
sexual abuse cases involving women aged 61 to 98 throughout 22 states.
Cognitive impairment on the part of the victim, reluctance to disclose,
and erroneous assumptions by caregivers and relatives were among the
barriers to reporting and prosecution. Fifty-two percent of the victims
had sustained one or more signs of physical injury; 46 percent had signs
of vaginal trauma; 17 percent had signs of anal trauma. Victims also
reported a wide range of emotional trauma related to the assaults. The
structure of the forensic interview is described with an emphasis on
recording all pertinent information in the written case record.

17\. S6351-9\*

Butler, S. et al.

**Depression and Caregiver Burden Among Rural Elder Caregivers**

Journal of Gerontological Social Work; Vol. 46 (1), 47-62; 2005.

This article analyzes the results of a study addressing factors related
to depression and caregiver burden among rural family caregivers of
older adults. Members of the Maine Primary Partners in Caring (MPPC)
project used a simple screening tool to identify those at risk for
depression and caregiver burden (which not only impacts the health and
well-being of the caregiver but may also have a negative impact upon the
care recipient) in order to provide interventions before caregivers were
in crisis. Sixty-two caregivers were identified as \"at risk.\" Family
support and knowledge regarding care provision appeared associated with
decreased caregiver burden and depression, while isolation appeared
associated with increased caregiver burden. Social workers can play a
significant role in assisting rural caregivers in developing and
expanding their support networks.

18\. S6420-9

Chokkanathan, S. & Lee, A.

**Elder Mistreatment in Urban India: A Community Based Study**

Journal of Elder Abuse & Neglect; Vol. 17 (2), 45-61; 2005.

Observing that the culture of India is in transition from traditionalism
to modernism, accompanied by changes in attitudes regarding filial
responsibility and the potential for increasing vulnerability among
elders, this community based study examines the scope of elder
mistreatment within this context. A residential community of Chennai,
India, representative of the demographics of the region, was selected
for analysis. Of the 400 randomly selected elders (aged 65 and older)
who participated in the study, 14 percent reported being abused or
neglected during the preceding year. Chronic verbal abuse was most
commonly reported, followed by financial abuse, physical abuse, and
neglect. Approximately half of those reporting abuse experienced a
single form of mistreatment, but 30 percent indicated they had
experienced multiple types of abuse. While 15 percent of the male
participants reported mistreatment, 31.5 percent of the females reported
mistreatment. Perpetrators were predominantly adult children. Mistreated
elders also reported more symptoms of depression.

19\. S6265-5

Collins, K., & Presnell, S.

**Elder Homicide: A 20-Year Study**

American Journal of Forensic Medicine & Pathology; Vol. 27 (2), 183-187;
June 2006.

In an effort to draw attention to the phenomenon of elder homicide and
the role that forensic pathologists can play in differentiating deaths
due to natural causes from those due to neglect, abuse, and other acts
of violence, researchers examined the characteristics of cases referred
during a 20 year period. From 1985 through 2004, 127 cases of homicide
of individuals aged 65 to 94 (including 12 aged 85 and over) were
referred to the Medical University of South Carolina\'s Forensic Section
of the Department of Pathology and Laboratory Medicine. Fifty-eight
percent of the victims were male, 55 percent were Black, and 45 percent
were White. Thirty-one percent of the deaths were attributed to gunshot
wounds, 28 percent to blunt force trauma, 22 percent to stabbing, 13
percent to asphyxia, and six percent to other causes (including four
cases of neglect). Eighty-three percent of the homicides occurred in the
victims' residences, including three occurring in nursing homes. Of
note, more than half of the perpetrators were known to the victim: 28
percent of the perpetrators were categorized as acquaintances and 23
percent were identified as relatives. Cases involving sexual assault
were also identified, but relatively few sexual assault examinations had
been completed.

20\. S6392-8

Cooney, C., Howard, R. & Lawlor, B.

**Abuse of Vulnerable People with Dementia by their Carers: Can We
Identify Those Most at Risk?**

International Journal of Geriatric Psychiatry; Vol. 21 (6), 564-571;
2006.

In order to analyze possible associations among characteristics of
informal carers, care recipients with dementia, and acknowledged
mistreatment, 82 carers were interviewed regarding verbally and
physically abusive and neglectful behaviors. Fifty-two percent of the
carers acknowledged that they had demonstrated abuse towards the care
recipient. Fifty-one percent of carers admitted to being verbally
abusive. Twenty percent admitted to physical abuse, and four percent
were neglectful. Thirty-five percent reported a mutually verbally
abusive relationship with the patient, and six percent reported a
mutually physically abusive relationship. Verbal abuse appeared
associated with psychological problems among carers and behavioral
problems among care recipients. Of note, carers who admitted to physical
abuse were no more likely to report having mental health problems than
those who did not report abuse, and they were more likely to rate their
physical health as better. The degree of cognitive and physical
impairment did not appear associated with risk for abuse. In light of
the high percentage of carers admitting to abuse, the authors recommend
including questions about abuse in routine assessments of patients with
dementia.

21\. S6276-9

Cooper, C., Katona, C., Finne-Soveri, H., Topinkova, E., Carpenter, G.,
& Livingston, G.

**Indicators of Elder Abuse: A Crossnational Comparison of Psychiatric
Morbidity and Other Determinants in the Ad-HOC Study**

American Journal of Geriatric Psychiatry; Vol. 14 (6), 489-497; June
2006.

The Aged in Home Care (AdHOC) study was conducted throughout 11 European
nations from 2001 through 2003 and gathered data on approximately 4,000
individuals aged 65 and older receiving community based health and
social services. This aspect of the study involved crossnational
analysis of indicators of elder abuse in relationship with risk factors,
particularly depression, dementia, and lack of service provision. At
least one indicator of abuse was reported in 4.6 percent of the
respondents with highest rates being reported in Italy (12.4 percent)
and Germany (9.6 percent). Nearly two-thirds of the elders screening
positive for abuse also screened positive for dementia; and those with
severe dementia had the highest rates of abuse overall. Individuals with
mild and moderate dementia appeared to be at risk for neglect.
Participants demonstrating symptoms of depression and delusions also
appeared at greater risk for mistreatment. Having a formal psychiatric
or dementia diagnosis, however, did not appear to correlate increased
risk. Crossnational differences are discussed along with cultural
implications. (France, the Netherlands, Nordic countries, Czech
Republic, United Kingdom/U.K.)

22\. S6343-14

Croog, S., Burleson, J., Sudilovsky, A. & Baume, R.

**Spouse Caregivers of Alzheimer Patients: Problem Responses to
Caregiver Burden**

Aging & Mental Health; Vol. 10 (2), 87-100; March 2006.

This study examines the stress responses of 199 spousal caregivers of
patients with Alzheimer\'s disease. Associations between specific
patient problem behaviors and individual stress responses are considered
along with the impact of caregivers\' symptoms of anxiety and
depression. Problem responses to caregiver stress were identified in
three major areas: concerns regarding long-term uncertainties; issues of
anger and resentment towards the patient; and concerns regarding the
impact of the caregiving upon the caregiver\'s own life. Concerns
regarding the future, including being able to continue to adequately
provide for the patient, were among the most serious issues identified.
Of significance, 41 percent of the participants indicated that they felt
anger and/or resentment towards patients \"frequently\" or
\"sometimes\". The patient\'s emotional lability, rather than cognitive
impairment, appeared to have a greater association with all three areas
of concern. The variables of age and gender are also discussed, along
with implications for program implementation based upon these findings.

23\. S6410-10

Daly, J. & Jogerst, G.

**Definitions and Indicators of Elder Abuse: A Delphi Survey of APS
Caseworkers**

Journal of Elder Abuse & Neglect; Vol. 17 (1), 1-19; 2005.

This Delphi study (a method that facilitates group consensus) was
designed to evaluate the definitions of different types of elder
mistreatment, and to validate indicators of specific types of
mistreatment. Three-hundred fifty-one adult protective services (APS)
representatives throughout the country comprised the expert panel for
the two phase survey, which incorporated definitions, terms and
indicators of mistreatment identified most frequently in the authors'
analysis of state statutes (see CANE file #P5495-21). Respondents were
to draw upon clinical experience in assessing the validity of survey
items. Round one generated feedback on the relevance of definitions of
specific types of mistreatment. The second round involved review of the
revised items. Final approval rates for each revised definition ranged
from 89 percent (for sexual abuse) to 98 percent (for self-neglect),
although approval of the revised definitions for neglect, physical
abuse, and sexual abuse decreased during the second survey. The term
\"willful\" was controversial; in round one respondents suggested
eliminating it from definitions but in round two respondents recommended
using it. Definitions derived through this process were very similar to
the ones provided by the National Center on Elder Abuse (NCEA), which
are accessible online at:
<http://www.elderabusecenter.org/default.cfm?p=basics.cfm> .

24\. S6394-13

Dietz, T. & Wright, J.

**Age and Gender Differences and Predictors of Victimization of the
Older Homeless**

Journal of Elder Abuse & Neglect; Vol. 17 (1), 37-60; 2005.

In general, rates of specific crimes among the homeless differ from
those among the population in general. For example, rape and homicide
rates are significantly higher among the homeless. Employing the Routine
Activities Perspective as a theoretical framework, this descriptive
study addresses age and gender differences in criminal victimization
rates of the homeless. The framework postulates that risk for criminal
victimization is based upon three factors: the absence of capable
guardians (such as the police); the presence of motivated offenders; and
vulnerable targets. Data was drawn from the National Survey of Homeless
Assistance Providers and Clients (NSHAPC). Older adults were defined as
anyone aged 50 and over. Although increasing age appears to be a
protective factor against criminal victimization within the general
population, it does not appear to be among the homeless population;
older homeless individuals reported rates of victimization consistent
with younger homeless individuals. Older women were as likely as older
men to report being robbed or physically assaulted. Having a variety of
health problems, including mental illness and substance abuse, was also
associated with greater risk for victimization.

25\. S6251-9

Erlingsson, C., Carlson, S. & Saveman, B.

**Perceptions of Elder Abuse: Voices of Professionals and Volunteers in
Sweden - An Exploratory Study**

Scandinavian Journal of Caring Sciences; Vol. 20 (2), 151-159; 2006.

This article reports the findings of a focus group study conducted among
various professionals and volunteers regarding elder abuse issues in
Sweden. Group interviews were conducted with representatives from
police, health care, and social services systems (including caregiver
support programs). Qualitative content analysis revealed many common
themes across various occupational groups. In particular, four themes
emerged, some that indicate that there is a tendency to blame the victim
and to tolerate elder abuse. Themes include the following: good
intentions in abusive situations; older generation\'s responsibility for
mistreatment; failure to report abuse; and prevention of abuse. The
concept that even abusers could be victims within the contexts of their
circumstances was also considered. These perceptions appear consistent
with an earlier focus group study involving elders themselves. Unclear
reporting procedures were also noted as problematic. (Sweden)

26\. S6426-5

Fisher, B. & Regan, S.

**The Extent and Frequency of Abuse in the Lives of Older Women and
Their Relationship with Health Outcomes**

The Gerontologist; Vol. 46 (2), 200-209; 2006.

This cross-sectional study of community dwelling older women was
designed to measure the extent of abuse experienced in later life and
the health related outcomes. Eight-hundred forty-two women aged 60 and
older participated in a telephone survey about the type and frequency of
mistreatment they had experienced since turning 55, health status and
conditions, and demographic information. The instrument, the Women\'s
Health and Relationship Survey (WHRS), measured five types of abuse:
psychological/emotional (such as being criticized, being possessive);
control (such as not letting the woman work); threat (with either verbal
or physical intimidation); physical (including hitting, shoving,
choking, etc.); and sexual (including being pressured or physically
forced to have sex). Nearly half of the women (47 percent) had
experienced at least one type of mistreatment since turning 55, most
commonly psychological or emotional abuse, followed by threatening
behavior, control abuse, physical and sexual abuse. Between 21 and 47
percent of the victims had been repeatedly abused, depending upon the
type of abuse reported. Women who had been abused also reported higher
rates of health problems, including bone or joint problems, digestive
problems, depression, anxiety, high blood pressure and/or heart
conditions. Physicians, nurses and other health care providers are
encouraged to be aware of the potential for abuse of older patients and
the health implications of such abuse.

27\. S6341-3

Fritsch, T., Tarima, S., Caldwell, G. & Beaven S.

**Intimate Partner Violence Against Older Women in Kentucky**

Journal of the Kentucky Medical Association; Vol. 103 (9), 461-463;
September 2005.

This population-based, random sample survey was designed to assess the
lifetime prevalence of intimate partner violence (IPV) among women aged
60 and older in Kentucky; to identify health-related consequences of the
abuse; and to determine the prevalence of IPV against older women during
the 12 months preceding the survey (2002-2003). Eighteen percent of
women aged 60 and over at the time of the survey had experienced IPV
during her lifetime. In the year preceding the survey, 0.8 percent of
the older women reported experiencing IPV. Nearly all (92.7) of those
victimized reported psychological stress related to the abuse and nearly
three-quarters (73.3 percent) sustained physical injuries. More than
half of those victimized (59.9 percent) sought medical attention and/or
counseling. Based upon these findings, researchers estimate that over
3,000 older Kentucky women were threatened, physically, sexually or
psychologically abused, or stalked during the year preceding the study.

28\. S6414-10

Fulmer, T., Paveza, G., VandeWeerd, C., Fairchild, S., Guadagno, L.,
Bolton-Blatt, M. & Norman, R.

**Dyadic Vulnerability and Risk Profiling for Elder Neglect**

The Gerontologist; Vol. 45 (4), 525-534; 2005.

Using a risk-and-vulnerability model, this dyadic research was designed
to analyze both caregiver characteristics and vulnerabilities of elders
that contribute to elder neglect. Older adult emergency department
patients (aged 70 and up) and their caregivers were invited to
participate. During admission, elders were screened for neglect.
Participants were then individually interviewed to identify
vulnerability and risk factors. Information on demographics, functional
status, presence of depression, health and cognitive status, perceived
social support, history of childhood trauma, and personality
characteristics for both elder and caregiver were collected. Data for
dyads evidencing elder neglect (n=29) and those not evidencing neglect
(n=136) were compared. Neglecting caregivers were more likely to have
poorer functional status, to have experienced childhood trauma
(particularly neglect), and to demonstrate the personality trait of
openness. Neglected elders were more likely to have cognitive
impairment, health problems that limited their daily activities, higher
levels of unmet needs, higher levels of depression, lower levels of
social support, to have experienced childhood neglect, and demonstrate
neuroticism as a personality trait. (This article draws upon the same
data set as that of CANE file #S6448-5.)

29\. S6448-5

Fulmer, T., Paveza, G., VandeWeerd, C., Guadagno, L., Fairchild, S.,
Norman, R., Abraham, I. & Bolton-Blatt, M.

**Neglect Assessment in Urban Emergency Departments and Confirmation by
an Expert Clinical Team**

Journal of Gerontology: Medical Sciences; Vol. 60A (8), 1002-1006; 2005.

This study, conducted in four emergency departments (ED) across two
states, focused on the identification of elder neglect cases and the
congruence in diagnosis of neglect by ED screeners and an expert
clinical team. After presenting problems were addressed, researchers
invited ED patients aged 70 and older to participate. Four-hundred and
five patients met the inclusion criteria (lived at home, received at
least 20 hours of caregiver support per week, and had a Mini-Mental
Status Exam score of 18 or above) and agreed to participate. Research
assistants in the ED collected demographic, health and social data and
diagnosed 22 cases (5 percent) of neglect. However, the neglect
assessment team (NAT) comprised of a physician, nurse and social worker,
identified 86 cases (22 percent). (This article draws upon the same data
set as that of CANE file #S6414.)

30\. S6475-17

Furness, S.

**Recognising and Addressing Elder Abuse in Care Homes: Views from
Residents and Managers**

Journal of Adult Protection; Vol. 8 (1), 33-49; May 2006.

This exploratory study focuses on the protection of older adults living
in residential care homes in the U.K. Nineteen care managers and 19
residents were interviewed regarding their experiences. Care managers
discussed all types of elder mistreatment except sexual abuse, which may
have been overlooked due to age bias. Most care managers had first or
second hand knowledge of elder abuse from their own work related
experiences. They reported using similar strategies in addressing
incidents of mistreatment. However, relatively few reported the
incidents to licensing agencies or police. Of concern, only six of the
residents were able to properly identify examples of abuse. The
potential for licensing agencies to provide enhanced protection against
elder abuse is discussed. The need to incorporate residents\' views in
policy planning is also emphasized, along with the need for mandatory
training for managers. (Note: Portions of the interview protocol are
included.) (U.K.)

31\. S6119-10

Golding, J., Yozwiak, J., Kinstle, T. & Marsil, D.

**The Effect of Gender in the Perception of Elder Physical Abuse in
Court**

Law and Human Behavior; Vol. 29 (5), 605-614; October 2005.

This article reports upon a study designed to evaluate the impact of
gender on the perception of elder physical abuse in court proceedings.
Two experiments were conducted eliciting responses of participants to
scenarios involving a fictional criminal trial case of elder abuse. The
scenarios varied according to the alleged victim\'s and perpetrator\'s
gender and age. In both experiments, the majority of participants voted
that the alleged perpetrator was guilty. In general, female mock jurors
were more likely than men to believe the alleged victim\'s testimony,
particularly when the alleged perpetrator was female. This finding is
consistent with previous research concerning other forms of abuse.

