Chapter 18
Elderly Victims of Crime
Abstract: This chapter
will provide participants with an opportunity to examine the unique
problems and needs of elderly crime victims, both in general and
based upon specific crime types. A brief overview of the elderly
crime victim's perception of crime is provided to place the participant
in the mind-set of the elderly victim and his or her need for
specialized, sensitive responses from those establishing and providing
program services.
Learning Objectives:
Upon completion of this chapter, students will understand the
following concepts:
1. Ageism and its impact on society's perception of elderly
persons as crime victims in our society.
2. Specialized services that can be implemented by victim
assistance personnel to better respond to the needs and problems
of the elderly crime victim.
3. The general profile of elder abuse victims and perpetrators.
4. Techniques that can be used to improve communications
with elderly victims.
5. Aspects of the impact criminal victimization has on the
elderly.
Statistical Overview
- In 1986, there were about 117,000 reports of domestic elder
abuse in the nation. This figure rose to 241,000 reports in 1994,
representing an increase of 106 percent.
- It is estimated that approximately 818,000 elders became victims
of various types of elder abuse in 1994. This figure, however,
excludes self-neglecting elders. If self-neglecting elders are
added, the total number of elder abuse victims would be 1.84 million
individuals in the same year.
- In most states, certain types of professionals are designated
as "mandatory reporters of elder abuse" and are required
by law to report suspected cases of elder maltreatment. In 1994,
21.6 percent of all domestic elder abuse reports came from physicians
and other health care professionals, while another 9.4 percent
came from service providers, and family members and relatives
of victims reported 14.9 percent of the reported cases of domestic
elder abuse.
- The majority of domestic elder abuse reports are substantiated
after investigations. For example, 54.9 percent of reports were
substantiated in 1994. Additionally, 54.9 percent of the substantiated
reports were self-neglect cases.
- Neglect is the most common form of elder maltreatment in domestic
settings. Of the substantiated reports of elder abuse for which
perpetrators were identified in 1994, 58.5 percent involved neglect.
Physical abuse accounted for 15.7 percent in the same year, while
financial/material exploitation was 12.3 percent of the substantiated
reports.
- In 1994, 65.4 percent of the victims of domestic elder abuse
was white, 21.4 percent were black, and Hispanic elders accounted
for 9.6 percent of the domestic elder abuse victims.
- Adult children are the most frequent abusers of the elderly
in domestic settings. It was found that 35 percent of the substantiated
elder abuse cases in 1994 involved adult children as abusers.
"Other relatives" ranked as the second most frequent
abusers (13.6 percent) and spouses with 13.4 percent.
- In 1994, the majority of abusers were female (52.4 percent)
and slightly more than three-fifths of victims were females (62.1
percent). Similarly, about three-fifths of self-neglecting elders
were also females (62.4 percent).
- The median age of elder abuse victims was 76.4 years, according
to 1994 data that excluded self-neglecting elders.
(The preceding statistics are derived from the findings of a national
study of domestic elder abuse reports conducted by the National
Center on Elder Abuse in 1994. Data on elder abuse reports were
collected from state adult protective service and state units
on aging across the nation for the years of 1993 and 1994. It
is important to note that some experts estimate the only one out
of 14 domestic elder abuse incidents (excluding the incidents
of self neglect) comes to the attention of authorities. NCEA
is operated by a consortium of the American Public Welfare Association
(APWA), the National Association of State Units on Aging (NASUA),
the University of Delaware, and the National Committee for the
Prevention of Elder Abuse (NCPEA), with funding assistance from
the Administration on Aging (AoA).
The Need for Elderly Victim Services
The last two decades have witnessed a tremendous growth in the
field of victim services. From its infancy in recognizing that
crime victims need and deserve basic rights and services, the
field of victim assistance has grown to be a very individualized,
complex system of service delivery.
In its early years, the victims' movement centered its energy
and demands on improving the rights and services available to
all crime victims. However, as time progressed and through
trial and error, it has become evident that the generic, "one
size fits all" type of victim programs do not meet
the needs of all crime victims: many victims require different
approaches, services, information and specialized rights.
Thus, a more pro-active, specific victim-centered approach for
America's crime victims has evolved, including:
- Laws granting special rights and enhancing services to children,
victims of domestic violence, and hate motivated crimes.
- Many victim service programs have conducted internal evaluations
to determine if they are meeting the needs of their clients and,
where less than adequate, services are being strengthened to meet
their needs.
- Today, a community may have programs tailored to meet the
needs of child sexual abuse, domestic violence, rape, drunk driving
and homicide victims.
- Some communities have even expanded their programs to meet
the needs of their ethnically-diverse clients.
However, there are few programs designed specifically to meet
the needs of this nation's largest growing population: the elderly.
Crimes against the elderly have emerged as a new, crucial area
of concern for victim assistance professionals. Consider the
following facts:
- By the year 2000, persons aged 65 and older will account for
13% of the nation's population.
- By current estimates, this number will continue to grow at
a rate of an additional twelve million each decade thereafter.
- Thus, the number of elderly victims entering the criminal
justice system can be expected to increase significantly.
