Research in Action: An Elder Abuse Study Impacts How Law Enforcement Work Their Cases

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2009 NIJ Conference 2009
Aileen Wiglesworth, Ph.D.
Assistant Clinical Professor of Family Medicine, University of California, Irvine
Cherie Hill, Detective, Anaheim, Calif., Police Department

Cherie Hill: Basically, when I first became a detective, I was working family crimes, which includes domestic violence, elder abuse, child abuse, and prior to that time we did not have a detective that specifically was trained for working elder abuse — this was about 2005. My first elder abuse case involved — well, actually she would be a dependent under our state code, but she's 54 years old, had Parkinson's disease. And I get a call stating that this woman has a fractured orbital — around the eye — she had bruising on her face, and that there's a suspicion that her boyfriend did it.

So, I go the hospital, and I try to interview her. And well, she tells me she fell. And in my training, I was trained that everybody lies. So I went, "Ok, well, here's another example of somebody lying, and you know what? If she doesn't want to be a victim, there's nothing I can do."

I didn't push it. So, what I did was, instead of going out to the home and measuring the carpet and seeing: Ok, could she have fractured her face by falling down? Didn't do any of that because I thought, "You know, no victim, no crime." And that's typically how we would handle cases because there's no other corroborating evidence.

Well, then, as time went on I became involved in the forensic center, which is an organization in Orange County. And there are doctors that work there, and Dr. Wiglesworth, Dr. Mosqueda, and what I found was that they did a bruising study. So I asked Dr. Bernite to send me this bruising study. And I look at the bruising study, and it says that accidental bruises don't typically happen on the face, the torso, the neck and the feet — and thighs, at that time. And so, it really caused me to go back and rethink the way I handle my cases.

Well, then, as time went on I became involved in the forensic center, which is an organization in Orange County. And there are doctors that work there, and Dr. Wiglesworth, Dr. Mosqueda, and what I found was that they did a bruising study. So I asked Dr. Bernite to send me this bruising study. And I look at the bruising study, and it says that accidental bruises don't typically happen on the face, the torso, the neck and the feet — and thighs, at that time. And so, it really caused me to go back and rethink the way I handle my cases.

So, now we're finally trying to catch up, and through this study, we're getting there; it's a battle, but we're getting there. So, it's just an invaluable study for me in law enforcement and in getting prosecutions.

NIJ: Tell us more about the study.

Aileen Wiglesworth: Well, actually there are two studies. The National Institute of Justice funded a study first, of what is accidental bruising, what does that look like in older adults. There hadn't been any research like that. And Cherie was able to use that work to say, "You know, accidental bruises don't tend to occur on the face and the torso, and other areas as well." Most of them tend to be on the arms, on the extremities, on the arms and legs, and on certain surfaces of the arms and legs.

So, then we got a second study, which we actually worked with clients of adult protective services who had been reported for physical abuse. We got an expert panel to confirm that, yes, they had been physically abused, and we looked at their bruises, and we did find, indeed, bruises on the face, bruises on surfaces of the arms that aren't ordinarily bumping into things, on the posterior torso tend to be — well, it's much more likely that they are associated with abuse if you find bruises, but bruises anywhere can be abuse. And among our other findings was that people can tell you — they do remember what happened; they may lie to you, but to our researchers they had no motive to lie, for the most part — whereas accidental bruises, only 25 percent or less are likely to remember how they got those bruises even the next day. People who are victims of crime and got bruises that way, 90 percent of them can remember. So, we say, "Ask them. Ask them in the right way," and Cherie is very skilled at doing that.

Hill: Can I give an example of that?

Wiglesworth: Sure.

Hill: I don't want to interrupt you. A perfect example of what Dr. Wiglesworth is talking about — I had a case, and I mentioned this yesterday, where there's a 74 year old. She's at home; she has a position of trust with her grandson who lives with her along with a lot of other family members. And basically, grandson's on the couch watching football and grandma decides, "You know what, time for me to put my wrestling on." So she goes in, and she tries to get the remote control, and he's not going to have anything to do with this because he wants to watch football. So he grabs onto her arm, and he shoves her, twists her, shoves her down. She gets an extremely large bruise right here. [Hill indicates her wrist.] And it goes around the arm like this, and she has a laceration. He also punches her, and she gets a mark on her face, which wasn't visible by the time I had gotten out a couple of days later.