32\. S6355-18\*

Harbison, J., Coughlan, S., Karbanow, J. & VanderPlaat, M.

**A Clash of Cultures: Rural Values and Service Delivery to Mistreated
and Neglected Older People in Eastern Canada**

Practice; Vol. 17 (4), 229-246; December 2005.

In this exploratory study, the authors examine strategies for service
delivery to abused and neglected older individuals from rural
communities of eastern Canada. They note that the little research
existing on rural victims of elder abuse tends to focus on the limits of
resources available in these regions but neglects to consider the impact
of cultural values that may also constitute service barriers. Health and
social services professionals (including adult protective services
professionals), law enforcement, and senior volunteers and advocates
were interviewed. Among the themes noted across localities was the
desire of older individuals in rural communities to maintain autonomy
and privacy regarding family matters, including abuse. Participants
echoed the desire to respect the rights and wishes of their clients
while offering assistance. Collaboration across disciplines was noted as
a means to enhance service provision in regions where resources were
scarce. Establishing a relationship with the client was considered the
most basic step in reducing resistance to help. A discussion of the
legal mandate governing the reporting of elder abuse is also presented.
(Canada)

33\. S6455-4\*

Heath, J., Brown, M., Kobylarz, F. & Castano, S.

**The Prevalence of Undiagnosed Geriatric Health Conditions Among Adult
Protective Service Clients**

The Gerontologist; Vol. 45 (6), 820-823; 2005.

The purpose of this retrospective study was to determine the prevalence
of undiagnosed health conditions among adult protective services (APS)
clients from two counties in New Jersey. Two-hundred eleven clients
referred to the Linking Geriatrics with Adult Protective Services
(LGAPS) program were assessed by a multidisciplinary health and social
service team. Dementia was diagnosed in 62 percent of the referred
clients, and depression was diagnosed in 37 percent. Nutritional
concerns and pain were also identified, along with 22 cases of alcohol
misuse. Dementia was positively correlated with financial exploitation
and caregiver neglect. The detection of many medical conditions
underscores the benefits of collaborative approaches in addressing elder
mistreatment. (Note: This article is based upon the same data set as
CANE file \# S6339-5.)

34\. S6339-5\*

Heath, J., Kobylarz, F., Brown, M. & Castano, S.

**Interventions from Home-Based Geriatric Assessments of Adult
Protective Service Clients Suffering Elder Mistreatment**

Journal of the American Geriatrics Society; Vol. 53 (9), 1538-1542;
September 2005.

This retrospective study describes the interventions applied in 211
cases referred to the \"Linking Geriatrics with Adult Protective
Services\" (LGAPS) multidisciplinary assessment team (New Jersey). In
this program, a geriatric health care team, in collaboration with a
referring social worker, conducted comprehensive in-home medical and
functional assessments of clients referred. Among those referred, many
had experienced multiple categories of mistreatment, but the most common
category experienced was self-neglect (76 percent), followed by
caregiver neglect (47 percent), financial exploitation (29 percent) and
physical abuse (15 percent). Based upon these assessments, home health
services were initiated for 46 percent of the APS clients; 35 percent
were placed in alternative settings (54 were placed in nursing homes, 16
in assisted living facilities, and six in other settings); and in 36
percent of the cases, mostly those involving neglect by caregivers,
guardianship proceedings were initiated. Urgent pharmacological
interventions were required in 25 percent of the cases, primarily due to
acute pain or significantly high blood pressure. In 19 percent of the
cases, hospitalization was necessary, primarily due to physical abuse.
(Note: This article is based upon the same data set as CANE file
#S6455-4.)

35\. S6175-39

Hernández-Medina, E., Eaton, S., Hurd, D. & White, A. for the AARP
Public Policy Institute

**Training Programs for Certified Nursing Assistants**

AARP Public Policy Institute; Washington, D.C.; March 2006.

As quoted from the AARP Public Policy Institute web site, \"Certified
nursing assistants (CNAs) provide most of the care received by nursing
home residents. Although their work is often perceived as \'unskilled,\'
CNAs perform complex and important functions. Despite their title, their
main role is not to assist nurses, but to assist residents. They help
residents with daily activities, measure their vital signs, watch for
and report changes in their conditions, and provide companionship and
emotional support. Good quality care for residents and a stable CNA
workforce depend on providing CNAs with the training they need to be
well prepared for their jobs since inadequate training contributes to
staff dissatisfaction and high turnover which adversely affect quality
of care. This AARP Public Policy Institute Issue Paper adds to the
literature on CNA training by examining how many hours of initial
training and clinical training are needed. It focuses on state nurse aid
training programs in California, Florida, Maine, Maryland,
Massachusetts, Michigan, New York, Pennsylvania, Texas and Wisconsin.
The study looks at pre-training screening, remedial education, training
in English as a Second Language, and shadowing. CNA testing and
reimbursement of CNAs for their training and testing expenses are also
considered. Based on their findings, the authors make recommendations
for ensuring that CNAs receive adequate training to provide good care to
residents, improving student retention, and ensuring that CNAs are
properly reimbursed for their training and testing expenses.\" (Note:
This report is accessible online at:
<http://www.aarp.org/research/longtermcare/nursinghomes/2006_08_cna.html>
.)

36\. S6429-11

Hightower, J., Smith, M. & Hightower, H.

**Hearing the Voices of Abused Older Women**

Journal of Gerontological Social Work; Vol. 46 (3/4), 205-227; 2006.

This paper reports upon research conducted in British Columbia on the
abuse of women aged 50 and older. Sixty-four participants were
interviewed via telephone and through group sessions regarding their
experiences of domestic violence (DV). Women described examples of
physical, psychological, sexual, and financial abuse, and violations of
human rights. Many women described multiple experiences of abuse in
numerous relationships, including lifelong histories of mistreatment.
While most reports involved intimate partner abuse, a small percentage
(consisting mainly of financial abuse) was perpetrated by adult
children. Participants revealed physical and psychological problems
related to the abuse. They expressed concern for their children, who in
many instances were also involved in abusive partnerships, reflecting
the theme of the intergenerational transmission of violence.
Participants identified the need for shelters and housing, counseling,
employment, and social support. (Note: This research design was modeled
after the Australian study conducted by Morgan Disney & Associates. See
CANE files P5083-103 and P5087-69.) (Canada)

37\. S6178-12\*

Iecovich, E.

**Elder Abuse and Neglect in Israel: A Comparison Between the General
Elderly Population and Elderly New Immigrants**

Family Relations; Vol. 54 (3), 436-447; July 2005.

This study, based upon data gathered on the occurrence of elder abuse in
Beer Sheva, a city in the southern region of Israel, focuses on the
differences of the types and frequency of elder mistreatment experienced
by individuals from the general elderly population and new elderly
immigrants. Researchers hypothesized that immigrants would be at greater
risk for all types of mistreatment, and that predictors for mistreatment
would differ among these two cultural groups. The first phase of the
research involved health and social care professionals and
paraprofessionals completing a brief questionnaire on clients that they
suspected were being victimized. The referrals were evaluated by trained
social workers who followed-up on cases with strong indicators of elder
mistreatment. Among the findings, 120 new cases of elder abuse and
neglect were identified in this city during a one-year period, including
48 cases involving new immigrants from former Soviet Union countries.
The overall incidence rate of new cases was 0.5 percent, only slightly
higher among new immigrants compared to the general population. Although
new immigrants were at lower risk for physical abuse, they were at
significantly higher risk for neglect. The article also discusses
specific sociodemographic characteristics that appear related to various
types of elder mistreatment. Limited information is also provided
regarding perpetrator characteristics. (Note: For additional information
on the incidence study see CANE file \# R6027-19.) (Israel)

38\. S6337-9

Irizarry Irizarry, A.

**Pilot Study of the Differences Among the Puerto Rican Aged by Gender
in Opinion,** **Attitude and Exposure to Abuse, Mistreatment and
Neglect**

Puerto Rican Health Science Journal; Vol. 24 (4), 303-311; December
2005.

This study analyzed gender differences related to the knowledge and
perceptions of elder mistreatment among older Puerto Ricans.
Four-hundred and thirty community-dwelling individuals (60 percent
female), aged 60 and older, from the area of Arecibo, participated in
the survey. Regardless of gender, participants appeared to be
knowledgeable about what constitutes elder mistreatment. Gender
differences were detected in opinions held regarding abuse. For example,
women were more likely than men to believe that abused elders suffer
from fear, and that abuse victims remain silent due to feelings of fear,
shame and guilt. Differences in responses to statements regarding
exposure to various types of mistreatment were compared with results
from previous studies conducted in Puerto Rico and the U.S. (Puerto
Rico)

39\. S6256-5

Jogerst, G., Daly, J., Dawson, J., Peek-Asa, C. & Schmuch, G.

**Iowa Nursing Home Characteristics Associated with Reported Abuse**

Journal of American Medical Directors Association/JAMDA; Vol. 7 (4),
203-207; May 2006.

This study was designed to analyze the relationship between nursing home
characteristics in Iowa licensed facilities and rates of elder abuse
reports made by employees. Administrators and/or directors of nursing
(DON) from the 369 of the state\'s 409 Medicare-certified stand-alone
nursing homes participated in a survey that included items relating to
incidents of elder abuse, reports made to the Iowa Department of
Inspections (IDIA), and substantiated cases of elder abuse during the
preceding year. Information on nursing home characteristics, staffing,
deficiencies, census demographics, and ownership was gathered from
Medicare\'s Nursing Home Compare Reports, Urban Influence Codes, and
county census demographics. The overall annual rate of abusive events
was 20.7 per 1000 residents, with an annual rate of 18.4 events per 1000
residents reported to the authorities, and an overall substantiation
rate of 5.2 per 1000. A higher number of residents and certified beds
were significantly associated with higher rates of abusive incidents,
reports, and substantiations. Higher incident and report rates were also
found in facilities located in metropolitan areas, and higher
substantiation rates were also associated with for-profit status.

40\. S6358-8\*

Jogerst, G., Daly, J. & Hartz, A.

**Ombudsman Program Characteristics Related to Nursing Home Abuse
Reporting**

Journal of Gerontological Social Work; Vol. 46 (1), 85-98; 2005.

This study considered the association between ombudsman reporting of
rates of abuse, gross neglect, and exploitation with public and
ombudsman staff education, investigative process, program expenditures
and census demographics. Data regarding reporting rates was drawn from
the National Ombudsman Reporting System (NORS) from 1997 through 2002
and state census demographics were obtained from the 2000 U.S. Census.
During that period, state rates of abuse, gross neglect, and
exploitation ranged from 0.4 to 158 per 1,000 nursing home beds, and
physical abuse and resident-to-resident abuse were the highest reported
categories of mistreatment. Among the findings: \"\...Community
education sessions presented at the state level were significantly
associated with higher abuse rates except for resident-to-resident
sexual abuse\...Ombudsman staff and volunteer training sessions and
number of trainees were significantly correlated with all categories of
abuse except neglect and resident-to-resident sexual abuse\...Total and
state program expenditures and full time equivalent paid ombudsman
program staff were significantly correlated with all types of
abuse\...\" The article provides a discussion regarding the ombudsman
reporting process, which requires the resident\'s approval, highlights
variations in classification of complaints, and points out that nursing
home abuse can be reported to the ombudsman, adult protective services,
law enforcement, or state licensure agencies. These issues, along with
individual program characteristics unique to specific states, coupled
with state demographic differences, are some reasons why cross state
comparisons are problematic, and why such annual reports alone \"should
not be construed to represent all abuse in nursing homes\...\"

41\. S6275-63

Karp, N. of the AARP Public Policy Institute and Wood, E. of the
American Bar Association Commission on Law and Aging

**Guardianship Monitoring: A National Survey of Court Practices**

AARP Public Policy Institute; Washington, D.C.; June 2006.

This report was designed to assess the current state of guardianship
monitoring throughout the U.S., and to determine how the field has
advanced since a 1991 ABA survey. The report provides an overview of the
guardianship process and a history of monitoring reform efforts. The
national project involved surveying experts in the guardianship system
(387 judges, court mangers, guardians, elder law attorneys, and legal
representatives of people with disabilities). There is an ongoing
initiative to research guardianship monitoring through site visits and
interviews in jurisdictions demonstrating exemplary practices. Key
findings include the following: \"Despite a dramatic strengthening of
statutory safeguards, guardianship monitoring practices continue to show
wide variation; practices regarding filing of reports by guardians have
advanced over the past 15 years, with more courts requiring periodic
personal status reports and forward-looking plans; verification of
guardian reports and accounts is frequently lacking; over one-third of
respondents said no one is designated to verify the information in these
mandatory reports; over 40 percent reported that no one is assigned by
the court to visit individuals under guardianship, and only one-fourth
said that someone visits regularly; use of technology in monitoring is
minimal, despite vast opportunities for web-based and email monitoring
techniques and computerized data collection; funding for guardianship
monitoring remains minimal.\" Appendices include the survey and a table
of state statutory authorities for guardianship monitoring. (Both the
\"In Brief \"and full report are accessible online at:
<http://www.aarp.org/research/legal/guardianships/2006_14_guardianship.html>
.)

42\. S6357-7

Keith, P.

**Nursing Home Administrators\' Views of Their Own and Volunteer
Resident Advocates\' Enhancement of Long-Term Care**

Journal of Elder Abuse & Neglect; Vol. 17 (1), 75-87; 2005.

The author of this article points out that the nursing home climate,
which is significantly established by the nursing home administrators
(NHAs), impacts the roles played by volunteer resident advocates
associated with a Long-Term Care Ombudsman Program, and the
effectiveness of their interventions. This study analyzed whether NHAs
value the efforts of volunteer resident advocates (not certified
ombudsmen) in enhancing long-term care. Such volunteers make regular but
unannounced visits to long-term care facilities to advocate for
residents and their families in order to resolve problems and to protect
the vulnerable. One-hundred ninety-nine Iowan NHAs completed a survey
regarding the impact they perceived that advocates had on residents\'
lives, how they protected residents\' rights, informed staff of
residents\' needs, and resolved complaints made by or on behalf of
residents. Eighty-nine percent of the participants believed most
residents benefited to some degree from the volunteers\' interventions,
and 70 percent agreed that residents were usually pleased to meet with
the volunteers. (Note: This article draws upon the same data set as that
of CANE file #S63361-4.)

43\. S6361-4

Keith, P.

**Nursing Home Administrators\' Views of Volunteers\' Work in an
Ombudsman Program**

Journal of Aging Studies; Vol. 19 (4), 513-520; 2005.

Noting that research suggests that the presence of representatives from
external state agencies within nursing home settings can be stressful to
nursing home administrators (NHAs), this article analyzes NHAs\'
opinions of their interactions with volunteer resident advocates and the
effectiveness of the volunteers\' interventions on behalf of residents
and their families. The author hypothesized that more frequent site
visits and a greater amount of direct contact between the volunteer
resident advocate (associated with a Long-Term Care Ombudsman Program,
but not a certified ombudsman) and administrator would be associated
with less satisfaction and perceptions of ineffectiveness; however, more
frequent visits and a greater amount of contact between the advocate and
administrator were associated with higher assessments of program
effectiveness. Among the results, approximately one-third of those
surveyed (n=196) found the program to be very effective, 45 percent
believed it was somewhat effective, and 20 percent believed the program
was somewhat or very ineffective. Eighty-one percent agreed or strongly
agreed that they were satisfied with the work of the volunteers.
Perceived benefits of volunteers\' efforts were also reported, and
included enhancements in the organizational environment of the nursing
home, and improved relationships among the facility and other community
entities. (Note: This article draws upon the same data set as that of
CANE file #S6357-7.)

44\. S6125-5\*

Kemp, B. & Mosqueda, L.

**Elder Financial Abuse: An Evaluation Framework and Supporting
Evidence**

Journal of the American Geriatrics Society/JAGS; Vol. 53 (7), 1123-1127;
2005.

This study was designed to develop a viable framework for evaluating
cases of alleged elder financial abuse. Eight elements were incorporated
into the framework: the older adult\'s vulnerability due to physical,
psychological, pharmacological, or social problems; a trusted individual
who exploits the vulnerability; the transference of assets during a
period of vulnerability; isolation of the vulnerable adult; a lack of an
appropriate assessment of the vulnerable elder\'s capacity to make such
decisions; inadequate compensation for transfers; a lack of commonly
accepted business protocols; a lack of recognition of the impact of the
transaction by the perpetrator. A sample of 159 professionals (district
attorneys, law enforcement, adult protective services professionals and
social workers) were asked to rate how well the framework evaluated
financial abuse cases, based upon their experiences in working directly
with such cases. Out of 5 total points, the average rating was a 4.4,
with 90 percent of the participants indicating that the framework
mirrored their experiences very much or entirely. No significant
differences were found among professional groups. The tool may be used
by multidisciplinary teams, and by clinicians (particularly geriatric
physicians) evaluating the victim\'s vulnerability and the dynamics
between perpetrator and victim.

45\. S6141-11\*

Konig, J. & Leembruggen-Kallberg, E.

**Perspectives on Elder Abuse in Germany**

Educational Gerontology; Vol. 32 (1), 25-35; 2006.

