NIH Hosts Workshop to Examine Multiple Approaches to Understanding and Preventing Elder Abuse

In discussions and comments received as part of the 2015 White House Conference on Aging (WHCOA), researchers, practitioners and other stakeholders highlighted the lack of research focusing on elder abuse as a major barrier to creating evidence-based solutions and developing policies that promote elder justice. Despite growing awareness of elder abuse, there remain significant evidence gaps in detecting, preventing, and intervening in elder abuse.

As a follow up to the WHCOA, the National Institutes of Health (NIH) held a workshop on October 30 on “Multiple Approaches to Understanding and Preventing Elder Abuse and Mistreatment.” This workshop was a trans-NIH effort that brought together representatives from multiple Institutes and Centers within NIH, experts from other agencies in the Department of Health and Human Services, as well as the Department of Justice, and leading academics from the fields of elder abuse, child abuse, and intimate partner violence. The purpose of the meeting was to focus on the applications of lessons learned across fields, and to consider common challenges and opportunities in elder abuse, child abuse, intimate partner violence, and other related fields.

The agenda was jam-packed with substantive discussions about the scientific, structural, and practical challenges of studying elder abuse. Researchers raised important concerns about the lack of fundamental “basic science” knowledge about elder abuse that is critical to developing evidence-based prevention and intervention strategies. Familiar research designs, such as randomized controlled trials, are not always optimal for abuse prevention and intervention studies. Because of concerns for participant safety and confidentiality, it can be difficult to get approval to include victims of abuse in longitudinal studies especially if Institutional Review Boards have limited experience with research on abuse. Elder abuse research raises unique issues for recruiting, enrolling and retaining participants, in particular for people with reduced decisional capacity.

Four breakout sessions brought together diverse perspectives around key topics: health disparities and cultural dimensions of abuse, preventing mistreatment in familial environments, diminished cognitive and decisional capacity as risk factors, and the bioethics and law in elder abuse research.

Overall, participants concluded that more research, training, and research infrastructure is necessary to make significant progress in preventing abuse and developing evidence-based programs in the future. Findings from child abuse to intimate partner violence could help inform elder abuse research strategies and directions. For example, arrest of perpetrators may remove the immediate cause of abuse for a child or intimate partner, but fear of family disruption creates situations in which family members are reluctant to report perpetrators. Another example of a more nuanced understanding of abuse in younger adults that could help our understanding of elder abuse is the concept of polyvictimization—the cumulative burden of multiple types of abuse. Creative research design is necessary to ensure that those impacted by abuse are included in research while at the same time not further injured by the research process.

The event was a great forum for discussing the opportunities and challenges to moving the elder abuse research agenda forward, and it brought new voices to the conversation. I look forward to hearing more in the coming months.

More information about the workshop, links to relevant reports and websites, and a link to the archived videocast is available on the NIH website.