- There is no other segment of our victim population that will
see such growth based upon their numbers alone.
Types of Elderly Victimization and Abuse
This chapter examines two types of crimes against elderly victims:
Elderly Victimization: Crimes against the elderly by strangers
or acquaintances, excluding those committed by caretakers, family
members, or crimes that are classified as domestic abuse.
Elder Abuse: Crimes against the elderly that are predominantly
committed by caretakers and family members, and include acts such
as sexual and physical violence, neglect and economic exploitation
and fraud.
Elderly Victimization
In 1992, 2.1 million persons 65 and over experienced some form
of criminal victimization (Bachman, 1992). For example:
- According to 1994 statistics, elderly males are more likely
to become victims of a violent crime than elderly females, and
elderly blacks are victimized at a rate of twice that of their
white counterparts.
- Elderly citizens living in urban settings are three times
more likely to experience some form of crime as those living in
suburban or rural settings.
- Rural elderly persons are more likely to experience more household
related crimes, i.e., burglary, vandalism, than elderly
persons living in urban areas.
- Income also seems to affect elderly victimization -- the less
income the elderly person has, he or she is twice as likely to
experience a violent crime compared to his or her more wealthy
counterparts. However, elders with higher incomes experience a
higher number of non-violent crimes such as theft, household crime
or additional crimes of fraud (Bureau of Justice Statistics, 1994).
- Elderly crime victims are almost twice as likely as younger
victims to be victimized at or near their homes (Bureau of Justice
Statistics, 1992).
Although the elderly are victimized less frequently than any other
age group, they have a higher fear of crime than any other age
group. This is due largely to the physical limitations that age
places on them. Physiological changes as persons age render them
less able to fight or flee from dangerous situations. This is
one reason why they are often targeted as potential victims.
For example:
- Although elderly men experience more violent crime than elderly
women, elderly women experience almost five times the rate of
personal larceny with contact -- such as purse snatching or mugging
-- as do elderly men.
- Elderly women may seemingly pose little threat to the attacker
through resistance or chase than their male equals, making them
better targets for crime.
However, when victimized, the elderly report the crime and participate
in its prosecution more than their younger counterparts.
In today's crime stricken world, young children are taught to
refrain from speaking to strangers. As a normal part of their
daily lives, citizens install multiple locks, security systems,
security bars or carry protective devices. They are simply taught
at an early age to trust no one, and that crime is an inescapable
fact in their lives. However, for many elderly victims, crime
victimization is a new concept. Most often, they grew up in an
era where one did not lock their doors, neighbors were trusted
and a stranger was a friend yet to be met.
Therefore, when victimized, the elderly victim may suffer far
greater emotional consequences than "street-wise" younger
persons.
Special Victim Assistance Needs Based
Upon Age
Providing assistance and support to elderly crime victim presents
many challenges to victim assistance personnel. Physical limitations
place a burden on both the victim and the personnel assigned to
assist them. To provide services, victim assistance professionals
should consider the following:
- Incorporating home, hospital or nursing home visits to accommodate
the specialized needs of the elderly.
- Sight and hearing impairments of victims may make services
more difficult to administer, and may necessitate a higher level
of personal involvement in the provision of program services and
information. For example, the program's informational brochures
may need to be redesigned to meet the needs of the sight-impaired,
and hearing impediments may considerably slow the exchange of
information.
- Older victims may need several reminders of court dates or
court-related appointments.
- Many elderly victims will need transportation to and from
these court-related appointments.
- Health problems in the elderly can cause significant delays
in the prosecution of a criminal case.
This chapter provides a background and suggested approaches for
the victim assistance provider serving the needs of the elderly
crime victim. The suggestions may be helpful based on individualized
need, and are not meant to imply that all person over age
65 will require specialized services.
There are many elderly victims who have not suffered significant
hearing, vision, mental or physical impairment due to aging.
Not all elderly victims will want or need assistance. Many
elderly victims have strong family networks to provide support,
guidance and assistance. The suggestions contained in this section
are offered for the elderly victim who does not have a
strong family support network, and will need the assistance of
trained victim personnel. However, some service providers find
it hard not to "rescue" elderly victims with services,
advice or information. Providing services is critical in helping
the elderly recover from a criminal victimization, but doing so
with sensitivity and respect for the victim's wishes or capabilities
is far more important.
Promising Practices
Victim Assistance Personnel Working with Elderly
Victims
It is important to note that some of the outlined promising practices
contained in this section identify emergency considerations for
elderly victims that will most often fall to the responding law
enforcement agency. It is strongly recommended that an interagency
agreement be established between law enforcement and other victim
assistance programs to ensure that information regarding crimes
against the elderly are shared immediately so assessments for
emergency services can be conducted. An interagency agreement
will also ensure that the "lion's share" of the workload
does not fall to any one agency in particular:
- Immediately assess the victim's need for emergency financial
intervention. In cases of physical assault or larceny with contact,
the elderly victim's eyewear or hearing aid may be damaged or
destroyed. The loss of or the damage to these items can significantly
impede the victim's ability to resume everyday activities. Work
with local agencies to identify emergency sources of funds to
replace or repair eyewear or hearing aids. It is also critical
to determine which medications might have been taken and need
to be replaced immediately to avoid a potential life threatening
situation. Work to identify agencies or pharmacies that will financially
assist elderly crime victims in replacing their medication in
an emergency situation.