This article describes the responses of 74 German participants (57 women
and 17 men, aged 15 through 62) who provided examples of what they
perceived as extremely, moderately, or mildly abusive behaviors of adult
children towards elderly parents. The authors note the difficulty in
finding a translation for the English word abuse; they used the term
\"missbrauch\" which means \"misuse\" and can include \"sexual abuse,
substance abuse and taking unfair advantage of someone,\" and
\"misshandlung\" which refers to physical violence. Among the findings,
physical abuse was categorized most frequently as extremely abusive in
nature, as were physical neglect and abandonment; psychological abuse
was more often viewed as moderately abusive; economic abuse was viewed
typically as moderate; and psychological neglect was viewed as primarily
mild. A few gender and age differences were noted; for example, women
offered more examples of psychological abuse as mild in degree, and men
offered more examples of physical abuse as moderate in degree. (Germany)

46\. S6294-16\*\*\*

Lachs, M., Bachman, R., Williams, C., Kossack, A., Bove, C. & Leary, J.

**Older Adults as Crime Victims, Perpetrators, Witnesses, and
Complainants: A Population-Based Study of Police Interactions**

Journal of Elder Abuse & Neglect; Vol. 16 (4), 25-40; 2004.

Drawing upon the New Haven EPESE study (Established Populations for
Epidemiological Studies in the Elderly), the goal of this research was
to examine the nature and extent of law enforcement contacts among older
community members. Police records from the cohort's catchment area for
1985 through 1995 were analyzed to identify interactions between
participants and law enforcement. The following details were abstracted
from the records of the elders who had police involvement: their role
(victim, perpetrator, complainant, or witness); type of crime;
participant\'s relationship to perpetrator; whether or not a weapon was
used; number of offenders; whether there was physical contact between
the victim and offender; and if the victim required medical attention.
These details were merged with the corresponding EPESE records to
provide a police-health data set including demographic characteristics,
psychological/social characteristics, medical indicators, and functional
ability. Of the 2,321 cohort members, 684 (29.5 percent) had at least
one police contact during this time frame, with a total of 1,651
incidents. Most commonly, participants were victims (57.5 percent),
followed by complainants (7.5 percent), offenders (4.2 percent), and
witnesses (3.4 percent). (Participants were also categorized as
\"other,\" and nearly 20 percent had multiple contacts involving various
roles.) Of the incidents wherein participants were victims, 21 percent
involved violence, including 42 episodes occurring in nursing homes,
primarily involving resident-to-resident abuse. Larceny and burglary
were the most common types of nonviolent crimes. Being male,
African-American, and/or younger members of the cohort appeared
associated with a statistically greater likelihood of police contact. An
interesting finding was that cohort members who had police contact were
less functionally impaired than those with no contact.

47\. S6252-9

Lauder, W., Ludwick, R., Zeller, R. & Winchell, J.

**Factors Influencing Nurses' Judgements about Self-Neglect Cases**

Journal of Psychiatric and Mental Health Nursing; Vol. 13 (3), 279-287;
2006.

In this survey, researchers attempted to identify which patient
characteristics had the greatest impact on nurses\' judgments concerning
decision-making capacity in cases of self-neglect, particularly
involving patients with dementia or mental illness. Forty public health
registered nurses from Ohio were surveyed regarding which interventions
they would select (including Meals on Wheels, house cleaning, patient
education, medication, community nursing referral, and referral to
mental health service) in response to six vignettes depicting various
cases of self-neglect. Results indicate nurses tended to broadly
categorize patients as having no mental illness, minor mental illness
and severe mental illness, and that the presence and degree of mental
illness had the greatest impact upon interventions chosen. Problems with
such immediate judgments are considered. (Note: The article includes a
list of variables incorporated in the vignettes and the rationale for
inclusion.)

48\. S6398-8

Lee, M. & Kolomer, S.

**Caregiver Burden, Dementia, and Elder Abuse in South Korea**

Journal of Elder Abuse & Neglect; Vol. 17 (1), 61-75; 2005.

This study analyzes characteristics that may increase the likelihood of
elder abuse among Korean elders with dementia who have family
caregivers. Analysis was based upon interviews with a sample of 481
caregivers, and data from the Comprehensive Study for the Elderly
Welfare Policy in Seoul. A number of predictors were evaluated,
including demographic characteristics, caregiver and care recipient
characteristics, the severity of cognitive impairment and functional
ability, caregiver burden, and social support. Fifteen percent of the
caregivers reported often ignoring care recipients questions; 15 percent
acknowledged verbally abusing the care recipient frequently; 7.5 percent
admitted to confining the care recipient in a room; and 3.3 percent
admitted to physically abusing the care recipient. The degree of elder
abuse appeared to be significantly associated with caregiver burden and
with severe cognitive impairment. Caregivers who utilized formal support
services were less likely to demonstrate abusive behaviors. (South
Korea)

49\. S6393-13

McCawley, A., Tilse, C., Wilson, J., Rosenman, L. & Setterlund, D.

**Access to Assets: Older People with Impaired Capacity and Financial
Abuse**

Journal of Adult Protection; Vol. 8 (1), 20-32; May 2006.

This research involved a secondary data analysis of 234 cases of
individuals aged 65 and over with impaired capacity who had been
referred to the Guardianship and Administration Tribunal of Queensland,
Australia. Data analysis focused on circumstances prior to referral to
the Tribunal. Referrals were made to the Tribunal to determine the need
for appointment of an administrator, either because of suspected
financial abuse, or because the individual required assistance with
asset management due to impaired capacity. Twenty-six percent of the
referred cases were classified as suspected intentional and
unintentional financial abuse. Findings suggest that in 60 percent of
the cases of suspected financial abuse, perpetrators had been granted
some level of authorization (for example, enduring power of attorney or
EPA) to manage assets. While formal legal mechanisms may be necessary to
ensure that individuals with impaired capacity are adequately protected,
monitoring of such mechanisms is also necessary. In addition, greater
education and preparation for those who provide substitute
decision-making is also warranted. (Australia)

50\. S6427-5

Mezey, M., Quinlan, E., Fairchild, S. & Vezina, M.

**Geriatric Competencies for RNs in Hospitals**

Journal for Nurses in Staff Development; Vol. 22 (1), 2-10; 2006.

This article reports on the development and testing of the *\"Geriatric
Competencies for RNs in Hospitals,\"* an instrument designed to measure
core nursing skills necessary for appropriate care of older patients.
Eight core competencies are identified: communication barriers;
physiological and physical age related changes; pain assessment among
cognitively impaired patients; skin integrity; functional status
(including overall functioning, urinary incontinence or UI,
nutrition/hydration, and falls and injuries); restraint use; elder
abuse; and discharge planning. Efforts to validate the instrument began
by testing geriatric registered nurses (RNs) and non-geriatric RNs on
issues related to incontinence and falls. Results indicate that the tool
is appropriate for use in the initial and ongoing monitoring of staff
strengths and weaknesses.

51\. S6344-9

Miller, L., Lewis, M., Williamson, G., Lance, C., Dooley, W., Schulz, R.
& Weiner, M.

**Caregiver Cognitive Status and Potentially Harmful Caregiver
Behavior**

Aging & Mental Health; Vol. 10 (2), 125-133; March 2006.

In this study, the association between caregiver cognitive status and
potentially harmful caregiver behavior was assessed among 180
caregiver-care recipient dyads. At least mildly compromised cognitive
status was detected among 39 percent of the informal caregivers. After
controlling for factors such as amount of care provided, care recipient
cognitive status, and caregiver depressed affect, care recipients of
caregivers with compromised cognitive status reported experiencing more
verbal abuse, including threatening behaviors. Also of note, spousal
caregivers reported providing more care, were more likely to be
depressed, and were more likely to be reported as abusive than
non-spousal caregivers. (Note: This article is currently available
online at:
[http://www.uga.edu/psychology/millerlab/publications/pubs_pdf/Miller_etal_Aging&MH_CGPaper.pdf#search=%22%22Caregiver%20Cognitive%20Status%20and%20Potentially%20Harmful%20Caregiver%20Behavior%22%22](http://www.uga.edu/psychology/millerlab/publications/pubs_pdf/Miller_etal_Aging&MH_CGPaper.pdf#search=)
.)

52\. S6451-10

Montminy, L.

**Older Women\'s Experiences of Psychological Violence in Their Marital
Relationships**

Journal of Gerontological Social Work; Vol. 46 (2), 3-21; 2005.

This qualitative research analyzes the types of psychologically violent
behaviors experienced by 15 women aged 60 to 81. Participants were
recruited by practitioners who worked with older women who had
experienced domestic violence (DV). Content analysis of the interviews
suggests that psychologically violent behaviors could be categorized
into the following broad groups: control; denigration; deprivation;
intimidation; threats; abdication of responsibility; manipulation;
blame; harassment; negation of reality; indifference; inducing guilt;
sulking; and infantilization. Control behaviors appeared predominant,
and increased during significant life transitions: upon retirement; when
children left home; and when husbands experienced a decline in health
status. Clinical implications underscore the need for early intervention
and to talk with older women about gender roles. (Canada)

53\. S6418-10

Moon, A., Lawson, K., Carpiac, M. & Spaziano, E.

**Elder Abuse and Neglect Among Veterans in Greater Los Angeles:
Prevalence, Types, and Intervention Outcomes**

Journal of Gerontological Social Work; Vol. 46 (3/4), 187-204; 2006.

By analyzing the medical records of 575 veterans who had received
services at the Veteran\'s Affairs Geriatric Outpatient Clinic in Los
Angeles over a three year period, researchers studied the prevalence,
types and intervention outcomes among this population. Elder abuse
reports had been filed on behalf of 31 of the clients, representing 5.4
percent of the study population. Rates were higher among those aged 80
and older, and among Caucasian and African Americans. Financial abuse
and self-neglect were reported most commonly, although eight veterans
experienced multiple forms of mistreatment. While perpetrators were
typically family members, three-fourths of the financial abuse was
committed by non-family members. Nearly half of the victims suffered
from dementia and over one-third experienced depression. The most common
intervention was relocation of the victim to either a nursing home or
board and care facility, followed by conservatorship arrangement. A
breakdown of intervention outcomes by case type is included.

54\. S6458-5

Morgan, E., Johnson, I. & Sigler, R.

**Public Definitions and Endorsement of the Criminalization of Elder
Abuse**

Journal of Criminal Justice; Vol. 34 (3), 275-283; 2006.

This article reports upon the findings of a longitudinal cross-sectional
study conducted to measure public definitions of elder abuse and the
willingness to endorse criminal sanctions for perpetrators. Data was
collected through random sample surveys conducted in the area of
Tuscaloosa, Alabama, in 1986-1987 (n=117), again in 1991-1992 (n=134),
and in 1996-1997 (n=159). Results suggest that the public perceptions of
what constitutes physical elder abuse remained constant over time.
Perceptions of neglect and psychological abuse also appeared relatively
constant, with some exceptions. For example, not spending time with the
elder was viewed as more neglectful in the earlier survey results
compared to later findings. Perceptions of financial abuse appeared less
consistent over time. Support for the criminalization of elder abuse
increased throughout the course of the study, as participants endorsed
the creation of misdemeanor and felony statutes, and prison sentences
for punishment of perpetrators.

55\. S6121-5

Mosqueda, L., Burnight, K. & Liao, S.

**The Life Cycle of Bruises in Older Adults**

Journal of the American Geriatrics Society/JAGS; Vol. 53 (8), 1339-1343;
August 2005.

Although bruising may be a sign of elder mistreatment, little research
on bruising has been conducted among geriatric patients. This study
analyzed information on the occurrence, progression and resolution of
accidental bruising in patients aged 65 and over. One-hundred and one
seniors, living in both community-based independent settings and skilled
nursing facilities participated, and were screened daily for evidence of
new bruises. Seventy-three of the subjects developed at least one
accidental bruise during the two week initial inspection period. Once
identified, it was observed daily until resolution (up to six weeks).
Participants (or their proxies) were asked to identify the source of the
bruise. Ninety-six of the 108 identified bruises occurred on the
extremities, while only 12 occurred on the trunk. None were found on the
neck, ears, genitalia, buttocks, or soles of the feet. Participants were
more likely to know the source of the bruise if it was on the trunk.
Sixteen of the bruises were predominately yellow within the first 24
hours of the onset, which is contrary to the general perception that
yellowing usually indicates an older bruise. People on medications
affecting coagulation commonly had more than one bruise. Such data
collection represents an initial step in providing a basis for
comparison between accidental and suspicious bruising. (Note: An
unpublished report of this research is available online at:
[http://www.ncjrs.gov/pdffiles1/nij/grants/214649.pdf#search=%22%22Bruising%20in%20the%20Geriatric%20Population%22%22](http://www.ncjrs.gov/pdffiles1/nij/grants/214649.pdf#search=)
.)

56\. S6445-13

Mouton, C., Larme, A., Alford, C., Talamantes, M., McCorkle, R. & Burge,
S.

**Multiethnic Perspectives on Elder Mistreatment**

Journal of Elder Abuse & Neglect; Vol. 17 (2), 21-45; 2005.

In order to devise strategies to identify elder mistreatment (EM) across
a variety of cultures, this study was conducted to gain insight into
perspectives of EM from different cultural groups. Focus group
interviews were conducted with three ethnically homogenous groups
(African American, European American and Mexican American) of elders and
a group of elder care professionals. Eighteen individuals participated
in the ethnic groups and six participated in the professional group.
Group discussion focused on the interpretation of various case
scenarios. Discussion centered on social expectations (including gender
role, filial obligations, marital fidelity and ageism); caregiver
expectations (family caregivers were given greater leeway than
professional caregivers); victim characteristics (vulnerabilities on the
part of the victim influenced the interpretation of abuse); and
characteristics of the interaction (such as resistance to care). Few
cultural differences were observed in this study, which conflicts with
previous findings. However, there were differences observed between the
professional group and the ethnic groups, particularly relating to the
issue of autonomy versus beneficence.

57\. S6295-00\*

NASD Investor Education Foundation, in cooperation with WISE Senior
Services and AARP

**Off the Hook Again: Understanding Why the Elderly Are Victimized by
Economic Fraud Crimes**

NASD Investor Education Foundation, with WISE Senior Services and AARP;
Washington, D.C.; July 2006.

This study examines \"why certain elderly investors are more susceptible
to investment fraud than others, exposes the various tactics used by
criminals to exploit seniors and offers strategies to help seniors avoid
becoming victims\... Researchers for the project analyzed undercover
tapes of fraud pitches and surveyed victims and non-victims to determine
how they differ. The researchers used their findings to develop
practical messages to increase fraud awareness among seniors. Some of
the key research findings include: investment fraud victims are more
financially literate than non-victims; investment fraud criminals use a
wide array of different influence tactics, from friendship to fear and
intimidation tactics, to defraud the victim; fraud pitches are tailored
to match the psychological needs of the victim; investment fraud victims
are more likely to listen to sales pitches; investment fraud victims are
more likely to rely on their own experience and knowledge when making
investment decisions; fraud victims experience more difficulties from
negative life events than non-victims; investment fraud victims are more
optimistic about the future; investment fraud and lottery victims
dramatically under-report fraud\...\" It is recommended that financial
literacy and fraud prevention programs include education on persuasion
tactics. (Note: To access the report and related materials, including a
PowerPoint presentation and an audio file of real-life fraud pitches,
visit <http://www.nasdfoundation.org/research.asp> .)

58\. S6155-4

National Institute of Justice (NIJ), the Research, Development, and
Evaluation of the U.S. Department of Justice

**Victim Satisfaction with the Criminal Justice System**

NIJ Journal; No. 253; January 2006.

This article was based upon the following three grant reports submitted
to NIJ: \"Victim Satisfaction with Criminal Justice Case Processing in a
Model Court Setting;\" \"Forgoing Criminal Justice Assistance: The
Non-Reporting of New Incidents of Abuse in a Court Sample of Domestic
Violence Victims;\" and \"Effects on Victims of Victim Service Programs
Funded by the STOP Formula Grants Program.\" In sum, this research
suggests that victims of domestic violence (DV, also known as Intimate
Partner Violence or IPV), may be so dissatisfied with the criminal
justice system intervention that they are unlikely to contact the police
the next time they need assistance. Among the women who chose not to
report subsequent abuse were women who were least likely to have
resisted the arrest of the offender during the previous incident, and
those who were most likely to believe that the police action had
negatively affected their safety. Among other findings, this research
suggests that mandatory arrest policies have not resulted in more cases
of DV being prosecuted. (Note: Not specific to elders.) (This article is
accessible online at:
<http://www.ojp.usdoj.gov/nij/journals/253/victim.html> .)

59\. S6463-4

Nusbaum, N., Cheung, V., Cohen, J., Keca, M. & Mailey, B.

**Role of First Responders in Detecting and Evaluating Elders at Risk**

Archives of Gerontology and Geriatrics; March 2006.

Observing that first responders, such as police, fire fighters and
emergency medical personnel, may have interaction with elders who live
in relative isolation, this study was designed to evaluate their
approach to vulnerable elders who may be victims of (or at risk for)
elder abuse and neglect. One-hundred eighty-six first responders from
northern Illinois completed a brief survey regarding their interactions
with elders during the previous six months. More than half had
encountered at least one elder that they believed may have been abused
or neglected, and more than three-fourths estimated that they had met an
elder who posed a danger to self or others, but very few (2 percent) had
screened the elders for potential risk. Immediately following the
survey, first responders participated in an educational intervention
designed to promote awareness and routine screening. The results of the
survey indicate that although first responders have potential to
identify abused, neglected and at risk elders, a structured approach to
screening for these conditions is warranted. (Note: This article is
currently only available in pre-publication electronic format.)

