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In 1998 Kentucky's Local Coordinating Councils on Elder Abuse (LCCEAs) were established to intervene in cases of elder abuse in local communities. As of 2008 there were 39 LCCEAs in the state, covering 112 of' Kentucky's 120 counties. This study was an attempt to understand a concerted statewide multidisciplinary team (MDT) effort related to elder abuse. Survey questions examined the roles, processes, varieties, and accomplishments of these councils. Nearly half of the councils have been in existence for less than 3 years. Councils provided a range of services from expert consultation to service provided for keeping members up to date about services, programs, and legislation. Roles for the councils included identifying service gaps and systemic problems and advocating for change. Half the councils conducted case reviews, and of those, most examined all types of cases. Lack of funding was a majorproblem for all councils. Funding came from a patchwork of sources, which suggested that it was inadequate and unreliable. The LCCEAs appear to function largely as community educators. To ensure the long-term viability of the LCCEAs and to better integrate and unify their efforts, LCCEAs need committed staffs, constant funding, clear vision and goals, and uniform and consistent outcome measures. KEYWORDS elder abuse, multidisciplinary teams, local elder abuse coordinating councils DOI: 10.1080/08946560903446063

The future directions for social policy and elder abuse are forecast using the characteristics of three contiguous generations: Baby Boomers, Gen Xers, and Nexters. The results suggest greater potential victimization for the Boomers than previous generations, particularly neglect and exploitation. Gen Xers may experience more self-neglect. Social policy will continue to emphasize the criminalization of elder abuse, reflecting Boomer self-righteousness and severity. Elder abuse victimization will have a medical hue, given the Boomer obsession with health and wellness. Although Gen Xers are less cynical than Boomers, they will be more concerned about their immediate lives and pass the elder abuse policy torch to the Nexters, who will elevate it in deference to the Boomers and in quest for a higher moral order. KEYWORDS elder abuse, social policy, generations, cohort differences DOI: 10.1080/08946560903446139

In response to a growing and worldwide recognition of elder abuse, the WorldView Environmental Scan on Elder Abuse was undertaken. It represented an attempt to collect both information on the nature of the problem of elder abuse and responses to it from a global perspective. The first of its kind, the Scan gathered information about elder abuse as well as on related legislation and policy, services and programs, educational resources and needs, training, and past and ongoing research. A total of 5.3 countries responded to the survey questionnaire, with 362 respondents representing the six world regions designated by the World Health Organization. Findings revealed that factors contributing to elder abuse include changing social and economic structures, isolation of victims, inadequate knowledge of laws and services, intergenerational conflict, and poverty. Barriers to seeking resources to intervene and protect older adults include the culture of the country, language issues, literacy, stigma, lack of mobility, lack of funding, and insufficient familiarity with and access to the internet. The data serve as a catalyst to take action, both globally and nationally, while emphasizing the changes necessary to protect the rights and dignity of older adults. KEYWORDS elder abuse, international study, policy DOI: 10.1080/08946560903445974

This article highlights the brief 30-year history of major U.S. policies that address elder abuse. The history of elder abuse policy is checkered and incomplete, reflecting a lack of comprehensive federal legislation. We begin our review by discussing the scope of elder abuse policy and, in particular, the Social Security Block Grant, which has become the sole source of federal aid for Adult Protective Services programs. The other source of federal aid, typically for helping efforts by Area Agencies on Aging, is the Older Americans Act. We document the incremental but increasing attention paid to elder abuse by chronicling key initiatives, including early congressional reports and hearings; White House Conferences on Aging; and efforts by pioneers such as Mario Biaggi, Claude Pepper, John Breaux, and Orin Hatch--efforts that we believe have led to the various introductions of the Elder Justice Act. KEYWORDS U.S. policies, Social Security Act, Older Americans Act, elder mistreatment policy, Elder Justice Act DOI: 10.1080/08946560903436130

Mental Health Services (MHS) meet mental health needs of older adults through active, outpatient, community-based care. Adult Protective Services (APS) are involved with needs of older adults who have mental disability and mental illness. Adult Protective Services and MHS staff may to work together when they respond to the needs of victims and adults at risk for abuse, neglect, self-neglect, and exploitation. The purpose of this study was to understand effective APS-MHS collaborations (e.g., leadership, organizational culture, administration, and resources in predicting success). A survey that was sent to members of the National Adult Protective Services Association (NAPSA) revealed that both APS and MHS have strong commitments to protecting clients' rights and autonomy, but there appear to be differences between the two with regard to implementation, apparent in cases involving clients with diminished mental capacity who are at imminent risk, but who refuse help. Strengths of APS-MHS collaborations included improved communication and better service for at-risk clients. KEYWORDS Adult Protective Services, Mental Health Services, older adults, collaborations, at-risk clients DOI: 10.1080/08946560903004821

