Running head: POLICY RESEARCH ON ELDERLY ABUSE

Marwa Hammoud
Policy Paper 1
November 2, 2015
Dr. Bowers, SW 4710

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Describe the current problem with which you are concerned:
Of the many social problems facing the world today, the most striking is the undetected
elder abuse that takes place. There is massive injustice in the way the elderly are treated. The
same age group who have sacrificed so much and deserve the utmost respect. The generation that
raised, taught, clothed, fed, and sheltered the current younger population. It is unjust that many
elderly live with very little dignity. The elderly fall victim to multiple forms of abuse ranging
from telemarketer calls to nursing home neglect. Due to their physical and mental fragility, it is
difficult for the elderly to defend themselves in the face of injustice. They become prey to those
looking to benefit off their frailty. It is important to note that there is a helpful non-profit called
Elder Law of Michigan that provides legal services to elderly that have fallen victim to
inequalities. All of the programs under that agency are free of charge. This is a way for senior
citizens to fight back and protect themselves. As inhumane as it sounds, there are many people
ready to take advantage of the elderly. Although elderly abuse occurs around the world, this
paper will focus on the abuse occurring in America and what exactly is being done to address
and fix this social problem.
A local non-profit called Bridging Communities provides services for the elderly residing
in southwest Detroit. This organization is linked to many sister-organizations that all strive to
give senior citizens the highest quality of life by helping them meet their needs. Some of the
services provided are Focus Hope applications, assistance in signing up for Medicare/Medicaid,
and minor home repairs. In addition, a housing department that aids in obtaining affordable
housing for the elderly. Bridging Communities also owns two independent living centers so their
level of care ranges. One Case Worker, Lisa Knott, was interviewed about her opinion on any
abuse she has witnessed in her 3 year of employment at Bridging Communities. It always

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surprises me how many of our clients are in a fragile state yet live alone and rarely get checked
up on by their families said Knott. There is a specific Remembrance List at Bridging
Communities that consists of clients that live alone and arent contacted frequently enough by
their families. The clients on this list are contacted with a quick phone call just to check up on
them and ensure that they are having a good day and that their needs are being met. What start
out as short phone calls; soon turn into lengthy venting sessions because these elderly have no
one else with which to converse. The elderly are alone and in need of affection. They will take
any kind of attention they can get from anyone that will give them the time of day. Without the
constant contact from Bridging Communities workers, the neglect would consume most of the
elderly living in southwest Detroit.
While it is customary in several cultures for the elder family members to move in with
their children, it seems as though the fast-paced American society makes it difficult to balance
work and care. Ageing has been seen as an increasing problem since the birth of the welfare
state, epitomized by enforced retirement, elderly medicines, the loss of self into the homogenous
group of the elderly, and a growing dependency which increases the burden on the hard working,
non-elderly population (Wahldin, 93). It is challenging to break the stigma of the elderly being
burdens and a strain on family dynamics. Families with both parents employed and children that
are involved in afterschool programs simple cannot find the time to care for their parents. As a
result, many families result in placing their elders in nursing facilities and do the best they can to
visit often. Elderly are tougher to take care of because they can very easily hurt themselves.
Their fragile state makes it difficult to leave them alone for an extended period. However, that
does not justify the way they are dismissed and left to be cared for by a stranger. Knott explained
a story of one client in particular that lives in a nursing home and is rarely visited by any of her

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eight children. This is a woman being neglected by the children that she tried her best to raise
and for whom she attempted to ensure a decent life. There is no reason for the elderly to spend
their final precious years alone. In addition, when clients seldom get visitations, there is no one
to assess their living situation outside of the nursing home workers.
Nursing home physical, emotional and mental abuse are common problems happening all
over the country. In some cases, it is a matter of frustrated workers taking their anger out on the
residents. In other cases, it is blatant neglect and due to little visitations, the workers know that
they will get away with the abuse. Abusers might rationalize their abusive acts before
committing the offense. Some might argue that the aides have irrational belief systems, giving
rise to unacceptable behavior (Payne, 211). In his book, Payne goes on to explain that there are
two forms of nursing home abuse, institutional and staff. Institutional factors are concerned with
the actual structure of the facility and the characteristics of the institution. The size of the facility
should be appropriate given the amount of residents. One should stray away from trying to place
as many residents as possible in the building while also avoiding having too few clients in a
building. Characteristic of the institution are in reference to the way the building is ran. Whether
the facility is a privately or publically owned building makes a lot of difference in the type of
care that the residents receive. The second form of nursing home abuse refers to the way workers
are trained to deal with various types of situations that might arise in the home. This is not only
affected by the level of training, but by a workers age, education, gender, level of pay,
occupational position, and attitude toward residents. Nursing home staff with negative attitudes
toward patients are more likely to commit theft in nursing than those with positive attitudes
toward patients are (Benson, Harris, 76). Theft is a serious prevalent issue held to its own level
of injustice because often times the clients is not in the correct mental state to address the theft.

