Acute Precipitants of Physical Elder Abuse: Qualitative Analysis of Legal Records From Highly Adjudicated Cases

Elder abuse is a common phenomenon with potentially devastating consequences for older adults. Although researchers have begun to identify predisposing risk factors for elder abuse victims and abusers, little is known about the acute precipitants that lead to escalation to physical violence. We analyzed legal records from highly adjudicated cases to describe these acute precipitants for physical elder abuse. In collaboration with a large, urban district attorney's office, we qualitatively evaluated legal records from 87 successfully prosecuted physical elder abuse cases from 2003 to 2015. We transcribed and analyzed narratives of the events surrounding physical abuse within victim statements, police reports, and prosecutor records. We identified major themes using content analysis. We identified 10 categories of acute precipitants that commonly triggered physical elder abuse, including victim attempting to prevent the abuser from entering or demanding that he or she leave, victim threatening or attempting to leave/escape, threat or perception that the victim would involve the authorities, conflict about a romantic relationship, presence during/intervention in ongoing family violence, issues in multi-generational child rearing, conflict about the abuser's substance abuse, confrontation about financial exploitation, dispute over theft/destruction of property, and disputes over minor household issues. Common acute precipitants of physical elder abuse may be identified. Improved understanding of these acute precipitants for escalation to physical violence and their contribution to elder abuse may assist in the development of prevention and management strategies.

Italian healthcare professionals' attitude and barriers to mandatory reporting of elder abuse: An exploratory study

INTRODUCTION

Elder abuse in recent times has reached a remarkable international importance. This complex phenomenon is still little understood and studied in Italy. The aim of this study was to explore Italian healthcare professionals' attitude and barriers toward elder abuse, with a glimpse on the current scenario and evidences to develop an action plan.

MATERIALS AND METHODS

42 healthcare professionals filled a questionnaire with 13 open-ended questions, analyzed with a qualitative content analysis. Data were grouped under the following 4 core-themes: description of elder abuse, abuse detection and perception, barriers to reporting, and professional orientation and approach; then they were analyzed to find their central component and discussed jointly.

RESULTS

The respondents described physical (64%) and psychological (50%) abuse and neglect (50%) as the three main characteristics of elder abuse; the 59% of them reported at least one experience in detecting or suspecting elder abuse. The 76% of participants believed the report has to be submitted to the Judicial Authority only in presence of compelling evidences. Furthermore, the 73% of the sample perceived that healthcare professionals are the main figures who have to cope with elder abuse, however they did not feel as their exclusive role the assessment of the patients' potential abuse.

CONCLUSION

Knowledge about elder abuse was limited to physical/psychological issues and, moreover, the legal obligation to report was only poorly known. Imperative is the creation of specific education and training courses, in addition to the need for a multidisciplinary and empathetic approach.

The Coroner's Role in the Prevention of Elder Abuse: A Study of Australian Coroner's Court Cases Involving Pressure Ulcers in Elders

The prevention of elder abuse is a health priority around the globe. The Australian Law Reform Commission's 2017 report on Australian residential aged care facilities found that neglect may constitute elder abuse and that painful pressure ulcers (PUs) fall into this category. The purpose of this article is to examine deaths from PUs in elders 65 years and older. A database search of Australian cases identified four coroner's court cases. This article considers the role and potential of coroners' recommendations to prevent PUs. The origin and site of PUs, prevention, wound and pain management, quality of care and coronial recommendations were examined. Coronial recommendations were made in two of the cases. As judicial officers with a statutory public health function, coroners have the potential to play an important role in the prevention of deaths attributable to PUs. This article makes recommendations to harness the potential of the coronial jurisdiction to prevent PUs.

Neglect by carers

There have been two widely reported criminal cases where informal carers, including family members, have been found guilty of the gross negligence manslaughter of the vulnerable person in their care. In this article, Richard Griffith considers the duty on informal carers when caring for a person and the duty on district nurses to protect vulnerable persons from harm.

Elder Fraud and Financial Exploitation: Application of Routine Activity Theory

Background and Objectives

Elder financial exploitation, committed by individuals in positions of trust, and elder fraud, committed by predatory strangers, are two forms of financial victimization that target vulnerable older adults. This study analyzes differences between fraud and financial exploitation victims and tests routine activity theory as a contextual model for victimization. Routine activity theory predicts that criminal opportunities arise when a motivated offender and suitable target meet in the absence of capable guardians.

