Physical and 

Emotional Abuse 

of the Elderly

Bryan K. Payne

No. 71

Problem-Specific Guides Series

Problem-Oriented Guides for Police 

Physical and Emotional Abuse of 

the Elderly

Brian K. Payne

This project was supported by Cooperative Agreement 

#2011-CK-WX-K019, awarded by the Office of Community Oriented 

Policing Services, U.S. Department of Justice. The opinions contained 

herein are those of the author(s) and do not necessarily represent the 

official position or policies of the U.S. Department of Justice. References to 

specific agencies, companies, products, or services should not be considered 

an endorsement of the product by the author(s) or the U.S. Department of 

Justice. Rather, the references are illustrations to supplement discussion of 

the issues. 

The Internet references cited in this publication were valid as of the date of 

this publication. Given that URLs and websites are in constant flux, neither 

the author(s) nor the COPS Office can vouch for their current validity.

© 2013 Center for Problem-Oriented Policing, Inc. The U.S. Department 

of Justice reserves a royalty-free, nonexclusive, and irrevocable license to 

reproduce, publish, or otherwise use, and authorize others to use, this 

publication for Federal Government purposes. This publication may be 

freely distributed and used for noncommercial and educational purposes.

www.cops.usdoj.gov

ISBN: 978-1-932582-67-3 

March 2013

Problem-Oriented Guides for Police

Problem-Specific Guides Series

Guide No. 71

Contents

Contents

About the Problem-Specific Guides Series. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Acknowledgments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

The Problem of Elder Physical and Emotional Abuse. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

What This Guide Does and Does Not Cover. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

General Description of the Problem. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Laws Relating to Elder Physical and Emotional Abuse. . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Harms Caused by Elder Physical and Emotional Abuse. . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Factors Contributing to Elder Physical and Emotional Abuse. . . . . . . . . . . . . . . . . . . . . . . 10

Vulnerable Targets. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Offender Motivations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Guardianship and Isolation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Community and Cultural Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Understanding Your Local Problem. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Stakeholders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Asking the Right Questions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Incidents. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Victims . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Offenders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Locations/Times. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Current Responses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Measuring Your Effectiveness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Outcome Measures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Process Measures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Responses to the Problem of Elder Physical and Emotional Abuse. . . . . . . . . . . . . . . . . 23

General Considerations for an Effective Response Strategy. . . . . . . . . . . . . . . . . . . . . . . 24

Specific Responses to Reduce Elder Physical and Emotional Abuse. . . . . . . . . . . . . . . . . 29

Responses with Limited Effectiveness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

Appendix A: Summary of Responses to Elder Physical and Emotional Abuse. . . . . . . . 35

References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

Endnotes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

About the Author. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

Other Problem-Oriented Guides for Police. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

| 1 |

About the Problem-Specific Guides Series

About the Problem-Specific Guides Series

The Problem-Specific Guides summarize knowledge about how police can reduce the 

harm caused by specific crime and disorder problems. They are guides to prevention and 

to improving the overall response to incidents, not to investigating offenses or handling 

specific incidents. Neither do they cover all of the technical details about how to implement 

specific responses. The guides are written for police—of whatever rank or assignment—

who must address the specific problem the guides cover. The guides will be most useful to 

officers who:

•	 Understand basic problem-oriented policing principles and methods. The 

guides are not primers in problem-oriented policing. They deal only briefly with the 

initial decision to focus on a particular problem, methods to analyze the problem, 

and means to assess the results of a problem-oriented policing project. They are 

designed to help police decide how best to analyze and address a problem they 

have already identified. (A companion series of Problem-Solving Tools guides has 

been produced to aid in various aspects of problem analysis and assessment.)

•	 Can look at a problem in depth. Depending on the complexity of the problem, 

you should be prepared to spend perhaps weeks, or even months, analyzing and 

responding to it. Carefully studying a problem before responding helps you 

design the right strategy, one that is most likely to work in your community. 

You should not blindly adopt the responses others have used; you must decide 

whether they are appropriate to your local situation. What is true in one place 

may not be true elsewhere; what works in one place may not work everywhere.

•	 Are willing to consider new ways of doing police business. The guides describe 

responses that other police departments have used or that researchers have tested. 

While not all of these responses will be appropriate to your particular problem, they 

should help give a broader view of the kinds of things you could do. You may think 

you cannot implement some of these responses in your jurisdiction, but perhaps you 

can. In many places, when police have discovered a more effective response, they 

have succeeded in having laws and policies changed, improving the response to the 

problem. (A companion series of Response Guides has been produced to help you 

understand how commonly-used police responses work on a variety of problems.) 
| 2 |

Physical and Emotional Abuse of the Elderly

•	 Understand the value and the limits of research knowledge. For some types 

of problems, a lot of useful research is available to the police; for other problems, 

little is available. Accordingly, some guides in this series summarize existing research 

whereas other guides illustrate the need for more research on that particular problem. 

Regardless, research has not provided definitive answers to all the questions you 

might have about the problem. The research may help get you started in designing 

your own responses, but it cannot tell you exactly what to do. This will depend 

greatly on the particular nature of your local problem. In the interest of keeping the 

guides readable, not every piece of relevant research has been cited, nor has every 

point been attributed to its sources. To have done so would have overwhelmed and 

distracted the reader. The references listed at the end of each guide are those drawn 

on most heavily; they are not a complete bibliography of research on the subject. 

•	 Are willing to work with others to find effective solutions to the problem. The 

police alone cannot implement many of the responses discussed in the guides. They 

must frequently implement them in partnership with other responsible private and 

public bodies including other government agencies, non-governmental organizations, 

private businesses, public utilities, community groups, and individual citizens. An 

effective problem-solver must know how to forge genuine partnerships with others 

and be prepared to invest considerable effort in making these partnerships work. 

Each guide identifies particular individuals or groups in the community with whom 

police might work to improve the overall response to that problem. Thorough 

analysis of problems often reveals that individuals and groups other than the police 

are in a stronger position to address problems and that police ought to shift some 

greater responsibility to them to do so. Response Guide No. 3, Shifting and Sharing 

Responsibility for Public Safety Problems, provides further discussion of this topic.

The COPS Office defines community policing as “a philosophy that promotes 

organizational strategies, which support the systematic use of partnerships and problemsolving techniques, to proactively address the immediate conditions that give rise to public 

safety issues such as crime, social disorder, and fear of crime.” These guides emphasize 

problem-solving and police-community partnerships in the context of addressing specific public 

safety problems. For the most part, the organizational strategies that can facilitate problemsolving and police-community partnerships vary considerably and discussion of them is 

beyond the scope of these guides.
| 3 |

About the Problem-Specific Guides Series

These guides have drawn on research findings and police practices in the United States, 

the United Kingdom, Canada, Australia, New Zealand, the Netherlands, and Scandinavia. 

Even though laws, customs and police practices vary from country to country, it is apparent 

that the police everywhere experience common problems. In a world that is becoming 

increasingly interconnected, it is important that police be aware of research and successful 

practices beyond the borders of their own countries.

Each guide is informed by a thorough review of the research literature and reported 

police practice, and each guide is anonymously peer-reviewed by a line police officer, a 

police executive and a researcher prior to publication. The review process is independently 

managed by the COPS Office, which solicits the reviews. 

For more information about problem-oriented policing, visit the Center for ProblemOriented Policing online at www.popcenter.org. This website offers free online access to:

•	 The Problem-Specific Guides series

•	 The companion Response Guides and Problem-Solving Tools series

•	 Special publications on crime analysis and on policing terrorism

•	 Instructional information about problem-oriented policing and related topics

•	 An interactive problem-oriented policing training exercise

•	 An interactive Problem Analysis Module

•	 Online access to important police research and practices

•	 Information about problem-oriented policing conferences and award programs
| 4 |

Physical and Emotional Abuse of the Elderly

Acknowledgments

The Problem-Oriented Guides for Police are produced by the Center for Problem-Oriented 

Policing, whose officers are Michael S. Scott (Director), Ronald V. Clarke (Associate 

Director), and Graeme R. Newman (Associate Director). While each guide has a primary 

author, other project team members, COPS Office staff, and anonymous peer reviewers 

contributed to each guide by proposing text, recommending research and offering 

suggestions on matters of format and style. 

The project team that developed the guide series consisted of Herman Goldstein (University 

of Wisconsin Law School), Ronald V. Clarke (Rutgers University), John E. Eck (University 

of Cincinnati), Michael S. Scott (University of Wisconsin Law School), Rana Sampson 

(Police Consultant), and Deborah Lamm Weisel (North Carolina State University). 

Members of the San Diego; National City, California; and Savannah, Georgia police 

departments provided feedback on the guides’ format and style in the early stages of the 

project.

Kimberly Nath oversaw the project for the COPS Office. Phyllis Schultze conducted 

research for the guide at Rutgers University’s Criminal Justice Library. Nancy Leach 

coordinated the Center for Problem-Oriented Policing’s production process. Peter M. Slavin 

edited this guide.
| 5 |

About the Problem-Specific Guides Series

The Problem of Elder Physical and 

Emotional Abuse

What This Guide Does and Does Not Cover

This guide begins by describing the problem of elder physical and psychological abuse and 

reviewing factors that increase its risks. It then identifies a series of questions to help you 

analyze your local elder abuse problem. Finally, it reviews responses to the problem and 

what is known about these from evaluative research and police practice.

Elder physical and emotional abuse are but two components of the larger set of problems 

related to maltreatment of vulnerable persons. This guide is limited to addressing the 

particular harms created by elder physical and emotional abuse. Related problems not 

directly addressed in this guide, each of which requires separate analysis, include:

•	 Abuse of developmentally disabled persons

•	 Child abuse and neglect

•	 Domestic violence

•	 Elder neglect

•	 Elder sexual abuse

•	 Financial exploitation of the elderly

•	 Human trafficking

•	 Patient abuse

Some of these related problems are covered in other guides in this series, all of which are 

listed at the end of this guide. For the most up-to-date listing of current and future guides, 

see www.popcenter.org. 
| 6 |

Physical and Emotional Abuse of the Elderly

General Description of the Problem

Elder physical and emotional abuse are two types of elder maltreatment that frequently 

occur simultaneously. The National Center on Elder Abuse defines physical abuse as “the 

use of physical force that may result in bodily injury, physical pain, or impairment.”1

Physically abusive acts include hitting, kicking, shaking, and a number of other acts. 

