Detecting, Addressing and Preventing Elder Abuse in Residential Care Facilities

This study focused on detection, investigation, and resolution of elder abuse and neglect complaints in what are known as residential care facilities (RCFs). We found significant challenges to effective detection, investigation and resolution of elder abuse in RCFs, even in states thought to have effective processes. The major barrier in all states and all agencies was the lack of adequate resources to carry out their responsibilities. We found underreporting of elder abuse, and many instances in which intake workers screened-out many cases that may have warranted further investigation or referral to other agencies. In addition, processes for investigating cases were deeply flawed. Staff lacked forensic training, and investigations were seldom completed in a timely fashion. Significant barriers to resolution were also discovered, including policies that required 'intent' for an act to be 'abuse' - something difficult to achieve when perpetrators were other residents with dementia or were over-worked and under-trained staff. Also, while involvement of police was reportedly increasing, it was still uneven across jurisdictions. In addition, prosecutors and judges were often unprepared or unwilling to deal with elder abuse cases. Finally, unlicensed homes remained a serious, largely unaddressed problem in some states.