Voting is a fundamental right for all United States citizens, one that usually continues for elderly people as long as they are alive. As adults age, certain issues regarding voting warrant deeper consideration than in previous years, especially those presenting as a result of impaired sight, hearing difficulty, dementia, or other special needs. What will happen to millions of men and women who have taken the right to vote for granted, but who gradually become immobile or physically impaired? What are states doing to help secure the enfranchisement of an increasing number of older adult voters? The purpose of this article is to address these issues by focusing on the following questions: What bas been the historical nature of polling place accommodations for elderly people? What are states doing in terms of accommodating older voters at the polls while ensuring the integrity of the voting process? What effect has recent Help America Vote Act legislation bad with regard to polling place accommodations? Our results indicate that accommodations for older voters are being made but are not yet at a level required to serve a rapidly aging population. KEYWORDS voting, older people, political participation, elections, Help America Vote Act (HAVA)

This article reports research findings concerning 119 alleged sexual perpetrators who were reported to state authorities for abusing elderly individuals residing in care facilities. The largest group of accused was employees of the facilities, followed by facility residents. Family members of the alleged victims and visitors to the facilities also were among those reported as sexually abusive. Investigation of the allegations by Adult Protective Services and regulatory staff resulted in 32 of these individuals being confirmed as sexual perpetrators against vulnerable elders. Male and female alleged and confirmed sexual perpetrators were identified as well as both male and female elderly sexual abuse victims. Perpetrator characteristics, victim vulnerabilities, abuse acts, locations of assaults, and available case outcomes are presented. Implications of the findings are discussed. KEYWORDS. Elder sexual abuse, sexual offenders, facility abuse, abuse investigation, resident perpetrators, abuse by facility staff

Previous research on the sexual abuse of older adults has revealed few cases of the sexual abuse of older men. The first national study of the sexual abuse of vulnerable adults in facilities, reported in this article, collected data on alleged, investigated, and substantiated cases of sexual abuse. This study revealed 26 cases reported and screened in for investigation concerning the alleged sexual abuse of older men (aged 50 and older) residing in nursing homes. Cases occurred in five states within a six month time period. Of these cases, six were confirmed upon investigation by Adult Protective Services or other regulatory agencies. Victims tended to be predominately white males with cognitive and physical deficits that limited their ability for self care. The most typical sexual abuse alleged and substantiated was fondling. Residents were more often substantiated as the abuser than other perpetrators. Sexual abuse of older men in nursing homes crosses traditional gender, cultural, and role boundaries for both victims and perpetrators. doi:10.1300/J084v19n01_03 KEYWORDS. Sexual abuse, older men, adult protective services, regulatory entities, elder abuse, abuse in nursing homes

Data from Virginia Adult Protective Services (APS) case files of 95 abused women aged 60 years and older were assessed to establish demographic trends; ability to care for self; type, pattern, and place of abuse; information on witnesses and alleged offenders; and case resolution and outcomes. The most common types of mistreatment reported were neglect, exploitation, and physical abuse. The women typically had several functional limitations and were dependent upon their family members for care. Most cases were not prosecuted, and the majority of women remain at risk for further abuse. Implications of these data for future research and practice are discussed. KEYWORDS. Older women, abuse, neglect, adult protective services outcomes

Elder abuse multidisciplinary teams (MDTs) include professionals from diverse disciplines who work together to review cases of elder abuse and address systemic problems. Using an e-mail survey format, the authors received information from 31 MDT coordinators across the country representing fatality review teams, financial abuse specialist teams, medically oriented teams, and 'traditional' teams. The coordinators provided information on the functions their teams perform, the importance of specific functions, cases reviewed, composition of teams. policies and procedures, administration, funding, and challenges to effective functioning. Teams expressed only mild concern for breaches in confidentiality. MDTs stressed the importance of input by professionals from the legal community for successful team functioning. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address: Website: [c] 2003 by The Haworth Press, Inc. All rights reserved.] KEYWORDS. Multidisciplinary team, elder abuse, interdisciplinary team, financial abuse, fatality review, coordination

Aggregated data from APS case files of sexually abused older women between the ages of 70 and 89 living in nursing homes were collected over a five-year period, yielding a total of 50 substantiated cases. The most common types of sexual abuse involved instances of sexualized kissing and fondling and unwelcome sexual interest in the women's body. All alleged perpetrators were male; they typically were 70 years of age and older and residents in the nursing home. In only three cases was the alleged offender prosecuted in court and only one of these cases was the offender convicted. Implications of these data for future practice and research are discussed. KEYWORDS. Sexual abuse, older women, adult protective services, nursing homes

Aggregated data from APS case files of sexually abused adults in Virginia aged 60 years and older were collected from July 1, 1996-June 30, 1999, yielding a total of 42 substantiated cases for the three years of collection. Data reveal demographic trends; ability to care for self; type, pattern, and place of abuse; information on witnesses and alleged offenders; and case resolution and outcomes. Results show that the majority of cases (n = 40) concerned women over 70 years of age residing in facilities; offenders were men (n = 40). Most cases were not prosecuted. Implications of these data are discussed. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: Website: [C] 2000 by The Haworth Press, Inc. All rights reserved] KEYWORDS. Sexual abuse, older adult, adult protective services, elder abuse, outcomes, perpetrators

This article provides a context and overview for what is known about polyvictimization in later life. Drawing from previous literature, the article includes a definition of the phenomenon, as well as theoretical constructs by which it may be understood. We place other forms of polyvictimization within the context of elder abuse, recognize frameworks for conceptualizing polyvictimization in later life, and distinguish between polyvictimization at younger ages and polyvictimization in later life. The paper concludes with implications of the framework for research, practice, and policy.