Emotional abuse (also known as psychological abuse) is defined as “the infliction of anguish, 

pain, or distress through verbal or nonverbal acts.”2 Harassment, making threats, and 

intimidation are examples of emotional abuse. In some states emotional abuse of persons 

receiving formal health care is specified as illegal by statute. In Delaware, for example, a 

statute outlaws emotional abuse under this definition: “ridiculing or demeaning a patient or 

resident, making derogatory remarks to a patient or resident or cursing directed towards a 

patient or resident, or threatening to inflict physical or emotional harm to a patient.”3

The first National Elder Abuse Incident Study found that approximately 450,000 older 

persons reported experiencing abuse or neglect in 1996.4 A later national study found that 

about 565,000 older persons reported experiencing abuse or neglect in 2003, with abuse 

substantiated in about one-third of those cases.5 Physical abuse made up about 11 percent 

of the substantiated cases and emotional abuse about 15 percent. Elder neglect, financial 

exploitation, and self-neglect made up the bulk of the remaining cases.

These figures underestimate the extent of elder physical and emotional abuse. Some older 

victims are unable to report their victimization because of cognitive impairments, and others 

are reluctant to report their mistreatment for one or more of the following reasons:

•	 Fear of retaliation

•	 Fear of being placed in a nursing home or becoming destitute

•	 Religious beliefs that dictate honoring one’s spouse (in elder domestic violence cases)

•	 Mistrust of the police

•	 Self-blame

•	 Feelings of futility

•	 Embarrassment6

Less than a third of elder physical abuse victims contact the police about their 

victimization.7
| 7 |

The Problem of Physical and Emotional Abuse of the Elderly

Even though emotional abuse is the most frequent type of elder maltreatment—

estimates suggest that approximately one in twenty older persons are emotionally/

psychologically abused each year8—victims are especially unlikely to report emotionally 

abusive acts, primarily because there are no visible injuries and they may fear the 

consequences of reporting.9

It is commonly estimated that between one and two million individuals are victims of elder 

abuse in the United States each year.10 In domestic settings, estimates from the National 

Elder Mistreatment Study suggest that about one in 62 older persons, or about 575,000 

in all, experience physical abuse each year.11 As the number of elderly persons living in the 

United States continues to grow, these numbers are likely to increase in the future. The 

percentage of people living in the United States who were elderly increased 15.1 percent 

between 2000 and 2010. A higher proportion of elderly persons now lives in the United 

States than at any time in its history.12

Regarding abuses occurring in institutional settings, a survey of nursing assistants from 10 

nursing homes participating in an abuse prevention training program found that roughly 

one in six reported engaging in physically abusive behaviors and about half reported yelling 

at residents in the previous 30 days.13 There is some evidence that for-profit homes have 

more abuse complaints than nonprofit homes.14 Larger facilities also have a higher rate of 

complaints. While some have suggested that living in a nursing home is a risk factor for 

physical and emotional abuse, an estimated 90 percent of abuse cases reported to adult 

protective services (APS) occur in domestic settings.15

A survey of nursing assistants found 

that one in six reported engaging 

in physical abuse and about half 

reported yelling at residents.
| 8 |

Physical and Emotional Abuse of the Elderly

In both domestic and institutional settings, females are more likely than males to 

experience elder abuse.16 Males are more likely to abuse males and females are more likely 

to abuse females.17 Regardless of gender, among older crime victims, more than half have 

experienced both physical and emotional abuse.18 Among older women who experienced 

physical abuse, 95 percent also experienced psychological abuse.19 In addition, these acts do 

not occur just once; instead, they often re-occur among those victims who experience abuse.

In long-term-care settings, the majority of physical and emotional abuse is committed by 

nurse’s assistants.20 Part of the reason that assistants have higher rates of abusive behavior is 

simply that they have more contact with residents than other staff. Another reason may be 

that the licensing and educational requirements for nurse’s assistants are much lower than 

they are for nurses, physicians, directors, and other long-term-care staff.21

Laws Relating to Elder Physical and Emotional Abuse

Laws of various kinds define elder physical and emotional abuse or prescribe the legal 

interventions available in these cases. These laws include:

•	 Protective order statutes

•	 Adult protective services (APS) statutes

•	 Guardianship laws

•	 State health care and nursing home licensing laws

•	 Medicare/Medicaid laws

•	 Specific elder abuse laws

•	 Long-term-care ombudsmen laws

•	 Traditional criminal laws (e.g., assault and battery, domestic violence)

•	 Penalty enhancement laws

•	 Mandated reporting laws22

Forty-nine states and the District of Columbia define elder maltreatment laws in their 

protective services legislation.23 Emotional abuse is prohibited in the APS statutes of 42 

states.24 Some states have laws requiring APS workers and the police to share information 

on certain types of cases.25
| 9 |

The Problem of Physical and Emotional Abuse of the Elderly

Harms Caused by Elder Physical and Emotional Abuse

Both elder physical and emotional abuse can have a devastating impact on victims, their 

family members, and communities. The consequences of these offenses include:

•	 Fear of future victimization is a frequent response. This fear may keep victims from 

reporting the abuse to authorities.26

•	 Physical abuse may cause serious injuries, and existing health or physical problems may 

be exacerbated by the abuse. Older persons are more likely than younger persons to be 

physically harmed by certain types of physical abuse.

•	 Health problems may result from either physical or emotional abuse. Older women 

who suffer psychological abuse are more likely to report ailments, such as bone or joint 

problems, high blood pressure, and digestive problems.27

•	 Victims often fall into depression as a result of either emotional or physical abuse.28

Depression may place older victims at a high risk for subsequent victimization.

•	 Loss of independence occurs when the abuse causes physical impairments. In addition, 

older victims living in domestic settings may be moved to nursing homes as a result of 

their victimization. 

•	 Victims lose trust in their caregivers, the institutions providing care to them, and/or the 

system they believe failed them. Victims may lose trust in individuals whom they once 

trusted (namely, spouses, adult offspring, and formal or paid caregivers).

•	 Older physical and emotional abuse victims commonly feel guilt and shame. Many 

blame themselves for their victimization, especially if they see themselves as burdening 

their caregivers. Others experience shame, particularly when adult offspring are the 

perpetrators. It’s generally believed that the older victim, feeling responsible for their 

victimization, may be ashamed that they raised a child capable of abusing others.

•	 Victims incur financial losses from treatment to deal with the physical and emotional 

consequences of these offenses.

•	 Secondary victimization occurs when individuals suffer emotional harm from hearing 

about the victimization of their peers. This dynamic is believed to be especially 

common among older victims.

•	 Elder physical abuse may also lead to death, either as the result of one severe incident or 

repeated mistreatment.

Researchers have only recently begun to explore the ties between mortality and elder 

abuse. One study found that elder abuse victims are about three times more likely to 

die prematurely than non-abuse victims.29 It is believed that many elder homicides are 

misclassified as deaths due to natural causes. 
| 10 |

Physical and Emotional Abuse of the Elderly

Factors Contributing to Elder Physical and Emotional Abuse

Understanding the factors that contribute to your problem will help you frame your 

own local analysis questions, determine appropriate effectiveness measures, recognize 

key intervention points, and select appropriate responses. This guide identifies the most 

common factors contributing to elder physical and emotional abuse. In some instances, 

additional factors may lead to abuse. After working with the various stakeholders involved 

in the collaborative response to elder abuse, law enforcement personnel will be able to 

identify risk factors that may not be addressed in this guide. 

Elder abuse researchers and criminologists have cited various explanations for elder physical 

and emotional abuse. These explanations are easily understood through an examination of 

vulnerable targets, offender motivations, the absence of guardianship, and community and 

cultural factors. 

Vulnerable Targets

Not all older persons experience victimization. Certain factors increase an older person’s 

risk. Two commonly cited risk factors are the presence of Alzheimer’s/dementia and 

dependency. Providing care to individuals with Alzheimer’s and related forms of dementia 

is especially challenging and may increase the odds of committing abusive acts. In some 

situations, caregivers react to violent behaviors initiated by the individual with dementia, 

while in others the caregiver’s aggression is tied to the strain that caregivers experience. 

Approximately one in ten caregivers of those with dementia reported physically abusing the 

individual in their care.30 Spouses are more likely to be violent toward care recipients who 

suffer from dementia, especially if they live in the same residence and if the care recipient 

sometimes hits the caregiver or is otherwise disruptive.31

Older individuals’ dependence on their relatives has also been cited as a factor that makes 

them more vulnerable. Gerontologists use the phrase “generational inversion” to refer to the 

process by which older individuals lose their independence and become more dependent 

on relatives who once depended on them. The dependence can be emotional, logistical, or 

financial.32 Elders with cognitive impairments are especially dependent on others and this 

dependence increases the risk of victimization. About one-fourth of those dependent on 

others have experienced elder emotional abuse.33
| 11 |

The Problem of Physical and Emotional Abuse of the Elderly

The nature of the dependence may influence the victim’s decision to contact the police. 

Being dependent on another person for care may cause victims to think about the 

consequences of not having the offender present to provide care. Dependence on a spouse 

for care inhibits older persons from reporting physical or emotional abuse by that person.34

Dependency varies across older persons. As a group, elderly persons are not nearly as 

dependent on younger persons as some may believe. Older people who report being 

mistreated are especially able to maintain independence in the criminal justice system and 

do things that make the system work for their interests.35

Offender Motivations 

Offender motivations refer to factors that increase offenders’ likelihood that 

they will be physically or emotionally abusive toward older persons. Offender 

motivations for committing elder abuse include the following:

•	 Mental illness. Living with an adult with mental health problems increases 

the risk of elder abuse. Those with Alzheimer’s or related forms of dementia 

may act aggressively toward their caregiver, who is often an older person with 

his own health problems.36 It has been estimated that about one-third of 

caregivers are “pinched, shoved, bit, kicked, or struck” by their care recipients.37

One-fourth of caregivers who experienced abuse reported abusing the care 

recipient in response to the victimization. Individuals with Alzheimer’s are 

about twice as likely as those without the disease to be physically abused.38

•	 Substance abuse. Drug and alcohol abuse is a risk factor for elder physical 

abuse. Some of these cases may involve adult offspring who have substanceabuse problems that result in their living at home with their aging 

relatives. Combined with the inability to find and keep a job, substance 

abuse issues increase the likelihood of abuse in these situations.

