Table of Contents

About This Course

1. Introduction to Elder Abuse
2. The Basics of Elder Abuse
3. Substance Use and Other Risk Factors
4. Screening and Assessment
5. Intervention and Treatment
6. Preventing Elder Abuse

Supplements
Case Studies
References
Resources

Out of the Shadows
Uncovering Substance Use and Elder Abuse

Intervention and Treatment Goals

The goals of intervention are to provide safety and support to victims and to work with abusers and hold them accountable. Depending on the type of abuse, the setting, and the victim's physical and mental health, the response to elder abuse will vary.

The complexity of elder abuse, particularly when alcohol or other substances is present, may require different service delivery systems and agencies. Collaboration among agencies is essential to avoid what researchers call "clashing paradigms."ref Clashing paradigms result when professionals in one field may define the goals and outcomes of a particular situation differently. Without collaboration, possible tensions between professionals focused mainly on helping the victims and others responsible for punishing the perpetrators can arise.ref

Cross-training on substance abuse, domestic violence, and elder abuse will help professionals work with individuals, families, and communities to find the most appropriate strategies to stop and prevent abuse.

Further complicating the situation is the fact that older adults sometimes refuse to admit abuse. Often, the older adult would rather endure continuing abuse than be separated from the family or move into an institutional setting. A survey of older victims of reported domestic abuse in New York City, for example, reported the tendency among elderly victims to be less likely to accept services if services were not made available for their abusive family members.ref These various manifestations of complex interpersonal dynamics of elder abuse demonstrate the importance of treating and addressing problems with the perpetrator as well as the victim.

Self-neglect is one of the most common forms of elder abuse and may be accompanied by mental illness or substance abuse. Yet determining an individual's cognitive ability and ability to function independently, the presence of mental health problems, and identifying possible treatment or intervention span complex health, legal, and policy areas. In fact, society has yet to fully grapple with the extent of this problem, find possible solutions, and allocate adequate resources to address the needs of self-neglecting older adults.