Sexual Assault and Elderly Victims: How to Build Your Case

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Morgan Lee
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1 Sexual Assault and Elderly Victims: How to Build Your Case William D. Johnson, Adult Abuse, Neglect, & Exploitation State Resource Prosecutor Prosecuting Attorneys Council Definition: Elder Sexual Assault Any non-consensual, unwanted sexual contact with an older adult. *Georgia defines as persons 65 and older, OCGA Sexual Abuse OCGA : Lewd exhibition of genitals Flagellation or torture on unclothed person Fettered, bound, restrained unclothed person Sexual stimulation of breasts, genitals, buttocks Defecation/urination for sexual stimulation Penetration of vagina/rectum with any foreign object 1

from: Family (including children and in-laws) Spouse/Partner

2 Other Possible Charges Rape Aggravated Sodomy Aggravated Sexual Battery Sexual Battery Incest Pimping Simple Battery Predators come from: Family (including children and in-laws) Spouse/Partner Caregiver Other long-term care residents Online predators Strangers (less frequent) 2

Bite marks, pelvic bleeding and pain; STI or HIV, unexplained genital infections, or

3 Initial Signs Outcry/report Physical indicators Physical evidence Behavioral cues Physical Indicators Explained Bruising: arms, chest, mouth, genitalia, pelvis, thighs; Bite marks, pelvic bleeding and pain; STI or HIV, unexplained genital infections, or pregnancy. Behavioral Cues Explained Mood Hygiene Fear Touch issues Inappropriate actions 3

4 Code Words Consider in context: S/He s my girlfriend/boyfriend! But he is a facility administrator S/He loves me! Both are married and have Alzheimer s I m his favorite guy/girl! An overly-friendly 25 year old restaurant server Determine Consent Free, knowing, and voluntary. Awareness of who is initiating sex? Consistent with values and beliefs? Capacity to say yes or no? Capacity Having sufficient understanding and memory to comprehend in a general way the situation in which one finds oneself, and the nature, purpose, and consequences of any act or transaction into which one purposes to enter. PA Dept. of Aging, Anne Burgess, RN 4

5 Capacity Having sufficient understanding and memory to comprehend in a general way the situation in which one finds oneself, and the nature, purpose, and consequences of any act or transaction into which one purposes to enter. PA Dept. of Aging, Anne Burgess, RN Capacity Having sufficient understanding and memory to comprehend in a general way the situation in which one finds oneself, and the nature, purpose, and consequences of any act or transaction into which one purposes to enter. PA Dept. of Aging, Anne Burgess, RN Capacity Having sufficient understanding and memory to comprehend in a general way the situation in which one finds oneself, and the nature, purpose, and consequences of any act or transaction into which one purposes to enter. PA Dept. of Aging, Anne Burgess, RN 5

Issues Sexual Abuse does not address elder-related issues. Elder Abuse does not address sexual trauma. Physical Abuse does not address the motive of sex crimes.

6 Issues Sexual Abuse does not address elder-related issues. Elder Abuse does not address sexual trauma. Physical Abuse does not address the motive of sex crimes. Further Issues Not every sexual situation is abusive. Most of our tools are generic: mandatory reporting and penalty enhancements. Motive: Power and Control A caretaker repeatedly upsets an 80 year old with dementia by claiming sex with his daughter. 6

Motive: Power and Control Rough touch used on genitals and

7 Motive: Power and Control Nursing staff hits a 78 year old in the face with a dirty diaper because of incontinence. Motive: Power and Control Rough touch used on genitals and sensitive areas of a patient who is difficult at bath time. Keep it up, and I ll do that again! 7

8 Example: 83 year old victim: burglary/rape. Severe injuries and trauma. Struggled to discuss the crime. Severely embarrassed. Only confirming minimal details. Would victim services be able to address her specific trauma/lifesituation? Victim Characteristics Easily overpowered Easily manipulated Unlikely to report Unlikely to be considered credible 67% are female 50% have cognitive impairments Victim Issues Longer recovery: physical/mental; Risk of serious injury; Difficulty in healing from sexual trauma; Broken bones; Risk of infection. 8

How These Cases Differ: Reduced support system. Exacerbated illnesses. Disbelief, especially from jurors. Lack words and understanding. Hastens death in fragile victims.

9 How These Cases Differ: Reduced support system. Exacerbated illnesses. Disbelief, especially from jurors. Lack words and understanding. Hastens death in fragile victims. Victim-Centered Responses: The initial response to any victim of sexual assault sets the tone for the entire investigation and must be tailored to the response and special needs of the victim. Victim-Centered Responses: An appropriate, victim-centered response on the part of the law enforcement officer is critical to the victim s recovery, as well as cooperation with investigation and prosecution. 9

10 Victim-Centered Responses: Elderly victims may require special services to appear in court. Special efforts and procedures may be available to obtain and preserve testimony if victims cannot come to court. Victim-Centered Responses: Difficulty testifying: impairments, medications, medical issues, diet. They may need more frequent breaks and shorter court sessions. Testimony may need to span more than one long court session. Tools Multidisciplinary Teams and collaboration. In Georgia: depositions available for witness/victim over 72. Use preliminary hearings to record testimony. 10

Tools: Expert Witnesses Sexual Assault Nurse Examiner or Sexual Assault Response Team Member Pharmacist/Pharmacologist Nurse (wound care or in-home) Forensic Psychologist Counselor/Therapist

11 Tools: Expert Witnesses Sexual Assault Nurse Examiner or Sexual Assault Response Team Member Pharmacist/Pharmacologist Nurse (wound care or in-home) Forensic Psychologist Counselor/Therapist Investigation Stage Talk to witnesses/victim quickly. Collect evidence before facilities clean. Confer with all agencies/groups involved. Proceed as if victim is unavailable. Competence Talk with doctors and nurses. Consider time of day morning. Consult an expert in gerontology or doctor who works with the elderly. Always presume competence in an Alzheimer s/dementia patient unless proven otherwise. 11

Communication Establish solid contact: yes and no. What level of comprehension and communication? Remember this may be the most difficult discussion they ve ever had.

12 Communication Establish solid contact: yes and no. What level of comprehension and communication? Remember this may be the most difficult discussion they ve ever had. Communication Indicate your knowledge of a bad incident. Use visuals, dolls, and short yes/no questions. Keep visits short. Be mindful of their schedule. Emotional Support Referral Info Presence throughout Encouragement Victim Advocate 12

13 Victim Advocate Assist with general questions and concerns. Explain the process repeatedly. Support family members of victims. Time is of the essence Remember: their dignity and justice is in your hands. 13

14 Reference Brian Payne, Understanding Sexual Abuse and the Criminal Justice System s Response, Justice Quarterly (2010). Ann Burgess, PA Department of Aging. Elder Abuse Guide for Law Enforcement (eagle.trea.usc.edu). Lean on We ( Thanks to Agatha Romanowski, Dekalb County District Attorney s Office. Thanks to Paul Greenwood, retired San Diego County District Attorney s Office. Notice This presentation may contain materials created by others. Such material is used under a claim of fair use pursuant to the Fair Use guidelines in face-to-face instructional education activities. Additional use or distribution of that material is prohibited. Contact Information Will Johnson wjohnson@pacga.org Work: Cell:

Responding to Older Victims of Sexual Abuse: Promising Practices from OVW Abuse in Later Life Program Grantees. By Bonnie Brandl and Madeline Kasper

Responding to Older Victims of Sexual Abuse: Promising Practices from OVW Abuse in Later Life Program Grantees By May and George have been married for 57 years. George has physically and sexually abused