•	 Histories of violence. A history of being abused as a child may predict 

one will commit elder abuse.39 However, child abuse victims are 

more likely to become child abusers than elder abusers.40 A history of 

violence in marriage may predict elder domestic violence, given that 

abusers do not stop abusing simply by reaching a certain age.41
| 12 |

Physical and Emotional Abuse of the Elderly

•	 Dependence. An offender’s dependence on aging relatives can also be a 

motivation for offending. Consider instances where an adult offspring lives at 

home with aging relatives because of his/her own problems (e.g., unemployment, 

relationship problems). For perpetrators, dependence on their parents may make 

them feel worthless and devalued. Offenders may use violence to compensate for 

their atypical dependence on their aging relatives. Similarly, those who commit 

emotional abuse are also more likely to be dependent on their victims.42 The 

emotional abuse may be their way of addressing feelings of worthlessness. 

•	 Burden. Caregivers experience physical and financial stress from caring for their 

aging relatives, and they sacrifice a great deal of their own time along the way. 

Stress, by itself, is not necessarily a predictor of elder abuse; rather, adaptations 

to stress are more likely the precipitating factors. Providing care to an aging 

relative is stressful for almost anyone, but many people provide such care without 

becoming abusive. But for those providing long-term care, the risk of burnout, 

aggression, and patient conflict increase, along with the risk of abuse.43

•	 Rationalizations. Elder abusers sometimes rationalize their abusive behavior.44

They may deny responsibility by blaming caregiving demands for their abuse, 

or they may claim the victim’s behavior precipitated the abuse. Perpetrators 

of emotional abuse may claim that the abuse did not harm the victim.

Guardianship and Isolation

The more socially isolated older individuals are, the more at risk they are for physical 

abuse.45 Socially isolated individuals are less likely to be protected by loved ones, public 

safety professionals, or other potential guardians. Isolation is so problematic in elder abuse 

cases that some have argued that when individuals actively isolate older persons to gain 

power and control over their lives, this amounts to emotional abuse.46 It is also argued 

that the isolation found in long-term-care settings may place residents at a higher risk for 

maltreatment.47
| 13 |

The Problem of Physical and Emotional Abuse of the Elderly

Community and Cultural Factors 

Community and cultural factors also contribute to elder physical and emotional abuse. In 

some cities, high poverty rates contribute to unemployment, which leads to adult offspring 

living at home with their aging parents. As noted, having unemployed adults live at home 

with aging relatives is a risk factor for elder maltreatment. In addition, residents providing 

care to Alzheimer’s patients in disadvantaged areas are less likely to accept formal services, 

which may place them at a higher risk for maltreatment.48 Also, services available for older 

victims vary across rural and urban communities.49 Fewer services not only put individuals 

in some communities at higher risk for victimization, but the consequences of victimization 

are more difficult to address when certain services are not available. 

Community factors also bear on institutional abuses. Urban areas, for example, have been 

found to have higher abuse rates in nursing homes.50 This difference potentially stems 

from the higher crime rates found in urban areas, and the difficulties of finding appropriate 

staff for these positions in these communities. In addition, nursing homes are distributed 

unequally across cities, making it more difficult for some loved ones to act as de facto 

guardians by visiting their aging relatives. 

Cultural factors may also promote elder abuse. Cultures with high respect for the elderly 

have lower elder abuse rates.51 Cultures that devalue the elderly, in turn, promote values 

and behaviors that place older persons at risk. Ageism refers to attitudes or practices that 

systemically discriminate against the elderly population. Ageist attitudes foster abusive 

behaviors. In addition, a culture’s level of altruism (willingness to help others) is tied to 

elder abuse. For example, institutional abuses have been tied to a culture’s willingness to 

devote scarce financial resources to help those in need. The more charitable counties are, 

the lower their rate of institutional abuses.52 Similarly, putting profit (a cultural value) 

before high-quality health care places older individuals at risk for patient abuse. 

| 15 |

Understanding Your Local Problem

Understanding Your Local Problem

The information provided above is only a generalized description of elder physical and 

emotional abuse. You must combine the basic facts with a more specific understanding 

of your local problem. Analyzing the local problem carefully will help you design a more 

effective response strategy. 

Stakeholders

In addition to criminal justice agencies, the following groups have an interest in elder 

physical and emotional abuse and ought to be considered for the contribution they might 

make to gathering information about the problem and responding to it:

•	 Adult protective services officials receive complaints about various types of elder abuse, 

investigate those complaints, and refer victims to available services.

•	 Aging advocates, including AARP,

† help develop programs that serve older victims.

•	 Area agency on aging representatives assist in identifying available programs and 

generating understanding about the needs of older persons in the community.

•	 Clergy may identify cases of elder abuse and refer victims to protective services or police.

•	 Coroners and medical examiners review fatalities and identify cases of fatal elder 

maltreatment.

•	 County geriatricians help identify cases of elder abuse and recommend services to help 

older victims.

•	 Domestic violence programs can assist in responding to cases of elder abuse that involve 

intimate partners.

•	 Elder law advocates can help victims address legal issues that surface when they separate 

themselves from offenders with whom they lived.

•	 Older persons can assist in developing responses and programs that are tailored to the 

needs of their peers and may be able to devote their time to volunteer programs that 

prevent or respond to elder abuse.

•	 Emergency services/first responders are often the first to identify cases of elder physical 

abuse.

•	 Regulatory agencies supervising facilities provide important information about long-termcare facilities in the community.

† AARP was formerly named the American Association of Retired Persons.
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Physical and Emotional Abuse of the Elderly

•	 Guardians are appointed to oversee and protect older persons, particularly their financial 

interests, and may prevent or identify cases of physical or emotional abuse.

•	 Hospital discharge planners can help physical abuse victims find safe environments.

•	 Legislators can write additional laws to protect the elderly and provide necessary funding 

for programs and response strategies.

•	 Long-term-care ombudsmen receive complaints about elder maltreatment in long-term 

settings and advocate for the victims.

•	 Medicaid Fraud Control Unit officials respond to cases of patient abuse reported in longterm-care businesses receiving Medicaid or Medicare funding.

•	 Medical providers assist in identifying cases of elder abuse and providing treatment to 

victims.

•	 Medical social workers identify cases of elder abuse and help direct victims toward 

appropriate services.

•	 Mental health caseworkers respond to cases involving victims or offenders who suffer 

from Alzheimer’s or related forms of dementia.

•	 Pharmacists may be able to identify vulnerable older persons if caregivers appear to be 

abusing prescription drugs.

•	 Probation and parole officers may be able to identify cases of elder abuse if offenders are 

living with vulnerable parents, grandparents, or other older persons.

•	 Postal workers are potential guardians who may be able to identify signs of isolation and 

emotional abuse.

•	 Public health workers are often able to help develop community-based prevention 

programs. 

•	 Public welfare caseworkers can assist victims in identifying available financial resources in 

the community. 

•	 Senior centers provide access to older persons who might be willing and able to 

participate in community-based, collaborative responses to elder abuse, and their staff 

are in position to identify cases of elder abuse.

•	 Transportation workers who focus on transporting older adults (for example, drivers 

of senior vans or buses that stop at long-term-care facilities) may be able to identify 

apparent cases of physical and emotional abuse.

•	 Victim/witness advocates help older victims navigate the criminal justice system.
| 17 |

Understanding Your Local Problem

Asking the Right Questions

To respond effectively to elder physical and emotional abuse, you need to clearly define 

these terms for purposes of analysis. In addition, you will need to reach agreement with 

other key agencies on how to collect and maintain data about older victims. Appropriate 

data collection strategies will help you to better understand elder physical and emotional 

abuse in your community and will aid in your response to the problem. 

The following are some critical questions you should ask in analyzing elder physical and 

emotional abuse, even if the answers are not always readily available. Your answers to these 

and other questions will help you choose the most appropriate set of responses later on. 

These questions may not apply in all situations, and some may call for answering over time 

to determine which responses to elder physical and emotional abuse are effective.

Incidents

•	 How many incidents of elder physical and emotional abuse are reported to your agency?

•	 What proportion constitutes physical abuse? What proportion constitutes emotional 

abuse?

•	 What type and degree of harm is being caused to elders in these incidents?

•	 What proportion of cases involves isolated abuse incidents? What proportion involves 

repeated abuse?

•	 What percentage of all crime victims are over the age of 60?

•	 What are the dynamics surrounding cases involving elder physical and emotional abuse?

•	 How many reports of elder abuse do adult protective services receive? 

•	 From what sources are elder abuse incidents reported and how many reports are 

received from each source (victims, victims’ friends or relatives, eldercare institutions, 

APS, medical service providers, and others)?

•	 How much elder physical and emotional abuse do you estimate is unreported in your 

community? 

•	 Does your agency cross report with APS?
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Physical and Emotional Abuse of the Elderly

Victims 

•	 What are the demographics of elder abuse victims in terms of age, gender, and race/

ethnicity?

•	 What percentage of residents in your community is elderly? What is the age breakdown 

of older residents?

•	 What proportion of elder abuse victims are married?

•	 What proportion of elder abuse victims live in a private residence? What proportion of 

those is in single-family houses? Apartments?

•	 What proportion of elder abuse victims live alone?

•	 What proportion of elder abuse victims suffer from a mental illness, such as Alzheimer’s 

disease or a related form of dementia?

•	 Which groups (health care providers, advocates, family members of victims, victims, or 

others) report elder abuse most often to police and APS? Do certain groups appear to 

be either over-represented or under-represented in the proportion of elder abuse reports 

made to officials?

Offenders

•	 What are the demographic characteristics of elder abusers in terms of their age, gender, 

and race/ethnicity?

•	 What proportion of elder abusers are known to the victim? What proportion lives with 

their victim? Work for their victim? Provide care for their victim?

•	 What proportion of elder abusers has criminal records?

•	 What proportion of elder abusers exhibited signs of stress?

•	 What percentage of elder abusers were the primary caregivers for the person they 

victimized?

•	 What percentage of elder abusers has a history of substance abuse? 

•	 What percentage of elder abusers has a history of mental health problems? 

Locations/Times

•	 Where do the elder physical and emotional abuse incidents occur?

•	 How many cases occur in domestic settings versus long-term-care facilities?

•	 Are certain long-term-care settings more prone than others to have complaints/reports 

about elder abuse?

•	 Does your community have a high number of unlicensed adult care homes?
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Understanding Your Local Problem

Current Responses

•	 Are there enough long-term-care services available in your community to meet the 

demand? (GIS can be used to map incidents involving older persons to help determine 

whether appropriate services are accessible in parts of the community where they are 

needed.)

