Abuse in Later Life: Practical Tools Judges Can Use to Help Identify and Respond to Elder Abuse Cases. Hon. Nathaniel Perry Candace Heisler

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1 Abuse in Later Life: Practical Tools Judges Can Use to Help Identify and Respond to Elder Abuse Cases Hon. Nathaniel Perry Candace Heisler National Council of Juvenile and Family Court Judges Annual Conference Learning Objectives As a result of this exercise, you will be better able to: Discuss the forms of elder abuse and its causes Describe how abusers justify elder abuse Describe the challenges older individuals face when seeking safety and justice in elder abuse cases Identify how a Court system can improve its response in elder abuse cases 2 1

2 WHY SHOULD WE LEARN ABOUT ELDER ABUSE? The TSUNAMI of a generation People are living longer than ever before as the result of improved life expectancy By 2030, more persons above the age of 65 than under the age of 18 By 2029, all Baby Boomers will be 65+ Over one in every 8 of the pop. is an older American Reported cases are increasing 4 2

3 Court Settings in Which Elder Abuse May Appear Criminal or civil institutional matters Guardianship/conservatorship, other probate Special protective proceedings Health care decisions for an incapacitated adult Protective Order proceeding Civil fraud of conversion Family cases 5 WHAT IS ELDER ABUSE? Depends on state statutes; can be defined many ways (physical, sexual, financial, emotional, stalking, neglect) National Center on Elder Abuse definition: Physical, sexual, emotional/psychological, financial, neglect, abandonment On going relationship between victim/perp where there is an expectation of trust (and/or when the person is targeted based on age or disability) Occurs in the elder s home or the caregiver s home 6 3

4 WHAT IS ELDER ABUSE? Self neglect = person no longer willing or able to provide basic care for self. Type of elder abuse most reported to Adult Protective Services ( APS ) Often an underlying medical condition Forms often co occur with other types of elder abuse Stranger perpetrated financial scams not covered in this course 7 WHO ARE VICTIMS OF ELDER ABUSE? Persons aged over 60 or 65+ Primarily females and some older males All racial, ethnic, socio economic, and religious backgrounds Heterosexual & homosexual relationships Does not include vulnerable or at risk adults age

5 WHO COMMITS ELDER ABUSE? Intimate partners (long term, new, or late onset) Occurs in heterosexual/gay/lesbian relationships Includes dating relationships Adult children and other family members Caregivers Fiduciaries Others with whom the victim has an expectation of trust and/or when the person is targeted based on age or disability This definition excludes victimization by strangers. 9 WHERE DOES ELDER ABUSE OCCUR? Domestic settings (89.3%)(APS Survey 2004) Facility settings (4.5 %) 10 5

6 WHAT ARE SOME CAUSES OF ELDER ABUSE? Complex Dynamics No single dynamic explains elder abuse Depending on the victim offender relationship and the type of elder abuse, elder abuse may resemble domestic violence, child abuse, or fraud or the phenomenon can stand on its own with the complexity of the relationships, individual vulnerabilities, and contexts in which it occurs. (Amendola, et al, 2010) 6

7 WHAT WE SEE MOST OFTEN: Greed Goal is financial exploitation Offender often committing other types of abuse Power and control As in domestic violence Pattern of abusive and coercive behaviors and threats used to control victim Actual and assumed power is used 13 7

Created by the National Clearinghouse on Abuse in Later Life (NCALL), a project of the Wisconsin Coalition Against Domestic Violence (WCADV) Aging, Abuse, and Capacity

8 Created by the National Clearinghouse on Abuse in Later Life (NCALL), a project of the Wisconsin Coalition Against Domestic Violence (WCADV) Aging, Abuse, and Capacity Think about some assumptions we have about older adults and where they may come from. These assumptions can work against older victims appear before you in court. 16 8

9 Ageism Ageist Attitudes Presumption of inability and/or incapacity Society often acts paternalistically towards elders Interventions mimic child abuse interventions 17 Perpetrators: Lethality, Dangerousness & Ageism Regardless of age you must assess dangerousness, including history of violence J. Campbell, et al (2007): leading risk factors for intimate partner homicide = prior DV plus: Firearms access Estrangement Forced sex Threats to kill Stepchild in home Non fatal strangulation Other: depression, substance abuse, stalking, hostage taking, obsessive about partner, homicidal suicidal ideation (Hart 1995) 9

10 Perpetrators: Lethality, Dangerousness & Ageism Age alone does not mitigate dangerousness (no specific research) But we know that elders of every age can and do inflict serious injury; elder victims are often not believed if the perps are frail or have disabilities Do not fall into trap that at the age of 60 or 65 potential for violence disappears! For example, seniors are almost as likely to be stalked as younger people (Jasinski & Dietz, 2003) Capacity Focuses on person s abilities What a person can do Clinical term and assessment, not legal determination Assessments of capacity are used to make judgments of competency Can be difficult to assess Competency A court finding that a person has the ability to do or not do something legal determination Requires a minimal ability to observe, recollect and communicate information Generally competence presumed unless challenged Determination of competency may require an expert s assessment 20 10