Research Design and Methods

Fifty-three financial exploitation and fraud cases were sampled from an elder abuse forensic center. Data include law enforcement and caseworker investigation reports, victim medical records, perpetrator demographic information, and forensic assessments of victim health and cognitive functioning.

Results

Fraud and financial exploitation victims performed poorly on tests of cognitive functioning and financial decision making administered by a forensic neuropsychologist following the allegations. Based on retrospective record review, there were few significant differences in physical health and cognitive functioning at the time victims' assets were taken, although their social contexts were different. Significantly more fraud victims were childless compared with financial exploitation victims. Fraud perpetrators took advantage of elders when they had no trustworthy friends or relatives to safeguard their assets.

Discussion and Implications

Findings support an adapted routine activity theory as a contextual model for financial victimization. Fraud most often occurred when a vulnerable elder was solicited by a financial predator in the absence of capable guardians. Prevention efforts should focus on reducing social isolation to enhance protection.

Protecting the Health and Finances of the Elderly With Early Cognitive Impairment

The projected expansion of the nation's elderly population necessitates the revision of health care and policy strategies for safeguarding the health and assets of this community. The elderly are at greatly increased risk for developing mild cognitive impairment and Alzheimer's disease. These conditions are associated with diminished complex decision-making abilities that adversely affect patients, their families, and society, even during early stages of Alzheimer's disease. We present three composite patient histories that demonstrate problems routinely encountered by families, health care providers, and legal professionals during the course of early AD and MCI. We review the prevalence of cognitive and behavioral symptoms associated with MCI and early AD. Obstacles to early detection of cognitive decline, limitations of current testing modalities and benefits of earlier detection are discussed. Central themes common to medical and judicial approaches toward capacity assessment are discussed. We argue that an emphasis on earlier detection will result in benefits for patient health and result in financial savings to patients and the country as a whole. Finally, we recommend national guidelines for the evaluation of task-specific decision-making capacities to reduce the variability of outcome and improve quality of evaluations found among medical professionals, forensic evaluators, and legal actors.

Financial Capacity and Financial Exploitation of Older Adults: Research Findings, Policy Recommendations and Clinical Implications

BACKGROUND

Financial exploitation (FE) of older adults is a social issue that is beginning to receive the attention that it deserves in the mediathanks to some high profile cases, but empirical research and clinical guidelines on the topic are just emerging.

OBJECTIVE

Our review seeks to synthesize the current research in the area and develop a concentpual model.

METHOD

In this review, we describes the significance of the problem, proposes a theoretical model for conceptualizing FE, and summarizes related areas of research that may be useful to consider in the understanding of FE.

RESULTS

We identify key structural issues that have limited interventions in the past and make specific public policy recommendations in lightof the largest intergenerational transfer of wealth in history.

CONCLUSIONS

FE is a significant social problem, in this article we discuss implications for clinical practice.

[Protecting people with diminished intellectual autonomy, respecting their wishes]

How do we respect, and at the same time protect, people unable to look after their own interests alone, due to the impairment of their faculties? A solid knowledge base regarding the legal framework which is common to us all and which forms the foundation of our freedom is essential. French law, with regard to people losing their intellectual autonomy, notably in the case of neurodegenerative diseases, aims to respect patients' wishes while at the same time protecting them.

The Forensic Lens: Bringing Elder Neglect Into Focus in the Emergency Department

We present 2 case studies of older patients who were brought to the emergency department (ED) in severely debilitated states. Both presented with severe malnutrition, contractures, and decubitus ulcers, and were nonverbal, with histories of dementia and end-stage disease. Their primary caregivers, adult children, were uncooperative with Adult Protective Services and disregarded treatment recommendations. Although both elders had signs suspicious for neglect, a comprehensive review revealed many layers of complexity. We use these cases to illustrate an approach to the assessment of possible elder neglect in ED settings and how to intervene to ensure patient safety. We begin with a discussion of the differences between willful, unintentional, and unsubstantiated neglect by a caregiver and then describe when to suspect neglect by evaluating the elder, interviewing the caregiver and first responders, assessing the caregiver's ability to meet the elder's needs, and, if possible, obtaining medical history and information about the home care environment. These cases illustrate the importance of careful documentation in cases of suspected neglect to assist investigative agencies, reduce the risk of further harm, and improve patient outcomes.