•	 Are APS resources adequate for the caseload?

•	 Does APS routinely contact the police about reports it receives of suspected elder abuse?

•	 Are there specific laws about elder abuse in your state?

•	 What resources are available to help caregivers of older persons in your community? 

What resources are available to help older persons receiving care in your community?

•	 What strategies does your agency use to reduce the isolation of older persons in your 

community?

•	 What procedures are in place for police officers assigned to investigate elder abuse 

reports? What training do investigating officers receive in elder abuse? Do your officers 

know how to contact APS officials? 

•	 Do mandatory reporting laws exist in your state? Who are the mandated reporters? Are 

police officers mandated reporters? 

•	 Are there penalty enhancement statutes for cases involving older victims in your state? 

Do these statutes appear to be effective or counterproductive?

•	 Are there state or federal patient abuse investigators in your community? 

•	 What types of programs are available for seniors in your community? Does your 

community have Meals on Wheels, adult day care, or similar programs?

•	 Does your state require criminal background checks for those working in elder care 

settings?

•	 Does your state have an elder abuse registry?

•	 Does your state collect data on elder abuse?

•	 Are elder advocates available to help older persons in your community?

•	 Are domestic violence advocates available to help older victims?

•	 What domestic violence shelters are able to help elder abuse victims effectively? 

•	 Other than arrest, what alternatives do police officers have in elder physical and 

emotional abuse cases?

•	 Are your victim specialists adequately trained to help older victims?

•	 Does your department have a strong working relationship with social services?

•	 Are specific officers or a special unit in your department assigned to elder abuse cases?
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Physical and Emotional Abuse of the Elderly

•	 What types of outreach efforts does your department use to increase awareness about 

elder physical and emotional abuse?

•	 Does your agency track repeat elder abusers?

•	 Does your agency have a system for checking in on vulnerable older adults?

•	 How do other agencies (for example, prosecutor’s office, victim/witness office, the 

courts) respond to these crimes?

•	 Has your agency executed collaboration agreements with other agencies governing 

response to elder physical and emotional abuse?

•	 How often do officers in your department accompany APS workers on APS calls?

Measuring Your Effectiveness

Measurement allows you to determine to what degree your efforts have succeeded and 

suggests how you might modify your responses, if they are not producing the intended 

results. 

You should take measures of your problem before you implement responses to determine 

how serious the problem is, and after you implement them to determine whether 

they have been effective. You should take all measures in both the target area and the 

surrounding area. For more detailed guidance on measuring effectiveness, see ProblemSolving Tools Guide No. 1, Assessing Responses to Problems: An Introductory Guide for Police 

Problem-Solvers, and Problem-Solving Tools Guide No. 10, Analyzing Crime Displacement 

and Diffusion.

The following are potentially useful measures of the effectiveness of responses to 

elder physical and emotional abuse. Outcome measures relate to the impact that your 

responses have on the problem. Process measures relate to the implementation of 

responses to the problem. 

Outcome Measures

•	 Reduced number of elder abuse incidents

•	 Reduced injury and/or emotional trauma to elder abuse victims

•	 Increased sense of safety and security in the home among elderly citizens
| 21 |

Understanding Your Local Problem

Process Measures

•	 Number of calls for services from older adults, either as victims, witnesses, or 

complainants

•	 Time between onset of elder abuse and first reporting to authorities

•	 Number of police reports referred to adult protective services

•	 Number of referrals from adult protective services

•	 Number of elder abuse prosecutions

•	 Number of cases dropped involving older victims because of victim or witness problems

•	 Number of requests made to police for speaking engagements to senior groups

•	 Number of meetings and community education sessions attended related to elder abuse

•	 Degree of awareness of elder abuse among community members

•	 Number of officers receiving training about elder physical and emotional abuse

•	 Degree of turnover in specialized units devoted to elder abuse cases

•	 Existence of interagency protocols related to elder physical and emotional abuse 

•	 Number of agencies involved in a coordinated response to elder abuse

•	 Changes in communication with various officials involved with elder abuse

•	 Number of programs available for older victims in the community

•	 Number of volunteers available to assist in response to elder abuse

•	 Changes in perceptions of police among older adults in the community

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Responses to the Problem of Physical and Emotional Abuse of the Elderly

Responses to the Problem of Elder Physical 

and Emotional Abuse

Your analysis of your local problem should give you a better understanding of the factors 

contributing to it. Once you have analyzed your local problem and established a baseline 

for measuring effectiveness, you should consider possible responses to address the problem. 

The following response strategies provide a foundation of ideas for addressing your 

particular problem. These strategies are drawn from a variety of research studies and police 

reports. Several of these strategies may apply to your community’s problem. 

It is critical that you tailor responses to local circumstances and that you can justify each 

response based on reliable analysis. In most cases, an effective strategy will involve several 

different responses. Law enforcement responses alone are seldom effective in reducing or 

solving the problem. 

Do not limit yourself to considering what police can do: carefully consider whether others 

in your community share responsibility for the problem and can help police better respond 

to it. The responsibility of responding, in some cases, may need to be shifted toward 

those who have the capacity to implement more effective responses. For more detailed 

information on shifting and sharing responsibility, see Response Guide No. 3, Shifting and 

Sharing Responsibility for Public Safety Problems.

For further information on managing the implementation of response strategies, see 

Problem-Solving Tools Guide No. 7, Implementing Responses to Problems.
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Physical and Emotional Abuse of the Elderly

General Considerations for an Effective Response Strategy

Responding to elder physical and emotional abuse cases can be complex and time 

consuming. The police role in elder abuse cases generally entails investigation, enforcement, 

and referral.53

1. Improving police understanding of elder abuse. Police officers must learn to watch 

for signs of elder abuse. Compared to other crimes, however, most police practitioners 

receive little training about elder abuse. Improved awareness of elder abuse is key to 

improving service delivery to older victims.54 In the early 1990s, some states began 

to train police officers about aging, elder abuse, and how to detect, investigate, and 

prevent the latter.55, † While researchers have not specifically examined whether 

gerontology training programs for police improve the response to elder abuse, studies 

have found that community training increases reports to APS,56 support for formal 

responses to elder abuse,57 and elder abuse substantiation rates.58 Training in and 

of itself will not improve the response to elder physical and emotional abuse, and in 

some cases, may be ineffective, particularly if officers are trained about elder abuse best 

practices but are not provided the tools to apply the best practices.

Elder abuse training should cover the following topics:59

•	 Demographics of aging and myths and facts about aging

•	 Sensitivity issues 

•	 Dynamics surrounding elder physical and emotional abuse 

•	 Recognizing signs of elder abuse 

•	 Mandatory reporting laws 

•	 Improving awareness about issues in residential care settings

•	 Risk assessments

•	 How to work with various agencies in the elder abuse network 

•	 Mandatory reporting laws 

•	 How to work with elder abuse victims 

† With funding from the U.S. Department of Justice Office of Violence Against Women, the National Sheriff’s Association 

and the Federal Law Enforcement Training Center developed and delivers training for police officers about elder abuse as well 

as a train-the-trainers course so that communities can develop their own community-specific training courses (Brandl and 

Dawson 2011).
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Responses to the Problem of Physical and Emotional Abuse of the Elderly

Recent studies have been especially effective in helping police understand bruises 

as a sign of physical abuse. One study concluded that if police officers see bruises 

somewhere other than on the older person’s torso, arms, or legs, they should raise 

questions about elder physical abuse.60 Other evidence suggests that bruises on both 

sides of the body and “wrap-around” bruises are rarely accidental.61 Bruises from elder 

physical abuse can be distinguished from accidental bruises: they tend to be larger 

and on the victim’s face, torso or right arm (the right arm presumably because of the 

victim’s efforts to defend him/herself).62

National City, California, police officers responded to numerous calls at one residence over 

a 10-year period. Within two years alone, they visited the residence on 67 separate occasions. 

Traditional efforts failed to eradicate the problems reported at the home. After examining the 

situation through a different lens, the neighborhood policing team recognized that the owner of 

the home—an elderly woman—was being taken advantage of by her daughter and grandson, 

who routinely brought gang members, drug users, and parolees to the home. Working with APS 

and other agencies, a public guardian was assigned to the woman and she was moved to an 

assisted-living facility. The daughter and grandson had to leave the residence and the calls for 

police to that home stopped. By recognizing that they were dealing with elder abuse, rather than 

traditional crimes, the neighborhood policing team was able to end the problem.63

2. Developing policies and protocol that communicate the importance of addressing 

elder abuse. Whereas most police departments have domestic violence policies, fewer 

have elder physical and emotional abuse policies. Police officers in agencies that do 

not clearly define police roles in elder abuse cases tend to understand less about elder 

abuse.64 The policies and protocol should define the roles and responsibilities of 

various agencies involved in responding to these cases. In addition, policies should 

convey that the abuses should be taken seriously. States with harsher penalties in 

elder abuse laws and policies have higher rates of investigation in elder abuse cases.65

Where laws and policies clearly define elder abuse as problematic, police and APS 

investigators tend to respond accordingly. After the West Columbia, South Carolina, 

Police Department developed the protocol and policies for its family violence unit, 

arrests for elder abuse increased 500 percent.66
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Physical and Emotional Abuse of the Elderly

3. Promoting collaborative efforts to respond to elder abuse. Victims of elder abuse 

require multiple interventions from criminal justice and social services professionals to 

be best served. A study of 83 elder abuse cases found that 473 intervention strategies 

had been employed to help the victims, an average of about six intervention strategies 

per case.67 In Rhode Island, eight different agencies with competing missions and 

goals respond to elder abuse.68 Because of the diverse agencies and the wide range of 

potential interventions, collaboration has been described as the “optimal method” for 

addressing elder abuse.69 By promoting awareness among team members, reducing 

duplication of effort, and minimizing turf battles, collaborative efforts benefit older 

persons, service recipients, and the community.70 Collaborative efforts are especially 

effective if they provide the victim with individual attention from a wide range of 

human services professionals.71

The police role in collaborative efforts can be quite broad. Officers may be called 

upon to determine if a crime was committed, make arrests, conduct well-being 

checks, assist with investigations, and file police reports and/or charges on behalf 

of the collaborative response team.72 In some cases, the police may take the lead in 

developing the efforts. The St. Petersburg, Florida, Police Department, for example, 

created an assisted living facility task force after receiving numerous calls for service 

from certain assisted-living facilities. One facility averaged 10 calls per month over a 

6-month period. Working with other agencies serving vulnerable adults and elderly 

residents, the task force was able to shut down or force the sale of the problem 

facilities. Police calls to the facilities ended.73

The following factors can make it difficult for police to collaborate with other agencies 

in elder physical and emotional abuse cases:

•	 Distrust between agencies

•	 Different beliefs about risk factors

•	 Communication barriers 

•	 Heavy workloads

•	 Lack of funding

•	 Ageism 

•	 Misunderstanding about each 

agency’s role

•	 Lack of participation

•	 Confidentiality concerns

•	 Unclear expectations

•	 Personal conflicts74

Some of these problems may surface in the early stages of collaborative efforts. 