- Variations in climate can also create life threatening situations
for the elderly. When the crime has occurred in the home, it is
important to repair damaged doors and windows to prevent heat
or cooling loss as quickly as possible. The victim service professional
should compile a list of local agencies, community or church groups
that can provide this service at little or no cost to the victim.
- In cases which involve the theft or robbery of the elderly
victim's money, pension or social security check, contact the
victim immediately to determine the need for emergency financial
assistance to buy food, medication or pay utility bills. Assist
the victim in reporting the loss and filing for emergency replacement
checks with the Social Security Administration or victim's retirement
fund. If the money cannot be issued immediately, work with food
banks to ensure that the victim will have food until a replacement
check can be issued; also, work with the utility company to ensure
that the elderly victim does not lose electrical service. These
are potential life threatening situations often overlooked.
- Provide frequent breaks when interviewing the elderly victim.
Sitting or standing on arthritic joints can become very painful,
and can result in extreme stiffness in a short time. Allow the
elderly victim to move around to reduce strain and swelling.
- Be aware that elderly victims may have complicated medication
schedules or illnesses that call for frequent meals or snacks.
Work with the victim or his or her family to determine such special
needs. This information is important for a number of reasons.
One, allowing the victim to control his or her schedule can reinstate
some sense of "control" that may have been lost due
to the victimization; second, some victims require food or medication
at very precise intervals to remain healthy and mentally alert.
If a meal or medicine is missed or significantly delayed, the
victim may give the appearance of being seriously confused, agitated
and/or disoriented when, in fact, they are suffering from a lack
of food or medication, such as in cases of diabetes.
- Talk to the victim or to the victim's family to determine
the time the victim will be most alert, and schedule appointments
or court appearances around these times, if possible. Consider
the elderly victim's need to nap periodically throughout the day,
and provide a quiet area for them to relax and rest if appointments
or court appearances cannot be scheduled around these needs.
- Determine if the physical space in your office or in the court
room needs to be adjusted to meet the needs of the elderly victim.
If the elderly victim is confined to a wheelchair, make sure that
access to your office or to the courtroom is clear of clutter.
If the victim is hard of hearing, determine if turning up microphones
in the courtroom will help the victim to better hear court proceedings.
Sometimes, difficulty in hearing and not answering the questions
correctly may be seen as confusion and uncertainty, rather than
a physical limitation. These small gestures can provide the victim
with a sense of dignity while minimizing any negative effects
their physical limitations might impose. The same consideration
should apply to elderly victims dependent on walkers or canes.
- Attempt to close the meeting room or court room to the public
in cases of elderly rape or sexual abuse.
- Consider having program brochures or informational resources
printed in larger type for elderly victims. Something as simple
as an increased font size will significantly help visually impaired
elderly victims understand services and programs available to
them. Some programs have recorded program information on an audio
tape to aid the visually impaired victim.
- When feasible, conduct "home or hospital" visits
to obtain all related case information including restitution,
victim compensation or presentence information rather than making
the elderly victim "come" to you. To many elderly persons,
even a short outing can cause extreme fatigue and mobility problems.
- Determine the transportation needs of the elderly. Many elderly
persons have little access to dependable transportation, especially
in rural areas. Additionally, weather conditions can adversely
affect elderly persons and the medications they take. For example,
some heart and blood pressure medications make the patient extremely
susceptible to heat or cold. When the elderly victim is dependent
on public transportation such as a subway or bus, long waits in
extremely hot or cold weather do seriously affect them. Additionally,
icy or snowy conditions in coming to court or to office appointments
can increase the chances of sustaining additional illnesses and
injuries. When at all possible, provide the elderly victim with
transportation to and from all court-related meetings or hearings.
Victims of Elder Abuse
As the average life expectancy increases due to better medical
and personal health care, the costs associated with the increase
in longevity have skyrocketed. Today many families find that they
cannot afford skilled nursing home care for their elderly parents
or grandparents and, as such, more and more families must now
assume a greater share of the "at home" care and expense
for these family members.
- It is estimated that as many as 80% of the elderly are forced
to receive care at home due to the rising costs of medical and
skilled nursing care, which places added financial and physical
stresses on these families (Tatara, 1992).
Our society is witnessing an increase in abuse and neglect towards
the elderly by family members, in-laws or "paid" home-based
care givers. Acts of abuse and neglect include:
- Physical abuse -- non-accidental use of physical force that
results in bodily injury, pain or impairment.
- Emotional and/or psychological abuse -- willful infliction
of mental or emotional anguish by threat, humiliation, intimidation
or other verbal or nonverbal conduct.
- Neglect -- willful (intentional) or non-willful (passive neglect)
failure by the care giver to fulfill their caretaking obligation
or duty to meet the needs of the elderly. This can include: isolation
of the victim, over medication of the victim, leaving the elderly
victim to live in unsanitary living conditions, failure to provide
adequate food, water and heat.