All Elder Abuse Perpetrators Are Not Alike: The Heterogeneity of Elder Abuse Perpetrators and Implications for Intervention

The tendency to label all elder abuse perpetrators as the "bad guys" has diminished our ability to respond effectively. A review of the literature demonstrates that elder abuse perpetrators are in fact heterogeneous with important differences across types of abuse. A reformulation of perpetrator interventions away from a singular emphasis on prosecution to meaningful alternatives that utilize criminal justice and/or therapeutic approaches tailored to the needs of the case is needed. These interventions must incorporate the needs of both victims and perpetrators, take into consideration the type of abuse involved, acknowledge the variations in perpetrator culpability, and recognize the continuum of complexity among these cases. Without addressing these nuances, intervention and prevention efforts will be futile if not harmful.

Expanding Slayer Statutes to Elder Abuse

Common law has a dictum that people must not benefit from their crimes. In years past, states have enacted slayer rules to prevent killers from inheriting from their victims. The specific criteria and applicability of slayer rules vary by jurisdiction. Recently, several states, including Washington, have expanded their slayer rules to disqualify persons from inheriting if they have been involved in abuse or financial exploitation of the deceased. Reviewed herein are the abuse disinheritance laws, the relationship of the laws to concepts of testamentary capacity and undue influence, and the relevance to forensic psychiatric evaluations.

Elder abuse awareness in Italy: analysis of reports to the Prosecutor Office of Bologna

BACKGROUND

In Italy, the prevalence of elder abuse is estimated from 10 to 12.7 %. Even if the elderly are not specifically protected by the Italian Penal Code, it contains several articles punishing crimes against disadvantaged groups in which elders may be included. Article 572 about mistreatment of family members or cohabitants, and article 643 about circumvention of incapable best fit elder abuse or neglect and financial fraud and exploitation, respectively.

AIMS

To evaluate the prevalence of reported elder abuse in Bologna and province (Italy) compared to available data on prevalence obtained by population-based surveys.

METHODS

Reports to the Prosecutor Office about articles 572 and 643 in the period from 2000 to 2013 were collected and analyzed according to victim's age at the report time.

RESULTS

For article 572 a total of 3,713 reports were found. The prevalence of reports ranged from 0.005 to 0.024 % for victims older than 65 years. Concerning article 643 a total of 786 reports were detected, with a prevalence ranging from 0.007 to 0.016 % for victims older than 65 years.

DISCUSSION AND CONCLUSION

A large gap was found between reported crimes related to elder abuse and the estimated prevalence of elder abuse in Italy. Our results showed that in Italy efforts to improve strategic approach on elder abuse as well as research at various levels following the examples of other abusive situations are needed in both health and legal systems.

Elder mistreatment: priorities for consideration by the white house conference on aging

Elder mistreatment is recognized internationally as a prevalent and growing problem, meriting the attention of policymakers, practitioners, and the general public. Studies have demonstrated that elder mistreatment is sufficiently widespread to be a major public health concern and that it leads to a range of negative physical, psychological, and financial outcomes. This article provides an overview of key issues related to the prevention and treatment of elder mistreatment, focusing on initiatives that can be addressed by the White House Conference on Aging. We review research on the extent of mistreatment and its consequences. We then propose 3 challenges in preventing and treating elder mistreatment that relate to improving research knowledge, creating a comprehensive service system, and developing effective policy. Under each challenge, examples are provided of promising initiatives that can be taken to eliminate mistreatment. To inform the recommendations, we employed recent data from the Elder Justice Roadmap Project, in which 750 stakeholders in the field of elder mistreatment were surveyed regarding research and policy priorities.

PERCEIVED FEASIBILITY OF ESTABLISHING DEDICATED ELDER ABUSE PROGRAMS OF CARE AT HOSPITAL-BASED SEXUAL ASSAULT/DOMESTIC VIOLENCE TREATMENT CENTETR

BACKGROUND

Elder abuse is an increasingly important issue that must be addressed in a systematic and coordinated way.

OBJECTIVE

Our objective was to evaluate the perceived feasibility of establishing an elder abuse care program at hospital-based sexual assault and domestic violence treatment centers in Ontario, Canada.

METHOD

In July 2012, a questionnaire focused on elder abuse care was distributed to all of Ontario's Sexual Assault/Domestic Violence Treatment Centre (SA/DVTC) Program Coordinators/Managers.

RESULTS

We found that the majority of Program Coordinators/ Managers favored expansion of their program mandates to include an elder abuse care program. However, these respondents viewed collaboration with a large network of well trained professionals and available services in the community that address elder abuse as integral to responding in a coordinated manner.

