- Email: [email protected]
Public definitions and endorsement of the criminalization of elder abuse
Journal of Criminal Justice 34 (2006) 275 – 283
Public definitions and endorsement of the criminalization of elder abuse Etta Morgan a , Ida Johnson b , Robert Sigler c,⁎ b c
a Department of Sociology, Jackson State University, Jackson, MS 39217, United States Department of Women's Studies, University of Alabama, P. O. Box 870320, Tuscaloosa, AL 35487-0320, United States Department of Criminal Justice, University of Alabama, P. O. Box 870320, Tuscaloosa, AL 35487-0320, United States
Abstract A longitudinal cross sectional ten-year study was conducted measuring public attitudes toward the definition and criminalization of elder abuse. The study found that the public endorsed a fairly broad definition of elder abuse and that this definition of elder abuse was fairly stable over time. Subjects also strongly endorsed the creation of misdemeanor and felony statutes and strongly endorsed the use of prison to punish elder abusers. The subjects also believed that the criminalization of elder abuse would be effective in reducing elder abuse. © 2006 Elsevier Ltd. All rights reserved.
Introduction Elder abuse is more difficult to examine than other forms of domestic abuse. Valid samples are difficult to obtain, and much of the abuse which is directed toward elders is neither physical nor occurring in a family context. Elder abuse, the most recent form of domestic abuse to be identified as an area of concern which requires justice system intervention is still in the process of criminalization. The justice system is in the process of developing appropriate policies for dealing with allegations of elder abuse; thus, there is a need to know more about this phenomenon. A series of assessments of the public definition of elder abuse and public willingness to criminalize elder abuse were conducted over a period of ten years. This article reports the types of behaviors
⁎ Corresponding author. Tel.: +1 205 348 8091. E-mail address: [email protected] (R. Sigler). 0047-2352/$ - see front matter © 2006 Elsevier Ltd. All rights reserved. doi:10.1016/j.jcrimjus.2006.03.004
that the general public endorsed as elder abuse and preferred punishments over that ten-year period. Literature review Public opinion regarding disposition of criminal cases In 1993, Durham questioned the existence of public opinion regarding sentences for crime. He reviewed the history of research in this area beginning with Thurstone's (1927) early measures of perceived seriousness of crimes tracing the attempts to assess seriousness of crimes and appropriate punishments through the work of scholars such as Durea (1933), Rose and Prell (1955), Sellin and Wolfgang (1964), and others with the National Punishment Survey (Jacoby, 1989) noted as the culmination of research efforts of this type before the 1990s. These studies generally found that the public could rank crimes in terms of severity, that violent crimes were both defined as more serious and deserving of greater punishments, and that, while
276
E. Morgan et al. / Journal of Criminal Justice 34 (2006) 275–283
the public consistently endorsed similar types of dispositions for specific types of crimes, there was less consistency in the degree of severity appropriate in the application of these dispositions. Durham (1993) questioned the validity of such findings suggesting that the judgments that subject's are asked to make are too technical and complex and that the methodology employed in mass surveys is not sufficiently powerful to measure this complex attitudinal set. Two years later Sigler and Lamb (1995), reporting the results of their study of community endorsement of the use of community corrections, acknowledged the difficulty in measuring a very complicated attitude set. They noted the history of research focusing on the acceptance of specific community corrections programs and the general acceptance of community corrections. They reported the development of a fairly sophisticated set of scales for measuring the endorsement of the various dimensions of the attitude set toward community corrections held by a range of justice system personnel and by the general public. The subjects appeared to understand the scales and provided valid responses for assessing perceived effectiveness along a number of dimensions. More recently the attitudes of inmates toward forms of correction had been measured (Wood & Grasmick, 1999) and the attitudes of police and ombudsmen toward the criminalization of elder abuse had been studied (Payne & Berg, 2003). Elder abuse as a justice system problem The problem of elder abuse is not a new phenomenon in society, but like other acts of violence in the family, it too is considered a private matter. Society, as well as the courts, until recently, viewed violence in the family as a private matter among family members and thought it best not to interfere. This attitude persisted for several centuries. Family violence as a societal concern began with children and extended to women through the feminist movement. The scope of family violence has since extended to include elder abuse. The idea of elder abuse was first discussed in British medical journals during the mid-1970s, but was not fully addressed until the latter part of the 1970s in the United States when it was linked to family violence. So many cases of elder abuse were being reported that Congress amended the Social Security Act during the 1960s and 1970s to address the abuse of adults with limited capability. These amendments provided funding to states to establish agencies (more commonly known as Adult Protective Services) to protect those persons deemed incapable of managing their own affairs. Adult