So, officers take a report. I get the report, and I decide — well, they arrest the suspect, they arrest the grandson for assault and battery and elder abuse, and the next day, what happens is, when the guy's in jail, the family members, the six other family members, bring grandma in to the front counter of the police department. So grandma comes in, and she says — and mind you, she has dementia — and she says, "No he didn't do it. He didn't do it. A cereal box fell on my arm. That's what happened." So, I'm like, "This isn't going to fly. Because I know, based on the bruising study, though not an atypical area, but based on the way it looks that this is — I feel it's abuse.

So I call Dr. Mosqueda and ask her to come in and sit in on the interview with me. And so, she actually looks at the bruise, and she's like, "Yeah, based on our study, this is abuse." So, we start interviewing this lady, who has dementia, and she says, "Well, he grabbed me. And then the cereal box fell on me." And then she kept going back to, "You know, he grabbed me. He grabbed me." Based on that, despite her dementia, based on the studies, we know that she was telling the truth. So this guy that had been fighting it, that had all his family members fighting this charge, actually ended up pleading guilty to elder abuse. So, did some time on it and is no longer allowed to live with his grandma.

So, again, this is something where we were able to go back and say, "Based on this study, we know that this was not an accident. We know that when she keeps saying 'He grabbed me,' she's telling the truth."

So, good job.

Wiglesworth: Yeah, there's another finding that the size of the bruise is — a bruise that's larger than two inches is much more likely to be associated with abuse. And all surfaces of the arm like that [gesturing to her wrist], that's unusual.

Hill: The other thing that's amazing, that I love about this study — I get very excited about this because it's completely changed the way I work my cases — is in the past, typically in child abuse as well as domestic violence, elder abuse, any type of abuse, if we saw a bruise — and remember, I was trained that everybody lies, right — when someone came in with a yellow bruise and said, "Well, he beat me up today. He beat me up today," I would take that case to my prosecutor, literally, and we would sit there and go, "Well, somebody's lying because this is a yellow bruise and people don't get yellow bruises the first day of an incident." So, basically, the case wouldn't go anywhere.

So, based on this study now we found out.

Wiglesworth: Yeah, I forgot to mention that. Yeah.

Hill: .that, yeah, I think it was something like 16 out of all of your people that you studied — yellow bruises on the very first day of the incident. We now know that what we had all thought in the past of the color of bruises, you can get a yellow bruise the very first day of an injury. So, it's just completely changed the way things — the way law enforcement at my department, the way our prosecutors at my city look at things. I've exposed them all to this training; they've gone to the training. We handle elder abuse cases completely different than we had ever handled them in the past. It's just been phenomenal for us in getting criminal filings and getting people off the streets.

Wiglesworth: Yeah, the finding from the first study was that the color of a bruise doesn't tell you about its age, and one nice thing that's happened since then, at the same time someone else was doing child abuse literature with the same findings, so that myth is gone. And, you know, it has been helpful.

Hill: Oh, it's phenomenal.

NIJ: Would you repeat that again? I'm not sure that was. Just say that again about the coloring.

Wiglesworth: The color of a bruise is not an indicator of how long someone's had the bruise. A bruise can be any color on any day. On the first day it can be any color. And then we show a graph that shows every color, and it's just like a nice rainbow, you know, that every color can be there on any day. So, there needs to be more research to see what that's about, but that's something that is sort of a popular myth, that we need to get the word out that that isn't true.

Hill: And why it is that it's so big and has such a big application, because we're all trained, not specifically in the police academy, but as we get experience on the street, that any age, when you see a bruise, if it's yellow, then it didn't happen right away.

You know, so, like, say I have a yellow bruise. If somebody were to come up and ask me, well, "When did you get that?" and I said, "Today," the officer would be like, "Uh, no, that's yellow; you probably got it a week ago. So what's the true story? What really happened?" This is why this has such significance, because we would think that way on children, on adults, on elders. But now, having this study tells us that we were wrong, that people can have yellow bruises on the first day of an incident. And now, with the research that you were saying that somebody's doing with children, it's indicative of the same thing.

So that'll be phenomenal to reach law enforcement.