60\. S6468-12

Oh, J., Kim, H., Martins, D. & Kim, H.

**A Study of Elder Abuse in Korea**

International Journal of Nursing Studies; Vol. 43 (2), 203-214; February
2006.

This study examines the nature and extent of elder abuse in Songpa Gu, a
district within Seoul, Korea. A total of 15,230 elders (representing 53
percent of the district\'s elderly population) were interviewed in their
homes during 1999. Results indicate that 6.3 percent of the sample had
experienced one form of mistreatment, with emotional abuse being most
commonly reported, and physical abuse being least commonly reported. In
more than three-fourths of the cases, sons and daughters-in-law were the
perpetrators. All types of abuse were more common among elders who lived
with their married children. (Korea)

61\. S6118-25

Pattison, B., Fields, T., Whitley, B., Tharp, D., Walker, M., Khoury,
S., Davis, T. & Tedesco, B., for the Office of Inspector General (OIG),
Department of Health and Human Services (DHHS)

**Nurse Aide Registries: Long Term Care Facility Compliance and
Practices (OEI-07-04-00140)**

Office of Inspector General (OIG), Department of Health and Human
Services (DHHS);

July 2005.

This study examined the screening practices applied by nursing home
administrators when hiring nurse aides and their compliance with federal
regulations. Findings were based upon the responses to a random sample
survey of 200 long-term care (LTC) administrators and on employment
information from their facilities. All administrators reported
consulting their state registry prior to offering employment, and 44
percent indicated that they periodically checked to determine if
registries had been updated with adverse events concerning current staff
members. Seventeen percent of the LTC facilities were not in compliance
with federal regulations as they had either employed aides for a period
longer than four months without completing required registrations or
with registrations that expired. Additionally, 55 percent of the
administrators only checked their own state registry. While 85 percent
of participants reported that they had implemented additional screening
procedures (such as criminal background checks and personal and
employment reference checks), these efforts appeared limited in their
usefulness for various reasons. Recommendations include the need to:
review the registries of other states; employ unregistered aides for no
more than four months, per federal regulations; and require periodic
registry checks of all employed aides, in addition to conducting
comprehensive criminal background checks prior to hiring. (Note: This
report is accessible online at:
<http://oig.hhs.gov/oei/reports/oei-07-04-00140.pdf> .)

62\. S6219-12

Pavlou, M. & Lachs, M.

**Could Self-Neglect in Older Adults Be a Geriatric Syndrome?**

Journal of the American Geriatrics Society (JAGS); Vol. 54 (5), 831-842;
2006.

Researchers conducted an anlysis of the literature to consider the
possibility that self-neglect is a geriatric syndrome. The authors
define a geriatric syndrome as \"\...an accumulation of impairments in
multiple systems that produces a phenotypic decline in function or
independence\...\" In order to identify relevant literature, the MEDLINE
and AGELINE databases were searched using keywords such as
\"self-neglect,\" \"squalor syndrome,\" \"Diogenes\' syndrome,\" with
related terms and known risk factors (such as dementia). In all, 54
articles were identified (24 case series, 13 theoretical articles, 11
observational studies and six reviews) of varying methodological
quality. To assess whether self-neglect appears to be a geriatric
syndrome, the material was evaluated along the following domains:
multifactorial etiology; risk factors shared with other geriatric
syndromes; association with functional decline; and association with
mortality. Results suggest that self-neglect has multiple etiologies,
that it shares risk factors with other geriatric syndromes, and that it
is associated with increased mortality (only an association with
functional decline was not identified). Therefore, the literature
supports the concept of self-neglect as a geriatric symptom, which holds
clinical implications for intervention. Recommendations are generated
regarding identified gaps in self-neglect research.

63\. S6411-9

Payne, B. & Gainey, R.

**Differentiating Self-Neglect as a Type of Elder Mistreatment: How Do
These Cases Compare to Traditional Types of Elder Mistreatment?**

Journal of Elder Abuse & Neglect; Vol. 17 (1), 21-36; 2005.

This study compares features of self-neglect cases handled by adult
protective services (APS) to other types of elder mistreatment. The
needs and characteristics of self-neglecting clients are examined, along
with the impact that stress has upon self-neglect. Seven hundred and
fifty-one APS cases from three cities in Virginia were reviewed for
information on demographic and family characteristics; reporter
relationship to the client; services used; types of benefits received;
functional, emotional and health status; problem areas; stressors; type
of mistreatment; type of caregiver; information on caregiver burden; and
case disposition. Results indicate that less education was associated
with lower rates of self-neglect; clients who were unmarried were more
likely to demonstrate self-neglect; and self-neglecting clients were
more likely to refuse services. Of note, self-neglect clients were less
likely than other clients to need assistance with toileting, with
eating, and with using the telephone. They were more likely to have a
psychiatric diagnosis and/or have problems with alcohol. No gender or
age differences were observed. Differences in rates of self-neglecting
clients were also found across city samples, which suggests the
possibility that there is a relationship between self-neglect and
community characteristics. These results are discussed within the
context of prior research.

64\. S6416-10

Powell, M. & Berman, J.

**Effects of Dependency on Compliance Rates Among Elder Abuse Victims at
the New York City Department for the Aging, Elderly Crime Victim\'s
Unit**

Journal of Social Gerontological Social Work; Vol. 46 (3/4), 229-247;
2006.

In this study, researchers considered the potential impact of dependency
upon the rate of compliance for elder abuse victims serviced through New
York\'s Elderly Crime Victim\'s Unit. Both dependency of the victim upon
the abuser and dependency of the abuser upon the victim were analyzed in
relationship to whether the victim followed through with referrals made
for services through the Crime Victim\'s Unit or other community
organizations. Ninety-five closed cases were analyzed. Dependency was
assessed using a two-part instrument developed by the authors (the
Dependency Scale), and the presence of cognitive impairment, substance
abuse issues, and mental illness on the part of victims and abusers were
also noted. The only significant association found was that victims of
abusers with mental health and/or substance abuse issues were more
likely to accept referrals for additional services. Further, abusers
with substance abuse and/or mental health problems were found to be more
dependent upon their victims.

65\. S6179-14\*

Rabi, K.

**Israeli Perspectives on Elder Abuse**

Educational Gerontology; Vol. 32 (1), 49-62; 2006.

Observing that a significant number of Israeli elders live within the
community, have limited economic resources, rely heavily on family
members for assistance and therefore may be a greater risk for elder
mistreatment, this article considers the perceptions of elder abuse and
neglect among two ethnic groups, the Ashkenazi (n=42) and the Sephardic
(n=27). Participants, aged 18 to 80, provided examples of various types
of mistreatment, and categorized the examples according to severity.
Examples of physical abuse and neglect/abandonment were most commonly
identified by both ethnic groups as extreme in nature. However,
Ashkenazi were more likely to view physical and economic abuse as
moderate in nature, and abandonment/neglect as mild in nature. Gender
differences were also analyzed, and the one significant difference noted
was that women were more likely to view disrespect as moderate abuse
while men were more likely to view it as mild. (Israel)

66\. S6534-12

Rabiner, D., O\'Keefe, J. & Brown, D.

**Financial Exploitation of Older Persons: Challenges and Opportunities
to Identify, Prevent, and Address It in the United States**

Journal of Aging & Social Policy; Vol. 18 (2), 47-68; 2006.

This study was designed to analyze the nature and scope of elder
financial abuse and exploitation occurring in domestic settings. The
following research methods were employed: a literature review on the
topic to develop a conceptual framework; the identification of a network
of nationally recognized experts; a meeting with a technical advisory
group (TAG, comprised of 11 of the recognized experts) in order to
discuss policy and research implications; and an examination of
promising practices as well as barriers to services which were
identified through site visits in four states (California, Colorado,
Pennsylvania, and Illinois). Challenges to prevention, identification
and intervention include the reluctance of the victim to report
exploitation; mental and physical impairments of the victim; impediments
to prosecution and civil litigation (including fear of the potential
consequences); lack of senior support services and other resources (and
a lack of awareness of existing resources); and the potential for misuse
of legal protections (including powers of attorney and guardianships).
National prevalence and incidence studies are recommended to measure the
scope of elder financial exploitation, along with both small-scale and
longitudinal studies to analyze various aspects of the problem (such as
studies measuring the impact of exploitation upon the mental and
physical health of victims; research on specific risk factors;
assessments of program effectiveness; etc.). (Note: This article draws
upon the same data set of CANE files R6024-22 and R6025-23.)

67\. S6462-8

Repp, M. & Hughes, E.

**The Rise in Reported Elder Abuse: A Review of State and National
Data**

Illinois Criminal Justice Information Authority; State of Illinois;
August 2005.

This report discusses trends relating to reported elder abuse in
Illinois from 1993 through 2003. During that time, reported cases rose
from 4,142 in 1993 to 7,672 in 2003. Among the findings from 2003,
financial exploitation (34 percent) was the most commonly reported,
followed by emotional abuse, passive neglect, physical abuse, and
deprivation. Of note, African Americans were disproportionately
represented among reported victims. Living arrangements, relationships
with abusers, and other characteristics are discussed. Twenty percent of
the victims were cognitively impaired to some degree and more than
one-fourth had multiple characteristics that put them at risk for
mistreatment. Forty-nine percent of the abusers were not considered
caregivers; 44 percent were categorized as informal caregivers, and 7
percent were paid caregivers. Data from state and national Ombudsman
reports on institutional abuse is also reviewed. (Note: This report is
available online at:
<http://www.icjia.state.il.us/public/pdf/Bulletins/Elderabuse2.pdf> .)

68\. S6423-21

Safarik, M. & Jarvis, J.

**Examining Attributes of Homicide Toward Quantifying Qualitative Values
of Injury Severity**

Homicide Studies; Vol. 9 (3), 183-203; August 2005.

Although the qualitative study of injuries can reveal information about
the dynamics between offender and victim, relatively little data is
gathered on the nature of injuries incurred during homicides. This
article reviews the modification and implementation of injury severity
scales in the analysis of data from a sample of 128 elderly female
homicide victims (aged 60 or older). In a previous study, these cases
were comprehensively reviewed for information on the physical, sexual,
behavioral, and psychological details of the homicides. Multivariate
analysis was conducted to determine if there was a relationship among
offender characteristics, the offender-victim relationship, and the
offender\'s geographical proximity to the victim and the degree of
injuries inflicted during the homicide. Of note, greater severity of
injuries appeared associated with younger offenders and offenders who
lived in closer proximity to their victims. Implications for criminal
investigations are considered. (Note: This data set is also the subject
of CANE file \# N4885-13.)

69\. S6477-6

Sauvageau, A. & Racette, S.

**Fatal Neglect of the Elderly by a Spouse: A Case Report**

Medicine, Science, and the Law; Vol. 46 (2), 173-176; 2006.

An atypical case study of a neglected 69 year old diabetic man is
presented. After suffering a cerebral stroke, the man fell and was left
on the floor by his spouse, who could not get him up and did not call
for help. According to police records, the women reported that he was
communicative after the fall and asked her not to call for emergency
assistance. Although she fed him and tended to him on the floor, she did
not administer his insulin. He died four days later due to
hyperglycemia. The case was ruled a homicide by neglect. However, the
spouse was not prosecuted. Authorities believed that she did not
intentionally neglect her husband and that she had a history of
psychological problems. (Canada)

70\. S6397-4

Schonfeld, L., Larsen, R. & Stiles, P.

**Behavioral Health Services Utilization Among Older Adults Identified
Within a State Abuse Hotline Database**

The Gerontologist; Vol. 46 (2), 193-199; 2006.

This study compared the behavioral health service usage of adults aged
65 and older identified through the Florida Abuse Hotline Information
System (FAHIS) with other older service users. Identifying data from
FAHIS was matched with Medicaid and Medicare data to determine frequency
and costs of behavioral health service usage for both sub-populations
for the calendar year 1999. Significantly higher rates of service usage
and costs were associated with both Medicare and Medicaid enrollees
identified through FAHIS, compared to other older adults. The authors
acknowledge under reporting of elder mistreatment as a limitation of
this study but recommend additional research in this area. They also
emphasize the need for more detailed data collection by protective
services, including screening for behavioral health problems.

71\. S6399-8

Sink, K., Covinsky, K., Barnes, D., Newcomer, R. & Yaffe, K.

**Caregiver Characteristics are Associated with Neuropsychiatric
Symptoms of Dementia**

Journal of the American Geriatrics Society/JAGS; Vol. 54 (5), 796-803;
2006.

In this cross-sectional study, based upon data from 5,788 patients and
caregivers in the Medicare Alzheimer\'s Disease Demonstration and
Evaluation project, researchers analyzed the association of caregiver
characteristics with neuropsychiatric symptoms (NPS) of dementia
patients. NPS include constant restlessness; constant talking;
hallucinations; paranoia; episodes of unreasonable anger; combativeness,
dangerousness to self; dangerousness to others; destructiveness;
repetitive questioning; wandering; and waking the caregiver. After
adjusting for severity of dementia and patient demographic
characteristics, results indicate that NPS were positively associated
with caregivers who were younger, less educated, more depressed, more
burdened, or spent more time providing care. Health and social service
professionals are urged to consider caregiver characteristics and the
relationship dynamics between caregiver and care recipient when
designing education and intervention plans.

72\. S6400-4

**Caregiver\'s Burden, Depression and Support as Predictors of
Post-Stroke Depression: A Cross-Sectional Survey**

Suh, M., Kim, K., Kim, I., Cho, N., Choi, H. & Noh, S.

International Journal of Nursing Studies; Vol. 42 (6), 611-618; 2005.

This study considers the impact of caregiver\'s burden, depression and
support on post-stroke depression (PSD). Data was collected from 225
stroke survivors and their informal caregivers in Seoul, Korea.
Multivariate analysis revealed that after adjusting for patient\'s
clinical status, caregiver depression was significantly associated with
an increase in PSD. Although increases in caregiver burden appeared
related to increases in PSD the association was not statistically
significant. Caregiver support was related to lower levels of PSD. The
emotional distress of caregivers appears to have a negative impact on
patients with clinical implications. Post-stroke care that addresses the
needs of caregivers as well as patients may reduce the risk of PSD.
(South Korea)

73\. S6332-11

Tam, S. & Neysmith, S.

**Disrespect and Isolation: Elder Abuse in Chinese Communities**

Canadian Journal on Aging; Vol. 25 (2), 141-151; 2006.

This qualitative study of home care workers focuses on the social
context of mistreatment among Chinese elders in Canada. Four focus
groups were conducted with 40 participants, Chinese home care
professionals and program coordinators who, while providing services,
were exposed to suspected or actual cases of elder mistreatment. They
described the prominence of disrespect, considered abusive because it
violates traditional Chinese cultural values, exhibited as verbal abuse,
ignoring the elder, scolding, nagging, name calling, threatening to
institutionalize, and talking or joking about death. It was also
manifested by isolating and restricting the elder, ignoring
psychological and social needs, and limiting food choices. Dependency
issues of the Chinese elderly immigrants were perceived, to a
significant degree, to be related to social exclusion and the
marginalization of this group in Canadian society. (Canada)

74\. S6139-12\*

Tauriac, J. & Scruggs, N.

**Elder Abuse Among African Americans**

Educational Gerontology; Vol. 32 (1), 37-48; 2006.

In this article, the authors review sociohistorical and other culturally
specific elements that influence the perceptions of elder abuse among
African-Americans. Financial strain is considered, along with the
traditional characteristic of extended family, which often provides
support and stability, but may also render the system vulnerable to
conflict. In this convenience sample study, 25 female and 10 male
African-American participants, aged 16 to 63, were asked to provide
examples of extreme, moderate and mild elder abuse. Extreme abuse was
predominantly characterized by examples physical aggression; verbal
abuse was least frequently categorized as extreme; neglect/abandonment
was classified as extreme in half of the examples provided. Although
research suggests that it is a more common form of elder abuse among
African-Americans (Dimah & Dimah, 2002; Griffin, 1994, 1999), only three
examples of financial abuse or exploitation were given. Gender and age
differences among responses are also discussed, along with implications
for prevention and intervention. (U.S.)

75\. S6396-2

Taylor, D., Bachuwa, G., Evans, J & Jackson-Johnson, V.

**Assessing Barriers to the Identification of Elder Abuse and Neglect: A
Communitywide Survey of Primary Care Physicians**

Journal of the National Medical Association; Vol. 98 (3), 403-404; March
2006.

Five hundred primary care physicians from Genesee County, Michigan were
sent a copy of either an attitude or knowledge survey regarding elder
abuse issues. Ninety-five participants completed and returned the
surveys. The attitude survey generated a greater response rate, and
results suggest that a majority of the respondents acknowledged that
physicians did not routinely screen for elder abuse. Those responding to
the knowledge instrument revealed that they did not have an accurate
understanding of the prevalence of elder abuse or of risk factors for
abuse. A lack of understanding of reporting procedures was considered
the greatest barrier to identification.

76\. S6363-49\*

U.S. Government Accountability Office (GAO)

**Long-Term Care Facilities - Information on Residents who are
Registered Sex Offenders or Are Paroled for Other Crimes (GAO-06-326)**

U.S. Government Accountability Office (GAO); Washington, D.C.; March
2006.