As representatives get to know one another and learn more about elder abuse, the 

obstacles can be overcome. Local laws that require police participation in collaborative 

efforts have been described as especially effective because they convey the importance 

of collaboration.75 The collaborating agencies should develop interagency protocols 

that describe their respective roles. 
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Responses to the Problem of Physical and Emotional Abuse of the Elderly

4. Customizing police responses to the special needs of elderly victims. Police 

referrals for some form of social services intervention are frequent in elder abuse cases. 

Some of the standard procedures for investigating conventional crimes and addressing 

victims’ needs might not work well in elder abuse cases. For example, health and 

physical impairments of many older victims can make it difficult or impossible 

for them to take certain measures to protect themselves.76 In response, in 2005 in 

Jefferson County, Kentucky, steps were taken to allow homebound individuals over 

the age of 60 to seek emergency protective orders over the telephone.77

Older victims have different needs and risk factors than younger victims. Some older 

victims commonly require a broad range of social services and especially need help 

navigating the service network and criminal justice system. Offering general programs, 

services, and activities to older victims is likely to be ineffective.78 So is applying child 

abuse models and strategies to respond to elder abuse.79

In the early 1990s, the Rhode Island Senior Citizens Police Advocate Program

placed an advocate for older persons in every police department in the state. The advocates 

received specialized training about older persons and served as an important bridge between the 

agencies and members of the community.80 Under this program, specialized officers rather than 

general patrol officers handled cases with older victims.81 The program reduced the workload of 

patrol officers and improved community relations.

The Community Police Partnership Unit in Glendale, California, created the First 

Responder Program by focusing on intervention and education for first responders to elder 

abuse. The unit formed a multidisciplinary partnership and developed a screening instrument that 

first responders were trained to use when they encountered older vulnerable adults. The program 

led to an increase in the number of older persons referred to police and a higher number of 

older adults receiving appropriate services. Officers believed that early intervention saved police 

time in the long term.82

The Milwaukee Police Department created the Senior Citizen Assault Prevention 

Unit in 1980. Subsequently called the Gray Squad, the unit was assigned primary responsibility 

for serving older victims. An evaluation found that victims served through this program were more 

satisfied with the police than were victims served through traditional responses.83
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Physical and Emotional Abuse of the Elderly

5. Reducing general community and cultural risk factors. Efforts to address 

community-level risk factors—such as high unemployment rates (important because 

unemployed adult offspring may target their aging parents or other relatives for 

abuse), lack of services for older mentally ill individuals and their families, and 

isolation of older persons—should reduce elder abuse rates. While police departments 

can do little to influence a community’s unemployment rate, they can take an active 

role in providing services to older persons and reducing their isolation. Strategies to 

provide services can be specifically directed toward reducing the isolation of older 

persons through many of the measures described below. In addition, the police can 

take a lead role in combating ageism in a community. An initial step should be 

ensuring that police officers have an adequate level of understanding about the elderly 

population and that misunderstandings about the elderly do not foster ageist reactions 

to elder abuse. For example, the assumption that all elderly persons are as vulnerable 

as children must be countered. Holding such a belief might prompt some professionals 

to treat elder abuse victims the same way that they would treat child abuse victims. 

Such a response would not help older victims. Training in aging issues can give police 

officers the knowledge they need to serve this population.

Cultural issues also need attention. Professionals tend to view issues through their own 

cultural perspectives and may fail to recognize the role of specific cultural issues in 

elder abuse cases.84 In cases involving Asian victims, for instance, older persons may 

be more reluctant to participate in the justice process because their culture emphasizes 

the importance of family and avoiding actions that would embarrass the family.85

By contrast, traditional American values place a stronger emphasis on individualism. 

Older immigrants may be reluctant to participate in the criminal justice system out of 

a fear of being deported. It is imperative that officers recognize the cultural differences 

that surface, and administrators must ensure that officers are culturally competent. 

Cultural competence can avoid issues arising from language barriers, trust problems, 

and concerns about revictimization.
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Responses to the Problem of Physical and Emotional Abuse of the Elderly

Specific Responses to Reduce Elder Physical and Emotional Abuse

6. Checking on elderly people at home. Some police departments have found success 

in developing home visit programs. In general, home visit programs are either 

proactive or reactive. Proactive programs entail police officers identifying vulnerable 

older persons and visiting them at different times to reduce their isolation. In reactive 

programs specially trained officers visit older victims after their initial contact with 

police to check in on the individual. In Chicago, an officer from the Senior Citizen’s 

Services Section visits elder abuse victims within 2 weeks of that person’s first contact 

with the police.86 Visits from specialized officers increase the likelihood that victims 

will seek services, call the police for future help, and hold more favorable attitudes 

toward the police.87 Most home visits to elder abuse victims take only 5 to 20 

minutes of officers’ time.88

Some police departments have used telephone technology to add additional 

guardianship to older individuals. The Norfolk, Virginia, Sheriff’s Department, 

for example, created the Check and Respond Everyday (CARE) program, using 

computer software to call and check in on isolated adults several times a day. If no 

one answers the call, an officer is sent to the home.89 The Kansas City, Missouri, 

Police Department created its own “Senior Watch” program, which allowed older 

residents to have information about themselves saved in a secure database should 

police be called to their residence. In this program, if residents do not come to the 

door when police are called to that residence, the police can check the database 

to see if neighbors or family members have keys to the residence and whether the 

resident has pressing medical issues.90 Other departments have developed programs 

where criminal justice officials personally call older vulnerable adults to talk to them 

about crime prevention and check on their welfare. The Glendale, California, Police 

Department developed the “Caring Caller Program,” which used volunteers to call 

homebound older adults on a weekly basis.91

As a word of caution, second-response programs, which entail follow-up visits to 

victims from specially-trained law enforcement officers or social workers, do not 

always lower the likelihood of subsequent abuse, especially if the programs are 

implemented without other services or programs being provided to victims and 

offenders.92
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Physical and Emotional Abuse of the Elderly

7. Undertaking community outreach. Police can be involved in educating the public 

about elder physical and emotional abuse on topics such as how to recognize, report, 

and prevent abuse.93 Raising public awareness about elder abuse risk factors can 

reduce the isolation of older adults, both by informing elderly people how to protect 

themselves and by informing others how to protect elderly people. The World Health 

Organization has encouraged communities to formally recognize elder abuse through 

“calls to action” that emphasize the need for a community-wide response.94 Outreach 

efforts should target places frequented by elderly people (such as churches, health care 

offices, and senior centers).95 Abuse prevention tips like the following can be shared 

with older persons to reduce their vulnerability:

•	 Reduce your isolation

•	 Use buddy systems where feasible to check on each other regularly

•	 Engage in volunteer activities

•	 Increase your visits to and from friends

•	 Resist the temptation to allow adult offspring with problems to live with you

•	 Maintain positive relationships with relatives who are helpful96

The media can be helpful in community outreach. Although newspapers tend to 

publish about 20 times as many articles on child abuse as on elder abuse, elder abuse 

receives more media coverage in regions of the country where criminal justice officials 

are active in responding to elder abuse. As an illustration, the San Diego UnionTribune newspaper published ten times as many articles about elder abuse than did 

the Boston Herald over a 4-year period. The researchers posited that investigators 

in San Diego had developed better relationships with local reporters than had been 

formed in other parts of the country.97

8. Promoting the use of ombudsmen to watch for abuse in long-term elder care 

facilities. Ombudsmen can help monitor for elder abuse in nursing homes and other 

long-term-care facilities.98 Ombudsmen programs, developed as part of the 1965 

Older Americans Act, receive and investigate complaints of all types about abuse 

occurring in nursing homes. While advocating on behalf of the residents, by law 

ombudsmen will not contact the police about suspected cases of mistreatment without 

the victim’s consent.99 They are especially helpful in identifying minor problems and 

addressing them before they escalate to more serious offenses.100 Ombudsmen should 

be taught to recognize facility policies and building-security conditions that increase 

the risks of abuse and taught how to advocate for improvements.101 Nursing homes 

with volunteer resident-advocates as part of the ombudsmen program tend to have 

lower rates of abuse, which suggests that the volunteers also serve as effective abuse 
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Responses to the Problem of Physical and Emotional Abuse of the Elderly

monitors.102 Some states permit nursing homes to install video surveillance cameras 

(sometimes referred to as “granny cams”) in their residents’ rooms to guard against 

physical and emotional abuse, although their use raises many privacy concerns.103

9. Checking the backgrounds of professional caregivers. Criminal background checks 

and abuser registries are ways to identify those with histories of abusing vulnerable 

adults. In most states, those hiring caregivers can purchase criminal background 

checks from the state police. Some states require criminal background checks for 

individuals working in licensed facilities, but individuals hiring their own caregivers 

might not do their own background checks unless they are encouraged to do so. 