This study examined 64 cases of sexual victimization of women ages 65+ (mean = 81) living in facilities that were investigated by APS and regulatory agencies in five states over a six-month period. Typically, abuse involved molestation (53%) and unwelcome sexual interest in the body (20%). Abilities and needs of women in substantiated and unsubstantiated cases were comparable. Resident perpetrators were more likely to be substantiated than staff or any other perpetrator (p = 0.008). Our results underscore the need to evaluate differences associated with gender, age, and residence, and to train on reporting and intervention by disciplines serving victims.

Using Bronfenbrenner's ecological systems model, this study examined allegations of elder abuse made to Kentucky Adult Protective Services (APS) and the investigation that followed, in order to understand how APS addressed the needs of abused elders. Elder abuse allegations made to APS during the study week were collected using 3 study tools. Allegations and resulting investigations were analyzed. During the study week, APS received 1,002 calls alleging elder abuse. Of these, 483 were categorized as reports needing protective services, with 177 reports screened in for investigation and 167 actually investigated. Results describe characteristics of abuse calls, investigations, victims, perpetrators, and total investigation times. Substantiation ratio, recidivism, and whether investigation increased or decreased the risk of abuse were also assessed. An examination of APS casework through the lens of nested systems frames the study findings and discussion. Such an examination has the potential to improve the quality of services provided to older adults.

This article explores the research question: What is the perceived level of elder abuse and neglect awareness and knowledge among Protestant clergy members in Kentucky? Of the 300 clergy contacted, 160 participated, for a response rate of 53.3%. Pearson Chi-Square analyses were used to determine statistical significance, and phi coefficient correlations examined the strength of the associations between variables. Findings indicate that approximately 44% of clergy members in this study report some "awareness" of elder abuse and neglect. However, 56% of clergy respondents do not know that Kentucky is an "any person" mandatory reporting state. Specifically, participating clergy appear poorly informed about legal requirements for reporting elder abuse and neglect and perceive types of abuse differently. Untrained clergy with little formal training indicate a willingness to provide therapy to victims despite reporting that they do not feel qualified to do so.

This study examined elder mentors' and students' roles, functions, and satisfaction with the Elder Mentorship program at the Graduate Center for Gerontology, University of Kentucky. The Elder Mentorship program matches gerontology doctoral students with older adults in the community. Parallel surveys were constructed to evaluate the program from the perspectives of elder mentors and student mentees. Data were analyzed using descriptive frequency analyses, with open-ended questions analyzed thematically. Results show that students and elder mentors were mostly satisfied with their experiences. Elder mentors perceived their participation more positively than did student mentees. Future programs utilizing the elder mentorship model may benefit from matching students and elder mentors in terms of shared interests.

Twenty-five interviews were conducted (18 clients and seven family caregivers) to identify the consumer's most important dimensions of personal care provision. Respondents were generally satisfied with their current aides, but there are unmet needs, including care at additional times of the day or week, and problems, particularly aides arriving late. The most common problems reported from past experience with prior aides included aides who arrived late, did not show up, or who were viewed as lazy. Eight important dimensions were identified, including having aides who are reliable, honest, easy to be around, and who possess a good knowledge base.

Implementing quality assurance (QA) programs in unregulated non-institutional settings remains a challenge for home- and community-based service providers. A sample of 65 Elderly and Disabled (E&D) Waiver providers were presented with eight problem scenarios commonly found in homecare services. Each of the respondents was able to identify strategies they would use to recognize and address each problem. Findings suggest providers currently use multiple mechanisms as part of their overall QA program. Discussion focuses on the strengths of using multiple approaches and on increasing provider awareness of complementary QA strategies and reducing the reliance on staff report as a major QA strategy.

Data from Virginia Adult Protective Services (APS) case files of 95 abused women aged 60 years and older were assessed to establish demographic trends; ability to care for self; type, pattern, and place of abuse; information on witnesses and alleged offenders; and case resolution and outcomes. The most common types of mistreatment reported were neglect, exploitation, and physical abuse. The women typically had several functional limitations and were dependent upon their family members for care. Most cases were not prosecuted, and the majority of women remain at risk for further abuse. Implications of these data for future research and practice are discussed.