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Clients might assume that they lost whatever was stolen and this creates a lot of confusion and
vulnerability.
Nursing home neglect is s problem because it is of the most important requirements that
nursing homes should meet. People trust putting their loved ones in facilities and rest assured
knowing that they are being taken care of and looked after. Adult Protective Services have been
called in many cases by family members of residents due to the lack of proper care and attention.
Research suggests that the 2.5 million vulnerable individuals in these settings are at much
higher risk for abuse and neglect than older persons who live at home (Bonnie, 47). It almost
seems as though there is no winning for families that cannot care for their loved ones and do not
trust nursing homes enough to place them in one. Nursing home neglect can also cause serious
psychological damage to residents. Dr. Quinn conducted a study of thirty-two nursing homes and
found that eight one percent had observed one or more incidents of psychological abuse. Fortyone percent had committed at least one type of psychological abuse, and ten percent had
committed an act of physical abuse (Quinn, 42). These are indeed frightening statistics. Family
members of clients pay good money and should not be expecting these types of results.
Psychological abuse can very well shorten the lifespan of an elderly so placing them in a sub-par
nursing home can essentially be a death sentence.
Physical abuse is also a rampant problem in nursing homes. It does not seem as
something that would go unnoticed due to physical marks and emotional responses from the
clients, yet a lot of it goes unreported. The elderly are much frailer and it becomes difficult for
them to defend themselves against physical abuse. Physical and cognitive impairments are
among the many things keeping the elderly from fully protecting themselves. It becomes
relatively easy to take advantage of someone in poor physical condition, especially ones that are

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on multiple medications. Nursing home workers are well aware of their advantage and use it in
any way that they can. Payne explains that there is also unintentional physical abuse occurring in
nursing homes. This typically happens without the knowledge of the worker. An example of
unintentional physical abuse is a worker placing an elderly resident in a tub without verifying
that all the equipment was functioning properly. A broken hot water valve or a faulty door that
leads to the resident injuring themselves would be unintentional physical abuse. Though the
consequences are not as severe, there would still be some repercussions. If a worker physically
abuses a resident, they are liable to face prison sentences.
Sexual abuse is not necessarily a form of abuse one would immediately link to the
elderly, though it is very much a real problem. Sexual abuse is a crime that preys on people who
are vulnerable, especially the young and the elderly (Summers, 131). For the elderly, sexual
abuse often occurs in forms of nonconsensual sexual contact of any kind. Even after not giving
consent, nursing home workers will go ahead and continue their behavior without fearing any
consequences because they understand the fragility of the elderly. Even if the elderly do not
report the sexual abuse because of fear, there are still signs to that show that some form of abuse
has taken place. A victim of sexual abuse may exhibit physical signs such as difficulty walking,
recurring or unexplained injuries, combination of new and old injuries, and injuries in areas
usually covered by clothing (Summers, 132). Along with injuries, socio-psychological signs
may be present. Social-psychological signs include depression or withdrawal, hesitation to
speak openly, fearfulness of caregiver or strangers, confusion, and denial (Summers, 132). If
this abuse occurs at a poorly rated nursing home, it will often go unreported and these behaviors
will continue.

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Although anyone could fall victim to fraud, the elderly are the leading population that is
taken advantage of by both telemarketers and credit theft. Telemarketers generally take
advantage of people at random, yet, it is easier to target the elderly that answer the phone. The
elderly are often more trusting that someone calling had their best interest at heart, when that is
not usually the case. Telemarketing fraud is a type of fraud that is pervasive in the United
States, with older adults being overrepresented as telemarketing victims (Payne, 88). The
American Association of Retired Persons conducted a study that states that one in six consumers
are victims of telemarketing fraud each year. This is an alarming amount of older adults being
taken advantage of by phone calls. People often pose as telemarketers and ask all of the right
questions to get the valuable information needed to do extensive damage. Loans can be taken out
in their names, personal information can be made public in seconds, and personal bank accounts
can be emptied. Once a telemarketer gets a hold of someones credit card information, they can
ruin all of the progress that a citizen has spent their lives working hard to build.
It is no secret that there are high rates of prisoner abuse. Once in prison, the
vulnerabilities of age are exacerbated by the lack of adequate facilities to enable prisons to fulfill
their statement of purpose where elders are concerned, namely, to enable them to lead law
abiding and useful lives in custody and after release (Wahldin, 182). Elder prisoners have much
more limited time than younger prisoners do. Not that they do not deserve the same kind of
punishment as everyone else in prison, but it should be made clear that they are in a more fragile
state. They need more frequent cellblock visits and their diets might need to be altered due to
physical deterioration. While prisoners use their time behind bars to reflect on what they have
done and prepare for life after prison, many elderly enter prison knowing that there is a chance
that they might not make it out alive. Because of these factors, levels of depression are much