Protective Services provided services to persons eighteen and older, thereby, extending services to the elderly; however, in order to fully protect the elderly from abuse, most state legislators in the 1990s passed some form of elder abuse laws (Wolf, 2000). These statutes are restrictive generally limiting elder abuse to physical abuse with some statutes including some form of financial abuse. This reflects the absence of a clear comprehensive generally accepted definition of elder abuse. The fact that much elder abuse is not domestic abuse further confuses attempts at definition. Elder abuse occurs in both domestic and institutional settings, and elder abuse is more than physical abuse or financial exploitation. According to the National Center on Elder Abuse (1998, p. 1), there are seven types of elder abuse “(1) physical, (2) sexual, (3) emotional, (4) financial/material exploitation, (5) neglect, (6) abandonment, and (7) self-neglect.” Block and Sinnott (1979) developed a list of types of activities that constituted elder abuse, which included poor residential environment, that was expanded in terms of neglect by Douglas, Hickey, and Noel (1980). Kosberg (1983) developed a comprehensive list of activities that constituted elder abuse. The list included physical abuse, psychological abuse, material abuse, and violation of rights. Johnson (1986) summarized the forms of abuse identified in twenty-one studies of elder abuse and developed a five-stage sequential definition of elder abuse. Her comprehensive list included abuse, neglect, active neglect, passive neglect, physical abuse, physical neglect, psychological abuse, psychological neglect, verbal or emotional abuse, material abuse, medical abuse, exploitation, and violation of rights. While the diversity of definitions of elder abuse that were available when this series of studies were begun produced confusing results in the literature, little had been done since then to clarify this concept (Daly & Jogerst, 2002). In the past, only the strong and healthy survived to old age. With improvements in medical care, less healthy and less strong individuals who require a higher level of care are surviving to old age. Many of those who survive severe illnesses have disabilities and chronic illnesses that require much care (Steinmetz, 1983). The survival of parents with high care needs creates stress for their middle-aged children who are attempting to cope with their own children (Silverstone & Hyman, 1976). Steinmetz (1981) had advanced the concept of generational inversion to explain one pattern which emerges. In generational inverted families, adult children assume the responsibility for one or more elders who are dependent on them for emotional,
E. Morgan et al. / Journal of Criminal Justice 34 (2006) 275–283
financial, physical, or mental support. When faced with the need to care for two or more elders, the amount of stress experienced by caregivers increases greatly, particularly as the degree of dependency increases (Steinmetz, 1983). This stress can lead to the forms of abuse which are the target of legislation designed to protect elders (Oakar & Miller, 1983). Much of what is asserted about elder abuse is essentially speculation. The broad surveys of victims and abuse incidents, which had been conducted for cases involving children and spouses, had not been conducted for cases involving elders at the time this research was initiated (Ferraro, 1990) with limited additional study of this type in the past two decades. Much of the data which were presently available were still found in unpublished manuscripts, reports of the proceedings of congressional committees, and in reports from state and federal agencies. There is a need for expanded research focusing on the nature of elder abuse so that the impact of criminalization can be assessed. The most recent survey found that in 1999 there were 190,005 domestic elder abuse reports from seventeen states, a rate of 8.6 per 1,000 elders; of which 242,430 were investigated in forty-seven of the fifty states and the District of Columbia, a rate of 5.9; and 102, 879 substantiated cases from thirty-five states, a rate of 2.7. States requiring mandatory reporting and tracking of numbers of reports reported significantly higher rates (Jogerst et al., 2003). Estimates of the prevalence of physical abuse in cases of elder abuse ranged from 14 percent (Milner, Robertson, & Rogers, 1990) to 64 percent (Pillemer & Finkelhor, 1988). In the latter study, a broad definition of elder abuse was used (including acts such as pushing and shoving). Neglect was identified as active and passive neglect (Cicirelli, 1986). Active neglect is the refusal or failure to fulfill a care-taking obligation, including a conscientious and intentional attempt to inflict physical or emotional distress on the elder. Passive neglect includes the same behaviors without the intent to do harm. Neglect is relatively invisible as it occurs in private, but tends to be the most common form of abuse (Steuer & Austin, 1980). Perceptions of abuse in some instances according to Moon and Williams (1993) were often predicated on three distinct factors: (1) the intent of the individual, (2) the attendant circumstances, and (3) the nature of the act itself. Pablo and Braun's (1997) study found that acculturation into the American way of life affected various cultures and the attitudes of various groups towards the norms of their culture. Due to the
