In discussions and comments
received as part of the 2015 White House Conference on Aging (WHCOA), researchers,
practitioners and other stakeholders highlighted the lack of research focusing
on elder abuse as a major barrier to creating evidence-based solutions and developing
policies that promote elder justice. Despite growing awareness of elder abuse, there
remain significant evidence gaps in detecting, preventing, and intervening in
elder abuse.
As a follow up to the WHCOA, the
National Institutes of Health (NIH) held a workshop on October 30 on “Multiple
Approaches to Understanding and Preventing Elder Abuse and Mistreatment.” This workshop was a trans-NIH effort that brought
together representatives from multiple Institutes and Centers within NIH, experts
from other agencies in the Department of Health and Human Services, as well as the
Department of Justice, and leading academics from the fields of elder abuse,
child abuse, and intimate partner violence. The purpose of the meeting was to focus on the applications of lessons
learned across fields, and to consider common challenges and opportunities in
elder abuse, child abuse, intimate partner violence, and other related fields.
The agenda was jam-packed with
substantive discussions about the scientific, structural, and practical
challenges of studying elder abuse. Researchers raised important concerns about the lack of fundamental
“basic science” knowledge about elder abuse that is critical to developing
evidence-based prevention and intervention strategies. Familiar research designs, such as randomized
controlled trials, are not always optimal for abuse prevention and intervention
studies. Because of concerns for
participant safety and confidentiality, it can be difficult to get approval to
include victims of abuse in longitudinal studies especially if Institutional
Review Boards have limited experience with research on abuse. Elder abuse
research raises unique issues for recruiting, enrolling and retaining
participants, in particular for people with reduced decisional capacity.
Four breakout sessions brought
together diverse perspectives around key topics: health disparities and cultural dimensions of
abuse, preventing mistreatment in familial environments, diminished cognitive
and decisional capacity as risk factors, and the bioethics and law in elder
abuse research.
Overall, participants concluded
that more research, training, and research infrastructure is necessary to make
significant progress in preventing abuse and developing evidence-based programs
in the future. Findings from child
abuse to intimate partner violence could help inform elder abuse research
strategies and directions. For example,
arrest of perpetrators may remove the immediate cause of abuse for a child or
intimate partner, but fear of family disruption creates situations in which
family members are reluctant to report perpetrators. Another example of a more
nuanced understanding of abuse in younger adults that could help our
understanding of elder abuse is the concept of polyvictimization—the cumulative
burden of multiple types of abuse. Creative research design is necessary to ensure that those impacted by
abuse are included in research while at the same time not further injured by
the research process.
The event was a great forum for
discussing the opportunities and challenges to moving the elder abuse research
agenda forward, and it brought new voices to the conversation. I look forward to hearing more in the coming
months.
More information about the workshop,
links to relevant reports and websites, and a link to the archived videocast is
available on the NIH website at https://www.nia.nih.gov/about/events/2015/nih-workshop-multiple-approaches-understanding-and-preventing-elder-abuse.
The following resources were shared
with participants in advance and provide excellent background on elder abuse,
child abuse, and domestic violence research.
1. SPECIAL ISSUE: Journal of Elder Abuse & Neglect (JEAN) Editors’ Choice article
collection. Available free online through the end of
2015.
2. REVIEW
ARTICLE: Dong, XQ, 2015. Elder
Abuse: Systematic Review and Implications for Practice.
3. WORKSHOP
REPORT: Institute of Medicine, 2013. Elder Abuse and Its Prevention - Workshop Summary.
4. REPORT:
National Institute of Justice, 2013. Understanding
Elder Abuse: New directions for developing theories in domestic settings. (PDF, 379K)
5. WORKSHOP
REPORT: U.S. Department of Health and Human Services, 2013. Intimate Partner Violence Screening and Counseling
Research Symposium. (PDF, 1.2M)
6. CONSENSUS
REPORT: Institute of Medicine, 2013. New Directions in Child Abuse and Neglect Research.
7. WORKSHOP
REPORT: National Institute on Aging, NIH, 2010. Meeting on Research Issues in Elder Mistreatment and
Abuse and Financial Fraud.
8. WORKSHOP
REPORT: National Institute of Justice, 2008. Elder
Abuse Workshop. (PDF, 707K)
9. CONSENSUS
REPORT: National Research Council, 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation
in an Aging America.
10. WEBSITE:
National Institute of Justice. Elder Abuse.
11. WEBSITE:
National
Center on Elder Abuse, Administration on Aging.
12. WEBSITE:
CDC Injury Prevention & Control: Division of
Violence Prevention. Elder Abuse.
13. WEBSITE:
National Library of Medicine resources related to
Domestic Violence.
14. WEBSITE: WHITE
HOUSE CONFERENCE ON AGING (WHCOA):
• Policy Brief
• Deliverables
• NIH at the WHCOA
15. WEBSITE: U.S.
Department of Justice
• DoJ CONSENSUS PAPER (PDF, 229K)
