Assisting Victims of Domestic Abuse in Later Life
Bonnie Brandl, Jane Raymond  -  2008/6/18
http://ovc.ncjrs.gov/ovcproviderforum
 
 
How can elderly people be encouraged to follow through on the legal remedies available to them when they often feel guilty about pursuing them,especially against children and/or grandchildren?
 
1.  Bonnie and Jane
 Older individuals, like victims of domestic violence of any age, often want the abuse to end and to maintain a relationship with the abuser. Especially in cases where the abuser is an adult child or grandchild, older victims may be more interested in getting the perpetrator help such as counseling or employment. An empowerment model is generally most effective when working with older victims where options are offered and the victim chooses what shehe believes will work best. If a crime has been committed, criminal justice professionals can continue to build their case based on the evidence, even if the victim is reluctant or unwilling to cooperate.
 
 
What percentage of elder abuse is perpetrated by the 'in home care provider', the county employee, who has been placed in charge of the elder? What measures has the Adult Aging Program implemented to ensure the safety of the elder and sustainability with regards to proper and appropriate care (other than the regular annual visits from the assigned social worker)? As a preventive measure, would it be feasible, for social services to offer a 'prevention and sustainability tool', allowing feedback in the form of a survey; giving the elder the opportunity to express and share her/his feelings regarding such care?
 
1.  Bonnie and Jane
 The question addresses elder abuse in a broader sense than todays specific discussion of domestic abuse in later life because you ask about home care providers from a regulatorylicensing perspective. While familiar with the topic, we are not experts in this arena. We are not aware of any studies that identify the percentage of elder abuse perpetrated by in-home care providers. We are also not aware of a national tool that measures the safety of the elder as you describe above. We suggest that you contact your local or state aging program http://www.aoa.gov/eldfam/How_To_Find/Agencies/Agencies.aspx to identify what protocolsystem is in place for your locale. If the aging program does not administer home and community based waivers you may ask their assistance in locating the agency that does.
 
 
Our long-running elder abuse council which meets monthly and has representation from over 20 criminal justice and CBO agencies would like to start a formal Duluth-like coordinated communtiy response effort for elder abuse. We will do this by identifying a "problem" through review of current cases, and then working as a group to resovle systemic problems as they arise through policy change, etc. Do you think this is the right approach?
 
1.  Bonnie
 Elizabeth: NCALL and AARP collaborated a few years ago to create a training on building a coalition. The link to the training guide is: http://www.ncall.us/docs/BuildingCoalitionTrainerRev.pdf. I do not know of any elder abuse CCR's that have evaluted their results.
 
2.  Bonnie
 Terri: I have someone in mind who I can recommend to contract with to help with your CCR. I'd like to check with her before I give out her name. I will see her next week and get back to you.
 
3.  Elizabeth Gay
 I work with Terri and our Elder Abuse Council in Seattle. Do you have other suggestions about things we can readguides for implementing a CCR? Also, do you know how others besides Duluth have measured the success of their CCR? Thanks.
 
4.  Terri Kimball
 Thank you for your good advice. Who would you recommend we contract with to help us through this initial CCR process?
 
5.  Bonnie and Jane
 We think this is an excellent approach that has been used successfully in other communities. One key issue to keep in mind is who is invited to the CCR team. In addition to criminal justice, professionals from a variety of fields such as: adult protective services, the aging network, health care (geriatric andor abuse specialty), domestic violence and sexual assault, the faith community and bankers often provide valuable insight.One other strategy that has been used in some communities to gain greater understanding of the needs is to run focus groups of older women. Facilitators have asked older women to give examples of abuse, to describe their thoughts about current systems responses and to give recommendations for next steps. In the communities that have used these groups, the information gathered has been used to guide the direction of service delivery and systems change. As an example of focus groups in Florida, see http://www.ncjrs.gov/pdffiles1/nij/grants/212349.pdf
 
 
What is the latest thinking regarding the connection between power and control dynamics and domestic abuse of elders that has traditionally be classified as "something else"? For example, chronic patterns of abuse due to "caregiver stress" or financial exploitation that is enabled through "undue influence". What do you think about the idea that power and control may be the predominant dynamic while caregiver stress, financial exploitation, and other "reasons" for domestic abuse are perhaps more appropriately looked at in the context of the abuser's motivation? Depending on your answer, how do you think community response to elder domestic victimization should be modified?
 