277
differences in the perception of elder abuse and the lack of knowledge about elder abuse combined with the isolation experienced by some elderly persons, many instances of elder abuse will go unnoticed and unreported (Moon, 2000). One recent study addressed preferred dispositions for elder abusers (Payne, 2003). He asked a sample of police chiefs, students, and nursing home professionals how they believed that cases of elder abuse should be handled. The results indicated that police chiefs and students held more punitive attitudes, while nursing home professionals endorsed more rehabilitative ideals. Childs, Hayslip, Radika, and Reinberg (2000) examined the impact of age and gender in regards to the respondent, victim, or perpetrator as well as the impact of a history of violence either as a victim or perpetrator on one's perception of elder abuse. According to Childs et al. (2000), age tends to impact one's perception of elder abuse among the respondents in regards to psychological abuse. Perceptions of elder abuse were also impacted by the age of the abuser. Additionally, Childs et al. (2000) found that there was some interaction between the respondent's age and gender and the abuser's age. First, middle-aged women judged their peers more harshly than younger women. Second, young men viewed the behaviors of middleaged abusers as more abusive, harmful, and reportable than they viewed the same behaviors committed by an elderly abuser (p. 82). The results from this study also revealed that psychological abuse was not viewed as harmful as physical abuse because of the level of harm experienced by the victim, nor was there a need to report acts of psychological abuse. Interestingly, the perceptions of elder abuse were influenced by a history of violence either in the form of family violence or childhood violence. Childs et al. (2000) noted that middle-aged persons who had experienced high levels of family violence were less critical about abusive behaviors towards the elderly than those who experienced low levels of family violence. They also found that young adults who demonstrated low levels of violent behavior held more abusive attitudes toward a grandparent than those who reported high experienced childhood violence (Childs et al., 2000, p. 83). Attitudes toward the elderly and the criminalization of acts identified as elder abuse have added a new dimension to the understanding of elder abuse and the need to insure that the elderly are protected. It will be difficult for the justice system to develop effective procedures for dealing with elder neglect. Some argue that elder abuse should be treated as a social
278
E. Morgan et al. / Journal of Criminal Justice 34 (2006) 275–283
problem and in clinical, treatment-oriented programs rather than in the justice system (Brownell & Wolden, 2002). A lack of attention from relatives could be characterized as a form of neglect of an elder and could be termed abuse; on the other hand, there could be a difference in expectations held by the actors regarding the level of attention due a parent by a child. That is, elders may perceive themselves as abused not because of a failure on the part of their children to provide services at an acceptable level, but because the level of care the elders receive is less than the level they expect. This does not suggest that elder abuse does not occur; it does suggest that elder abuse is less clear and broader in scope than other forms of domestic abuse, and thus, more appropriate for treatment than for punishment. Elder abuse is also broader in the sense that it frequently extends beyond the home into nursing homes and similar institutions (Sigler, 1989). This difficulty with definition will create difficulties for justice agencies charged with the control of elder abuse. In the past, suspected acts of elder abuse were referred to social service agencies responsible for protecting the elderly in hopes of ending the abuse. While these agencies have been effective in ending some cases of abuse, a number of professionals have come to believe only the criminal justice system will be capable of stopping the abuse, protecting the victim, and holding the offender accountable in serious cases (Heisler, 2000, p. 52). The criminalization of elder abuse is a relatively new focus for the criminal justice system. Perpetrators are now held accountable for their actions because some states have enacted statutes that criminalize various acts of elder abuse and allow for sentence enhancements for elder abuse committed during the commission of other crimes (Heisler, 2000). Various social service and law enforcement agencies have implemented training programs for law enforcement officers, judges, and prosecutors to improve the disposition of cases of alleged elder abuse. Additionally, many social service agencies are now working in conjunction with law enforcement officials so that the case includes information that would otherwise not be available to law enforcement and to insure that the victim's needs are met during the entire criminal justice process. In some states, court procedures have been changed to accommodate elder abuse cases, such as setting early trial dates and controlling the location and manner in which testimony is taken. Finally, some criminal justice agencies use an alternative approach to case building whereby less emphasis is placed on victim participation (Heisler, 2000). There is pressure to further criminalize elder abuse (Quinn & Heisler, 2002).
