Policy Development

In the United States interest in elder abuse was sparked by testimony on battering of parents before a U.S. House of Representatives subcommittee investigating family violence in 1978. The growing numbers of elderly persons in society, the rising political power of the older population, and the existing state bureaucracies for delivering protective services lent legitimacy to making elder abuse a public issue. Despite the efforts of a few representatives to pass national legislation throughout the 1980s, no action was taken by the Congress. Nevertheless, federal agencies did incorporate elder abuse into their agendas, but not at the funding level of the U.S. Children's Bureau program for child abuse.

Without a national focus, a knowledge base, or model statutes, the states developed their own laws, definitions, and reporting procedures. Some used existing adult protective legislation; others, domestic violence acts. Still others passed specific elder abuse laws. By the late 1980s, each of the fifty states had a system in place for receiving reports and investigating, assessing, and monitoring cases. Four-fifths of the states adopted the child-abuse approach, making it mandatory for health and social-service professionals and others who work with older persons to report suspected cases of abuse and neglect, subject to a fine or imprisonment or both. In the other states, reporting is voluntary.

Despite the widespread enactment of mandatory reporting laws, most elder abuse is not reported to authorities charged with investigating the problem. It is estimated that only one in eight (or fewer) abuse situations are reported (Pillemer and Finkelhor; U.S. House Select Committee on Aging). Still, elder abuse reporting has increased over time. From 1986 to 1996 the number of reports nationwide grew 150 percent (i.e., 117,000 to 293,000). During this period reports of neglect and self-neglect increased; those of sexual abuse remained constant; and reports of physical, financial, and psychological abuse decreased (Tatara and Kuzmeskus).

Since the 1980s all states have made revisions to their protective or elder abuse laws, often to clarify definitions, increase penalties for perpetrators, or criminalize certain abuse types. Much recent policy activity seems centered at the federal level. This includes convening the first National Policy Summit on Elder Abuse in 2001. More than eighty individuals and agencies from across the country identified priority recommendations to address elder abuse at multiple levels of responsibility. Some of these recommendations are evident in the first comprehensive legislation to address elder abuse—the Elder Justice Act, introduced in the U.S. Senate in 2002. Among its many provisions, the Act seeks to create Offices of Elder Justice in the Departments of Health and Human Services and Justice, develop forensic capacity in abuse detection, establish safe havens and other programs for elderly victims, and increase efforts to address abuse in long-term care.

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