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higher in elderly prisoners. They feel as though they have nothing to live for if they are going to
spend the rest of their lives behind bars. The lack of facilities catering for individual elderly
needs increases the pain of imprisonment where the prisons focus resources and facilities
(Wahldin, 183). As mentioned earlier in this paper, elderly very rarely are visited by their family
members, this is even more so the case for the elderly in prison. There is neglect coming from
both prison workers and their family members.
The form of elder abuse that is the hardest to detect is emotional abuse. Emotional elderly
abuse can occur at home by family members as well as in nursing homes by the workers.
Emotional abuse accounts for approximately thirty-six percent of the reported cases of abuse in
nursing homes (Bradley, 54). Emotional abuse includes talking down to a client, yelling at
them, ridicule, humiliating, harsh criticism, name calling, and threatening them are all forms of
emotional abuse. Yelling at a client with dementia that is already forgetful, so it does not make
sense for a worker to get angry when they need to repeat themselves. Blaming and shaming
clients is also a form of emotional abuse. For example, if a client is incontinent, their actions are
not in their control and do not deserve to me embarrassed about their condition. There are many
ways that the elderly will find themselves lacking dignity and the worst thing a worker can do is
make them feel even worse about themselves.
As well as emotional abuse in nursing homes, their own family members emotionally
abuse the elderly often. Frustrated children and grandchildren find it easy to take their anger out
on the elderly. Children of elderly may feel, as though they have the right to treat the elderly
anyway they want to since they are the closest family member. The emotional abuse that comes
with families is often linked to ignoring the elderly. Families tire of taking care of their loved
ones and learn to ignore their needs instead of constantly tending to them. They see it as they are

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not working for their family member therefore their needs can be put aside for the time being.
Neglect from family members can be considered a form of elder abuse. A child neglecting the
parents nutritional needs is also a form of emotional abuse. Threatening to send the elderly to a
nursing home or to abandon them is emotional abuse because it makes them feel dispensable.
Threatening to deprive them of things is a malevolent form of abuse because it is stripping the
elderly of their dignity.
What are the policies in place to address this concern?
Some legislators have taken notice of this social problem and decided to focus their
efforts into making some changes. Although this social issue in particular is not given the
attention it deserves, there are still some policies in place. There are multitudes of statutes that
have been passed by Michigan Legislature in regards to addressing elder abuse. One policy in
place to address this social problem has been introduced by the Michigan Senate in 2015 and is
in the process of being passed by both the House and Senate. Senate Bill No. 49 deals with
punishments that may arise because of elder abuse. This statute is important because it enhances
the consequences for such abuse and as a result, can be an effective preventative measure. This
Bill is relatively new and the consequences in the Bill have not yet had the opportunity to be
enforced. However, the Bill has the potential to be a driving force in preventing future cases of
elder abuse. The fact that Bills such as this one are still being introduced to this day is a good
sign that the awareness of this social problem is prevalent and will hopefully be resolved in the
near future.
Another 2015 Bill introduced by Senator Bieda is the Senate Bill No. 460, which require
the establishment of a vulnerable adult registry (Senate Bill No. 460). Essentially, this Bill
would require the establishment of a system similar to a sex offender list. Similarly, to Bill No.