This report was intended to determine the prevalence of sex offenders
and paroled non-sex offenders residing in nursing homes and long-term
care facilities; identify the legal requirements for notifying
facilities and others when offenders are residents; and assess the
extent to which long-term care facilities provide different supervision
for these residents. Analysis of data from the FBI\'s National Sex
Offender Registry (NSOR) revealed that approximately 700 registered sex
offenders were living in nursing homes or intermediate care facilities
for people with mental retardation (ICF-MR), comprising about 0.05
percent of the nation\'s 1.5 million long-term care population. Most
offenders were male and under age 65. About 3 percent of all homes and
.7 percent of ICF-MR receiving Medicare and Medicaid funds housed at
least one sex offender during 2005, although this figure is considered
an underestimate due to state data reporting limitations. Information
was gathered from 8 reviewed states in which 204 residents were
identified as paroled non-sex offenders. Because offender status is not
tracked with abuse reporting, the overall risk posed by registered sex
offenders and parolees could not be determined. Facility administrators
voiced most concern for risk to cognitively impaired and mentally ill
residents. The extent to which long-term care facilities are notified
regarding the status of sex offenders varies significantly from state to
state, as does the extent to which this information is shared by the
administrators with staff and others. Specialized supervision of these
residents is not typically based upon prior convictions but upon their
demonstrated behaviors. As a result of this report, the GAO recommended
that the Attorney General direct the FBI to conduct an assessment of the
completeness of the NSOR, including state submission rates, and to
consider ways in which this database could be more effective on a
national level. (Note: This report is accessible online at:
[http://www.gao.gov/new.items/d06326.pdf#search=%22GAO-06-326%20Offenders%22](http://www.gao.gov/new.items/d06326.pdf#search=)
.)

77\. S6457-12

Wang, J.

**Psychological Abuse and Its Characteristic Correlates Among Elderly
Taiwanese**

Archives of Gerontology and Geriatrics; Vol. 42 (3), 307-318; May-June
2006.

Despite recently enacted protective services legislation in Taiwan,
psychological elder abuse remains difficult to detect and to address.
This cross-sectional study was designed to assess the prevalence of
psychological abuse among elderly Taiwanese and to identify
characteristics associated with this type of mistreatment. Data was
drawn from a random sample of 195 institutionalized and community-based
individuals, aged 60 and older, from several regions in southern Taiwan.
Results indicate that 22 percent of the participants reported that they
had experienced psychological abuse. Unmet needs for family contact,
financial dependence, and being left alone involuntarily were the most
common situations. There were no statistically significant differences
in prevalence rates between the community-based and institutionalized
groups. Psychological abuse appeared higher among participants with
lower levels of cognitive and physical functioning. (Note: Items from
the Psychological Elder Abuse Scale/PEAS, a tool developed by the
author, are included.) (Taiwan)

78\. S6336-10\*

Wang, J.

**Psychological Abuse Behavior Exhibited by Caregivers in the Care of
the Elderly and Correlated Factors in Long-Term Care Facilities in
Taiwan**

Journal of Nursing Research; Vol. 13 (4), 271-280; December 2005.

This cross-sectional study analyzed characteristics associated with
psychologically abusive behaviors perpetrated by long-term caregivers.
The Caregiver Psychological Elder Abuse Behavior Scale (CPEAB) and the
Caregiver Burden Scale were administered to 114 randomly selected
participants (56 nurses and 58 care attendants) from nursing homes
throughout southern Taiwan. Results suggest that caregivers with higher
education, without special geriatric training, or who experienced higher
work load burdens displayed more severe psychologically abusive
behaviors. Younger participants demonstrated more psychologically
abusive behaviors than did older participants; and nurses were more
abusive than care attendants. Only one participant reported never
displaying psychologically abusive behavior during the previous six
months. Accusing the resident verbally, ignoring his or her requests,
and insulting the resident were the most frequently reported behaviors.
(Taiwan)

79\. S6437-7

Werner, P., Eisikovits, Z. & Buchbinder, E.

**Lay Persons\' Emotional Reactions Toward an Abused Elderly Person**

Journal of Elder Abuse & Neglect; Vol. 17 (2), 63-75; 2005.

One-hundred and sixty nine adults aged 45 and over were interviewed and
presented with a case vignette depicting elder abuse. Two versions of
the scenario were devised which varied on one aspect; in one version the
victim had Alzheimer\'s disease, and in the other the victim had
osteoporosis. Participants were randomly assigned to one of the two
versions. Seventy-four percent of the participants indicated that, to at
least some degree, the scenarios depicted abuse. The scenarios elicited
predominantly positive emotional reactions, including compassion,
concern and sympathy, although a very few respondents experienced
neutral responses (including embarrassment, discouragement) or negative
reactions (such as ridicule, irritation or rejection). Increased
education appeared to be inversely associated with negative reactions,
and feelings of sympathy appeared associated with increased exposure to
abuse. The participants responding to the Alzheimer\'s version of the
vignette reported higher levels of discomfort and concern for the
victim. (Israel)

80\. S3689-4\*

Wigelsworth, A., Mosqueda, L., Burnight, K., Younglove, T. & Jeske, D.

**Findings from an Elder Abuse Forensic Center**

The Gerontologist; Vol. 46 (2), 277-283; 2006.

Employing a variety of research methods, including case study reviews
and surveys of team members, the authors present the findings of an
evaluation of the effectiveness and efficiency of the multidisciplinary
Elder Abuse Forensic Center (EAFC). The EAFC, which was established in
2003 and addresses cases involving mistreatment of elders and vulnerable
adults, is comprised of representatives from adult protective services
(APS), social services, law enforcement, the district attorney\'s
office, a medical response team, public guardian, ombudsmen, mental
health services, victims services and domestic violence. Collaborators
indicated that, overall, they believed the multidisciplinary format of
case management and review was more time efficient than handling cases
within a single agency or discipline; they also concurred that the
interventions of the EAFC were more effective. They were more neutral on
the question of whether the case outcomes would have been different if
not addressed by the EAFC. Two cases are presented that highlight the
collaborative process of the format, and the degree of complexity, in
terms of forensic issues and family dynamics, of such cases.

81\. S6446-13

Wilke, D. & Vinton, L.

**The Nature and Impact of Domestic Violence Across Age Cohorts**

AFFILIA; Vol. 20 (3), 316-328; Fall 2005.

This study, a secondary analysis of data from the National Violence
Against Women Survey (NVAWS, 1995-1996), compared the nature and impact
of domestic violence (DV) across different age cohorts. Three-hundred
and ninety-eight women who reported being victimized were divided into
three age cohorts (aged 18 to 29, n=157; aged 30 to 44, n=187; and aged
45 and older, n=54). Similar patterns regarding the severity, types of
abuse experienced and perpetrators were observed across all age groups.
Older women reported experiencing abuse for longer periods of time and
were more likely to be currently involved with their abusers. Also,
older women experienced higher rates of chronic mental health problems
and greater use of tranquilizers and antidepressants. Three-fourths of
the respondents across all age groups reported that they were unlikely
to report abuse to the police.

82\. S6424-9

Winterstein, T. & Eisikovits, Z.

**The Experience of Loneliness of Battered Old Women**

Journal of Women & Aging; Vol. 17 (4), 3-19. 2005.

This qualitative research was part of a larger study on the experiences
of older battered women. In-depth interviews were conducted with 21
Jewish women from Northern Israel aged 60 to 85. Thirteen of the
participants were living with abusive partners during the time of the
study, and eight were separated but not divorced. This article focuses
on content analysis regarding the theme of loneliness as an outcome of
intimate partner violence. Loneliness was discussed as it permeated the
intimate partnership, which in some cases began with an arranged
marriage. For many women, it was reflected by estranged relationships
with their children. It was also reflected by limited social contact and
support. Therapists and others working with older survivors of domestic
violence are encouraged to use a narrative approach to allow women to
reframe their experiences in order to see their strengths while
expanding their social support systems. (Israel)

83\. S6454-5

Zink,T., Fisher, B., Regan, S. & Pabst, S.

**The Prevalence and Incidence of Intimate Partner Violence in Older
Women in Primary Care Practices**

Journal of General Internal Medicine; Vol. 20 (10), 884-888; 2005.

This study was designed to analyze the incidence and prevalence of
intimate partner violence (IPV) among women, aged 55 and older, who were
seen at least one time in a primary care practice during the previous
year. Nine-hundred and ninety-five women who had been seen in health
care settings affiliated with an academic institution completed
telephone interviews that assessed health status and the experience of
psychological, physical and sexual abuse occurring since age 55. The
prevalence rate of physical abuse (since age 55) among those surveyed
was 1.52 percent, and the incidence rate for the preceding year was 0.41
percent. Prevalence and incidence rates for sexual abuse were 2.14
percent and 1.12 percent respectively. Victims of IPV reported a greater
number of health conditions (3.84) than those not victimized (3.21), and
victims were more likely to experience chronic pain, anxiety and
depression.

84\. S6439-9

Zink, T., Jacobson, C., Pabst, S., Regan, S. & Fisher, B.

**A Lifetime of Intimate Partner Violence: Coping Strategies for Older
Women**

Journal of Interpersonal Violence; Vol. 21 (5), 634-651; May 2006.

This study analyzed the coping strategies used by 38 women, aged 55 and
older, to survive long term abusive intimate partner relationships.
Through grounded theory analysis of interview transcripts, three coping
strategies were identified. Women reappraised their situations in a
manner that allowed them to create boundaries within the relationships.
They also focused on different domestic roles. Finally, they sought
emotional support from other sources, including friends, extended
family, and through work or volunteer experiences. Participants
indicated that maintaining the appearance of conjugal unity was of great
importance.

**III. Scholarship**

85\. S6434-3

Alford, D.

**Legal Issues in Gerontological Nursing - Part I: Abuse and Neglect of
Older Adults**

Journal of Gerontological Nursing; p10-p12; January 2006.

In this article, an expert nursing panel highlights legal aspects of the
nurse's response to elder abuse. Being alert to the possibility of abuse
and neglect and understanding reporting obligations are paramount.
(Panel participants included Deborah Karas, of the Nursing Services
Group, Barrington, IL; Annette Lueckenotte, of Barnes-Jewish West County
Hospital, Creve Coeur, MO; Karen Devereaux Melillo, Department of
Nursing, University of Massachusetts, Lowell, MA; Jane Nunnelee, of the
Louise Herrington School of Nursing, Baylor University, Dallas, TX;
Susan Scanland of GeriScan Geriatric Consulting, Clarks Summit, PA; Karl
E. Steinberg, geriatrician and a nursing home and hospice medical
director, Oceanside, CA; Ronald Walent, of Laguna Honda Hospital and
Rehabilitation Center, San Francisco, CA; and Lin Zahn, Professor of
Nursing, University of Massachusetts, Lowell, MA.)

86\. S6151-13

American Bar Association Commission on Law and Aging

**State Adult Guardianship Legislation: Directions of Reform - 2005**

American Bar Association Commission on Law and Aging; January 2006.

This paper summarizes the highlights of legislation related to adult
guardianship enacted in 2005 throughout the U.S. As quoted from the
introduction: \"\...at least 14 states passed a total of 24 adult
guardianship bills \-- as compared with 19 bills in 14 states passed in
2004\...New Jersey enacted the first major reform of the state\'s
guardianship laws in more than 30 years. Six states made changes in
their public guardianship programs, including legislation in Texas
providing for extensive reform and reorganization of adult protective
services (APS) and guardianship; as well as the creation of a public
guardianship program in Georgia. Two states (Texas and New Jersey)
initiated guardian certification/registration programs, and one state
(Idaho) included certification in a pilot program. In addition, a number
of states strengthened the monitoring and accountability of guardians,
while others made procedural changes or addressed the powers and
authorities of guardians\...\" Additional legislation is highlighted
from the following states: North Dakota, Nevada, Virginia, New
Hampshire, Colorado, Arkansas, New York, Minnesota, Washington, and
Connecticut. (Note: This paper is available online only at:
<http://www.abanet.org/aging/docs/guardian1.pdf>.)

87\. S6177-23

American Bar Association Commission on Law and Aging, and the Maryland
Office of the Attorney General

**Making Medical Decisions for Someone Else: A Maryland Handbook**

American Bar Association Commission on Law and Aging; April 2006.

This handbook provides detailed and practical guidelines for surrogate
decision-makers of incapacitated individuals in the state of Maryland.
The handbook addresses the scope of responsibilities of the health care
proxy (such as obtaining medical information, consenting to or refusing
tests and treatment, authorizing the transfer of the patient, etc.)
Surrogates are advised to communicate with the individual for whom they
may need to make decisions regarding their beliefs, values, and wishes
prior to incapacitation, if possible. (Note: This handbook is accessible
online at:
<http://www.abanet.org/aging/publications/docs/proxy_guide_long_final_2.pdf>
. The brochure, \"Making Medical Decisions for Someone Else: A Guide for
Marylanders,\" is available at:
<http://www.oag.state.md.us/Healthpol/Proxy_guide_brochure.pdf> .)

88\. S6156-125\*

The Anti-Ageism Taskforce at the International Longevity Center (ILC) -
USA, sponsored by the Open Society Institute

**Ageism in America**

International Longevity Center - US, LTD.; New York; 2006

This publication begins with a \"report card\" of seven major areas
where ageism is evident within the United States (elder abuse,
discrimination in health care, nursing homes, emergency services, the
workplace, the media, and in marketing). It is also considered within
the context of the family and culture. A history of ageism in America is
presented, and topics covered include the creation and perpetuation of
ageism, personal and institutional ageism, and the costs of ageism. The
effectiveness of existing policies designed to combat age discrimination
are reviewed, along with recommended initiatives. (Note: This
publication is available online at:
<http://www.ilcusa.org/news/story_aging.htm> . To request a hard copy of
this report please contact the ILC-USA Communications Department at
meganm@ilcusa.org or 212-606-3380.)

89\. S6385-7\*

Baker, M. & Heitkemper, M.

**The Roles of Nurses on Interprofessional Teams to Combat Elder
Mistreatment**

Nursing Outlook; Vol. 53 (5), 253-259; September/October 2005.

This article describes the contributions that nurses can make to
interdisciplinary teams addressing elder mistreatment, such as the King
County Elder Abuse Project (EAP) of Seattle, Washington. Established in
2001 by the King County Prosecuting Attorney\'s office, the EAP was
designed to facilitate the prosecution of cases of mistreatment among
elders and individuals with disabilities; foster collaboration with law
enforcement; and provide training on elder mistreatment to first
responders in the community. Specifically, nurses can assist in chart
reviews, provide education to other team members, and provide education
to the public. Participation in the EAP by faculty from the University
of Washington School of Nursing has led to the institution\'s
development of a Master\'s degree program, the Advanced Practice
Forensic Nurse Specialists.

90\. S6464-12

Bergeron, L.

**Self-Determination and Elder Abuse: Do We Know Enough?**

Journal of Gerontological Social Work; Vol. 46 (3/4), 81-102; 2006.

In this discussion, the author suggests that the notion of competency
and the principles of self-determination are oversimplified in elder
abuse literature, and that adult protection laws provide inadequate
guidelines for social workers and others who encounter competent elders
who refuse services and opt to remain in potentially life-threatening
situations. APS professionals are encouraged to base decisions balancing
autonomy and protection not only on the client\'s immediate stated
wishes, but after considering the client\'s life history (including
decision-making practices), an in-depth understanding of the client\'s
competency, awareness of cultural influences, knowledge of relevant
legal statutes, and the ability to think critically about ethical
complexities. The impacts of intergenerational issues and family
dynamics upon decision-making capacity are also considered. Case
scenarios from the media as well as from the author\'s experiences are
used to illustrate various aspects of the question, \"At what point is a
depressed, or sick, or abused person unable to choose?\" Offering the
choice of \"negotiated consent\" by assisting the client in minimizing
the abuse or developing a safety plan is an alternative intervention. A
multidisciplinary, collaborative response is considered vital.

91\. S6470-11

Bomba, P.

**Use of Single Page Elder Abuse Assessment and Management Tool: A
Practical Clinician\'s Approach to Identifying Elder Mistreatment**

Journal of Gerontological Social Work; Vol. 46 (3/4), 103-122; 2006.

By framing elder abuse as a geriatric syndrome, it is hoped that
physicians and other health care professionals will be more willing to
and capable of screening for elder mistreatment. This paper describes
the purpose and development of a one-page tool that provides practical
guidelines for screening and assessment of elder abuse, neglect and
exploitation. The Principles of Assessment and Management of Elder Abuse
Tool (included) has been distributed in primary care, long-term care,
and emergency settings. It has also been used by social service
professionals, law enforcement and bank employees. The article provides
a general discussion of indicators of abuse and screening questions
included in the tool.

92\. S6460-9

Boxerbaum, E. & Donaldson, P.

**Respecting and Protecting Elders**

Journal of Healthcare Protection Management; Vol. 21 (2), 67-75; 2005.

This article provides an overview of security in elder care settings,
such as long-term care facilities, as a means of preventing
victimization. A needs assessment should be performed to determine a
facility\'s strengths and weaknesses, and should cover perimeter and
access controls, internal security, the means to protect residents who
are not capable of protecting themselves, and measures to protect
caregivers and visitors. Recommendations should be implemented in ways
that are consistent to the organization\'s mission and values. A number
of technologies are discussed, such as the use of video security and
wearable GPS-based devices.

93\. S6474-31

Bruce, P.

**The Ascendancy of Assisted Living: The Case for Federal Regulation**

Elder Law Journal; Vol. 14; 2006.