- Sexual abuse -- non-consensual sexual contact of any kind
with an older person.
- Financial or material exploitation -- unauthorized conversion,
transfer or use of funds, property or resources of an older person
for personal gain (Tatara, 1992).
Unique Characteristics of Elder Abuse
Elderly victims suffer the same psychological affects of domestic
abuse as do younger victims of domestic violence. Some unique
characteristics of elder abuse include the following:
- The abuse is rarely an isolated event, but one that is normally
repeated over and over.
- Elder abuse is found among families of all racial, ethnic
and socio-economic backgrounds.
- Victims feel trapped in situations in which they have little
control and no chance of escaping. Elderly abuse victims may have
even fewer options for leaving an abusive environment than younger
victims of domestic abuse.
- There may be no other family member to live with that can
assume the physical or financial demands of caring for them. Many
of America's elderly do not have the funds necessary to place
themselves in a "cost for service" facility or retirement
housing unit.
- Due to physical limitations or mental infirmities, elderly
victims may be unable to protect themselves from further abuse
or neglect once they report the abuse.
- In other cases, family members may not believe an older person's
claim of abuse.
- In many cases, the elderly may be embarrassed within their
community to report that a child they raised would resort to such
behavior -- reflecting poorly on them as parents.
Barriers to Reporting Abuse
According to a report released in 1990 by the Subcommittee on
Health and Long-Term Care of the Select Committee on Aging of
the U.S. House of Representatives, it is estimated that only
one out of every eight cases of elder abuse are reported (Subcommittee
on Health and Long-Term Care, 1990).
Some elderly victims may be fearful of destroying their children's
marriages if they report their son-in-law or daughter-in-law for
abuse and/or neglect. For many elderly, it is safer to remain
silent and they often fall into a pattern of "learned helplessness"
or "resignation" over time (National Victim Center [NVC],
1995).
In almost all states, laws have been drafted to address elder
abuse and neglect that specifically requires the reporting of
elderly abuse and neglect just as in the cases of child sexual
and physical abuse and neglect. Physicians, care givers and social
service personnel are required in these states to file a report
of abuse to local law enforcement agencies for further evaluation.
(Portions of the above section were excerpted from Focus on
the Future: A Systems Approach to Prosecution and Victim
Assistance, Nation Victim Center under a grant from the U.S.
Department of Justice, Office for Victims of Crime, 1995.)
Types of Elder Abuse Victims
Typically, the elder abuse victim tends to be female, above the
age of 75, and lives with the perpetrator of the abuse. Due to
a range of physical and mental impairments, the victim generally
requires extensive physical care. The abuser tends to be related
to the elderly victim and is more often female. Many abusers
have alcohol or drug dependency problems and live under severe
stress. Based upon research, the percentage of abusers by category
in relation to their elder victims is as follows (Tatara, 1995,
pp. 9-17):
- Adult Children 35.0%
- Spouse 18.4%
- Other Relatives 22.4%
- Non-family care giver 6.3%
- Friend or Neighbor 5.2%
motional abuse and neglect is most often found to be perpetrated
by a female family member or caregiver. Physical and sexual abuse
is most often perpetrated by a male family member or caregiver.
One-third of elderly abuse and neglect occurs in an institutional
setting, and is not relevant to this section since it primarily
addresses interfamiliar abuse.
However, this topic is introduced to provide a scope of the severity
of the topic. Care givers at an institution have a legal or financial
contractual agreement to provide care for the elderly. Institutions
may include:
- Hospitals
- Nursing homes
- Group homes
- Foster homes
- Day care facilities for the aged
Civil, as well as criminal, remedies can be sought when physical,
emotional, sexual abuse or neglect is perpetrated against the
elderly in these facilities. Just as in a home situation, victims
of elderly abuse often suffer intense threats and intimidation
by care giver personnel to keep the disclosure of the abuse to
a minimum.
Promising Practices
Victim Assistance Services for Victims of Elder
Abuse
Victim assistance services provided to victims of elderly abuse
and victim should be similar to those offered to victims of domestic
violence:
- Information, referrals or removal to safe havens should be
arranged once the report of abuse or negligence is made. This
will most often fall to the state's department of protective services.
They may look for foster care or additional family members to
provide services and support to these aged victims.
- Obtaining protective orders, along with a thorough explanation
as to the reporting of any threat or act of intimidation by the
defendant or a representative on his or her behalf, should be
offered. Due to their physical vulnerability, elderly victims
may be more unwilling to prosecute cases in which they fear there
will be defendant or family retribution.
- Information about mental health counseling services and support
groups within the community should be provided. The emotional
ramifications of charging your child with physical abuse and/or
neglect can be immense.
- Transportation should be arranged for those that need assistance
and, if the victim is bed-ridden, locate a mental health therapist
willing to make "house calls."
- If possible, "senior" companions from an elderly
community-based service program should be investigated to aid
elderly victims. Senior companions can provide support, encouragement
and a supportive ear for elderly victims without a strong family
support system. Often this support system will assist elderly
victims more than any other service the victim assistance professional
can provide.
