Help Getting Help: Preliminary Findings on Service Needs and Barriers after Older Adult Maltreatment

by Julie Olomi, Naomi Wright, Leslie Hasche, & Anne DePrince

Approximately one in ten older adults experience abuse, neglect and/or exploitation, according to national research (Lachs, & Pillemer, 2015; Laumann, Leitsch, & Waite, 2008). For practitioners and policy makers, national research makes clear how big of a problem older adult maltreatment is, but not how to connect older adults to services in the aftermath. That’s where preliminary findings from the Older Adult Research (OAR) Project, led by Drs. Anne DePrince and Leslie Hasche, comes in.

As part of the OAR Project, our team interviewed 40 older adults who had incidents of abuse, neglect, or exploitation come to the attention of law enforcement or adult protective services. We asked older adult participants about their service needs and learned several important things about barriers to services and unmet needs.

When asked about getting their needs met, one in five older adults said that they did not know services existed. This finding speaks to the importance of getting service information out to older adults – and repeating that information across interactions. As we’ve discussed elsewhere in Trauma Notes, trauma can affect attention and memory such that older adults may not remember service information in the aftermath of abuse.

Even when older adults knew about services, another one in five reported to us that they were unable to access the services because they could not physically get to the office or lacked technological knowledge necessary for some services. Practitioners may want to pay particular attention to helping older adults plan how they will access services when describing service options.

Findings also suggested that factors related to the abuse itself might make service access difficult. For example, one in ten older adults told us that the offender or another person prevented them from accessing services. And, nearly one in ten older adults said that shame prevented them asking for help. These findings point to the fact that addressing the abuse and its consequences has to happen along with efforts to connect older adults to services.

When asked about what specific service they felt they needed, over a quarter of older adults asked for mental health services, ranging from therapy and counseling to social support and companionship. One in four asked for more help with finances such help paying bill or taxes. One in five felt they needed help maintaining their home, such as assistance with chores or yard work. Nearly one in five also needed transportation assistance, for instance because of physical limitations or scarcity of public transportation. Transportation was needed to accomplish a variety of activities, from moving homes, accessing service providers (such as doctors), or grocery shopping.

When older adults were able to access services, they frequently reported that their needs went unmet. Older adults saw communication problems as driving down the effectiveness of services. For example, some older adults described providers’ communications as unclear or insufficient; and noted problems in terms of providers coordinating with one another or across agencies. In the face of communication problems, older adults were left feeling that they did not know what steps to take next or how to advocate for themselves. Further, communication problems led older adults to wonder whether they had gotten to the right service or were being treated with dignity and respect.

Take-Aways

Preliminary findings from the OAR Project make plain that older adults have unmet needs following maltreatment. Factors related to the abuse – such as abuser tactics, shame, and memory problems – may prevent older adults from accessing services. In addition, older adults are not necessarily aware of service options, but face physical and technological barriers to accessing services when they are aware.

So, here’s the take-away from our preliminary findings: Older adults need help getting help in the aftermath of maltreatment. Practitioners may want to consider strategies to repeat information about services and problem-solve a range of access issues that are common to older adults (e.g., physical limitations) and unique to older adult maltreatment (e.g., the role of abusers in preventing service access, shame).

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References

Lachs, M., & Pillemer, K. (2015). Elder abuse. New England Journal of Medicine, 373, 1947–56. doi: 10.1056/NEJMra1404688

Laumann, E., Leitsch, S., & Waite, L. (2008). Elder mistreatment in the United States: prevalence estimates from a nationally representative study. The Journals of Gerontology Series B, Psychological Sciences and Social Sciences, 63(4), S248–S254.

Acknowledgements

This work was supported by the National Institute of Justice [Grant #2013-MU-CX-0032]. The views expressed are those of the authors and do not necessarily represent the views or the official position of the National Institute of Justice or any other organization.

Thank you to the Denver Forensic Collaborative for their collaboration to make this work possible, particularly Denver City Attorney’s Office (especially Linda Loflin Pettit), Denver District Attorney’s Office (especially Maro Casparian), and Denver Human Services-Adult Protective Services.

Update

September 30, 2019: A research article describing this research is now available here.