Elder Abuse Project
Elder abuse and neglect is among the many challenges we face with the dramatic increases in the number of people living to advanced old age and the rapidly growing older adult population. Elder abuse and neglect is a serious concern not only in institutional settings, but increasingly so in domestic settings because so many elderly who need care do not residing in institutional facilities, but are living at home in the community as a matter of personal preference and public policy that respects self-determination and supports community-based care for as long as feasible. According to national estimates, only 5% of elders reside in institutional settings.
The Administration on Aging recognizes three basic categories of abuse (defined by the National Center on Elder Abuse).
- Domestic elder abuse- Domestic abuse refers to maltreatment of an older person residing in his or her own home or the home of a caregiver. Domestic elder abuse generally refers to any of several forms of maltreatment of an older person by someone who has a special relationship with the elder (e.g., a spouse, a sibling, a child, a friend, or a caregiver in the older person's own home of in the home of a caregiver.)
- Institutional abuse- Institutional abuse generally refers to any of the forms of abuse that occur in residential facilities for older persons (e.g., nursing homes, foster homes, group homes, board and care facilities).
- Self neglect or abuse- Self abuse or neglect refers to the conduct of an older person living alone which threatens his or her own health or safety.
The National Center on Elder Abuse also defines seven types of elder abuse, including:physical abuse, sexual abuse, emotional or psychological abuse, financial or material exploitation, neglect, abandonment, and self-neglect.
Hawaii's law that applies to elder abuse and mandates protective services to adult abuse victims is found in Chapter 346, Hawaii Revised Statutes relating to Dependent Adult Protective Services (APS). According to this law, "abuse means actual or imminent physical injury, psychological abuse or neglect, sexual abuse, financial exploitation, negligent treatment, or maltreatment".
Results of a National Elder Abuse Incidence Study that focused on elders in domestic settings, shed light on a significant problem of elder abuse and neglect among elders living in their own homes and who have gone largely unidentified and unnoticed. The study noted that elder abuse and neglect may not be as hidden and under-reported to adult protective services agencies as they were during the time of earlier studies (between 1989 and 1996), however, a significant current finding is that only one in five new incidents of abuse, neglect or self neglect are reported to adult protective services agencies.
As a result of this study, the National Center on Elder Abuse initiated a Sentinel Pilot Project that is designed to identify unreported victims of elder abuse and neglect. Elders at most risk are those who are "hidden" and isolated from the community and may be suffering from abuse inflicted by a family member or caregiver behind closed doors; or who live alone and threaten their own health of safety through self-neglect.
Based on an estimated elderly population (60 years+) of 212,000 in 2000, and national estimates (ranging from 5 to 10%), there could be as many as 10,600 to 21,200 elderly victims of abuse, neglect and exploitation in Hawaii.
An application of the National Elder Abuse Incidence Study estimates (1.3%) could yield approximately 2,750 abused, neglected, or self-neglected elders in domestic settings.
According to the Hawaii State Department of Human Services, Adult Protective Services Program Reports, 453 cases of adult abuse, neglect and exploitation were investigated and 257 cases were confirmed in 1999. The elderly (60+) were seventy-eight percent, or 200 of these cases.
A National Federal Justice Act was passed last year as part of the Health Care Reform Legislation that added many protections for elders. The article can be viewed at this website (http://www.aahsa.org/article.aspx?id=11461).
The following is a report on a survey of adult protective services and elder abuse in hawaii and nationwide: Report on Elder Abuse