Community support is essential to the development of effective interventions in cases of elder abuse. The series of surveys reported here measured the breadth of community definitions of elder abuse and the willingness of community members to criminalize elder abuse. Methodology Design characteristics Data were collected with four self-administered questionnaires that were delivered and retrieved from randomly selected households within the city limits of Tuscaloosa, Alabama, a southern city with major educational and mental health institutions and a light industrial base. The four separate surveys shared a common sampling frame, common variables, and common data collection techniques. Data were collected in 1986–87, in 1991–92, and in 1996–97. The first instrument focused on the location of domestic violence within the broader context of social violence. The second, third, and fourth instruments focused on the dimensions of domestic abuse and perceived need for criminalization for specific types of domestic abuse (spouse abuse, child abuse, and elder abuse). Variables While the variables remained fairly constant across the four instruments, there were some differences from one instrument to another in the scales used to measure some of the variables. In the elder abuse instrument, the subjects' willingness to label specific acts that could be seen as neglect or as psychological, financial, or physical abuse was measured by a set of nineteen items that subjects were asked to label as “always elder abuse,” “sometimes elder abuse,” or “never elder abuse.” Physical acts were measured in terms of degree of force and in terms of frequency of use of force. Additional items measured willingness to criminalize elder abuse and preferred penalties. In addition to the primary variables, a number of standard demographic variables were measured. These variables included gender, race, age, education, occupation, marital status, religious activity, and political activity. The last two variables were measured on scales that measured affiliation and perceived level of activity. The population The population for the four surveys was the adult resident population of the city of Tuscaloosa. The
E. Morgan et al. / Journal of Criminal Justice 34 (2006) 275–283
279
Table 1 Endorsement of types of behavior as elder abuse by year Type of behavior
Year 1986–87 Never
Psychological abuse Criticize ⁎⁎⁎ N Percent Call worthless N Percent Cursing N Percent Not love ⁎⁎⁎ N Percent Threaten N Percent Neglect Tie or lock up N Percent Too little food N Percent Inadequate clothing N Percent Physical abuse Hit with hand occasionally N Percent Hit with hand frequently N Percent Hit with fist occasionally N Percent Hit with fist frequently N Percent Hit with stick or belt occasionally N Percent Hit with stick or belt often N Percent Financial abuse Force out of home ⁎ N Percent Prevent spend money ⁎⁎ N Percent
Sometimes
Year 1991–92 Always
Never
Sometimes
Year 1996–97 Always
Never
Sometimes
Always
5 4.4
57 50.4
51 45.1
21 15.9
53 40.2
58 43.9
17 11.0
50 32.3
88 56.8
8 7.0
6 5.2
101 87.8
19 14.4
13 18.8
100 66.8
17 10.9
8 5.1
131 84.0
8 7.0
12 10.4
95 82.6
17 12.8
18 13.5
98 73.7
18 11.5
14 8.9
125 78.6
11 9.7
43 38.1
59 52.2
22 16.5
46 34.6
65 48.9
26 16.8
22 14.2
107 69.0
8 7.0
15 13.0
92 80.0
16 12.1
27 20.5
89 67.4
16 10.3
26 16.7
114 73.0
7 6.1
9 7.9
98 86.0
17 12.9
15 11.4
100 75.7
16 10.0
10 8.5
129 81.5
7 6.1
1 0.9
107 93.0
17 12.8
5 3.8
111 83.4
15 9.6
8 5.1
134 85.4
7 6.0
6 5.2
103 88.8
16 12.0
8 6.0
109 82.0
16 10.2
11 7.0
130 82.8
7 6.0
1 0.9
108 93.1
16 12.0
5 3.8
112 84.2
16 10.3
3 1.9
137 87.8
7 6.0
0 0.0
109 94.0
16 12.1
1 0.8
115 87.1
16 10.3
3 1.9
137 87.8
6 5.2
0 0.0
109 94.8
16 12.0
1 0.8
116 87.2
16 10.2
4 2.5
137 87.3
7 6.0
0 0.0
109 94.0
17 12.8
0 0.0
116 87.2
16 10.3
1 0.6
138 89.1
7 6.0
0 0.0
109 94.0
17 12.8
0 0.0
116 87.2