11 Victims: Capacity & Ageism Suspicion of incapacity can result in legal vulnerability for elder abuse victims Elders who report abuse, especially sexual abuse, are often presumed to have capacity issues or are disbelieved Aging may create accessibility issues that does not equal incapacity! 21 Victims: Capacity & Ageism Often facing abuse plus failing health, loss of vision/hearing/memory Abusers exploit this in and out of court! Normal process of aging will impact an older victims perception of choices and the consequences of the choices COULD HAVE CHILLING EFFECT FOR VICTIMS INVOLVED WITH THE COURT 22 11

12 Final Points on Aging, Ageism, Abuse & Capacity/Competency Normal aging CAN create accessibility challenges Normal process of aging will impact older victims perception of his or choices and the consequences of the choice, i.e. court ordered loss of autonomy Slowing of response time does NOT = cognitive decline Interventions often mimic child abuse interventions ineffective and inappropriate Until the contrary is demonstrated, individuals are presumed capable of making their own decisions 23 THE IMPACT OF ELDER ABUSE Consequences and Challenges 24 12

Senate Special Committee on Aging: Mickey Rooney s Testimony, 2011 25 Identifying Elder Abuse Challenges Shame, fear, embarrassment, intimidation Elders may try to hide abuse to avoid being placed in

13 Senate Special Committee on Aging: Mickey Rooney s Testimony, Identifying Elder Abuse Challenges Shame, fear, embarrassment, intimidation Elders may try to hide abuse to avoid being placed in a nursing facility Stereotypes of elderly may contribute to misdiagnosis or failure to recognize risks Symptoms attributed to age or dementia Bruises may be seen as more common due to use of blood thinners or blood vessel changes Minimize dangerousness 26 13

14 Additional Challenges Lack of awareness and training about Elder Abuse Law enforcement Prosecutors Civil Attorneys, including Guardians and GALs Advocates Judges, Court Commissioners, Court Personnel Elder abuse professionals May view offenders as overwhelmed Increasingly limited resources when caseloads are growing 27 The Human Toll Victims of elder abuse are 3 times more likely to die prematurely Longer recovery time for older victims physically, psychologically, financially some never fully recover 28 14

15 RESPONDING TO ELDER ABUSE A Call to Action 29 Reflection Question: What can you do in your courthouse to respond to elder abuse? 15

16 Court Practices to Assist Older Litigants Accommodations including amplification systems Scheduling of cases in late morning Early memorializing of testimony in criminal cases Use of telephonic hearings in civil matters when needed Court Practices to Assist Older Litigants One docket for elder abuse matters (criminal, court orders, possibly guardianships) or hear all cases at the same time separate from others (separate docket) Court may need to consider more frequent breaks Modify forms by increasing font size (and contrast between ink and paper color) 16

17 Reflection Question: What services are available to victims of elder abuse in your community? 33 Keys to a Better Response Identify local resources Focus on victim safety Be aware of and avoid assumptions Recognize abuser tactics Work collaboratively 34 17

18 Who Might Be Involved? Faith Leaders Advocates Financial Institutions APS and Aging Network Health Care Professionals Friends & Family Civil Attorneys Law Enforcement & Prosecution Older Individual 35 A CALL TO ACTION Go home find out what is happening in your community to prepare for this wave Tap into national resources NCALL, NCEA Seek state of art training on elder abuse already occurring with Law Enforcement and District Attorneys and judicial officers 36 18

19 Learn More National Judicial Institute for Domestic Violence NCJFCJ Futures Without Violence (formerly Family Violence Prevention Fund) U.S. DOJ, Office on Violence Against Women 3.5 Day Program, started in 2007 Faculty: Judges and National Experts 37 Enhancing Judicial Skills in Elder Abuse Cases Dates: August 11 14, 2013 Location: Portland, OR For more information, please visit: or contact Brianne Smith at or at 38 19

20 Contact Candace J. Heisler, J.D. 134 Oxford Lane San Bruno, CA (650) Hon. Nathaniel C. Perry, III District Court Judge 68th District Court 630 S. Saginaw Court Flint, MI (810) (810)

WHY SHOULD WE LEARN ABOUT ELDER ABUSE? Learning Objectives. The Changing Family, Elder Issues, and Intergenerational Considerations

WHY SHOULD WE LEARN ABOUT ELDER ABUSE? Learning Objectives. The Changing Family, Elder Issues, and Intergenerational Considerations The Changing Family, Elder Issues, and Intergenerational Considerations Hon. Katherine Tennyson Learning Objectives As a result of this exercise, you will be better able to: Discuss the forms of elder