In light of the increase in assisted living residents, the author argues
that the industry requires uniform, and therefore federal, regulation to
protect vulnerable adults from inadequate care. A history of long-term
care in the U.S. is provided along with the sociodemographic factors
contributing to the development and growth in assisted living. Although
states have attempted to regulate the industry, the definitions of
assisted living and resultant regulations have varied significantly.
State regulation schemes and their shortcomings are examined. Notable
discrepancies exist in many areas: regulation of disclosure; regulation
of care level expectations and ambiguity regarding scope of care;
staffing requirements; physical and facility regulations; and medication
management. Most states lack sufficient resources to adequately monitor
assisted living facilities. The author argues that federal regulation of
assisted living is permitted under the Commerce Clause of the U.S.
Constitution since multi-state providers generate interstate commerce.

94\. S6293-21\*\*\*

Caccamise, P. & Mason, A.

**Policy Paper: New York State Summit Targets Elder Abuse, \"The Time to
Act is Now\"**

Journal of Elder Abuse & Neglect; Vol. 16 (4), 41-61; 2004.

In May, 2004, 96 leaders in aging services met to create the New York
State Action Agenda to advance the state\'s response to elder abuse.
This article describes the purpose and process of the event from its
inception through recommendations generated. Lifespan of Rochester
convened the summit which was modeled after the 2001 National Policy
Summit on Elder Abuse, held in Washington D.C., sponsored by the
National Center on Elder Abuse (NCEA). Representatives from aging
services, adult protective services (APS), criminal justice, domestic
violence agencies, financial institutions, faith communities, and
education participated. Work group topics included intervention models,
financial exploitation, public awareness and education, self-neglect,
prosecution and law enforcement, and public health. Areas of discussion
included policy and legislation, funding and resources, research and
data, program development and prevention. The following needs were among
the highest priorities identified: legislative reform to enhance
prevention, intervention, and prosecution; statewide research on the
scope of elder abuse and the development of methodology for ongoing data
collection; and statewide evidence-based training for first responders
and community partners.

95\. S6408-5

Cohen, C.

**Consumer Fraud and the Elderly: A Review of Canadian Challenges and
Initiatives**

Journal of Gerontological Social Work; Vol. 46 (3/4), 137-144; 2006.

This article reviews the available data on consumer fraud affecting
elders in Canada. Findings from various studies suggest that financial
exploitation is the most common form of elder abuse perpetrated in
Canada, and recent studies suggest that between 50 and 90 percent of
telemarketing fraud victims are over age 60. Risk factors are
considered, including social isolation. Promising practices, model
programs and legislative initiatives are highlighted, including
PhoneBusters (a national deceptive telemarketing call center based in
Ontario) and the Competition Bureau of Canada (which collaborated with
other agencies to form the Deceptive Telemarketing Prevention Forum).
(Canada)

96\. S6387-9\*

Curtis, L.

**Partnering with Faith Communities to Provide Elder Fraud Prevention,
Intervention, and Victim Services**

OVC Bulletin; April 2006.

This article provides an overview of an elder fraud prevention program,
an initiative of the Denver District Attorney\'s Office, combining
education and intervention through faith communities. The components of
the Clergy Against Senior Exploitation (CASE) Partnership, an eighteen
month demonstration project of the Office of Victims of Crime, U.S.
Department of Justice, are described and include efforts to form
alliances between the District Attorney\'s office and various faith
communities, train clergy regarding elder fraud, provide education and
outreach to seniors, distribute monthly fraud alerts and provide
assistance to seniors through crime reporting, victim support, and fraud
prevention services. Follow-up surveys of both clergy and senior
participants suggest that the project was effective in raising awareness
and developing prevention strategies. Measurable goals, flexibility in
customizing programs to meet the needs of individual faith
denominations, sharing \"best practices,\" and employing adult learning
techniques were identified as key in the successful implementation of
the project. Due the success of this program, it has been successfully
replicated in three other Colorado sites, and is scheduled to be
replicated throughout the country. (Note: This publication is accessible
online at:
<http://www.ojp.usdoj.gov/ovc/publications/bulletins/elderfraud_case/pfv.html>
.)

See also CANE file \# S6533-5.)

97\. S6212-19\*

Dessin, C.

**Elder Law: Should Attorneys Have a Duty to Report Financial Abuse of
the Elderly?**

Akron Law Review; Vol. 38; 2005.

This article considers whether attorneys can and should report suspected
elder financial abuse under mandatory reporting statutes. Conflicts
arising from the mandate to report suspected abuse, and the Model Rules
of Professionals Conduct which describes the attorney\'s duty to
maintain client confidences, are discussed. Distinctions between the
Pre-Ethics 2000 version of the Model Rules and the Ethics 2000 revision
are highlighted; under the latter, in some cases an attorney would be
able to reveal information in order to \"prevent reasonably certain
death or substantial bodily harm\...\" in states only where the
reporting is mandatory. The author summarizes the three basic approaches
adopted by states to deal with the need to protect client
confidentiality while complying with any mandatory reporting
requirements. She argues that difficulties in assessing the potentially
exploitative nature of financial transactions notwithstanding, attorneys
remain responsible for being alert to potential abuse in order to
protect the best interests of the client and to fulfill the obligation
to provide competent representation. In conclusion, under the principles
of providing competent representation, the author argues that the
attorney should report suspected financial abuse when the client is
perceived as incapable of consenting to the allegedly abusive behavior.
In addition, the attorney should report suspected abuse when learning of
it through the perpetrator.

98\. S6120-20\*\*\*

Doron, I., Alon, S. & Offir, N.

**Time for Policy: Legislative Response to Elder Abuse and Neglect in
Israel**

Journal of Elder Abuse & Neglect; Vol. 16 (4), 63-82; 2004.

This article provides an overview of the history of the policy response
to elder abuse and neglect in Israel. The initial legislative response
was characterized by the authors as paternalistic. The following phase
appeared more punitive and required mandatory reporting. The third phase
emphasized protection and intervention. It appears that the current
phase is evolving to emphasize education and empowerment. The authors
advocate for a policy response that is multidisciplinary, involves the
\"unheard voice\" of the older population, and allocates necessary
resources to develop and implement training and education initiatives.

99\. S6386-11\*

Dubble, C.

**A Policy Perspective on Elder Justice Through APS and Law Enforcement
Collaboration**

Journal of Gerontological Social Work; Vol. 46 (3/4), 35-55; 2006.

In this overview, the historic, economic, political, ideological, and
societal aspects of policies that promote collaboration between adult
protective services (APS) and law enforcement in response to elder
mistreatment are examined. The impact of the right to self-determination
upon legal interventions (such as reporting issues, prosecution) is
among the topics considered. Efforts of the AARP and the National Center
on Elder Abuse (NCEA) to promote awareness of elder mistreatment are
highlighted. In conclusion, the need for and the costs associated with
policies that reflect elder justice are discussed.

100\. S6129-2

Epplin, J.

**Identifying Elder Abuse in the Home Care Setting**

Annals of Long-Term Care; Vol. 14 (1), 15-16; January 2006.

Through a question and answer format, this column provides an overview
on identifying elder abuse, neglect and self-neglect among home care
patients. Potential physical and psychological indicators and risk
factors, including dementia, are discussed, along with the need to
report suspected mistreatment to the appropriate authorities. (Note:
This article is accessible online at:
<http://www.hmpcommunications.com/altc/displayArticle.cfm?articleID=article5137>
.)

101\. S6417-15

Geroff, A. & Olshaker, J.

**Elder Abuse**

Emergency Medicine Clinics of North America; Vol. 24 (2), 491-505; May
2006.

In this overview, the role of the emergency physician in detecting and
addressing elder abuse is described. The history of the recognition of
and response to elder mistreatment, definitions of abuse, indicators of
abuse, and victim and perpetrator characteristics are highlighted. The
importance of taking an accurate patient history and suggested
screenings questions are also discussed. Ethical and legal issues
encountered when addressing suspected mistreatment are reviewed.

102\. S6257-7

Gibbons, S.

**Self-Neglect: A Proposed New NANDA Diagnosis**

International Journal of Nursing Terminologies and Classifications;
Jan-March 2006.

This article proposes a new North American Nursing Diagnosis Association
(NANDA) diagnosis for self-neglect and provides the basis for
standardized terminology. The author believes that this will not only
facilitate multidisciplinary/interdisciplinary communications often
necessary in addressing such cases, but will facilitate the
international and national study of the phenomenon. The importance of
assessing the severity and intentionality of self-neglecting behaviors
are considered. Brief case studies are presented to illustrate defining
characteristics. (NANDA International is an organization which promotes
the development of nursing diagnostic terminology.)(Note: Currently,
this article is available online at:
<http://www.findarticles.com/p/articles/mi_qa4065/is_200601/ai_n16118485>
.)

103\. S6438-20

Gibson, M. & Hayunga, M. for the AARP Public Policy Institute

**We Can Do Better: Lessons Learned for Protecting Older Persons in
Disasters**

AARP Public Policy Institute; Washington, D.C.; May 2006.

As quoted from the AARP Public Policy Institute Web site: \"In an effort
to identify lessons learned in the aftermath of hurricanes Katrina and
Rita and to share promising practices, AARP convened a diverse group of
more than 100 government officials at federal, state and local levels;
emergency preparedness and response experts; relief organizations, and
aging and disability advocates in Washington, DC, on December 1st, 2005.
All of the panelists were 'people who had been there'. The goal of the
conference was to bring the right stakeholders together to explore
workable strategies for the future to better protect older persons in
both the community and in nursing homes\...\"(Note: Both the full report
and summary are accessible online from:
<http://www.aarp.org/research/assistance/lowincome/better.html> . To
obtain hard copies, free of charge, contact Tish Williams,
<twilliams@aarp.org> .)

104\. S6441-9

Griffith, R.

**Making Decisions for Incapable Adults 3: Protection, Guardians and
Advocates**

British Journal of Community Nursing; Vol. 11 (5), 214-221; 2006.

In this article, a district nurse and general practitioner discuss a
case of suspected elder abuse involving a community dwelling elder.
Health care professionals believe that her needs would be more
adequately addressed in a care home, but her son, the suspected abuser,
refuses to consider the placement. When the police conclude that there
is insufficient evidence to prosecute the son, the multidisciplinary
care team considers the Mental Capacity Act of 2005 as a potential means
to protect the patient. (U.K.)

105\. S6530-14

Hockley, C.

**Staff Violence against Those in Their Care** (from *[Workplace
Violence: Issues, Trends, Strategies;]{.underline}* Bowie, V., Fisher,
B. & Cooper, C., eds.)

Willan Publishing; Devon, UK; Chapter 5, 77-96; 2005.

This chapter presents an overview on violence perpetrated by staff
members against those in their care, such as residents of nursing homes
or aged care facilities, or of other health and residential care
settings. Abusive health care professionals, including caregivers, are
categorized into three groups: sadistic abusers, who repeatedly and
systematically abuse residents and patients without remorse; reactive
abusers, who behave violently out of impulse; and those who are
negligent. Management may also perpetrate abuse and neglect indirectly
through the organizational culture. Means to address the problems are
discussed, including legislation from the U.S. and the U.K., and
education and training. Levels of intervention include conciliation,
civil disciplinary action, and criminal legal action. (U.K., U.S.)

106\. S6335-10\*

Jayawardena, K. & Liao, S.

**Elder Abuse at End of Life**

Journal of Palliative Medicine; Vol. 9 (1), 127-136; February 2006.

This article provides palliative care professionals, including the
hospice team, with an overview of elder abuse and neglect issues that
may be encountered during end of life care. The authors point out that
caregiver stress should be of special consideration when assisting
terminally ill patients. All health care professionals should be aware
of family dynamics and cultural issues relevant to patients\'
circumstances. The multidisciplinary nature of hospice care is also
effective in addressing elder abuse and neglect. Providing education
regarding the dying process, assistance in delegating responsibilities
and providing referrals when necessary are not only elements of good
care provision, but are also strategies that reduce stress and may
prevent abuse and neglect. If the need to report mistreatment to
protective services arises, members of the palliative care team are in a
position to collaborate with APS in various ways: by providing
information regarding mistreatment, as well as patient and family needs;
by assisting in engaging the victimized patient in protective services;
by participating in the evaluation of the patient\'s capacity to make
decisions; and in communicating ongoing concerns.

107\. S6413-5

Kenney, J.

**Domestic Violence: A Complex Health Care Issue for Dentistry Today**

Forensic Science International; Vol. 159 (Supplement 1), S121-S125;
2006.

This article discusses the role of the dentist in the detection and
intervention of domestic violence, including child abuse, intimate
partner violence, abuse of the disabled, and elder abuse. As the head
and neck are visible during dental exams, clinicians are in a position
to observe many injuries that may result from mistreatment. The author
recommends using the RADAR protocol: routinely screen; ask direct
questions; document findings; assess patient\'s safety; and review
options and refer victim for appropriate services. In addition, dentists
may further assist victims by providing reduced price or free dental
care.

108\. S6148-3\*

Kruse, C.

**\"Think of Me as the Daughter You Never Had\"**

NAELA News; 9-11; August-September 2005.

In this commentary, the author describes scenarios of undue influence
that may be encountered in elder law practice. The first phase of the
exploitation is accomplished when the elder has entered a state of
dependency upon the predatory caregiver, a state in which he or she is
isolated from other friends, relatives, and acquaintances. He argues
that not only may the attorney intervene when he or she suspects that an
elder is being financially exploited, but that he or she should
intervene to protect, by seeking the appointment of a guardian or
through other means, as allowed for in the Model Rules of Professional
Conduct 1.14 (b).

109\. S6378-4

Liao, S. & Mosqueda, L.

**Physical Abuse of the Elderly: The Medical Director\'s Response**

Journal of the American Medical Director\'s Association (JAMDA); Vol. 7
(4), 242-245; May 2006.

This article provides an overview of the role of the medical director in
home health care settings in detecting and addressing elder physical
abuse. In particular, he or she should ensure that the potential for
elder abuse is openly discussed at multidisciplinary team meetings.
Reporting issues, physical indicators, and risk factors are discussed
using a case study as a focal point.

110\. S6401-42

Luu, A. & Liang, B.

**Clinical Case Management: A Strategy to Coordinate Detection,
Reporting, and Prosecution of Elder Abuse**

Cornell Journal of Law and Public Policy; Vol. 15; Fall 2005.

Despite legal mandates to report elder abuse, cases of elder
mistreatment remain significantly under-reported. In this article, the
authors emphasize the need for coordination between the health care and
legal systems in order to provide support and protection to older
victims, and to increase the likelihood of bringing the perpetrator to
justice. In particular, nursing case managers could perform this
function in a variety of health care settings. Part I of the article is
an overview of the nature of elder abuse and the settings in which it
may occur. Part II outlines the state of California\'s statutes
addressing elder abuse. Part III identifies problems and gaps in the
current response to elder abuse. In Part IV, the role of the nursing
case manager in detecting and reporting mistreatment, and in providing
care, support and referral for the victim, is described.

111\. S6138-11\*

Malley-Morrison, K., Nolido, N. & Chawla, S.

**International Perspectives on Elder Abuse: Five Case Studies**

Educational Gerontology; Vol. 32 (1), 1-11; 2006.

This article serves as an introduction to an issue of Educational
Gerontology dedicated to international and cultural perspectives related
to elder abuse. The authors review the existing literature to highlight
cultural differences in how elders and others throughout the U.S.
perceive various forms of mistreatment, and provide a brief comment
regarding the World Health Organization\'s Missing Voices research
series which addressed elder mistreatment throughout eight countries
(including five developing countries as well as western, industrialized
nations). Researchers describe the cognitive-ecological approach that
their international working group has adopted. The perspective focuses
on \"individual, neighborhood, and sociocultural contributors to abuse
\-- and conceptions of abuse.\" Universal themes of human rights and the
impact of traditional roles within culturally specific settings are also
examined. The \"Cross-Cultural Definitions of Family Violence and Abuse
Survey,\" is also described. The instrument was developed by the
research group, translated into 20 languages, and posted online in order
to generate cross-cultural data, which is the source of information for
the studies included in this special issue. The themes of collectivism
and individualism are among those highlighted by the articles selected
for this issue. (Note: The survey is accessible online at:
<http://people.bu.edu/jdgmnts/survey.html> . To view descriptions of
other articles included in this issue, see CANE file #s S6180-11,
S6141-11, S6179-14, S6139-12, and S6403-10) (International)

112\. S6533-5

Morrissey, M. & Curtis, L.

**Partnering with Faith Communities to Prevent Elder Fraud and
Exploitation**

The Prosecutor; Vol. 39 (6), p10, 12, 14, 15, & 47; November/December
2005.

This article describes the Communities Against Senior Exploitation
(CASE) Partnership of the Denver District Attorney\'s Office, which was
selected by the Bureau of Justice Assistance, Office of Justice
Programs, as a \"national model for replication, training, and technical
assistance.\" The project is designed to combat elder fraud through a
coalition of faith-based communities, prosecutors and other law
enforcement entities. Basic components of the program include partner
recruitment, clergy/leader training, monthly fraud alerts, power against
fraud seminars, and victim and fraud prevention assistance. Through the
initial project, 210 faith community partners were recruited; 340 clergy
and other leaders participated in training; 4,500 older adults, their
family members and caregivers participated in Power Against Fraud
seminars; and over 200 older individuals and their families were
assisted through victim and prevention services. (For more information
visit: <http://case.denverda.org/case/default.htm> . See also CANE file
\# S6387-9.)