DISCUSSION

The expansion of health services to address the needs of abused older adults in a comprehensive and integrated manner should be considered as an important next step for hospital-based violence care programs worldwide.

[Myiasis because of neglect]

Myiasis is known as the infestation of living organisms with maggots. It is often caused by (self-) neglect. Eight cases of myiasis have been examined at the Institute of Legal Medicine in Hamburg between 2002 and 2014. It is important that the medical examiner compares the maggots' stage of development with the alleged time of death. Especially in cases of home care, myiasis and neglect are suspicious and deserve special attention.

Analysis of elder abuse statutes across the United States, 2011-2012

The purpose of this article is to describe the state elder abuse statutes in the United States and Washington DC during 2011-2012. The last review of elder abuse statutes occurred in 2001; thus, a reexamination is warranted given the increased awareness of elder abuse at the state and national level and the growing number of older adults in the United States. This descriptive study analyzed the following components of elder or dependent abuse statutes: definitions, reporting requirements, training, and consequences for failure to report. It was determined that differences remain in how states respond to elder abuse at the community-based level.

[Elder abuse: practice issues for physicians]

Elder abuse is frequent (from 4 to 6% of adults aged 65 + according to WHO). It can take various forms: psychological, financial, violation of rights, neglect and physical. Due to demographic changes, it is expected that the number of cases will increase over coming years. Scientific data show the importance of a systemic analysis of elder abuse situations in order to avoid the simplistic thinking of the "horrible abuser" and the "poor victim". A multidisciplinary team, including a physician (a general practitioner, or a specialist), is necessary. Physicians can play a role in the prevention, detection and follow up of such cases. In order to detect elder abuse, active and attentive listening is mandatory. When a possibility exists that the older adult is abused, the suspicion should be documented (per example, by using the EASI tool), in order to implement an adequate follow-up. In the French part of Belgium, specialised services can be involved: Respect Seniors (www.respectseniors.be) in Wallonia and the SEPAM d'Infor-Homes in Brussels.

[Systemic reading, another way of thinking to apprehend situations of elderly abuse]

In 2007, a national call number was created to receive reports of ill-treatment for aged or handicapped subjects, and departmental platforms of phone-tapping were organized. Professionals of listening receive the calls for assistance or confidences of distresses related to ill treatments. They should initiate a relationship and assess the danger of the condition, therefore, in a systemic paradigm, performing a double task. According to the systemic approach, ill-treatments are usually the product of interaction and not that of an individual. They do not only concern individuals which suffer or undergo ill treatment but a system including all people leaving at home and social environment. To apprehend the complex relationships of ill treatments by professional of listening requires clarification of the situation together initiating a relation of confidence between the person calling and the professional. Therefore, the requests necessary for clarification should not be intrusive but create conditions of an exchange of information allowing a co-construction with the person calling for help. To accommodate a call for a critic situation, we need to take into account the context and not to be focused on the search of the causes of ill-treatment.

[Elder abuse]

The Prevention Law of Elder Abuse was enacted from April 1, 2006. There are two kinds of abuse by nursing family and by staff of nursing care home. In the case of abuse by family, 80s women were most victims and they were abused by their sons or husbands. While abused by staff of nursing care home, the number was small but increased rapidly. In the background of victims, they need high degree of care, and their dementia is severe. Those may affect the incident of abuse. Health Care workers have to examine the elders with thinking of their backgrounds, and it is important that we always suspect of the existence of abuse.

Combating the maltreatment of older persons by staff in long-term care nursing homes: legal aspects

A great deal of research has considered the dynamics of family violence and the way that family violence is processed and handled in the criminal justice system. Very little nursing research has considered the dynamics of older persons' maltreatment in long-term care. Older people living in a residential setting have the right to respectful care based on professional ethics. To fill this void, the current study proposes to identify policy implications for effectively implementing the recently developed Israeli public law designed to protect vulnerable older adults in nursing homes. In addition, this article presents the elder abuse reporting systems and the service delivery systems that have been established to protect older adults at risk of abuse and neglect.

Understanding elder abuse in family practice

OBJECTIVE

To discuss what constitutes elder abuse, why family physicians should be aware of it, what signs and symptoms might suggest mistreatment of older adults, how the Elder Abuse Suspicion Index might help in identification of abuse, and what options exist for responding to suspicions of abuse.

