Experts in a workshop conducted by RAND and RTI International identified needs related to identifying and responding to elder mistreatment, which includes physical, psychological, and sexual abuse; fraud and financial exploitation; and neglect. The top-priority needs include research to support evidence-based, culturally appropriate approaches and widespread adoption of effective programs to reach the greatest number of victimized older adults.

Improving the Identification of and Responses to Victims of Elder Mistreatment

Lynn Langton, Duren Banks, Madison Fann, Dulani Woods, Michael J. D. Vermeer, Brian A. Jackson

ResearchPublished Oct 8, 2024

Elder mistreatment—which includes physical, psychological, and sexual abuse; fraud and financial exploitation; and neglect of older individuals—is a serious public health issue and a growing area of concern as the percentage of the U.S. population age 60 and older continues to rise. Medical, financial, legal, and social service providers who come into contact with older adults can be well positioned to identify persons at risk for or experiencing elder mistreatment and connect them with service providers to address their needs. However, these service providers require tools and training to identify elder mistreatment. Once victims or at-risk individuals are identified, there are also challenges with how best to intervene and provide victims with effective support and services. 

To explore these challenges and potential solutions, RAND and RTI International convened an expert panel in 2023 to identify knowledge and resource gaps and explore strategies to improve the identification of and responses to elder mistreatment. The workshop participants identified the highest-priority needs in this area, including research to support evidence-based, holistic, and culturally appropriate approaches, while also supporting the widespread adoption of effective programs to reach the greatest number of older adults who have been victimized.

Key Findings

  • There is a lack of evidence-based interventions to respond to and support older adults who are at risk of or experiencing different types of mistreatment.
  • There is insufficient evidence about the impacts of the full variety of programs (Adult Protective Services, law enforcement, social services, home and community-based services, etc.) on elder mistreatment outcomes.
  • Victims of elder mistreatment sometimes lack holistic support and do not receive necessary services.
  • Limited research exists on how elder mistreatment is experienced and understood by different cultural groups, and cultural differences are not understood or integrated into developing policies and practices.
  • There are adoption and implementation challenges for prevention, detection, and intervention strategies.

Recommendations

  • Development of evidence-based interventions should start with rigorous testing of those programs where there is reasonable case study evidence that they reduce harm.
  • Incorporate research and evaluation into development of new intervention programs to build an evidence base.
  • Develop a strong conceptual framework, building on work done around other types of violence, to inform the development of interventions.
  • Conduct a systematic review of case study evidence, demonstration studies, randomized controlled trials, multi-site evaluations, and replication with different populations and geographic areas.
  • Conduct rigorous evaluations of existing programs to identify the impact of various approaches to mitigate elder mistreatment.
  • Conduct research to evaluate how existing programs are implemented with different populations.
  • Conduct research with diverse key stakeholders from different perspectives, including victims and perpetrators, to identify a minimum standard set of outcomes for different types of mistreatment.
  • Consider approaches that build relationships with victims and offer victim-centered care.
  • Conduct rigorous research to identify the full scope of elder mistreatment victim needs.
  • Funding opportunities should encourage qualitative research with older adults to understand whether experiences of elder mistreatment vary across subgroups, to what extent, and the nuances of these experiences. This would help to develop a continuum of experiences from those consistent across all groups to those specific to certain cultures.
  • Incorporate principles of implementation science within any intervention research to better understand how to apply those interventions to different contexts and subpopulations.

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Citation

RAND Style Manual

Langton, Lynn, Duren Banks, Madison Fann, Dulani Woods, Michael J. D. Vermeer, and Brian A. Jackson, Improving the Identification of and Responses to Victims of Elder Mistreatment, RAND Corporation, RR-A108-27, 2024. As of April 8, 2025: https://www.rand.org/pubs/research_reports/RRA108-27.html

Chicago Manual of Style

Langton, Lynn, Duren Banks, Madison Fann, Dulani Woods, Michael J. D. Vermeer, and Brian A. Jackson, Improving the Identification of and Responses to Victims of Elder Mistreatment. Santa Monica, CA: RAND Corporation, 2024. https://www.rand.org/pubs/research_reports/RRA108-27.html.
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This research was sponsored by the National Institute of Justice and conducted in the Justice Policy Program within RAND Social and Economic Well-Being.

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