113\. S6474-3

Multhaup, K.

**A Multicomponent Approach to Teaching Sensitive Topics: Elder Abuse as
an Example**

Teaching of Psychology; Vol. 32 (4), 261-263; 2005.

This brief article describes one instructor\'s method of teaching
sensitive topics, such as elder abuse, in psychology curricula. The
multicomponent approach, which includes an attitude and perception
survey, video presentation, class discussion, and written exercises, is
designed to raise awareness of the topic, relevant cultural issues, and
research implications.

114\. S6430-5

Neno, R. & Neno, M.

**Identifying Abuse in Older People**

Nursing Standard; Vol. 20 (3), 43-47; September 28, 2005.

Intended for nurses, this overview covers the following issues related
to elder abuse and neglect: definitional problems; limited data on
prevalence and incidence; risk factors; assessment strategies (including
multidisciplinary approaches); and interventions. Tables included list
potential indicators for neglect and physical, psychological, financial,
and sexual abuse. Note: This article is available online at:
[http://www.nursing-standard.co.uk/archives/ns/vol20-03/pdfs/v20n03p4347.pdf#search=%22%22Identifying%20Abuse%20in%20Older%20People%22%20Nursing%20Standard%22](http://www.nursing-standard.co.uk/archives/ns/vol20-03/pdfs/v20n03p4347.pdf#search=)
.)

115\. S6405-15

Nerenberg, L.

**Communities Respond to Elder Abuse**

Journal of Gerontological Social Work; Vol. 46 (3/4), 5-33; 2006.

This article presents an overview of the community response to elder
abuse throughout the past 20 years. Types of mistreatment are defined
and theories of abuse are summarized. The evolution of abuse reporting
laws, adult protective services (APS), and other agencies that
investigate and address abuse (such as the Long-Term Care Ombudsman
Program) are also discussed. Victims\' service needs are identified and
include shelters, legal assistance, mental health assessments and
counseling. The role of multidisciplinary teams is highlighted. Funding
issues and other barriers to service access are considered. The article
concludes with examples of practices and programs designed for
prevention and intervention.

116\. S6433-3

O\'Doherty, M.

**Lessons Learned: A Case Study**

Home Health Care Management; Vol. 18 (2), 103-105; February 2006.

In this case study presentation, family members describe how an in-home
caregiver financially exploited their elderly parents. They also
chronicle the difficulties they encountered in attempting to intervene,
due in part to the father\'s resistance. A lawsuit is pending on the
issue of whether the agency hiring the caregiver acted negligently by
not conducting a criminal background check.

117\. S6403-10

Patterson, M. & Malley-Morrison, K.

**A Cognitive-Ecological Approach to Elder Abuse in Five Cultures: Human
Rights and Education**

Educational Gerontology; Vol. 32 (1), 73-82; January 2006.

This paper, the concluding article in an issue dedicated to the topic of
culture and elder abuse, synthesizes the themes identified in preceding
studies. The recognition that elder abuse is underestimated in all
cultures studied (the U.S., Israel, Germany, Japan and Brazil) and
variance of rates within and across cultures reinforces the need for
prevalence studies. Research on the context in which abuse occurs is
also needed in order to better identify risk factors. While physical and
psychological aggression and economic abuse were identified in all
studies, specific examples of each type of abuse varied across cultures.
Cultural differences in family structures may be relevant to
perspectives on elder mistreatment, and societal elements contribute to
various aspects of abuse and neglect. (Note: To view descriptions of
other articles included in this issue, see CANE file #s S6180-11,
S6141-11, S6179-14, S6139-12, and S6138-11.)

118\. S6154-7

Pearsall, C.

**Forensic Biomarkers of Elder Abuse: What Clinicians Need to Know**

Journal of Forensic Nursing; Vol. 1 (4), 182-186; December 2005.

This overview describes biomarkers that could signal elder abuse and
neglect to physicians, nurses and other health care practitioners.
Bruises, lacerations, abrasions, and fractures are among the potential
indicators of physical abuse, and although they may be the result of
accident or complications of the aging process, such biomarkers should
trigger further discussion and assessment on the part of the clinician.
Dehydration, decubiti, malnutrition, and burns may be indicators of
intentional or unintentional abuse, neglect, and self-neglect. Dementia
and mental health issues contribute to the risk for mistreatment.
Guidelines for nursing assessments for all types of abuse, including
inadequate levels of care, and sexual abuse, are outlined.

119\. S6467-12

Podnieks, E.

**Social Inclusion: An Interplay of the Determinants of Health - New
Insights into Elder Abuse**

Journal of Gerontological Social Work; Vol. 46 (3/4), 57-79; 2006.

This essay emphasizes the need to promote the principles of social
inclusion across health and social sectors in order to enhance the
protection of older Canadians. Research reveals a number of complex
interactions among socioeconomic, personal, and behavioral factors that
create risk for elder abuse and neglect and that are also associated
with health status. Income, income distribution, social status, social
support networks, employment and working conditions, physical and social
environments, personal health practices, individual capacity, coping
skills, genetic endowment, and health services are considered in this
light. Shookner\'s \"The Inclusion Lens\" is summarized and presented as
a tool for analysis of legislation, policy, and practices, and as a
strategy for intervention to decrease the marginalization of elders.
(Canada)

120\. S6419-7

Reingold, D.\*

**An Elder Abuse Shelter Program: Build It and They Will Come, A Long
Term Care Based Program to Address Elder Abuse in the Community**

Journal of Gerontological Social Work; Vol. 46 (3/4), 123-135; 2006.

This article describes the establishment of the Weinberg Center, part of
The Hebrew Home for the Aged at Riverdale. The goals of the Center are
to promote public education and awareness regarding elder abuse in the
community; to implement strategies for identifying and engaging victims;
and to provide a long term care based shelter. The Center initiatives
employ a multidisciplinary approach in collaboration with the Bronx
District Attorney, the Manhattan District Attorney, New York City Adult
Protective Services, New York Weill Cornell Medical Center, Pace
Women\'s Justice Center, Westchester Adult Protective Services,
Westchester District Attorney, and Westchester County Department of
Senior Programs and Services. The Center provides both short term
emergency shelter as well as long term care planning, which includes the
client\'s safe return home with community supports, or transition to one
of the Hebrew Home\'s housing arrangements.

121\. S6449-18

Schall, V.

**The New Extreme Makeover: The Medical Malpractice Crisis, Noneconomic
Damages,** **the Elderly, and the Courts**

Appalachian Journal of Law; Vol. 5 (1); Spring 2006.

Tort reform and damage caps are emerging as solutions for the U.S.
\"medical malpractice crisis\" but appear to disadvantage elder
residents of nursing homes who are victims of abuse and neglect. This
legal commentary provides background on sociodemographic trends and the
increasing need to provide protection for institutionalized elders. The
author reviews the conflict among the courts addressing the
constitutionality of statutory noneconomic (pain and suffering, for
example) damage caps. Arguments that suggest these measures are
necessary to protect medical insurance rates are challenged. In
conclusion, the author argues that nursing home abuse should be either
treated as a distinct form of custodial neglect, or should not be
subjected to caps on noneconomic damages.

122\. S6440-27\*

Schuyler, D. & Liang, B.

**Reconceptualizing Elder Abuse: Treating the Disease of Senior
Community Exclusion**

Annals of Health Law; Vol. 15; Summer 2006.

This paper outlines a multidisciplinary approach to assessing the needs
of the elderly within the community and addressing existing abuse and
neglect. An overview of elder abuse is presented, including a history of
the federal and state (notably California) initiatives. In particular,
the function of multidisciplinary teams (MDTs) is highlighted along with
a number of model programs: the Elder Abuse Forensic Center in Santa
Ana, California; the Family Justice Center of San Diego, California; and
the Elder Justice Centers of Tampa and Palm Beach, Florida. The
components of a proactive, community systems approach include local
needs assessment sensitive to the cultural needs of an area; the
identification of service providers; and facilitating access between
service providers and seniors.

123\. S6432-5

Shyrock, S., Hunsaker, D., Corey, T. & Weakley-Jones, B.

**Forensic Evaluation of the Elderly**

The Journal of the Kentucky Medical Association; Vol. 103 (9), 451-455;
2005.

Clinical forensic medicine (CFM, a branch of medicine that evaluates the
victim of trauma and or neglect) may assist in detecting elder abuse. An
overview of the risk factors for maltreatment and the clinician\'s
responsibilities are presented. Specific screening questions are
included that address the patient\'s general circumstances, health and
well-being, functional abilities, financial status, emotional and
psychological status, and specifics regarding the presenting injury.
Physical indicators that require further investigation are outlined.

124\. S6459-39

Stafford, B.

**Expeditious Efforts for the Elderly: Covenant Care, Inc. v. Superior
Court**

U.C. Davis Law Review; Vol. 39; February 2006.

This legal note examines the California Supreme Court ruling on Covenant
Care, Inc. v. Superior Court and its potential impact upon cases
involving resident abuse and neglect. Case law is cited that illustrates
the overlap of the Elder Abuse and Dependent Adult Civil Protections Act
( referred to by the author as the \"Elder Abuse Act\", which enhances
remedies for \"reckless, fraudulent, oppressive, and malicious acts of
abuse and neglect by individuals and entities\"), the Medical Injury
Compensation Reform Act (MICRA, which provides defendant protections for
nursing homes and other health care providers), and the California Code
of Civil Procedure Section 425.13 (which \"seeks to prevent
unsubstantiated punitive damages claims from being included in claims
against healthcare providers\"). The details, rationale, and rulings of
the Covenant Care v. Superior Court case are described. The case
involved a family seeking punitive damages against a nursing home
facility for abuse of a resident and claimed the \"intentional,
egregious elder abuse went beyond the scope of professional
negligence.\" The court determined that section 425.13 did not apply to
this or other claims alleged under the Elder Abuse Act. The author
indicates that this decision will provide incentives for attorneys to
take on elder abuse claims by expanding the boundaries for punitive
damages and by eliminating procedural hurdles.

125\. S6461-10

Straka, S. & Montminy, L.

**Responding to the Needs of Older Women Experiencing Domestic
Violence**

Violence Against Women; Vol. 12 (3), 251-267; March 2006.

This overview describes the response and limitations of both the
domestic violence (DV) and the elder abuse fields in addressing the
needs of older women experiencing victimization. The feminist theory of
DV and the women\'s shelter network is described as it meets, or fails
to meet, the needs of older women. Although there is growing interest in
this area, and more programs exist now for this population than did
fifteen years ago, there are still relatively few specialized resources
available. Issues that restrict the accessibility of traditional
shelters for older women (such as time limits on occupancy, physical
barriers, etc.) are described. The response to elder abuse, originally
based on the child protection model and viewed as primarily relating to
caregiver issues, is incongruent with the power and control theory of
DV. Due to the caregiver burden conceptualization of elder abuse, cases
of DV may be missed; moreover, responses may be based upon sympathy for
abusers. The authors briefly describe current research initiatives
designed to foster dialogue across the two networks in order to develop
integrated services. (Canada)

126\. S6431-11

Thompson, H. & Priest, R.

**Elder Abuse and Neglect: Considerations for Mental Health
Practitioners**

Adultspan Journal; Vol. 4 (2), 116-128; Fall 2005.

This article is intended to raise awareness of elder abuse among mental
health professionals, including counselors, psychologists,
psychiatrists, and other therapists. Risk factors, abuser
characteristics, and victim characteristics that are observable within
the therapeutic process are described. The importance of cultural
sensitivity in understanding intergenerational issues and attitudes is
emphasized, and findings related to specific ethnic groups are
presented. Clinical interventions may include individual, family, and
relationship counseling; treating the victim's symptoms which may
include depression, shame, sadness, etc., through emotional, cognitive,
and behavioral approaches; empowerment for caregivers; and positive
reminiscence to enhance the caregiver-care recipient relationship. When
victimized elders choose to remain in the home with an abuser, the
interventions must address both victim and perpetrator and should
emphasize accountability on the part of the abuser. Legal and ethical
issues are also discussed.

127\. S6190-12

Twomey, M., Quinn, M. & Dakin, E.

**From Behind Closed Doors: Shedding Light on Elder**

**Abuse and Domestic Violence in Later Life**

Journal of the Center for Families, Children & the Courts; Vol. 6; 2005.

This article, intended for members of all judicial systems, provides an
overview of elder abuse and domestic violence in later life with a
particular emphasis on legislation and projects from the state of
California. Definitions, causal theories and risk factors are presented,
along with barriers that older individuals may experience when
attempting to seek assistance. The complex nature of elder abuse cases
that reach the courts are highlighted. (Note: This article is available
online at:
<http://www.courtinfo.ca.gov/programs/cfcc/pdffiles/4_Twomey.pdf> .)

128\. S6254-21

Uekert, B., Dancy, D., Peters, T. & Herman, M., for the National Center
for State Courts

**Policy Paper: Report from the First National Meeting of the Elder
Abuse and the Courts** **Working Group Meeting**

National Center for State Courts; Williamsburg, VA; June 2006.

Policy paper (online)

The multidisciplinary Elder Abuse and the Courts Working Group was
\"established by the NCSC in 2005 to increase judicial awareness, build
court capacity, and develop tools that courts can use to improve the
identification of and response to the growing problem of elder abuse.\"
The first meeting of the Working Group was convened in April 2006.
Recommendations were made in the following areas: to encourage judicial
leadership; to increase judicial and court awareness of elder abuse; to
foster the training of judges and court staff; to improve court
documentation of elder abuse; and to encourage funding agencies to
provide adequate resources to allow for an improved court response.
(Note: This paper is accessible online at:
<http://www.ncsconline.org/famviol/elderabuse/pdf/MeetingReportFINAL.pdf>
.)

129\. S6428-3

Underwood, R.

**Good Reasons to Take Elder Abuse Seriously**

Nursing Homes; Vol. 54 (9), 106-108; September 2005.

This brief article provides guidelines for nursing home administrators
to assess their facilities\' potential risk for elder abuse and neglect.
Two key issues are highlighted: the need to provide consumer education
on elder abuse and neglect; and the need to have in place a clear and
comprehensive protocol for addressing mistreatment. Specific
recommendations for achieving these goals are outlined.

130\. S6435-3

Walling, A.

**Intervention and Treatment Strategies for Elder Abuse**

American Family Physician; Vol. 72 (5), 896; September 2005.

This brief overview discusses the importance of assessing residential
arrangements, dementia, social isolation, mental illness, and substance
abuse in order to improve the identification of elder abuse and neglect
victims in primary care settings.

131\. S6472-28

Watts, L. & Sandhu, L.

**The 51st State - The \"State of Denial\": A Comparative Exploration of
Penal Statutory Responses to \"Criminal\" Elder Abuse in Canada and the
United States**

Elder Law Journal; Vol. 14; 2006.

In this article, the authors describe and compare the criminal justice
response to elder abuse in the U.S. and Canada. While the U.S. \"has
experienced a vibrant and substantive discussion of the issues related
to the criminality of elder abuse...,\" Canada has not. The current
status of the law of both countries is discussed, as well as factors
that may contribute to the differences. The authors argue that although
the Canadian penal response may be ultimately different from that of the
U.S., a national debate is long overdue. (Canada)

132\. S6388-7

West, S.

**Joining Up Adult Protection and the Disciplinary Process**

Journal of Adult Protection; Vol. 8 (1), 4-10; May 2006.

\"No Secrets,\" a report published in the U.K. by the Department of
Health and the Home Office in 2000, emphasized the need for multi-agency
policies in response to adult protection issues. The author is reporting
on the implementation of this approach in Peterborough and
Cambridgeshire, England. While the implementation has been generally
successful with collaboration among health care and mental health
professionals, housing officers, social services and law enforcement,
certain agencies have remained unintegrated in terms of reporting
suspected mistreatment and continue to act independently. The benefits
of the multi-agency, multidisciplinary approach are described in an
effort to encourage further coordination of services. (U.K.)

133\. S6166-6

Wislowski, A. & Cuellar, N.

**Voting Rights for Older Americans with Dementia: Implications for
Health Care Providers**

Nursing Outlook; Vol.54 (2), 68-73; March-April 2006.

In light of the aging U.S. population, the fact that seniors are the
most likely citizens to exercise the right to vote, and the likelihood
of the increase in the prevalence of dementia among voting aged
citizens, this article examines possible implications for health care
providers. Very little research exists on the voting patterns of
individuals diagnosed with dementia, but one small study (n=75) of
dementia caregivers revealed that nearly two-thirds of the sample with
dementia did vote, and it was not uncommon for caregivers to assist in
the voting process. Although some research suggests that certain
characteristic features of certain types and degrees of dementia affect
cognitive abilities operant in the voting process, other research
suggests that in and of itself, a diagnosis of dementia \"does not
presuppose inability to vote.\" The lack of a uniform policy regarding
voting for long-term care residents and homebound elders, access to
voter registration, and voting technology are among the topics
considered in the article. Physicians and other health care
professionals not only play a role in the functional assessment of
patients with dementia, but may also participate in the development,
testing, implementation, and monitoring of screening tests for voter
eligibility in order to preserve the civil liberties of voters with
dementia.

**IV. Books, Manuals and Training Resources**

134\. S6264-00\*

Banker\'s Academy of the Edcomm Group

**Focus on Elder Financial Abuse**

Banker\'s Academy, Edcomm Group; 2006.