SOURCES OF INFORMATION

MEDLINE, PsycINFO, and Social Work Abstracts were searched for publications in English or French, from 1970 to 2011, using the terms elder abuse, elder neglect, elder mistreatment, seniors, older adults, violence, identification, detection tools, and signs and symptoms. Relevant publications were reviewed.

MAIN MESSAGE

Elder abuse is an important cause of morbidity and mortality in older adults. While family physicians are well placed to identify mistreatment of seniors, their actual rates of reporting abuse are lower than those in other professions. This might be improved by an understanding of the range of acts that constitute elder abuse and what signs and symptoms seen in the office might suggest abuse. Detection might be enhanced by use of a short validated tool, such as the Elder Abuse Suspicion Index.

CONCLUSION

Family physicians can play a larger role in identifying possible elder abuse. Once suspicion of abuse is raised, most communities have social service or law enforcement providers available to do additional assessments and interventions.

Elder mistreatment and the Elder Justice Act

Elder mistreatment is unrecognized, hidden, and underreported. Studies show that health professionals, nurses among them, are largely unaware of the various forms of elder mistreatment that take place and of the proper course of action to pursue when mistreatment is suspected. In this article, we describe elder mistreatment policies, examining them in the light of the United States national elder abuse policies with a focus on important provisions of the Elder Justice Act. Next, we review the various types of abuse, the identification of abuse, and the nurses role in addressing elder mistreatment. We present an example of a case of physical abuse and conclude by discussing nurses' advocacy role and issuing a call to action, challenging nurses to ‘"act now" to protect the well being of elders.

Elder abuse

Five types of elder abuse (physical, psychological, sexual, neglect and financial) are recognized. They are not new, occur worldwide and are associated with persistent morbidity and mortality. The forensic clinician has responsibilities to: (i) the patient, with competent history taking and examination, (ii) interpret findings and recognize patterns of harm and (iii) promulgate this issue in wider professional and public forums. Research into elder abuse is relatively recent; standardized terminology remains unsettled, and small-scale, local studies are hard to generalize. Cross-sectional, population-based studies of elder abuse should be possible, and standardized endpoints will require forensic science contributions.

["Natural" death of a person under the care of a custodian]

An ambulance service doctor was called to the death of a 76-year-old woman and attested cardiac arrest and psycho-organic brain syndrome as the cause of death on the death certificate. At the second external examination mandatory before cremation, extensive hematomas were detected on the right thorax and multiple haematomas in the face and on the forehead. The autopsy initially ordered by the public health officer revealed serial rib fractures and a fractured skull. After notifying the prosecutor, a forensic autopsy was ordered and death was found to have been caused by fat embolism following massive blunt force to the thorax with serial rib fractures and haematopneumothorax. After that, the adopted son, who had been appointed care custodian for the woman, and his wife were suspected, because they had given contradictory explanations for the injuries. At first, they were only suspected of failure to render assistance, but in the end they were both charged with murder. Only because of the second external examination prescribed by the law still in force could the errors of the improper first external examination be corrected.

Nursing home social services directors and elder abuse staff training

In a nationally representative study of 1,071 nursing home social services directors 80% of social services departments provided resident rights training and 60-70% were involved in abuse training. Departments headed by recent grads and in chain nursing homes or in the northeast were more likely to be involved in training. Seventy-two percent of social services directors were able to provide one-on-one training about reporting suspected abuse; education and licensure were related to ability to train.

Assessment in Adult Protective Services: do multidisciplinary teams make a difference?

This study compared 2 approaches to the assessment of Adult Protective Services (APS) cases. Using administrative data from 869 cases in 2 counties in Maryland, the differences between a nurse/social worker team and a lone social worker in case disposition, risk reduction, recidivism, and cost effectiveness were examined. Lone social workers were significantly more likely to confirm financial exploitation, physical abuse, and neglect by others; while the team approach resulted in significantly greater risk reduction. No differences were observed in relation to recidivism, self-neglect and cost savings. Given limited resources, research that examines optimal staffing patterns in APS agencies is warranted.