Police administrators can also consider supporting abuse registry policies. Twenty-one 

states have registries that list individuals convicted of elder abuse offenses.104 Licensed 

facilities are expected to consult the registries before hiring employees who would 

have contact with vulnerable adults. Of course, background checks and registries do 

not protect residents from being abused by fellow residents.105

10. Participating in elder abuse centers. Demonstrating the need for a collaborative 

response, communities across the United States are developing elder abuse centers 

to respond to these cases. There are two primary types of centers: elder forensic 

centers and elder justice centers. Elder forensic centers bring together medical, social 

service, and criminal justice professionals to review possible elder abuse cases, educate 

one another about elder abuse, and identify appropriate interventions.106 Elder 

forensic centers differ from multidisciplinary teams: they meet more often, have 

more members, and are more focused on specific tasks related to investigations.107

The first elder abuse forensic center was developed in Orange County, California, 

in 2003 to provide abuse victims a one-stop shop through an initiative led by the 

University of California, Irvine’s program in geriatrics.108 Since then, forensic centers 

have developed in several other locations, including New York City, Houston,109 San 

Diego,110 Los Angeles,111 and San Francisco. Elder abuse forensic centers have been 

shown to be efficient and effective.112

Elder justice centers are focused specifically on the criminal justice process. In the 

early 2000s, Palm Beach County, Florida, created an elder justice center to “enhance 

linkages between elder adults, the courts, and legal and social services systems within 

the community.”113 Center employees assist victims in navigating the judicial system 

and identify older defendants with mental health issues to divert them from the 

criminal justice system and into mental health programs. Placing advocates, officers, 

prosecutors, and others in the same office makes it much easier for older victims to 

navigate the justice system.114
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Physical and Emotional Abuse of the Elderly

11. Developing elder abuse fatality review teams. Elder abuse fatality review teams are 

interdisciplinary, multi-professional groups that review fatalities to more accurately 

identify the cause of death in elderly persons. As of 2007, 11 states had these teams 

in place.115 Composed of coroners, police and prosecutors, medical examiners, social 

workers, health care workers, and others, the teams collect information about the 

victim, perpetrator, risk factors, and circumstances surrounding the death.116 The 

teams tend to serve one of two purposes: (1) identify suspicious deaths for subsequent 

prosecutions or (2) identify systemic problems in need of change.117 These review 

teams allow professionals to learn about elder physical abuse from one another and 

to improve the collaborative response system.118 The U.S. Department of Justice 

Office for Victims of Crime has developed a replication manual to assist jurisdictions 

in developing their own elder abuse fatality review teams. The manual provides an 

overview of why the teams are needed, how they evolved historically, issues that arise 

in forming teams, team activities, and strategies to maintain the team.119

Responses with Limited Effectiveness

12. Enacting elder abuse laws and policies in isolation from other effective practices 

and strategies. Laws that are passed and implemented without considering the 

victims’ needs or available services have limited effectiveness in responding to elder 

physical and emotional abuse. Penalty enhancement statutes and mandatory reporting 

laws are illustrative. Penalty enhancement statutes provide for longer sentences for 

crimes that involve older victims. Ironically, research shows that penalties given to 

some elder abusers are actually shorter in states with these laws than are the penalties 

in states without the laws.120 One possible explanation is that the statutes are used to 

leverage plea bargains, which defeat the very purpose of the statutes. 

A similar situation arises with regard to mandatory reporting laws. Based on child 

abuse reporting statutes, these laws were passed in the 1980s, even though no research 

supported the need for the laws. In addition, police officers were not trained in how 

to enforce the laws and no funding was provided to implement the laws.121 Thus, 

mandatory reporting laws, by themselves, should not be seen as an effective response 

to elder physical and emotional abuse.
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Responses to the Problem of Physical and Emotional Abuse of the Elderly

13. Adopting mandatory arrest and prosecution policies. Although many police 

administrators are inclined to adopt aggressive responses to elder abuse, including 

mandatory arrest policies, such policies are potentially ineffective. Arrest and 

prosecution is not always the best option in elder abuse cases. For one thing, in 

contrast to child abuse cases, for example, older victims have more of a voice in selfdetermination.122 Whereas children may not have a choice about being removed from 

a violent home, older persons should be given such a choice. 

Second, arresting and incarcerating the abuser may force the victim to move into an 

assisted living arrangement as they may not be able to manage living alone. They 

may be placed in a nursing home despite their lack of interest in nursing home 

care, and such a placement might not be in the victim’s best physical, emotional, or 

financial interests. Sometimes criminal prosecutions jeopardize the victim’s wellbeing. 

Advocates and elder abuse experts have long argued that the safety of the victim 

should take precedence over punishing the offender.123

To be sure, in some elder abuse cases arrests are necessary. When arrest is supported 

by the evidence and appears to be the appropriate course of action, police should 

initiate the arrest if local law permits, rather than leaving that responsibility to the 

victim. When family violence victims are expected to file the official complaint, they 

suffer a higher rate of further abuse than when the police make the arrest.124 When 

victims file the arrest complaint, the possibility that the offender will retaliate against 

the victim increases.

14. Punishing older offenders with Alzheimer’s/dementia. Some cases of elder abuse 

may involve individuals with Alzheimer’s/dementia being abusive toward those 

caring for them. In these situations, it is important to recognize that the aggressor 

usually lacks the capacity to form the intent to commit a crime. These individuals 

should not be treated as violent criminals; rather, the goals should be to protect 

the victim from further harm and to treat the offender medically. Cases of this sort 

should automatically be referred to adult protective services. APS officials can assist 

the caregiver and care recipient in understanding the services and resources available 

to them. In situations involving nursing home residents whose dementia results 

in repeated abuses of other residents, the emphasis should be on getting facility 

administrators and staff to better protect residents from abusive fellow residents, and 

holding them legally accountable if they fail to do so.125

| 35 |

Appendix 

Appendix A: Summary of Responses to Elder 

Physical and Emotional Abuse

The table below summarizes the responses to elder physical and emotional abuse, the 

mechanism by which they are intended to work, the conditions under which they ought to 

work best, and factors to consider before implementing a particular response. It is critical 

that you tailor responses to local circumstances and that you can justify each response based 

on reliable analysis. In most cases, an effective strategy will involve implementing several 

different responses. Law enforcement responses alone are seldom effective in reducing or 

solving the problem.

Response 

No.

Page 

No.

Response How It Works Works Best If... Considerations

General Considerations for an Effective Response Strategy

1 24 Improving police 

understanding of 

elder abuse

Improves response 

to elder physical and 

emotional abuse 

by better preparing 

professionals for 

these cases

...training covers 

a range of specific 

topics

Limited evaluation 

of its overall impact 

on the problem; 

may be ineffective 

if not backed up by 

adequate resources 

to respond to elder 

abuse cases

2 25 Developing policies 

and protocol that 

communicate the 

importance of 

addressing elder 

abuse

Improves quality 

of investigations 

by providing 

specific directions 

and emphasizing 

seriousness of the 

problem

...policies and 

protocol are clear 

and specify nature 

of interagency 

relationships 

Policies must be 

reinforced through 

monitoring and 

enforcement

3 26 Promoting 

collaborative efforts 

to respond to elder 

abuse

Ensures that 

victims will 

receive appropriate 

interventions 

from multiple 

professionals 

...professionals 

are committed to 

working together 

and focused on the 

goal of protecting 

vulnerable older 

adults; backed by 

laws that require 

collaboration 

Requires attention 

to factors that 

commonly 

undermine 

interagency 

collaborations
| 36 |

Physical and Emotional Abuse of the Elderly

Response 

No.

Page 

No.

Response How It Works Works Best If... Considerations

4 27 Customizing police 

responses to the 

special needs of 

elderly victims

Ensures that 

interventions are 

responsive to older 

persons’ needs

...tailored to local 

conditions

Requires extra time 

and effort to develop 

special responses for 

elderly victims

5 28 Reducing general 

community and 

cultural risk factors

Reduces general 

risk factors that 

contribute to elder 

abuse

...special attention is 

given to risk factors 

affecting highestrisk victims (e.g., 

elderly persons with 

adult children as 

caregivers, mentally 

ill elderly persons)

Difficult for police 

to affect general 

communitylevel factors 

such as poverty, 

unemployment, and 

isolation of elderly 

persons; impact on 

the problem may be 

difficult to measure

Specific Responses to Reduce Elder Physical and Emotional Abuse

6 29 Checking on elderly 

people at home

Provides a layer of 

guardianship to 

vulnerable adults

...targeted at 

highest-risk 

victims; personal 

and technological 

methods are 

integrated; 

intervention 

responses are 

available if needed

Requires extra time 

and effort by police, 

but technology can 

improve efficiency

7 30 Undertaking 

community outreach

Reduces 

victimization risk 

by spreading abuse 

prevention tips 

and encouraging 

reporting of abuse

...the community 

has a “call to action” 

to demonstrate 

concern about the 

problem; targeted at 

places that seniors 

regularly visit

Media can assist 

in outreach efforts 

if encouraged by 

criminal justice 

leaders 
| 37 |

Appendix 

Response 

No.

Page 

No.

Response How It Works Works Best If... Considerations

8 30 Promoting the use 

of ombudsmen to 

watch for abuse in 

long-term elder care 

facilities

Improves 

guardianship and 

reporting 

...ombudsmen are 

properly trained, 

including in police 

role in responding to 

elder abuse

Advocates in nursing 

homes may not be 

permitted by law to 

report abuse without 

victim consent; 

ombudsmen 

primarily serve 

victims, not 

police; surveillance 

technology can be 

useful, but raises 

privacy issues 

9 31 Checking the 

backgrounds 

of professional 

caregivers

Limits offenders’ 

access to vulnerable 

older persons

...policies and 

laws require abuser 

registries or criminal 

background checks

Background checks 

will not always 

show criminal 

backgrounds from 

other states; will 

have no effect on 

abuse committed by 

fellow residents

10 31 Participating in elder 

abuse centers

Improves systemic 

response to problem 

...dedicated 

space is made 

available where 

all professional 

responders can meet 

regularly 

Elder abuse 

forensic centers 

are distinct from 

multidisciplinary 

teams: they meet 

more regularly, are 

larger, and require 

greater effort to 

coordinate

11 32 Developing elder 

abuse fatality review 

teams

Helps detect and 

apprehend offenders, 

reducing future risk 

to other victims; 

improves systemic 

responses to elder 

abuse

...purpose of the 

team is clearly 

established and all 

relevant responders 

regularly participate

Requires time and 

effort to establish 

and maintain; may 

require special 

information-sharing 

agreements
| 38 |

Physical and Emotional Abuse of the Elderly

Response 

No.

Page 

No.