1.  Laura Seff
 I hadn't read this paper before. The way you bring the concepts together is consistent with what I have been learning by talking with older women while doing field research. Glad to see a male victim story! Thanks.
 
2.  Bonnie and Jane
 Current research identifies dynamics of power and control similar to those experienced by traditionally younger victims of domestic violence as the primary reason for domestic abuse in later life. Therefore, when working with any older potential victim, we recommend treating a case as if power and control dynamics are present until this is ruled out. Caregiver stress, substance abuse, and dysfunctional family dynamics may also be present but victim safety should be the primary concern. Empowerment strategies such as safety planning, support groups, emergency housing and legal advocacy may be most effective in many cases.In addition, we recommend that local domestic abuse and elder abuse/adult protective services agencies collaborate on a frequent basis. This means learning each systems philosophies, potential tensions and servicesresources that can be provided. To read more on this, please see Name It! Claim It! at http://www.ncall.us/docs/Name_it_Claim_it.pdf
 
 
What Law Enforcement training is available in the New York City/Westchester County N.Y. area regarding Domestic Abuse later in life? What referral agencies are in this area? What related material is available to disseminate to the public?
 
1.  Bonnie and Jane
 Since Jane and I are located in Wisconsin and Colorado, we do not have up-to-date information about trainings in New York City on DV in later life. I have several contacts in New York who might be able to give you more specific information. Please send me an e-mail after this session at bonnieb@wcadv.org and I can send you a couple of names to call in NY.
 
 
I was just wondering how you work with elderly people who have pets and will not leave them behind. Do you have resources for these clients?
 
1.  Sarah Mullin
 Thanks for the information. I will take a look at it.
 
2.  Bonnie and Jane
 You are right to recognize the importance of companion animals in the life of older individuals. In some domestic violence programs, arrangements are made to care for the animal while the needs of the victim is addressed. Frank Ascione of Utah State University has recently completed a study titled The Abuse of Animals and Domestic Violence: A National Survey of Shelters for Women Who Are Battered. (see http://www.vachss.com/guest_dispatches/ascione_1.html ) In it he describes ways that domestic violence programs work to address this issue. In addition, the Humane Society of the United States of America has two brochures that may prove helpful, http://files.hsus.org/web-files/First_Strike/Elder_Abuse_Brochure_2004.pdf and http://files.hsus.org/web-files/First_Strike/FSDomesticViolenceBro04.pdf
 
 
I work for a domestic violence agency and one of our programs works with victims of DV 50 years and older. We are having a difficult time with finding this population. What procedures do you do to access this population?
 
1.  Bonnie and Jane
 Many domestic violence programs across the country serve very few persons over age 50. DV programs that work with larger numbers of older victims have often tailored services, such as support groups for older victims. They also may have staff member(s) who specialize in working with older women. They hire/recruit older individuals as volunteers, staff and board members. Successful programming and high quality staff can lead to positive word-of-mouth advertising in the community. Outreach is also crucial. Staff members often conduct community awareness sessions at places older people gather, such as senior centers and meal sites. Brochures and posters have images of older women on them not just pictures of young moms and kids. Advertising of programming is often placed in publications read by older people or during radio/tv programs targeted for older people. Finally, consider the use of language. Using language like older battered womens support group may not draw many participants because many individuals do not see themselves as old or battered. Names of support groups that have proved helpful include Staying Strong, Staying Safe, Golden Voices and Silver Circle.
 
 
1. We struggle to build collaborations with Senior Centers, have others been successful and how? 2. We have a support group along with shelter, hotline... What types of services do other agencies offer? 3. Are there websites that can be helpful? We have a webpage on eons.com, which is a site for seniors, are there others?
 
1.  Aquita Burrus
 Family Srvices, Inc's Domestic Violence in Later Life have been sucessful in collaboratives by attending (on a regular basis)the Area Agency Planning Committee meetings. It is a collobaorative of organizations serving seniors and the hub for Home and Community Block Grant Funding.
 