Analysis of legal cases for prevention of elder abuse: decisions from New Zealand

Elder abuse is a universal concern and is gaining greater public and professional attention. This increased concern to protect elders is internationally evident in policy reform, multidisciplinary research and education. Yet neglect in care settings continues. This research responds by contributing to the international effort to promote humane care for elders who are in a position of dependence, particularly in residential facilities. The legal cases that result from some complaints by aggrieved elders and their advocates may offer insights that are relevant for prevention. While the law is often viewed merely as a system of control, it may also be a resource for learning, particularly in the context of abuse prevention. Although the analysis references New Zealand law, the discussion may have broader application by indicating factors that precede, or trigger, unacceptable conduct. By understanding what went wrong and why, we may decrease the likelihood of future incidents. Also, understanding the legal ramifications may have a deterrent effect. Many advocates and activists have asked how we can ensure that abuses do not recur; some answers may lie within the legal cases themselves. How may recent legal cases be used to prevent mistreatment of elders in residential facilities? This question is applied to select decisions of New Zealand's Health and Disability Commissioner, Human Rights Review Tribunal and Health Practitioners Disciplinary Tribunal. While each body has distinct functions, relevant factors identified within the cases may reveal information that is of interest to elderly people and their advocates, caregivers, health educators and professional registration bodies. The research is timely in light of New Zealand's Review of Elder Abuse and Neglect Prevention Services in New Zealand (Department of Child Youth and Family Services, 2004) and New Zealand's Positive Ageing Strategy (Office of Senior Citizens, 2001). This article incorporates current debates regarding the use and analysis of legal cases and suggests that such analyses offer learning opportunities.

[Domestic violence--the physician's role: screening, diagnosis and primary intervention]

In 1997, the WHO declared domestic vioLence to be a health issue requiring medical attention. According to epidemiological data, it is a highly prevalent disease, with considerable short and long-term effects. Its treatment mandates diverse skills, such as clinical knowledge, emotional consideration, systemic vision and multi-disciplinary cooperation. There is controversy as to the effectiveness of screening for the disease. There is no agreement as to a single screening questionnaire and its use. Therefore, there are no recommendations for or against screening. Nevertheless, according to the Israeli Health Ministry's directives, it is the duty of physicians to perform screening for domestic violence in women and it is mandatory, according to criminal law, to report the abuse of children and helpless elderly to the proper authorities. Although there is no direct evidence from controLLed trials that medical intervention reduces the occurrence of the disease and prevents its recurrence, some medical organizations recommend that physicians should screen their patients for it, provide primary intervention, support, information, protection and connection with supportive authorities.

[Different perspectives on old age in prison]

The governor of Caen prison and two inmates describe the reality of the detention of elderly people. These inmates suffer from age-related pathologies or disabilities but still have the cognitive capability required to give their consent to take part in this interview. An opportunity for those who experience prison on a daily basis to express their views.

[Examination results and autopsy findings in assaults on elderly people]

As the percentage of elderly people in the population grows, violence against persons of advanced age constitutes an increasing social problem. The findings of the clinical forensic examinations (CE group) and autopsies performed on elderly violence victims (> or = 60 years) between 1999 and 2008 at the Institute of Legal Medicine of the Hanover Medical School were retrospectively analysed. In all, the study material comprised 55 victims of the CE group (35 females and 20 males, median age 73.5 years) and 55 autopsies (33 females and 22 males, median age 72.7 years). In most of the autopsy cases, the suspect was a family member or partner. In contrast, the alleged perpetrator was a stranger in most cases of the CE group. Blunt force injuries were most often found in the CE group victims (63.6%). Altogether, 38.2% (CE group) and 20.0% (autopsy cases) of the violent assaults were associated with robbery. In the majority of the CE cases, the victims suffered potentially or acute life-threatening injuries. In summary, the analysis shows that elderly people frequently become victims of robbery and blunt force injury. In most homicides of old people, the perpetrator is familiar to the victim. In surviving elderly violence victims, the assault is more likely to be reported to the police if the suspect is a stranger.

Elder abuse and neglect: challenges and directions for legal reform

The last two decades have heralded an increased community and professional awareness of the phenomenon of elder abuse and the challenges it poses to the enjoyment of the human rights of some older people. The contemporary Australian legal system provides many of the components of a framework required to assist in the promotion of the rights of the elderly and in the prevention and remedy of elder abuse. This framework acts in concert with health and community services dedicated to the advancement of health and wellbeing into old age. In the future, the acknowledgment and adoption of international legal principles which are directed to the needs of the elderly, the reform of existing domestic legislation and the development of new elder-specific statutes may all impact upon the incidence and consequences of elder abuse. To date, no Australian jurisdiction has adopted a legislative regime targeted specifically at the issues confronting older Australians who may be vulnerable to abuse and neglect. This column looks at some of the options for legal reform in this area.