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49, it provides another aspect of a potentially more comprehensive policy regarding this social
issue. This could be critical to the prevention and awareness of elder abuse because it clearly
identifies the abusers in such a manner that has proven to be effective with similar registries in
the past.
A third Bill introduced is Senate Bill No. 466, also known as The Mozelle Senior or
Vulnerable Medical Alert Act, which concerns what information is to be given to law
enforcement in the event of a missing elderly. Specifically, it entails what procedures should be
taken by the law enforcement, including which authority the law enforcement should share the
information regarding the missing person. This Bill provides a very effective route in spreading
the information in a way that helps locate the missing elderly. Pertaining to this Bill, Governor
Snyder was quoted as saying, The abuse of seniors and vulnerable adults is one of the fastestgrowing crimes in our state. In summation, this issue appears to be a top priority to not only the
Senate but also the people of Michigan.
Are these policies dictated by local, state, or federal statute?
All of the Bills mentioned above are dictated by state statute and are enforced by local
law enforcement. Although the more recently introduced Bills have not been enacted, their
enactment would fall under same dictation and enforcement.
What is working; what is not working especially for at risk populations? (Your critique)
One flaw of Bill No. 466 is that there does not appear to be a mechanism that allows
elderly citizens in more isolated situations, such as one who might live alone and does not have
someone to check up on them, to be protected under the Bill the same way as others. However,

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prevention of this issue would be very difficult to regulate. The Bill fulfills its purpose of
establishing a safety net for what is a major issue concerning elderly disappearance.
How long has the current policy been in place? Who supports and who opposes the policy?
Bill No. 466 has been in place since June of 2012. Supporters of this Bill include those
who introduced it: Senator Schuitemaker, Jones, Hansen, Emmons, Proos, Kahn and Marleau.
There does not appear to be any clear opposition of this policy.
Interview one advocate, legislator regarding their opinion of current policy
One senior citizen champion in particular that was worked tirelessly for ensure the safety
of seniors is Senator Tonya Schuitmaker. Senator Schuitmaker was interviewed about her
involvement in the Senior Protection Legislation signed into law on June 19, 2012. When asked
if there was a specific eye-opening moment when her mindfulness of elderly abuse peaked, she
responded, There wasnt really one specific occurrence of abuse that made me get involved in
this issue. I heard from different senior advocacy groups that this was a real and growing
problem and I wanted to address it. According to the Senator, it took just over one year to work
on the Senior Protection Legislation and get it passed. Senator Schuitmaker, after seeing the
Legislation in action, feels that presently, there are not any shortcomings or problems with the
Legislation that was passed. When asked if she had noticed any changes due to the policy she
had a hand in implementing, Senator Schuitmaker said, Many of the bills increased penalties
faced by those who are guilty of elder abuse. These are hopefully serving a dual purpose of
discouraging people from committing these crimes in the first place, as well as sufficiently
punishing those who would harm a senior, either financially or physically. Senator Schuitmaker,

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along with this policy and other like it, have been driving forces for the protection and defense of
the elderly.

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References:
Quinn, Mary Joy., and Susan K. Tomita. Elder Abuse and Neglect: Causes, Diagnosis, and
Intervention Strategies. New York, NY: Springer Pub., 1986. Print.
Payne, Brian K. Crime and Elder Abuse: An Integrated Perspective. Springfield, IL: Charles C
Thomas,, 2000. Print.
Mellor, M. Joanna., and Patricia J. Brownell. Elder Abuse and Mistreatment: Policy, Practice,
and Research. New York: Haworth, 2006. Print.
"Senior Protection Legislation Signed into Law - Senator Tonya Schuitmaker." Senator Tonya
Schuitmaker. Ed. Derek Sova. N.p., 18 June 2012. Web.
Interview with Senator Schuitmaker held on Wednesday October 28, 2015.
Lachs, Dr. Mark. "Abuse and Neglect of Elderly Persons NEJM." New England Journal of
Medicine. N.p., n.d.
Cooper, C., A. Selwood, and G. Livingston. "The Prevalence of Elder Abuse and Neglect: A
Systematic Review." Age and Ageing 37.2 (2008): 151-60. Web.
Bonnie, Richard J., and Robert B. Wallace. Elder Mistreatment: Abuse, Neglect, and
Exploitation in an Aging America. Washington, D.C.: National Academies, 2003. Print.
Harris, Diana K., and Michael L. Benson. "Theft in Nursing Homes: An Overlooked Form of
Elder Abuse." Journal of Elder Abuse & Neglect 11.3 (2000): 73-90. Web.
Summers, Randal W., and Allan M. Hoffman. Elder Abuse: A Public Health Perspective.
Washington, DC: American Public Health Association, 2006.

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Wahidin, Azrini, and Maureen E. Cain. Ageing, Crime and Society. Cullompton: Willan, 2006.
Senate Bill No. 49: January 16, 2013, Introduced By Senators Casperson And Walker And
Referred To The Committee On, and Judiciary. SENATE BILL No. 49
Senate Bill No. 466
Senate Bill No. 460