2.  Bonnie and Jane
 Yes, strong collaborations between DV programs and senior centers exist. We know of senior centers from around the country that host support groups for older victims of DV. One method for starting a collaboration is to have staff from both organizations meet regularly to develop relationships. Another option is to work on a project together - like a training event or new brochure or poster. Traditional DV services may be more effective if they are tailored for older persons. Some communities have a support group developed specifically for older women. At least one program has designated hours (like every Tuesday from 1 4) when an older woman answers the crisis line. Legal advocacy services may deal with different issues, like changing a will. Economic advocacy may focus on Social Security and other benefits rather than getting a job (although some older women will want assistance finding employment.) There is information on DV in later life at the National Clearinghouse on Abuse in Later Life website at www.ncall.us. The National Center on Elder Abuse website is http://www.elderabusecenter.org.
 
 
In my county, it is a struggle to get elderly victims of domestic abuse to report to law enforcement and follow through with criminal charges, mainly because they fear retaliation and their primary caregiver is usually the abuser. What type of plan/assistance would you recommend for their safety and protection?
 
1.  Mary Day
 Reducing the victim's isolation is definitely important - is the victim willing to receive any in-home support through the Area Agency on Aging? Is she willing to go to a day program once a week? attend church? allow a neighbor to visit?Exploring with the older adult what the outcome would be if they relinquish their current situation can be a helpful process - e.g. what would it be like if you didn't have to depend on your daughter every day?
 
2.  Bonnie and Jane
 You are correct that some older victims avoid contacting the criminal justice system because of fear of retaliation or being moved to a nursing home; their abuser is their caregiver and a host of other reasons. In these situations, some victims may be willing to work with advocates or APSsocial workers who might be able to provide support such as safety planning and services that may break their isolation. Sometimes providing additional people in a victims life and support/services can enhance their safety. Criminal justice professionals can continue to collect evidence and move forward with a case if they choose - even with a reluctant older victim.
 
 
Many Domestic Violence providers state that older women do not access their shelters. What has been your experience regarding this view and, if true, why don't older victims?
 
1.  Bonnie and Jane
 In Wisconsin, I would state this is not true. The most recent data I have from Wisconsin domestic violence programs, dated 2005, reflects a total of 728 women and 100 men over the age of 60 using domestic violence services. This includes all forms of DV services (e.g., legal advocacy, one on one counseling, support group, housing assistance, etc) not just shelter utilization. I think older victims will use services if accommodations are made to meet their needs. For programming tips, one resource can be found at: http://www.ncall.us/docs/Prog_Ideas_Grid_06.pdf
 
 
What are the most common myths about domestic violence in older adults? How do community educators incorporate these myths and realities into their ongoing education about domestic violence prevention?
 
1.  Bonnie and Jane
 Common myths about domestic violence in later life are to numerous too name here but include she is too old to change, caregiver stress is the primary reason for the reason older people are hurt or harmed and the victim is frail and needs to be protected. I think community educators need to tell stories about older victims that clearly debunk these myths. One way I get immediate attention, and therefore many less assumptions, is to ask how old is the oldest victim of domestic violence in later life who has used a shelter in Wisconsin. The answer is 99; her grandson was peddling drugs out of her home and they used the shelter to house the older woman until eviction papers could be served and the woman returned home.
 
 
What suggestions do you have for raising and addressing issues of sexual assault or abuse for those experiencing domestic abuse in later life?
 
1.  Bonnie and Jane
 Since we have heard from numerous domestic violence support group facilitators on the frequency of sexual abuse occurring in the lives of older victims, we think this question is especially pertinent. It is important that the issue is raised rather than assumed that the older individual is asexual and therefore nothing like that would occur. One thing we have learned is that it is important for older women to acquire language to describe what has happened. Debunking the erroneous assumption that because I am married, I have to do whatever he wants is important. Understanding that marital rape does occur is critical. Adult sons and other family members or caregivers may also be perpetrators of sexual abuse. Another thing we are aware of is the use of pornography as a method of dehumanizing an older victim.
 
 
Can you make suggestions on assisting victims of Domestic Abuse in Later Life that may experience additional life variables of being an immigrant in a foreign country, language (including: native language different then mainstream or hearing impaired)and cultural and religious diversity issues? Thank You.
 
1.  Sandra
 Our agency has built a collaboration with other DV agencies that specialize in working with specific cultures, plus we started a language bank that has been extremely helpful.
 
2.  Bonnie and Jane
 This is a complicated question and not one that we can fully respond to. However, some of the particular variables we have seen in cases involving immigrants and undocumented workers are the use of fear of deportation; threats of throwing the individual out of the home, knowing that the individual cannot survive on his/her own; being forced to provide child care and up-keep of the household and ridicule of traditional values. For this population breaking the isolation is critical. Connecting with community-based organizations that serve the various populations is a first step.
 
