Elder abuse prevention, detection, and prosecution

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Congress should reauthorize the Elder Justice Act (EJA). It should fully fund the EJA and other programs that address elder abuse. This includes programs within Social Services Block Grants and the Older Americans Act. Congress should appropriate funds to implement all provisions in the EJA (see also Social Services and Community Services Block Grants). 

Federal, state, and local agencies should collaborate to prevent, detect, and prosecute all forms of elder abuse. These efforts should include: 

  • facilitating uniform definitions of abuse, neglect, and exploitation; 
  • uniformly collecting and publishing data and conducting ongoing research on the extent of abuse; 
  • providing survivors of abuse with assistance, including in-home care and housing as needed; and 
  • supporting training of Adult Protective Services, as well as law enforcement and judicial personnel, to increase the quality of investigations and prosecutions. 

The public and private entities should be made aware of how and where to report elder abuse. 

Research is needed to improve our understanding of the markers of physical and psychological elder abuse. That research should be used to develop means to ensure that abuse is identified and addressed. 

States should train professionals from a variety of disciplines, including health care, to improve detection, investigation, and enforcement regarding cases of abuse, neglect, and exploitation. States should support the formation and ongoing operation of multidisciplinary teams to address elder abuse issues. 

Policymakers should enact adult protective services laws. These laws should apply in the community and in long-term care settings. Such laws should balance the individual’s autonomy and self-determination with the state’s obligation to protect those who are unable to protect themselves. 

Adult Protective Services (APS) should be adequately funded to fulfill its mandate. Adult protection laws should be fully enforced and should require prompt investigations. APS should intervene in cases of abuse, neglect, or exploitation of vulnerable individuals, including in cases of financial exploitation. APS should also offer programs for family members and caregivers aimed at curbing abuse. 

Adult Protective Services should: 

  • have sufficient legal authority to require record holders to provide all relevant and requested records to an investigation without the requirement of a signed privacy waiver. Alternatively, Adult Protective Services could be provided subpoena power. Laws should encourage third-party recognition of APS authority to receive requested or subpoenaed records. 
  • be required to report relevant data concerning both reported and investigated cases involving the jurisdiction of Adult Protective Services while protecting the privacy of individuals. 
  • use the least-restrictive protective action that meets the specific needs of the individual. 
  • routinely provide staff with comprehensive skills training, including diversity, equity, and inclusion training, to ensure high-quality and effective services are provided to clients and that services are provided equitably and without discrimination. 

Domestic violence and adult protective services agencies must be responsive to the particular needs of older abused spouses and partners. 

Abuse, neglect, and exploitation of a vulnerable individual should be criminal offenses subject to enhanced penalties. Every state or county should have a designated elder abuse prosecutor. 

Survivors and their legal representatives should have adequate civil procedures and remedies against those who commit all forms of abuse. Burden of proof must be shifted when proof of wrongdoing is limited to circumstantial evidence, such as in undue influence cases. Survivors should be awarded attorneys’ fees and costs and treble damages. Hearings should be expedited, and provisions made for out-of-court prerecorded testimony. Posthumous recoveries for pain and suffering should be available. 

Institutions should face criminal and civil penalties for all forms of abuse of those in their care (see also Quality and Consumer Protections in Long-Term Services and Supports Settings).