Medicare and supplemental medical coverage will seldom cover the
cost of mental health counseling. It is important that the victim
or a supportive family member receive an application and information
for filing a claim to the state's victim compensation program.
If the elderly victim does not have a support system, the victim
service professional should assist the victim in completing the
application and mailing it on behalf of the victim. The victim
service professional should continue to update the filing of all
new bills to the compensation program. The victim and supportive
family member(s) should be given information concerning their
right to file for civil recovery against paid caretakers to recover
medical or financial losses should the alleged defendant not be
found guilty or restitution not ordered.
Elderly Victims of Sexual Assault
For many elderly women -- raised in a time when sexual matters
were never discussed in the open -- becoming a victim of sexual
abuse or rape represents the worst crime possible. To have to
air one's private sexual life in the public arena of the criminal
justice system is unfathomable.
- To many older victims, it is the worst form of lost dignity.
There may be profound shame in discussing the crime, or participating
in a medical exam with law enforcement and medical personnel.
- In some rural areas, the rape victim may have never had a
pelvic exam, giving birth to her children at home and with the
assistance of female family members or a midwife only.
- There may be feelings of embarrassment that family members
and/or neighbors will find out, or that the media may somehow
access and release the information to the community.
For some, the fear their religious community will discover the
rape is unbearable. Some elderly victims are still surrounded
with embarrassment about sexual activity, and have never discussed
it, even with their children. Elderly victims may also suffer
much anguish from the fear of contracting a sexually transmitted
disease at their age.
As an added insult, a large percentage of elderly women are raped
in their own homes during the commission of another crime -- such
as burglary. This type of assault may intensify the older woman's
sense of a loss of control. She can't control who enters her
home or what happens to her body.
- The shame and guilt may be overwhelming. The elder rape victim
may be asked to perform sexual acts that she has never done before,
often degrading and humiliating her.
- These acts may have been condemned in her religious training
or within her culture. Being forced to perform oral or anal sexual
acts may also intensify her feelings of helplessness and shame.
- It is thought that some elder rape victims do not report these
crimes for the very reason that they cannot talk about being made
to perform such acts.
Rape in older victims can increase the chance of sustaining serious
injury. Vaginal linings are not as elastic as those of a younger
woman due to hormonal changes; this proclivity towards increased
sexual trauma may cause infections, bruising, or tears that may
never fully heal. Brittle bones such as the pelvis and hips can
be more easily broken or crushed by the mere friction and weight
of the rapist (NVC, 1995).
Promising Practices
Elderly Sexual Assault Victims
Law enforcement protocol should be used when responding to the
needs of the elderly sexual assault victim. This protocol should
include training for first-responders as to the emotional consequences
of rape for the older woman; assigning a female officer to question
and accompany the victim for medical care and rape exam when possible;
community-based programs and services for referrals; seeking the
victim's consent before any contact is made with the victim's
family, where possible; allowing the victim to retrieve a change
of clothing so she is not released in hospital garb or inappropriate
donated clothing; seeking the victim's consent prior to calling
in a rape crisis advocate for emotional support both at the hospital
and after release; ensuring the victim is shielded from any and
all media if she so requests; providing information on security
options; and perhaps most importantly, ensuring the victim has
a safe place to go after the medical exam.
Victim assistance professionals can:
- Assist the victim in determining a need to relocate either
temporarily or permanently, based on the victim's wishes and feeling
of safety and help the victim find shelter or funds to relocate
if a decision is made to do so.
- Work with community programs to repair damage to windows,
doors or locks damaged or destroyed as a result of the crime if
the victim is unable or does not wish to relocate. Have law enforcement
personnel conduct a safety check of the home and work with the
victim to increase her security options.
- Provide the victim with information on her rights to file
for crime victim compensation, and help her the complete the application
if the victim so desires.
- Make sure the victim has referral information to mental health
providers and support groups.
- Work with the victim's family members or friends, if consent
is granted by the victim, to help them understand the emotional
ramifications of the sexual assault.
- If no family support network is available, close contact should
be maintained with the victim to help increase her feelings of
self-worth. After a sexual assault, many elderly victims will
further isolate themselves from friends, family or community networks.
This contact may provide the comfort and support she needs in
increased phone calls or home visits.
- Keep the victim apprised of any arrest or release of the offender.
This serves two purposes: to increase the victim's sense of safety
if the offender is detained; and if not detained, to prepare the
victim to take extra security precautions. The victim should be
notified of the procedures to report any threats or intimidation
by the defendant.
- Protect the elderly sexual assault victim at all costs
from all publicity! Victims should be shielded from media
attention, and never identified by the media. Advocates
should ask the judge to close the courtroom to the public -- at
least while the victim testifies. A secure waiting area should
be provided during all court-related hearings or trials. Whenever
possible, escort the victim to and from the courtroom.
- Work with prosecutor's office to establish protocol for fast-tracking
and vertical prosecution of sexual assaults against the
elderly. Fast-tracking will alleviate the additional stress of
lengthy delays in court-related hearings; vertical prosecution
will minimize the number of times the elderly victim has to recount
the details of the assault.
