Addressing Elder Mistreatment
Some jurisdictions have developed innovative approaches to improve system response to elder mistreatment, such as special elder abuse prosecution units, elder fatality review teams, and the expansion and improvement of statutes that mandate abuse reporting for vulnerable adults. Although these approaches show promise, they are in the nascent stages of their development and have not been rigorously evaluated.
For example, researchers have examined implementation of the Arkansas law giving county medical examiners the authority to investigate deaths occurring in long-term care facilities (LCF). [1] They conducted focus group interviews with medical examiners, coroners, and geriatricians from 27 States to determine their involvement in investigations into the deaths of LCF residents. Although Lindbloom's findings suggest that the Arkansas law had a positive impact on attention to elder mistreatment and the quality of care of LCF residents in Pulaski county, whether care has improved State-wide is not clear because of differences in implementation.
Researchers in Arkansas identified specific characteristics within four categories of markers that investigators can look for to determine whether elder mistreatment is occurring or has occurred—see Potential Markers for Mistreatment [2].
The second phase of this study concluded in 2007. The resulting data indicates that the Arkansas Long-Term Care Reporting law, which mandated that all deaths that occur in nursing homes in Arkansas be officially investigated, has not made a difference in quality of care in the state. The project also revealed additional factors associated with higher level of mistreatment suspicion, including family dissatisfaction with care; minority race; tube feeding; the presence of a severe pressure sore or recent ostomy. [3]
The Office for Victims of Crime (OVC) teamed up with the American Bar Association to produce a replication manual to aid elder abuse fatality teams in reviewing the causes of elder deaths and enhancing the response of community agencies to elder victims of abuse.
Notes
[1] A brief description of the Arkansas law and how it came about can be found in the research report Role of Forensic Science in Identification of Mistreatment Deaths in Long-Term Care Facilities. A final report submitted to the National Institute of Justice, January 2005, NCJ 209334.
[2] Lindbloom, E., J. Brandt, C. Hawes, C. Phillips, D. Zimmerman, J. Robinson, B. Bowers, and P. McFeeley. "Role of Forensic Science in Identification of Mistreatment Deaths in Long-Term Care Facilities." Final report submitted to the National Institute of Justice, January 2005, NCJ 209334.
[3] Lindbloom, E., R. Kruse; J. Brand; M. Malcolm; A. Hough, Jr.; D. Zimmerman and J. Robinson. "Mandatory Reporting of Nursing Home Deaths: Markers for Mistreatment, Effect on Care Quality, and Generalizability Final Report (pdf, 98 pages)." Final report submitted to the National Institute of Justice, March 2008, NCJ 221893.
