Ending elder abuse: The way forward

In 2017, I sat in on a conversation about elder abuse led by Dr. Brian Kaskie at the Federal Courthouse in Cedar Rapids. The following year, Kaskie and fellow University of Iowa professor Leonard Sandler, JD released a report informing the public of the impact of elder abuse on Iowans, and the pathway to improved outcomes.

Elder abuse hadn’t yet been granted its own protective category in Iowa unless the older adult was “dependent” upon the abuser — and under existing law, the report stated that victims had “less than a 5% chance of any formal litigation taking place after filing a claim.” The report recommended specific actions be taken to address elder abuse in the state, including increasing public awareness, penalizing failure to report, and ensuring that any “vulnerable” adult who experienced abuse had the ability to report it and receive protections.

It would take four more years from the release of the report for legislation to pass that made elder abuse its own distinct crime and broadened the scope of protection to better include a wider range of adults who may be at risk. Nationwide, 10% of people over age 65 experience elder abuse, but only one in 24 cases is reported. This is hardly surprising when taken in context with the minuscule likelihood of litigation. There are many types of elder abuse, including financial abuse, physical abuse, psychological/emotional abuse, sexual abuse and neglect.

Several factors might make an older adult more susceptible to abuse. Age-related physical and cognitive decline often plays a significant role, as these conditions can make individuals more dependent on others for daily care and financial management, increasing vulnerability. Social isolation is another critical risk factor, as it can limit interactions with others who might notice and report signs of abuse. Additionally, individuals with dementia or other mental health conditions are at increased risk because their ability to recognize or report abuse may be compromised. Economic factors also contribute; older adults with limited financial resources may depend more on others for support, potentially exposing them to exploitation. Lastly, residing in settings with insufficient staffing or oversight, such as some long-term care facilities, can increase the likelihood of neglect and abuse.

The Iowa Department of Health and Human Services releases a “ Dependent Adult Abuse Statistical Report” twice each year, documenting the most recent data pertaining to elder abuse. Reviewing data from the first half of 2016 vs the first half of 2024, several new categories of reports have been added — including financial institutions. In the first year of documentation (2018), financial institutions submitted 220 reports of abuse. This number jumped to 715 in the first half this year. This increase may be attributable to both the escalating rates of financial fraud and scam activity, and to the increased training of financial employees related to identifying and reporting financial abuse. There also has been nearly a 10% increase in the number of accepted reports of all types of abuse — meaning that when reports are filed, less are being disqualified. It would seem that the expansion of who qualifies for protection has made a significant difference in terms of outcomes for victims.

Nearly 20% of reported cases of elder abuse were submitted by “other social service professionals.” One such agency, Horizons’ Meals on Wheels, is in direct contact with older adults five days per week. Many of these clients live with physical limitations, and have little to no other human contact throughout the week.

“Every day, Monday through Friday Meals on Wheels volunteers go into the homes of homebound seniors and deliver not only a meal but a warm smile, a short chat and what we consider a wellness check. Most of our clients live alone and do not have friends or family to check in on them or help advocate for them. Our volunteers serve as eyes and ears to help identify client needs and in some cases abuse that might be occurring in the home. From there, they communicate back to our More than a Meal Coordinator who works with the client to determine the next steps to get them the resources and the help they need,” said Community Health and Nutrition Director Melissa Meyer.

The hard-won and long fought progress that has been made is encouraging, but there still is so much to be done. Several bills introduced in the last legislative session intended to reduce elder abuse in the nursing home setting did not survive the session — these bills, designed to address chronic understaffing, Medicaid reimbursement rates, oversight, minimum wage, and camera usage could have provided huge results for people who are at the mercy of their environment. Just a few months remain between right this moment and the next legislative session — now would be a great time to let your own elected officials know that the well-being of older adults in our community is a priority for you and it should be for them as well.

Sofia DeMartino is a Gazette editorial fellow. sofia.demartino@thegazette.com