Impact of an elder abuse multidisciplinary team on prosecution rates

Joyce DeMonnin, MPH, CHES; Rick Knapp, JD, and Grady Tarbutton

ABSTRACT: The goal of elder abusemultidisciplinary teams (MDT) is to enhance theidentification, investigation and prosecution ofelder abuse crimes in the community. Elder abusepresents a significant public health risk to olderadults, and developing interventions and acoordinated response is poorly understood.

Since the Washington County Elder Abuse MDTwas formed in 1999, the team has met 11 times ayear staffing difficult cases, providing inservicetrainings and an opportunity for informalnetworking and decision making acrossdisciplines. The team also sponsored a number ofinterdisciplinary workshops.

The number of cases referred to prosecutorsincreased 570% in four years. The MDT hasdocumented elder crime and adult protectiveservices rates in the community leading tointervention strategies and increases inprosecution rates.

Problem Description: Best estimates indicate eldersreport only 20% of such elder abuse, mistreatmentand crime. (NCEA National Elder Abuse IncidenceStudy, 1998) Many barriers exist to elders reportingcrime or abuse including lack of understandingwhom to call, inadequate training among criminaljustice professionals and inadequate laws andprotection.

In 1998 in Washington County, law enforcementreported one elder abuse crime to the DistrictAttorney. In 1999, the first year of the MDT, 10cases were referred. In 2002, 67 cases were referred.While the numbers are still low, this marks aparadigm shift in our community.

What is elder abuse relating to the criminal justice system?

Any crime in which the victim (65 of older) may have been targeted because of his or her age, or was harmed due to vulnerability of age or disability.

Washington County Elder Abuse Multidisciplinary Team

Elder Abuse MDT members include mental health professionals, adult protective service workers, prosecutors, emergency services personnel, law enforcement, victim advocates and private attorneys. Members meet each month to staff cases, identify gaps in services, barriers to prosecution and better ways to share information.

Program Design: Few communities track elder crimestatistics, so crime rates among this population are notwell known. An early objective was to improvesurveillance. Elder Safe receives about 90% of allpolice reports in the county where the victim is 65 orolder, and staff or volunteers contact nearly all eldercrime victims in the county by letter and in phone orin person.

Victim demographic and crime information is enteredinto a database, along with available information onthe suspect, and whether or not the case has beenforwarded to the District Attorney’s Office forprosecution. Cases are cross-referenced with the DA’sdatabase. Information about the types of victimservices provided is also tracked. Elder Safe uses Epi2002, a downloadable epidemiological programavailable free through the Centers for Disease Controland Prevention. In addition to easy-to-developquestionnaires, the program has built-in statisticalanalysis capabilities.

Criminal justice barriers to investigating elder abuse Concern over civil vs criminal issues Lack of understanding of what may

constitute an elder abuse crime Isolation and inability of elders to report

crime Shame of elder reporting victimization

by family members

Training key to MDT success

Learn issues of elder abuse from criminal justice, medical and social services perspectives

Learn to speak each other’s language Agree on common goals and methods Know who community partners are

Elder abuse trainining for law enforcement, APS, EMTs

Clergy Training

Members of the faith community are mandatory reporters in Oregon, but reports rarely come from them. The MDT held a training for pastors and laity to increase their knowledge of signs and symptoms of elder abuse, and how to report it, in addition to many other groups.

Relationship of suspect to victim

32 4313 14

5410

33

306

050

100150200250300350

caregiver child grandchild spouse unrelated related other stranger unknown

Abstracting information from police reportsElder Safe staff track information such as relationship of suspect to victim, whether or not the suspect uses drugs or alcohol, type of crime, age of victims and other information.

Elder abuse cases referred to DA

110

46 4967

020406080

1998 1999 2000 2001 2002

This represents about 12% of incident reports

MDT starts

Elder Safe Program Starts

Impact of MDT on prosecution rates

Since the inception of the Elder Abuse MDT, referrals for prosecution increased 570% in Washington County over a four-year period.

Measurable outcomes and benefits: The programhas tripled its capacity in just three years. Elder Safeassisted approximately 120 elder crime victims in2000 and nearly 500 in 2002. Program location at alaw enforcement agency allows staff to fullydocument elder crime statistics, the number ofvictims served and the types of services offered.Through a multidisciplinary team approach,prosecution referrals have increased 570%. In 2002,about 10 volunteers donated more than 1,700 hours.Brochures on Elder Safe, elder abuse restrainingorders, and how to report abuse or crime have beendistributed throughout the county. In 2002, morethan, 1,000 seniors accessed either victim assistanceor adult protective services. (There areapproximately 40,000 individuals aged 65 and olderin the county.)

References:

Wolf R, Li D. Factors affecting the rate ofelder abuse reporting to a state protectiveservices program. Gerontologist. 39(2):222-8. 1999.

Lachs MS, et al. The mortality of eldermistreatment. Journal of the AmericanMedical Association. Aug 5;280(5):428-32

Costen, R. National Center on Elder AbuseNewsletter, March 2003

The National Center on Elder Abuse. TheNational Elder Abuse Incidence Study.1998.

DeMonnin, J. Elder Safe Annual Report.2001 and 2002. Hillsboro, Oregon