Response How It Works Works Best If... Considerations

Responses with Limited Effectiveness

12 32 Enacting elder abuse 

laws and policies in 

isolation from other 

effective practices 

and strategies

...criminal laws are 

used in conjunction 

with social service 

interventions

If penalty enhancers 

are used merely for 

plea bargaining, net 

effect may be weaker 

sentences

13 33 Adopting mandatory 

arrest and 

prosecution policies

...victim’s 

individual needs 

and preferences are 

considered when 

deciding whether to 

arrest and prosecute 

offender 

Victims may lose 

their independence 

and experience more 

harm than good if 

offender is arrested; 

if arrest is to be 

made, police should 

initiate the action, 

rather than putting 

burden on victim to 

do so

14 33 Punishing older 

offenders with 

Alzheimer’s/ 

dementia

...victims are 

protected and 

offender is treated 

medically; case is 

referred to APS; 

care facility is made 

to improve security 

to protect potential 

victims

Offender usually 

cannot form intent 

to commit the crime
| 39 |

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| 47 |

Endnotes

Endnotes

1. Teaster et al. (2006).

2. Teaster et al. (2006).

3. Daly and Jogerst (2006, p. 25).

4. Teaster et al. (2006). 

5. Teaster et al. (2006). 

6. Heisler (2000); Payne (2011); Reay and Browne (2001). 

7. Bulman (2010); Acierno et al. (2010).

8. Acierno et al. (2010).

9. Begle et al. (2011).

10. Bonnie and Wallace (2003). 

11. Bulman (2010) provides estimate extrapolating from Acierno et al. (2010).

12. Brandon (2012).

13. Pillemer and Hudson (1993).

14. Allen, Kellett, and Gruman (2003). 

15. Teaster et al. (2006).

16. Brownell (1998); Klein et al. (2008).

17. Payne (2011). 

18. Post et al. (2010).

19. Fisher, Zink, and Regan (2011). 

20. Payne (2011).

21. Payne (2011).

22. Gittler (2008); Howze and White (2010).

23. Daly and Jogerst (2006). 

24. Daly and Jogerst (2001).

25. Brandl et al. (2007).

26. Payne (2011).
| 48 |

Physical and Emotional Abuse of the Elderly

27. Fisher and Regan (2006). 

28. Fisher and Regan (2006).

29. Lachs et al. (1998). 

30. Coyne, Reichman, and Berbig (1993).

31. Pillemer and Suitor (1992). 

32. Kang and Lynch (2010).

33. Cooper, Selwood, and Livingston (2008). 

34. Kang and Lynch (2010). 

35. Brownell (1998).

36. Pillemer and Suitor (1992). 

37. Coyne, Reichman, and Berbig (1993).

38. Paveza et al. (1992).

39. Reay and Browne (2001). 

40. Korbin, Anetzberger, and Austin (1995). 

41. Payne (2011).

42. Powell and Berman (2006).

43. Pillemer and Moore (1990); Payne (2011).

44. Tomita (1990). 

45. Bonnie and Wallace (2003).

46. Leisey, Kupstas, and Cooper (2009). 

47. Hawes and Kimball (2009).

48. Payne (2011).

49. Nusbaum et al. (2006). 

50. Jogerst et al. (2006). 

51. Payne (2011).

52. Payne (2011).

53. Dolon and Hendricks (1989).
| 49 |

Endnotes

54. Zevitz and Gurnack (1991). 

55. Rykert (1994). 

56. Wolf and Li (1999).

57. Bell, Oyebode, and Olliver (2004).

58. Jogerst et al. (2004).

59. Hawes and Kimball (2009); Payne (2011); Shibley (1995).

60. Connolly (2010). 

61. Illinois State Triad (1998). 

62. Bulman (2010). 

63. National City Police Department (2002).

64. Plotkin (1996).

65. Jogerst et al. (2005). 

66. West Columbia Police Department (2008).

67. Nahmiash and Reis (2000).

68. Klein et al. (2008).

69. McNamee and Mulford (2007). 

70. Nerenberg (2003); Quinn and Heisler (2002).

71. Groh and Linden (2011). 

72. Nerenberg (2003).

73. St. Petersburg Police Department (1997).

74. Dolon and Hendricks (1989); Nerenberg (2003); Plotkin (1988).

75. U.S. Department of Justice (2000).

76. Fisher and Regan (2006); Payne (2011). 

77. Stiegel and Teaster (2011).

78. Nahmiash and Reis (2000). 

79. White and Lawry (2009).

80. Shibley (1995, p. 24).
| 50 |

Physical and Emotional Abuse of the Elderly

81. Gilfillan (1994). 

82. Glendale Police Department (2001).

83. Zevitz and Gurnack (1991).

84. McGee (1997).

85. Grayson (2001).

86. Amendola et al. (2010). 

87. Stover et al. (2010). 

88. Davis, Medina, and Avitabile (2001, p. 21).

89. Payne (2011).

90. Kansas City Police Department (1999).

91. Glendale Police Department (2001).

92. Davis, Weisburd, and Hamilton (2007).

93. Miller and Johnson (2003).

94. World Health Organization (2002).

95. Leisey, Kupstas, and Cooper (2009). 

96. Douglass (1992).

97. Payne (2011). 

98. Cox (2008); Payne and Gainey (2006). 

99. Brandl et al. (2007).

100. Allen, Kellett, and Gruman (2003). 

101. Payne (2011). 

102. Allen, Kellett, and Gruman (2003).

103. Nerenberg (2008).

104. Teaster et al. (2006).

105. Connolly (2010).

106. Connolly (2010).

107. Schneider et al. (2010). 
| 51 |

Endnotes

108. McNamee and Mulford (2007).

109. Navarro et al. (2010).

110. San Diego Police Department (2003).

111. Navarro et al. (2010).

112. Wiglesworth et al. (2006, p. 27). 

113. Stiegel and Teaster (2011).

114. San Diego Police Department (2003). 

115. Connolly (2010). 

116. Nerenberg (2008). 

117. Stiegel (2005). 

118. Stiegel (2005). 

119. Stiegel (2005). 

120. Payne and Gainey (2006).

121. Payne (2011). 

122. Plotkin (1996). 

123. Wiglesworth et al. (2006). 

124. Klein (2008). 

125. Lachs et al. (2007).

| 53 |

About the Author

About the Author

Brian K. Payne

Brian K. Payne is professor and chair of the Department of Criminal Justice and 

Criminology at Georgia State University. He has authored more than 140 scholarly 

journal articles and seven books including Crime and Elder Abuse: An Integrated Perspective;

Family Violence and Criminal Justice: A Life Course Approach; and White-Collar Crime: 

The Essentials. He serves on the editorial board of numerous journals, including Journal of 

Criminal Justice, Criminal Justice Policy Review, Journal of Family Violence, and Journal of 

Elder Abuse and Neglect. He is a past president of the Southern Criminal Justice Association 

and the second vice president of the Academy of Criminal Justice Sciences. He is the 

recipient of the Southern Criminal Justice Association’s Outstanding Educator Award and 

Indiana University of Pennsylvania’s Department of Criminology Distinguished Alumni 

Award. He received his doctorate in criminology from Indiana University of Pennsylvania.

| 55 |

Other Problem-Oriented Guides for Police

Other Problem-Oriented Guides for Police

Problem-Specific Guides Series:

1. Assaults in and Around Bars, 2nd Edition. Michael S. Scott and Kelly Dedel. 2006. 

ISBN: 1-932582-00-2

2. Street Prostitution, 2nd Edition. Michael S. Scott and Kelly Dedel. 2006. 

ISBN: 1-932582-01-0

3. Speeding in Residential Areas, 2nd Edition. Michael S. Scott with David K. 

Maddox. 2010. ISBN: 978-1-935676-02-7

4. Drug Dealing in Privately Owned Apartment Complexes. Rana Sampson. 2001. 

ISBN: 1-932582-03-7

5. False Burglar Alarms, 2nd Edition. Rana Sampson. 2007. ISBN: 1-932582-04-5

6. Disorderly Youth in Public Places. Michael S. Scott. 2001. ISBN: 1-932582-05-3

7. Loud Car Stereos. Michael S. Scott. 2001. ISBN: 1-932582-06-1

8. Robbery at Automated Teller Machines. Michael S. Scott. 2001. 

ISBN: 1-932582-07-X

9. Graffiti. Deborah Lamm Weisel. 2002. ISBN: 1-932582-08-8

10. Thefts of and From Cars in Parking Facilities. Ronald V. Clarke. 2002. 

ISBN: 1-932582-09-6

11. Shoplifting, 2nd Edition. Ronald V. Clarke. 2013. ISBN: 978-1-932582-34-5

12. Bullying in Schools. Rana Sampson. 2002. ISBN: 1-932582-11-8

13. Panhandling. Michael S. Scott. 2002. ISBN: 1-932582-12-6

14. Rave Parties. Michael S. Scott. 2002. ISBN: 1-932582-13-4

15. Burglary of Retail Establishments. Ronald V. Clarke. 2002. ISBN: 1-932582-14-2

16. Clandestine Methamphetamine Labs, 2nd Edition. Michael S. Scott and Kelly 

Dedel. 2006. ISBN: 1-932582-15-0

17. Acquaintance Rape of College Students. Rana Sampson. 2002. 

ISBN: 1-932582-16-9

18. Burglary of Single-Family Houses. Deborah Lamm Weisel. 2002. 

ISBN: 1-932582-17-7

19. Misuse and Abuse of 911. Rana Sampson. 2002. ISBN: 1-932582-18-5

20. Financial Crimes Against the Elderly. Kelly Dedel Johnson. 2003. 

ISBN: 1-932582-22-3

21. Check and Card Fraud. Graeme R. Newman. 2003. ISBN: 1-932582-27-4

22. Stalking. The National Center for Victims of Crime. 2004. ISBN: 1-932582-30-4

23. Gun Violence Among Serious Young Offenders. Anthony A. Braga. 2004. 

ISBN: 1-932582-31-2

24. Prescription Drug Fraud and Misuse, 2nd Edition. Julie Wartell and Nancy G. La 

Vigne. 2013. ISBN: 978-1-932582-37-6 
| 56 |

Physical and Emotional Abuse of the Elderly

25. Identity Theft. Graeme R. Newman. 2004. ISBN: 1-932582-35-3

26. Crimes Against Tourists. Ronald W. Glensor and Kenneth J. Peak. 2004. 

ISBN: 1-932582-36-3

27. Underage Drinking. Kelly Dedel Johnson. 2004. ISBN: 1-932582-39-8

28. Street Racing. Kenneth J. Peak and Ronald W. Glensor. 2004. ISBN: 1-932582-42-8

29. Cruising. Kenneth J. Peak and Ronald W. Glensor. 2004. ISBN: 1-932582-43-6

30. Disorder at Budget Motels. Karin Schmerler. 2005. ISBN: 1-932582-41-X

31. Drug Dealing in Open-Air Markets. Alex Harocopos and Mike Hough. 2005. 

ISBN: 1-932582-45-2

32. Bomb Threats in Schools. Graeme R. Newman. 2005. ISBN: 1-932582-46-0

33. Illicit Sexual Activity in Public Places. Kelly Dedel Johnson. 2005. 

ISBN: 1-932582-47-9

34. Robbery of Taxi Drivers. Martha J. Smith. 2005. ISBN: 1-932582-50-9

35. School Vandalism and Break-Ins. Kelly Dedel Johnson. 2005. 

ISBN: 1-9325802-51-7

36. Drunk Driving. Michael S. Scott, Nina J. Emerson, Louis B. Antonacci, and Joel B. 

Plant. 2006. ISBN: 1-932582-57-6

37. Juvenile Runaways. Kelly Dedel. 2006. ISBN: 1932582-56-8

38. The Exploitation of Trafficked Women. Graeme R. Newman. 2006. 

ISBN: 1-932582-59-2

39. Student Party Riots. Tamara D. Madensen and John E. Eck. 2006. 

ISBN: 1-932582-60-6

40. People with Mental Illness. Gary Cordner. 2006. ISBN: 1-932582-63-0

41. Child Pornography on the Internet. Richard Wortley and Stephen Smallbone. 2006. 

ISBN: 1-932582-65-7

42. Witness Intimidation. Kelly Dedel. 2006. ISBN: 1-932582-67-3

43. Burglary at Single-Family House Construction Sites. Rachel Boba and Roberto 

Santos. 2006. ISBN: 1-932582-00-2

44. Disorder at Day Laborer Sites. Rob T. Guerette. 2007. ISBN: 1-932582-72-X

45. Domestic Violence. Rana Sampson. 2007. ISBN: 1-932582-74-6

46. Thefts of and from Cars on Residential Streets and Driveways. Todd Keister. 2007. 

ISBN: 1-932582-76-2

47. Drive-By Shootings. Kelly Dedel. 2007. ISBN: 1-932582-77-0

48. Bank Robbery. Deborah Lamm Weisel. 2007. ISBN: 1-932582-78-9

49. Robbery of Convenience Stores. Alicia Altizio and Diana York. 2007. 

ISBN: 1-932582-79-7
| 57 |

Other Problem-Oriented Guides for Police

50. Traffic Congestion Around Schools. Nancy G. La Vigne. 2007. 

ISBN: 1-932582-82-7

51. Pedestrian Injuries and Fatalities. Justin A. Heinonen and John E. Eck. 2007. 

ISBN: 1-932582-83-5

52. Bicycle Theft. Shane D. Johnson, Aiden Sidebottom, and Adam Thorpe. 2008. 

ISBN: 1-932582-87-8

53. Abandoned Vehicles. Michael G. Maxfield. 2008. ISBN: 1-932582-88-6

54. Spectator Violence in Stadiums. Tamara D. Madensen and John E. Eck. 2008. 

ISBN: 1-932582-89-4

55. Child Abuse and Neglect in the Home. Kelly Dedel. 2010. 

ISBN: 978-1-935676-00-3

56. Homeless Encampments. Sharon Chamard. 2010. ISBN: 978-1-935676-01-0

57. Stolen Goods Markets. Michael Sutton. 2010. ISBN: 978-1-935676-09-6

58. Theft of Scrap Metal. Brandon R. Kooi. 2010. ISBN: 978-1-935676-12-6

59. Street Robbery. Khadija M. Monk, Justin A. Heinonen, and John E. Eck. 2010. 

ISBN: 978-1-935676-13-3

60. Theft of Customers’ Personal Property in Cafés and Bars. Shane D. Johnson, Kate 

J. Bowers, Lorraine Gamman, Loreen Mamerow, and Anna Warne. 2010. 

ISBN: 978-1-935676-15-7

61. Aggressive Driving. Colleen Laing. 2010. ISBN: 978-1-935676-18-8

62. Sexual Assault of Women by Strangers. Kelly Dedel. 2011. 

ISBN: 978-1-935676-43-0

63. Export of Stolen Vehicles Across Land Borders. Gohar Petrossian and Ronald V. 

Clarke. 2012. ISBN: 978-1-935676-59-1 

64. Abandoned Buildings and Lots. Jon M. Shane. 2012. ISBN: 978-1-932582-01-7

65. Animal Cruelty. Kelly Dedel. 2012. ISBN: 978-1-932582-05-5

66. Missing Persons. Kenna Quinet. 2012. ISBN: 978-1-932582-20-8

67. Gasoline Drive-Offs. Bruno Meini and Ronald V. Clarke. 2012. 

ISBN: 978-1-932582-15-4

68. Chronic Public Inebriation. Matthew Pate. 2012. ISBN: 978-1-932582-07-9

69. Drug-Impaired Driving. Joe Kuhns. 2012. ISBN: 978-1-932582-08-6

70. Home Invasion Robbery. Justin A. Heinonen and John E. Eck. 2012. 

ISBN: 978-1-932582-16-1

71. Physical and Emotional Abuse of the Elderly. Brian K. Payne. 2012. 

ISBN: 978-1-932582-67-3 
| 58 |

Physical and Emotional Abuse of the Elderly

Response Guides Series:

1. The Benefits and Consequences of Police Crackdowns. Michael S. Scott. 2003. 

ISBN: 1-932582-24-X

2. Closing Streets and Alleys to Reduce Crime: Should You Go Down This Road?

Ronald V. Clarke. 2004. ISBN: 1-932582-41-X

3. Shifting and Sharing Responsibility for Public Safety Problems. Michael S. Scott 

and Herman Goldstein. 2005. ISBN: 1-932582-55-X

4. Video Surveillance of Public Places. Jerry Ratcliffe. 2006. ISBN: 1-932582-58-4

5. Crime Prevention Publicity Campaigns. Emmanuel Barthe. 2006. 

ISBN: 1-932582-66-5

6. Sting Operations. Graeme R. Newman with assistance of Kelly Socia. 2007. 

ISBN: 1-932582-84-3

7. Asset Forfeiture. John L. Worall. 2008. ISBN: 1-932582-90-8 

8. Improving Street Lighting to Reduce Crime in Residential Areas. Ronald V. Clarke. 

2008. ISBN: 1-932582-91-6

9. Dealing With Crime and Disorder in Urban Parks. Jim Hilborn. 2009. 

ISBN: 1-932582-92-4

10. Assigning Police Officers to Schools. Barbara Raymond. 2010. 

ISBN: 978-1-935676-14-0

Problem-Solving Tools Series: 

1. Assessing Responses to Problems: An Introductory Guide for Police ProblemSolvers. John E. Eck. 2002. ISBN: 1-932582-19-3

2. Researching a Problem. Ronald V. Clarke and Phyllis A. Schultze. 2005. 

ISBN: 1-932582-48-7

3. Using Offender Interviews to Inform Police Problem-Solving. Scott H. Decker. 

2005. ISBN: 1-932582-49-5

4. Analyzing Repeat Victimization. Deborah Lamm Weisel. 2005. ISBN: 1-932582-54-1

5. Partnering with Businesses to Address Public Safety Problems. Sharon Chamard. 

2006. ISBN: 1-932582-62-2

6. Understanding Risky Facilities. Ronald V. Clarke and John E. Eck. 2007. 

ISBN: 1-932582-75-4

7. Implementing Responses to Problems. Rick Brown and Michael S. Scott. 2007. 

ISBN: 1-932582-80-0

8. Using Crime Prevention Through Environmental Design in Problem-Solving.

Diane Zahm. 2007. ISBN: 1-932582-81-9

9. Enhancing the Problem-Solving Capacity of Crime Analysis Units. Matthew B. 

White. 2008. ISBN: 1-932582-85-1
| 59 |

Other Problem-Oriented Guides for Police

10. Analyzing Crime Displacement and Diffusion. Rob T. Guerette. 2009. 

ISBN: 1-932582-93-2

11. Analyzing and Responding to Repeat Offending. Nick Tilley. 2013. 

ISBN: 978-1-932582-71-1

Special Publications:

Crime Analysis for Problem Solvers in 60 Small Steps. Ronald V. Clarke and John E. 

Eck. 2005. ISBN:1-932582-52-5

Policing Terrorism: An Executive’s Guide. Graeme R. Newman and Ronald V. Clarke. 

2008.

Effective Policing and Crime Prevention: A Problem-Oriented Guide for Mayors, City 

Managers, and County Executives. Joel B. Plant and Michael S. Scott. 2009. 

Problem-Oriented Policing Implementation Manual. Michael S. Scott and Stuart Kirby. 

2012. ISBN: 978-1-932582-61-1

Upcoming Problem-Oriented Guides for Police 

Problem-Specific Guides

Insurance Fraud by Arson

Hate Crimes

Robbery of Pharmacies

Problem-Solving Tools

Understanding Hot Products

Identifying and Defining Policing Problems

Response Guides

Monitoring Offenders on Conditional Release

Using Civil Actions Against Property to Control Crime Problems

Special Publications

Intelligence Analysis and Problem-Solving

For a complete and up-to-date listing of all available POP Guides, see the Center for 

Problem-Oriented Policing website at www.popcenter.org.

For more information about the Problem-Oriented Guides for Police series and other 

COPS Office publications, call the COPS Office Response Center at 800.421.6770, 

via e-mail at AskCopsRC@usdoj.gov, or visit COPS Online at www.cops.usdoj.gov.

Got a Problem? We’ve got answers!

Log onto the Center for Problem-Oriented Policing website at 

www.popcenter.org for a wealth of information to help you deal 

more effectively with crime and disorder in your community, 

including:

•	 Recommended readings in problem-oriented policing 

and situational crime prevention

•	 A complete listing of other POP Guides

•	 A listing of forthcoming POP Guides

Designed for police and those who work with them to address 

community problems, www.popcenter.org is a great resource for 

problem-oriented policing.

Sponsored by the U.S. Department of Justice, Office of Community 

Oriented Policing Services (COPS Office).

Center for Problem-Oriented Policing
Physical and Emotional Abuse of the Elderly describes the problem of elder 

physical and psychological abuse, reviews factors that increase its risks, 

identifies a series of questions to help you analyze your local elder abuse 

problem, and reviews responses to the problem and what is known about these 

from evaluative research and police practice.

Office of Community Oriented Policing Services

145 N Street, N.E.

Washington, DC 20530

To obtain details on COPS Office programs, 

call the COPS Office Response Center at 800.421.6770.

Visit COPS Online at www.cops.usdoj.gov.

March 2013

ISBN: 978-1-932582-67-3 e12123530

Scan this QR code with your 

smartphone for more information 

about the POP Guides Series, or visit 

www.popcenter.org.