Elderly Victims of Financial Schemes or
Frauds
Elderly victims are targeted for crimes of a financial nature
more than any other type of victim population. Although the elderly
victim of fraud will not sustain any direct physical injury, the
psychological impact of this type of crime can be devastating.
- Many victims blame themselves for the loss of their life savings.
- Out of this blame, elderly victims can suffer additional health
problems from stress, depression, insomnia and loss of appetite.
- Some elderly victims will feel shame for not being more savvy
in recognizing "cons," making some victims reluctant
to report the crime out of fear that family members may blame
them for mismanagement of finances, and seek to terminate their
financial independence.
A vast majority of our elderly population live on fixed incomes.
The financial impact of a crime of fraud can be devastating to
those living on fixed incomes. They can lose their entire life
savings and sometimes their homes. For some elderly victims,
the crime costs them more than money because some must give up
their last vestige of independence when forced to move in with
adult children or other family members out of financial necessity.
Promising Practices
Working with Elderly Victims of Fraud or Financial
Schemes
- Provide creditor/landlord intervention if the victim is left
with too few funds to pay his or her bills.
- Provide the elderly victim (or family members) with information
on the victim's right to file for civil recovery.
- Ask the court to order restitution so the elderly victim is
paid before court cost, fines and attorney fees are collected.
Request that the court permit the Court Clerk's office to pay-out
partial payments to the victim -- as restitution payments are
made. (Many jurisdictions allow for restitution payments only
after the full amount of restitution has been paid. In cases of
fraud, there may be multiple-victims, and the order for reimbursement
should be made based on financial need).
- Encourage judges to impose sentence enhancements for vulnerable
victims in suitable cases. Encourage prosecutors to consider large
up-front payments to elderly victims as a routine part of any
plea settlement in cases involving fraud.
- In allowable states, assist the elderly victim in recording
a lien against any real property of the defendant through appropriate
court procedures.
Elderly Victims of Violent Crime
Statistically, elderly citizens are the least likely to be physically
injured in the commission of a crime. However, when injuries
are suffered, they tend to be more serious due to the normal
physical vulnerability of the aging body. According to national
statistics for 1987 to 1992, the elderly are twice as likely as
any other age group to be seriously injured and require hospitalizations
when victimized. Elderly robbery victims are more likely than
their younger counterparts to face multiple offenders and offenders
armed with a gun (Bureau of Justice Statistics, 1987).
Most homicide victims age 65 or older were killed during the commission
of another felony (like robbery) and were more likely to be killed
by strangers. By contrast, younger homicide victims are more
likely to be killed by an acquaintance and to die during events
such as a fight or family argument (Bachman, 1992). The elderly
are less apt to try to protect themselves than their younger counterparts.
As part of the aging process, the elderly have an increased frailty
that makes them more susceptible to physical injury and less able
to recover from such injuries. Even slight resistance during
a criminal incident may result in serious injuries for an older
victims. For example, as a victim of a mugging, a younger person
may experience only minor bruising or scraping as a result of
being pushed to the ground. For the elderly victim, there is
a marked increase in sustaining serious injuries, such as broken
bones or concussions -- injuries from which they may not fully
recover.
Promising Practices
Working with Injured Elderly Victims
- Establish an interagency agreement between local law enforcement
agencies (sheriff and police) and the appropriate agency representing
the rights of the elderly (normally the state's Department of
Human or Social Services) to be contacted when a police or social
worker responds to a report of elderly victimizations with injuries.
- Establish a policy of providing hospital or home visits (only
if the victim is stable or his or her family is receptive) to
inform the victim and his or her family of available services.
Use this time to determine specialized needs such as food shopping,
transportation to and from doctors appointments and drug stores.
Provide information on witness intimidation and harassment and
security options. It might be a good idea to take a victim compensation
form with you. Explain the benefits under your state plan and
assist the victim in applying for compensation. For example, provide
victims with several self-addressed stamped envelopes to forward
the application to your agency, and ask that as they or family
members receive medical or counseling bills, these to be forwarded
to your agency as well. Obtain a police report for the victim;
and, mail the package to the compensation program on behalf of
the victim.
- Determine the physical extent of injury to the victim and
any special assistance he or she may need in attending meetings
and court-related hearings once released from the hospital and/or
physician's care. If the elder does not have family in the nearby
area and depends on public transportation, getting to and from
court or medical appointments can be difficult if the victim is
in a wheelchair or uses other mobility aide such as canes or walkers.
Work with local agencies to determine services available to help
the elderly with transportation issues.
- If the elderly victim is to be hospitalized for an extended
length of time, be prepared to work with your local utility and
phone companies to ensure that the injured victim will have electrical
and phone service when he or she returns home. The phone may be
his or her only life-line to emergency medical care upon return.
- Alert the prosecuting attorney of any extended hospital or
physical therapy stay anticipated for the elderly victim. This
information will be useful in determining when to hold police
line ups, filing of charges, bond hearings, etc.