 
What suggestions do you have for young professional to help older victims feel more comfortable in asking for assistance?
 
1.  Alethea Brown
 I have been working with elderly victims for the past 11 years, so I have encounter many situations, but I would suggest respect first and foremost. When helping elderly victims, always refer to them by their tile named. When you inquire about their problems, ask them how can you assist or help make them. You should also ask them about the perpertrator, and if there are issues that need to be addressed to help stop the abuse. Although sometimes, jail is required but I also stress treatment which most victims want in the end. Most older victms rely on these perpertrators for assistance and have no one else to help them, and if it is a spouse same thing applies for support. If an older victims feels like you have their best interest at hand they will be more open to discuss their issues. Also once they are on board, you have to make their experience in the Criminal Justice System less traumatizing. I bring the victims in later in the day because they require medications, always do court accompaniment, and inquire if transportation or social services are needed. I also work with the court staff to get them in and out of court. In addition, I keep them informed from the beginning of their case to the end. Older victims respect you when you are honest and supportive.
 
2.  V. Padayachee
 Young and other professionals need to understand the special needs of older persons, and design strategies around this.
 
3.  Laura Seff
 I would add that training - either self education through reading or training through programs - about aging, agism, and working with older people is very important. Also, reading the growing literature on domestic abuse in later life. All you have to do is google on the phrase and lots of links come up.
 
4.  Bonnie and Jane
 We have heard from older women that one of the reasons they may not call a DV program is that they are concerned that the staff are so young. That said, we know many examples where younger advocates have done a terrific job working with older victims. Treating people with respect and dignity is the key. Advocates of any age who listen and work hard to meet the needs of an individual woman without passing judgment on her decisions can be successful. And we also encourage programs to continue to recruit older women as staff, volunteers and board members so they can help younger staff as needed.
 
 
Can you point to any resources/publications that discuss the surfacing of and coping with psychological trauma as a result of domestic abuse later in life?
 
1.  Bonnie and Jane
 We have found Judith Hermans book on Trauma and Recovery to be especially helpful in our understanding of working with victims of all ages. We can't think of any specific written resources on trauma and DV in later life.
 
 
I am interested in providing information and services to our older ressidents. Can you share a few effective program implementation ideas?
 
1.  Mary Day
 The Long-Term Care Ombudsman Program in your area may be another resource to working with other adults who have experienced domestic violence. You can locate yours through your Area Agency on Aging, or using eldercare.gov. Domestic violence does not always end when someone is admitted to a nursing home or other long-term care. And, when someone has been victimized in one setting she may be more vulnerable to victimization in another setting or by another perpetrator.
 
2.  Laura Garcia
 If your agency is working with adult protective services, you can go into the state government office and then can give you a list of resources in the community that assist elder abuse. Also area agency on aging is a wonderful booklet with an array of information. example, AAAP,azag.gov.
 
3.  Bonnie and Jane
 Elisa: Based on your question, we are not sure what type of program you work in. If you work in a DV shelter, please see some of the previous answers. If you are working in a facility setting, feel free to e-mail me at bonnieb@wcadv.org and I will try to give you a more complete answer.
 
 
What advice to you have for professionals working with victims of domestic abuse that tolerate the abuse for fear of the alternative, nursing home or living alone? Often, the victim is dependent on the abuser for care and it is difficult to get them to understand that their are alternatives.
 
1.  Mary Day
 One important aspect of empowerment is providing a victim with the information she needs in order to make informed choices, at the rate she chooses. Victims are often isolated from others as a part of the domestic abuse. One thing that keeps victims isolated and keeps the victim from leaving is the belief that leaving will be worse than staying. When the victim is isolated from others, there is no reality check for this belief. The perpetrator can use this as a means of control, until the victim learns more about hisher full range of options. Sometimes, what a victim may fear the most about leaving may not be as horrible as hisher daily existence. Exploring what the fears are, and the basis of these may also help the victim recognize a broader range of options that do not feel so threatening and overwhelming. For example, there is an ever-increasing range of alternatives to a nursing home. Sometimes, the fact that the victim knows she can leave to a situation that would not be worse is empowering, even if the victim takes no other immediate action.
 
