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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.

• 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 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.

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.

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.

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.

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.

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 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.

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.

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.

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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