Elderly Victims of Burglary
For many elderly, their world becomes the area immediate to their
home as they begin to lose networks that have supported them throughout
their life. They retire from jobs, friends and family members
begin to die, and outside leisure activities decrease due to increasing
physical or mental limitations. Largely, this explains why the
majority of elderly crime victims are victimized in or near their
home.
Burglary's Impact on Elderly Victims:
- The larceny of even a small amount of money means many elderly
victims must go without food, medication or other necessities,
especially if the victim lives on a fixed-income.
- Undue hardship may occur when paying for property damage resulting
from a crime.
- Hardships are possible in finding extra money to replace stolen
items. Even with insurance, there may be large deductibles and
depreciation on the items, making the replacement of stolen items
difficult, if not impossible.
- The loss of items deemed non-important to many younger people
poses life-changing impact on the elderly. For example, the loss
of a TV or radio can further restrict the elderly's outside communication
and further isolate them from society.
The sentimental loss of possessions stolen during a burglary is
often far greater for the elderly. Their grief and emotional trauma
may be extreme. It may be helpful for victim assistance personnel
to work with family members so they can understand the emotional
ramifications of the burglary on the victim.
Elderly victims are more likely than any other burglary victims
to want to relocate after the crime, but financial limitations
may not allow such a move. Although few, there are several federal,
state and community programs that do help with the financial burdens
of relocation. (A list of these resources is contained at the
end of this chapter.)
In the event the elderly victim does not wish to move, he or she
may experience an emotional need to withdraw from community involvement.
As soon as possible after the crime is reported, it is important
to restore a sense of security and safety to the elderly victim
of burglary.
One approach is to conduct a thorough search of the property to
identify points of entry that may need to be repaired or further
secured. If the victim is unable to afford the repairs, replacement
or increased security options, a list of community resources that
can help should be provided to the victim or contacted on behalf
of the victim.
Promising Practices
Elderly Victims
- Learn all local and state statutes applicable to elderly abuse
and neglect and your professional role in carrying out these mandates.
- Learn of all local, state and national agencies and community
support programs to form a solid framework for referrals for services.
Be especially aware of safe havens for the elderly and any funding
requirements or time restrictions entering and remaining in such
havens.
- Create a multi-disciplinary team approach of working with
the elderly abuse victim by including representatives of the law
enforcement and criminal justice system, state health and human
service organizations, social security administration, nursing
home officials, medical community, local clergy and local community-based
elderly programs especially those dealing with domestic abuse.
The multi-disciplinary team approach should define and clearly
delineate each agency's role in the reporting of elderly abuse,
and in referring or providing the elderly victim with additional
services.
- Attend seminars and meetings, and work closely with programs
designed to educate the community and professionals about the
changing trends concerning elderly issues.
- Work with local law enforcement and criminal justice personnel
to "fast track" cases of elderly abuse through the justice
process.
- Work closely with local community-based domestic violence
assistance program(s) to learn the dynamics of elder abuse. If
no specialized programs and services exist, work with local programs
to establish such services. Consider adding the expertise of a
senior citizen with a background in elderly abuse to serve as
a liaison in matters pertaining to the elderly.
- Incorporate senior citizens as volunteers where appropriate.
Most often, people relate best to someone of their own generation.
Senior citizen volunteers can provide many services that busy
professionals often cannot. They are more often able to initiate
home visits and referrals; provide court accompaniment and transportation;
serve as a warm and caring friend and advocate; and be a useful
resource in determining special needs, fears or concerns for professional
administration.
Preventing/Addressing Elder Abuse
Although each state has a different system to address elder abuse,
the following agencies have been established by federal, state
and local governments to help:
State Elder Abuse Hotlines: Many states have instituted a 24-hour
toll free number for receiving reports of elder abuse. These
calls are confidential.
Adult Protective Services: In most jurisdictions, either Adult
Protective Services or the County Department of Social Services
is designated as the agency to receive and investigate allegations
of elder abuse and neglect. If the investigators find abuse or
neglect, they are mandated to make arrangements for services to
protect adult victims.
Medicaid Fraud Control Units: Every State Attorney General's
Office is required by federal law to have a Medicaid Fraud Unit
to investigate and prosecute Medicaid provider fraud and patient
abuse or neglect in health care programs that participate in Medicaid,
including home health care services.
Law Enforcement: Local police, sheriff's offices and prosecuting
attorneys may investigate and prosecute cases of elderly abuse
and neglect. In states where statutes make elder abuse a crime,
there may be a requirement to report all suspected cases to a
law enforcement agency.
Long-Term Care Ombudsman Program: Since the passage of the 1975
Older Americans Act, every state has established a Long-term Ombudsman
Program to investigate and resolve nursing home complaints, including
elderly abuse and neglect.
Information and Referral: Every area Agency on Aging operates
an information and referral line that can refer people to a wide
range of services for people who are 60 years and older. These
services can be particularly helpful in locating services that
can help prevent abuse and neglect.
