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The purpose of this study was to identify characteristics of investigations of sexual abuse concerning vulnerable adults residing in facility settings that were associated with case substantiation. Data on 410 reports of sexual abuse were collected prospectively from Adult Protective Services (APS) and state licensure agency staff in New Hampshire, Oregon, Tennessee, Texas, and Wisconsin over a six-month period. Specifically, we examined differences between reports that were substantiated and those that were not by comparing characteristics of alleged victims, alleged perpetrators, and aspects of investigation using logistic regression. We found that a relatively low proportion of cases (18%) were substantiated overall. Compared to cases that were not substantiated, cases that were substantiated were more likely to feature nursing home residents, older victims, female victims, and allegations of physical contact between the alleged perpetrator and victim. Despite the high proportion of alleged perpetrators who were facility staff (51%) compared to resident perpetrators (25%), cases with resident-to-resident allegations of abuse were much more likely to be substantiated, accounting for 63% of substantiated cases. In light of these findings, we believe it is important that investigators are trained to handle sexual abuse cases appropriately and that they are able to investigate the case thoroughly, promptly, and with as much information as possible. It is also critical that investigators make substantiation decisions using the appropriate standard for confirmation (e.g., preponderance of the evidence, beyond a reasonable doubt, clear and convincing evidence) as state law dictates. [ABSTRACT FROM AUTHOR]

The article presents a study on the sexual victimization of women aged 65 and older living in nursing homes. The results of the study reveal that sexual abuse of older women in nursing homes continue to occur, that victims are exposed to abuse due to mental or physical impairments or both, and that men are the alleged abusers. In addition, more nursing home residents than facility staff confirm the existence of such abuses.

Adult Protective Services (APS) workers were interviewed regarding investigating reported sexual abuse of healthcare facility residents. Authorities in five states provided data on cases of facility sexual abuse investigated over six-months. Data were collected and analyzed regarding 429 cases. Workers assigned to 15 percent of the cases were interviewed about conducting facility investigations and their decision-making processes. Findings demonstrate that lack of investigator training and resources has deleterious consequences on resident safety; facility response to resident sexual assault ranges from poor to excellent and has profound consequences on residents; and enhanced law enforcement involvement is needed. [ABSTRACT FROM AUTHOR]

Our ageist attitudes toward sex in old age impede the quality of life and the detection and prevention of elder sexual abuse. When sexual abuse is alleged or suspected, responders rarely ask the right questions or take the appropriate steps to assist victims, preserve evidence, or comply with reporting requirements. The legal, medial, social, ethical, and practical issues at the intersection of aging and cognitive incapacity are rarely addressed, so practitioners and families have little guidance. Recent studies demonstrate a far greater interest in intimacy among elders than is assumed. Elder abuse prevalence studies also show more incidences than has been assumed. Once all parties accept that there is both intimacy between elders and abuse in facilities and elsewhere, they will be better able to pursue perpetrators and ensure quality of life for all elders. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

An exploratory study of 284 cases of alleged elder sexual abuse revealed fairly equal numbers of reports to the criminal justice system (CJS) and to Adult Protective Services (APS). Comparison of these two routes of reporting indicated the following: Suspected victims reported to APS were more likely to reside in their own homes, not receive rape exams, and have cognitive disabilities. Their alleged offenders were typically spouse/partners or family members age 40 or older. Victims reported to CJS were more frequently abused in institutions, received rape exams, and were victimized by offenders under age 40 who also committed nonsexual crimes. In cases reported to the CJS, alleged offenders were less likely than those in the APS cases to be identified, but once identified, were more likely to be arrested, referred for prosecution, and convicted, or to plea bargain their case. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Suspected elder sexual abuse cases investigated by the Massachusetts Elder Protective Services Program between 1993 and 2002 were qualitatively analyzed using clinical consultation records. Cases that involved perpetrators who were family members of their victims inform this discussion of elder sexual abuse within the family. The cases fall into two groups: marital sexual abuse and incestuous abuse. Three patterns of marital cases were observed: (1) long-term domestic violence, (2) recent onset of sexual abuse within a long-term marriage, and (3) sexual victimization within a new marriage. Incestuous elder abuse involved cases perpetrated by adult children, other relatives, and quasi-relatives. Clinical dynamics observed in all types of cases are discussed. Selected cases illustrate abuse dynamics, problems confronting victims, and perpetrator characteristics. The range of abusive behaviors observed, etiological and contributing factors, and forensic markers of elder sexual abuse are discussed. [ABSTRACT FROM PUBLISHER]

Suspected elder sexual abuse cases investigated by the Massachusetts Elder Protective Services Program between 1993 and 2002 were qualitatively analyzed using clinical consultation records. Cases that involved perpetrators who were family members of their victims inform this discussion of elder sexual abuse within the family. The cases fall into two groups: marital sexual abuse and incestuous abuse. Three patterns of marital cases were observed: (1) long-term domestic violence, (2) recent onset of sexual abuse within a long-term marriage, and (3) sexual victimization within a new marriage. Incestuous elder abuse involved cases perpetrated by adult children, other relatives, and quasi-relatives. Clinical dynamics observed in all types of cases are discussed. Selected cases illustrate abuse dynamics, problems confronting victims, and perpetrator characteristics. The range of abusive behaviors observed, etiological and contributing factors, and forensic markers of elder sexual abuse are discussed. [ABSTRACT FROM AUTHOR]