By integrating text, graphics, sound, video, and interactive scenarios,
this online modular learning package is designed to educate employees of
banks and financial institutions regarding elder financial abuse and
exploitation, and their responsibilities to address the problem. The
program presents an overview of various types of elder financial abuse,
and includes information on recognizing the signs of exploitation,
protecting customers, and appropriately reporting suspected abuse. The
program can be tailored to the specific needs of the institution. For
more information on the program, including fees, visit the Banker\'s
Academy at: [http://bankersacademy.com](http://bankersacademy.com/) or
[http://bankersacademy.com/index.php?fromU%20of%20Del](http://bankersacademy.com/index.php?fromU of Del)
. )

135\. S6284-28\*

BITS

**BITS Fraud Protection Toolkit: Protecting the Elderly and Vulnerable
from Financial Fraud and Exploitation**

Washington, D.C.; February 2006.

This toolkit was developed to assist employees of banks and financial
institutions in addressing elder and vulnerable adult financial
exploitation. Descriptions are provided for numerous types of frauds,
scams and exploitation schemes, perpetrated by professional predators as
well as caregivers, family members, friends and acquaintances of the
victim. Guidelines for implementing employee training and protection
plans are outlined, as are guidelines for addressing suspected fraud.
The roles of loss prevention and legal departments are discussed, along
with recommendations for collaborating with external community, state
and federal agencies, adult protective services (APS) and law
enforcement. The toolkit also includes a list of consumer protection
tips, and a resource list for additional information, education and
training on elder financial abuse and related issues. (Note: BITS is a
nonprofit consortium comprised of executives from 100 of the largest
financial institutions in the US. The consortium fosters collaborative
approaches to emerging issues in the financial services field. The
toolkit is accessible online only at:
[http://www.bitsinfo.org/downloads/Publications%20Page/bitstoolfeb06.pdf](http://www.bitsinfo.org/downloads/Publications Page/bitstoolfeb06.pdf)
. The BITS Fraud Protection Guide: Protecting the Elderly and Vulnerable
from Financial Fraud and Exploitation, is also available online at:
[http://www.bitsinfo.org/downloads/Publications%20Page/bitselderly.pdf](http://www.bitsinfo.org/downloads/Publications Page/bitselderly.pdf)
.For additional resources, including a PowerPoint presentation on this
material, visit the BITS homepage at:
<http://www.bitsinfo.org/index.html> .)

136\. S6115-104

Brandl, B., for the National Clearinghouse on Abuse in Later Life
(NCALL)

**Mandatory Reporting of Elder Abuse: Implications for Domestic Violence
Advocates**

National Clearinghouse on Abuse in Later Life (NCALL)/Wisconsin
Coalition Against Domestic Violence (WCADV); 2005.

As quoted from the WCADV web site: \"Americans are growing older and
increasingly domestic violence programs are working with older victims.
In many states, domestic violence staff members are mandated reporters
of elder abuse. This issue paper is designed to assist domestic violence
advocates in finding the necessary information to engage in critical
analysis of how to provide safety and women-defined or victim-centered
advocacy in an environment of mandatory reporting of elder abuse.
Several key issues must be examined and analyzed when considering best
practice and development of policies, protocols, and procedures. This
project, in response to requests for information and technical
assistance by domestic violence advocates, was funded by the Office on
Violence Against Women, with legal research provided by the American Bar
Association Commission on Law and Aging\...\" (Note: This publication is
available online at:
[http://www.ncall.us/docs%5CMandatory_Reporting_EA.pdf](http://www.ncall.us/docs\Mandatory_Reporting_EA.pdf)
, by emailing <ncall@wcadv.org> or by telephoning (608) 255-0539.)

137\. S6255-00

GeroNurse Online

**Elder Mistreatment and Abuse**

GeroNurse Online; 2006

This online geriatric nursing education resource provides a succinct
overview of elder mistreatment, including definitions and examples,
background and epidemiology, risk factors, assessment and screening
tools, physical assessment, interventions and care strategies, and
expected outcomes. Decision trees and additional tools are included.
(Note: This tool is available online only at:
<http://www.geronurseonline.org/index.cfm?section_id=50&geriatric_topic_id=29&sub_section_id=216&page_id=476&tab=2>
.)

138\. S6350-225\*

Harris, D. & Benson, M.

**Maltreatment of Patients in Nursing Homes There Is No Safe Place**

Haworth Press, Inc.; Binghamton, NY: 2006.

This book presents an overview of issues of abuse, neglect and
exploitation involving nursing home residents and presents a framework
for developing practical methods of addressing these problems. In
addition, it presents the results of a nationwide study on thefts of
residents\' possessions and assets. Employees, administrators, and
family members of residents from 47 nursing homes throughout the U.S.
were surveyed on a wide range of topics, including the factors that
contribute to maltreatment, characteristics of residents and employees,
the bureaucracy of nursing homes, victimization rates, workforce issues,
and federal regulations for nursing homes. Recommendations for enhancing
the nursing home environment and reducing all forms of abuse are
generated, and include theft-prevention training programs, criminal
background checks and improved screening of potential employees,
education and advocacy for staff members, and the reform of federal
regulations. (Note: This book is not available through CANE. To
purchase, contact the publisher online at:
<http://www.haworthpress.com/store/product.asp?sku=5461> . Price: hard
cover: \$34.95 or soft cover: \$16.95. Telephone: 1-800-429-6784 in the
U.S./Canada or 607-722-5857 outside the U.S./Canada.)

139\. S6114-00\*

National Consumers League (NCL)

**Telemarketing Fraud Educators Toolbox**

National Consumers League (NCL); 2005.

As quoted from Justice Information, a newsletter of the U.S. Department
of Justice: \"\...The Telemarketing Fraud Educators Toolbox provides
tips, presentations, scripts for radio PSAs and speeches, and much more.
Materials are available in both English and Spanish\...\" The toolbox is
intended for \"representatives from government agencies, unions, social
service agencies, schools, and nonprofit organizations\... The Toolbox
is not intended for use by businesses, trade associations, or the media.
If you are not sure whether you qualify to use the Toolbox, please
contact NCL at toolbox@nclnet.org.\" (Not specific to elders.) (Note:
This resource is available online only at:
<http://www.fraud.org/toolbox/members.htm> .)

140\. S6334-00

New York Protective Services for Adults

**Facing the Challenges of Dementia: Tools to Support and Protect
Persons with Dementia**

New York Protective Services for Adults; 2006.

This online training course, designed specifically for New York\'s adult
protective services caseworkers, covers the following topics: Signs and
Symptoms of Dementia; Understanding the Disease; Communication
Strategies; Living Alone: Special Challenges; the Home Environment;
Day-to-Day Care; and Supporting Caregivers. (Note: This training
material is accessible online at:
[www.ocfs.state.ny.us/main/psa/cbt/dementia/dementia.htm](http://www.ocfs.state.ny.us/main/psa/cbt/dementia/dementia.htm)
.)

141\. S6140-55\*

Patronek, G., Loar, L. & Nathanson, J.

**Animal Hoarding: Structuring Interdisciplinary Responses to Help
People, Animals, and Communities at Risk**

The Hoarding of Animals Research Consortium/HARC; Tufts University, MA;
2006

While the majority of self-neglect cases do not involve animal hoarding,
animal hoarding cases often accompany cases of human self-neglect. This
manual contains the findings from a forum held in April, 2004, among
representative stakeholders (human health and welfare, municipal
government, and animal welfare) regarding the process of effective
intervention in animal hoarding cases. The goal of the forum was to
generate an understanding of the role each discipline plays in resolving
cases and minimizing recidivism. The manual presents an overview of
various stakeholders, and a plan to maximize the resources each brings;
discusses the means to foster cooperation among collaborating agencies;
identifies different types of hoarders; describes how to establish
integrated interventions based upon the characteristics of the agencies
involved, the hoarder and the specific case; and discusses the means to
reduce recidivism and to effect long-term change. Appendices include
models of documents needed to establish an interdisciplinary team,
including sample ordinances, statutory models, and memoranda of
understanding. (Note: This publication is available online at
<http://www.tufts.edu/vet/cfa/hoarding/pubs/AngellReport.pdf> . Hard
copies are available. Price (including s/h): \$15 each for orders of 1-5
copies \$10 each for orders of 6-15 copies. For orders of \>15 copies,
please contact us for volume discounts. Make check payable to MSPCA and
mail to: MSPCA, Attn: Jan Holmquist 350 South Huntington Avenue Boston,
MA 02130.)

142\. S6333-00

Williams, M.E.

**The Ethical Challenges of Elder Abuse (CME Course)**

Medscape CME Center; May 26, 2006.

This online CME course for physicians and other health professionals
summarizes a presentation delivered at the American Geriatrics Society
2006 Annual Scientific Meeting, entitled \"Ethical Dilemmas in Elder
Abuse: Successful Resolutions of Challenging Cases.\" It is intended to
enable health professionals to demonstrate an understanding of ethical
principles in their treatment of the older patient, recognize community
resources needed to assist in resolving difficult cases, identify
barriers and limitations in the social service and legal system; and
identify the threshold and appropriate approaches for reporting elder
abuse and the liabilities for failing to report. (Note: This course is
accessible online at:
[www.medscape.com/medscapetoday/cme](http://www.medscape.com/medscapetoday/cme)
. To find the session, type the search term \"Ethical Challenges of
Elder Abuse\".)

**V. Selected Federal Hearings**

143\. S6482-00

U.S. Senate Special Committee on Aging

**Caring for Seniors in a National Emergency: Can We Do Better?**

Washington, D.C.; May 18, 2006.

This hearing examines the needs of the vulnerable elderly during
national and local emergencies (such as the Gulf Coast hurricanes of
2005) with a focus on how to better prepare for such disasters.
Testimony was heard from the following witnesses: Maurice Frisella, a
senior who survived Hurricane Katrina, from New Orleans, LA; Jean
Cefalu, a former nurse and volunteer from Slidell, LA; Dan Sutherland,
Officer, Office for Civil Rights and Civil Liberties, Chair, Interagency
Coordinating Council on Emergency Preparedness and Individuals with
Disabilities, Department of Homeland Security, Washington, DC; Cindy
Bascetta, Director, Health Care, U.S. Government Accountability Office,
Washington, DC; Amy B. Aiken, Assistant Director, Miami-Dade Office of
Emergency Management, Miami, FL; Carmel Bitondo Dyer, M.D., Associate
Professor of Medicine, Director, Baylor College of Medicine Geriatrics
Program at The Harris County Hospital District, Houston, TX. (Note: The
testimony from this hearing can be accessed online from:
<http://aging.senate.gov/public/index.cfm?Fuseaction=Hearings.Detail&HearingID=170>
.)

144\. S6215-00

U.S. Senate Special Committee on Aging

**Not Born Yesterday: How Seniors Can Stop Investment Fraud**

Washington, D.C.; March 29, 2006.

According to the U.S. Federal Trade Commission\'s data, investment fraud
is responsible for significant losses among Americans aged 50 and over,
ranking fourth among all complaints lodged by this age group. This
hearing addresses the need for enhanced financial literacy among older
individuals, and emphasizes the need for prevention and intervention
programs, which would be funded through the proposed Elder Justice Act.
Testimony was provided by the following speakers: Ruth Mitchell, Victim
of Investment Fraud, Columbiana, OH; Barry Minkow, former scam artist,
San Diego, CA; Patricia Struck, President, North American Securities
Administration Association (NASAA), Washington, DC; Elisse Walter,
Executive Vice President, Policy & Oversight, National Association of
Securities Dealers (NASD), Washington, DC; and Susan Ferris Wyderko,
Acting Director, Division of Investment Management, U.S. Securities and
Exchange Commission (SEC), Washington, DC. (Note: The transcript and web
cast of this hearing are available online at:
<http://aging.senate.gov/public/index.cfm?Fuseaction=Hearings.Detail&HearingID=166>
.)

145\. S6478-00

U.S. Senate Special Committee on Aging

**Preparing Early, Acting Quickly: Meeting the Needs of Older Americans
During a Disaster**

Washington, D.C.; October 5, 2005.

In the wake of Hurricane Katrina, inadequacies in national, state, and
local emergency response systems were exposed. This hearing focuses on
how vulnerable adults and the elderly could be better served during such
disasters. Testimony was provided by the following witnesses: Keith Bea,
Specialist, American National Government, Government and Finance
Division, Congressional Research Service, Washington, DC; Maria Greene,
Director, Division of Aging Services, Georgia Department of Human
Resources, Atlanta, GA; Jeffrey Goldhagen, Director, Duval County Health
Department, Jacksonville, FL; Leigh Wade, Executive Director, Area
Agency on Aging of Southwest Florida, Inc., Fort Myers, FL; Carolyn S.
Wilken, P.hD., MPH. , Associate Professor, FYCS, Extension Special,
Gerontology, Gainesville, FL; Susan Waltman, Senior Vice President and
General Counsel, Greater New York Hospital Association, New York, NY.
(Note: Testimony from this can be accessed online from:
<http://aging.senate.gov/public/index.cfm?Fuseaction=Hearings.Detail&HearingID=100>
.)

146\. S6216-00

U.S. Senate Special Committee on Aging

**Old Scams - New Victims: Breaking the Cycle of Victimization**

Washington, D.C.; July 27, 2005.

This hearing focuses on scams, frauds, and identity theft, and their
impact upon older Americans. The following witnesses testified on
various types of financial exploitation, interventions, and prevention
initiatives: Lois C. Greisman, Associate Director, Federal Trade
Commission; Zane M. Hill, Acting Assistant Chief Inspector, United
States Postal Inspection Service; Anthony Pratkanis, Professor of
Psychology, University of California at Santa Cruz; Denise C. Park,
Director, National Institute on Aging Roybal Center for Healthy Minds,
University of Illinois; Helen Marks Dicks, Director, Elder Law Center,
Coalition of Wisconsin Aging Groups; and Vicki Hersen, Director of
Operations, Elders in Action, Portland, OR. Testimony also highlighted
scientific research that provides insight into the social, psychological
and physiological factors that contribute to the vulnerability of older
victims. (Note: The transcript and web cast of this hearing are
available online at:
<http://aging.senate.gov/public/index.cfm?Fuseaction=Hearings.Detail&HearingID=71>
.)

**Other Hearings Sponsored by the U.S. Senate Special Committee on Aging
from July 2005 through June 2006:**

06-27-2006 10:00 AM [The Globalization of Health Care: Can Medical
Tourism Reduce Health Care
Costs?](http://aging.senate.gov/public/index.cfm?Fuseaction=Hearings.Detail&HearingID=182)

06-21-2006 10:00 AM [Managing Retirement Assets: Ensuring Seniors Don\'t
Outlive Their
Savings](http://aging.senate.gov/public/index.cfm?Fuseaction=Hearings.Detail&HearingID=180)

05-25-2006 10:00 AM [Preparing For Pandemic
Flu](http://aging.senate.gov/public/index.cfm?Fuseaction=Hearings.Detail&HearingID=171)

05-03-2006 10:00 AM [Innovation in the Aging Network: The Future of
Social Services for Older
Americans](http://aging.senate.gov/public/index.cfm?Fuseaction=Hearings.Detail&HearingID=169)

04-06-2006 10:00 AM [Employment and Community Service for Low Income
Seniors: Are We Getting The Job
Done?](http://aging.senate.gov/public/index.cfm?Fuseaction=Hearings.Detail&HearingID=168)

03-15-2006 10:00 AM [Bridging the Gender Gap: Eliminating Retirement
Income Disparity for
Women](http://aging.senate.gov/public/index.cfm?Fuseaction=Hearings.Detail&HearingID=164)

03-09-2006 10:00 AM [Long-Term Care Financing: Are Americans
Prepared?](http://aging.senate.gov/public/index.cfm?Fuseaction=Hearings.Detail&HearingID=163)

02-02-2006 10:00 AM [Meeting The Challenges of Medicare Drug Benefit
Implementation](http://aging.senate.gov/public/index.cfm?Fuseaction=Hearings.Detail&HearingID=72)

10-05-2005 10:30 AM [Preparing Early, Acting Quickly: Meeting the Needs
of Older Americans During a
Disaster](http://aging.senate.gov/public/index.cfm?Fuseaction=Hearings.Detail&HearingID=100)

09-29-2005 10:00 AM [The Impact of Direct-to-Consumer Drug Advertising
on Seniors\' Health and Health Care
Costs](http://aging.senate.gov/public/index.cfm?Fuseaction=Hearings.Detail&HearingID=101)

07-20-2005 02:30 PM [Sound Policy, Smart Solutions: Saving Money In
Medicaid](http://aging.senate.gov/public/index.cfm?Fuseaction=Hearings.Detail&HearingID=70)

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\*This article has been highlighted in a previously posted annotated
bibliography. To search the [**CANE Bibliography
Series**](http://www.elderabusecenter.org/default.cfm?p=cane.cfm), go to
[**www.elderabusecenter.org/default.cfm?p=cane.cfm**](http://www.elderabusecenter.org/default.cfm?p=cane.cfm)
.

\*\*\* Although some publication dates may be earlier, these
publications first appeared in print during this time frame.

To search for earlier references on topics related to elder abuse,
please visit the **[CANE](http://db.rdms.udel.edu:8080/CANE) Web site**

at:

**<http://db.rdms.udel.edu:8080/CANE>** .