National and State Information: Often people who want to help
older relatives or friends do not live near them. Long-distance
caretakers can call a nationwide toll-free Eldercare Locator Number
(1-800-677-1116) to locate services in the community in which
the elder lives. In addition, some states have established a
statewide toll-free number to provide centralized information
on aging services for state residents.
(The preceding section excerpted from the Focus on the Future:
A Systems Approach to Prosecution and Victim Assistance training
manual developed by the National Victim Center under a U.S. Department
of Justice, Office for Victims of Crime grant project, 1995.)
Promising Practices
Effective Communication Techniques with
Older Adults in Stressful Situations
- Only fifteen percent of all adults over the age of sixty-five
have serious visual impairments and over one-third are affected
by documented hearing loss. Do not assume that an older adult
has a sensory or cognitive impairment.
- Choose an environment most conductive to communication. Eliminate
factors that interfere with listening. Minimize any distractions
such as excessive background noise or interruptions by other staff
members.
- Assure adequate lighting without glare. If reading is required
by the older adult, provide enhanced lighting. If the elderly
adult needs to identify information on a board or flip-chart,
allow him or her to approach the documents rather than sitting
in a chair and straining to read or identify it.
- Sit or stand facing the older adult at their eye level. This
will ensure that your eyes and mouth are clearly visible. If the
older adult has documented hearing loss, make sure you have their
attention before you begin to speak.
- Keep instructions short and simple.
- Keep your voice and mannerisms calm.
- Do Not Shout. If necessary, speak slightly louder without
shouting or yelling. Continue to raise your voice as the elder
instructs you. If audio equipment is used, slowly turn the equipment
up until the elder indicates he or she can hear it. Do not automatically
assume he or she is hard of hearing and set the equipment on high.
- Ask questions to clarify confusion, but ask only one question
at a time and allow for a response before asking another question.
Allow plenty of time for hearing, comprehending and understanding.
- Be sensitive to whether the older adult is tired, not feeling
well or becoming too upset. Allow breaks were possible for the
taking of food, medication or moving about.
- Observe closely for nonverbal clues to see if you have been
understood. For example: squinting of the eyes or a blank expression.
- Be patient. Expect to repeat what you say often or
to rephrase questions.
- Never interrupt. It discourages free speaking and interruption
may cause an older adult to forget what they were going to say.
(The preceding section excerpted from the Focus on the Future:
A Systems Approach to Prosecution and Victim Assistance training
manual developed by the National Victim Center under a U.S. Department
of Justice, Office for Victims of Crime grant project, 1995.)
Self Examination Chapter 18
Elderly Victims of Crime
1) What are the five types of elder
abuse and neglect?
2) Identify three "promising practices" for victim
service providers for helping elderly victims.
3) What are three special concerns of elderly victims of
sexual assault?
4) What are three specific services that can be offered to
elderly burglary victims by victim service and law enforcement
professionals?
5) Discuss the difference(s)
between elder abuse and neglect and elderly victimization.
References
American Association of Retired Persons. (1990). Issues
affecting crime victims: Background, current status, and implications
for older persons. Washington, DC: American Association
of Retired Persons, Criminal Justice Services.
Bachman, R. (1992, October). Special report: Elderly victims.
Washington, DC: U.S. Department of Justice, Office of Justice
Programs, Bureau of Justice Statistics.
Bureau of Justice Statistics. (1981) Crime and the elderly.
Washington, DC: U.S. Department of Justice, Office of Justice
Programs, Bureau of Justice Statistics.
Bureau of Justice Statistics. (1987) Elderly victimization.
Washington, DC: U.S. Department of Justice, Office of Justice
Programs, Bureau of Justice Statistics.
Bureau of Justice Statistics. (1994, March). Elderly crime
victims: National crime victimization survey (NCJ-147186).
Washington, DC: U.S. Department of Justice, Office of Justice
Programs, Bureau of Justice Statistics.
Bureau of Justice Statistics. (1994). Selected findings from
BJS: National crime victim survey, elderly crime victims.
Washington, DC: U.S. Department of Justice, Office of Justice
Programs, Bureau of Justice Statistics.
Hunzeker, Donna. (1990). State legislative response to crimes
against the elderly. Denver, CO: National Conference on
State Legislatures
National Aging Resource Center on Elder Abuse. (1991). Working
with abused and neglected elders in minority populations: A synthesis
of research. Washington, DC: Author.
National Victim Center. (1995). Focus on the future: A systems
approach to prosecution and victim assistance. (Grant project).
Washington, DC: U.S. Department of Justice, Office for Victims
of Crime.
Roberts, A.R., Andrews, A.B. (c1990). Helping crime victims:
Research, policy and practice. Newbury Park, CA: Sage.
Straus, Martha B. (1956). Abuse and victimization across
the life span. Baltimore: Johns Hopkins University Press,
(c1988).
Subcommittee on Health and Long-Term Care. (1990, May). Elder
abuse: A decade of shame and in-action. Washington, DC:
U.S. House of Representatives, Select Committee on Aging.
Tatara, T. (1995). Elder abuse: Questions and answers, an
information guide for professionals and concerned citizens
(5th ed.). Washington, DC: National Aging Resource Center on
Elder Abuse.
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