2.  Bonnie and Jane
 One of the challenges for professionals working with victims of domestic violence of any age is staying true to an empowerment model. It can be easy to fear for a victims life or want her to make changes because we see the situation as dangerous or unhealthy. So we have to be extremely careful not to set our own agenda for a victim and then try to convince her to live her life they way we think is best. We have to be cautious about our professional power and control because the abuser is likely already telling her what decisions to make and how to live her life. We recommend asking the victim what she wants. If she wants to stay in the relationship, then focus on what small changes might she like to see happen. I know one advocate who worked with a woman to move into a separate bedroom (away from her husband) and bought her a radio so she could listen to classical music. This was all the older woman wanted and it made her extremely happy. And for this woman, the outcome was a success.
 
 
Are there specific strategies you find effective in engaging an elder experiencing emotional abuse? Do you find any particular approach helpful for elders who may be resistant to accepting assistance?
 
1.  Laura Seff
 As the primary field researcher of the referenced report I should emphasize that the great majority of the 134 women we talked to in the 21 focus groups said that emotional abuse was worse than physical abuse. Not only is it unnamed by victims, but also by external support systems that often don't recognize this is a legitimate abuse experience. Many older people do not know that emotional abuse is a criminal offense in both domestic violence and elder abuse statutes -- at least in Florida. Learning this may help a victim validate emotional victimization.
 
2.  Bonnie and Jane
 This is a great question to ask since emotional abuse is almost always present when other forms of abuse, neglect andor exploitation exist. We have heard it said that I wish he had only broke my arm because it would heal. A broken heart never does. We think a great document to look at is the one referenced in our response to Terri Kimball below. See http://www.ncjrs.gov/pdffiles1/nij/grants/212349.pdf The document is a compilation of findings from several focus groups held in South Florida. It has captured the voices of older victims, many of them describing emotional abuse and its long-term impact.
 
3.  Sandra
 Working with seniors on this topic is like working with the younger women. Many times you have to put a name to their reality. Many do not want to believe they are in an abusive relationship, but once you have named the reality...its like looking in a mirror.
 
 
What are some factors to keep in mind when assisting elderly victims of domestic violence that are different from younger victims?
 
1.  Bonnie and Jane
 Like any victim of domestic violence, it is important to meet the woman where she is at. Older victims have many things in common with younger victims often fear, wanting to maintain the relationship, and poor or limited options. There are some issues that are unique to older victims. For some women, the abuse has been going on for 40 or more years. It may take more time to tell her story. Some older women have generational values that may impact the options they see as available to them. Some older women (as well as younger women) may have physical disabilities or cognitive limitations that can pose additional challenges. Some older women are abused by an adult child, grandchild or family member although the dynamics of domestic violence remain the same. Some older women will be eligible for different remedies such as Social Security, pensions or senior housing.
 
 
Can you offer any insight into steps that can be taken to assist an elderly person whose health is quickly deteriorating that is being physically and verbally abused by a mentally handicapped senior citizen over whom they have legal guardianship?
 
1.  Mary Day
 Often an older adult in this situation feels a huge sense of responsibility for their older adult disabled child, and fears what will happen to him/her, so tolerates the situation. Addressing this fear and the contributing factors that overwhelm both parties in this situation may also help. Other helpful resources would be 1 - the county board of Mental Retardation/Developmental Disabilities - find out if they have any emergency intervention options. 2 - There are also good non-profit resources in many states to help families plan for the needs of their adult disabled children, to relieve the stress that contributes to this situation.3 - the county probate court that established the guardianship may also have resources to help with this situation (e.g. appointing an alternative volunteer guardian). 4 - check with the Area Agency on Aging to find out what in-home supports and day center options are available to assist either or both parties, which may also alleviate some of the stress that is contributing to the situation
 
2.  Bonnie and Jane
 The situation you describe above would in our opinion be best handled by your state or local adult protective services agency. To locate that agency, go to this site: http://www.apsnetwork.org/Abuse/index.html
 
 
What can you tell us about programs and services for people with developmental disabilities who are crime victims late in life?
 
1.  Sandra
 If there is a police report or restraining order they can qualify for victim assistance/witness?
 
2.  Bonnie and Jane
 Unfortunately, this is a question that we do not know the answer to. Hopefully someone reading this response will post a reply that is much more helpful.
 
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