16 10.2
3 1.9
138 87.9
7 6.1
0 0.0
108 93.9
16 12.0
1 0.8
116 87.2
16 10.3
5 3.2
135 86.5
7 6.1
25 21.9
82 72.0
18 13.6
43 32.6
71 53.8
17 10.9
36 23.1
103 66.0
7 6.1
68 59.1
40 34.8
18 13.7
73 55.7
40 30.6
18 11.7
60 39.0
76 49.3
(continued on next page)
280
E. Morgan et al. / Journal of Criminal Justice 34 (2006) 275–283
Table 1 (continued) Type of behavior
Year 1986–87 Never
Spend elder's money N Percent
7 6.1
Sometimes 24 20.9
Year 1991–92 Always 84 73.0
Never
Sometimes
17 13.0
26 19.8
Year 1996–97 Always 88 67.2
Never
Sometimes
Always
17 10.9
36 23.1
103 66.0
⁎ P < .05 Pearson's for chi square. ⁎⁎ P < .01 Pearson's for chi square. ⁎⁎⁎ P < .001 Pearson's for chi square.
campuses of Stillman College and the University of Alabama and the student housing area adjacent to the university campus were excluded to eliminate nonresident students from the population. The reservations of the mental health facilities and the Veterans Administration Hospital were excluded to eliminate nonresident patients from the population. This process might have excluded a small number of Tuscaloosa residents, introducing a small bias, which was outweighed by the bias that would result if the student and patient populations were included. The sample In the first data-collection period (1986–87), four separate stratified random samples were drawn from the population. The data were collected in three separate two to three-month periods. In the second and third datagathering period (1991–92 and 1996–97), a single stratified random sample was drawn from the population, with all four instruments delivered during a ninemonth period. At the beginning of each data-gathering session, a city map was obtained from the City Engineer's Office. The grids formed by the latitude and longitude lines on the maps constituted the first set of strata, and city blocks constituted the second strata. The number of city blocks in each section was counted, and a number of units were assigned to each section based on its portion of the total blocks in the city. In all, 150 units were selected for each instrument in the first period, and 200 units were selected for each instrument in the second and third periods. One house was selected from each during the first collection period. Four houses were selected from each block during the second and third data-gathering period. Each randomly selected household received one questionnaire. If an apartment building was selected, the list of random numbers was used to select an apartment. The next-oldest-birthday method was used to select one adult from each household.
Adult was defined as a permanent Tuscaloosa resident over eighteen years of age. The collection of data The questionnaires were placed in campus mail envelopes for delivery. These envelopes were delivered and retrieved by research assistants working in teams. Each team consisted of one driver and one contact person. All of the contact persons were women. The contact person would introduce herself and ask for the adult with the next birthday. If the subject was not at home, the contact person would leave the questionnaire with the person who answered the door with instructions to give the questionnaire to the subject with an explanation and request for assistance. She would leave the envelope and questionnaire with instructions to place the questionnaire in the envelope when completed or to place the uncompleted questionnaire in the envelope if the subject decided not to participate. The contact person would make arrangements to return to retrieve the questionnaire two days later. Subjects were asked to leave the completed instruments outside the front door for retrieval if they left home. If an instrument was not retrieved on the return trip, the team would make up to three additional trips in an attempt to retrieve the questionnaire. This approach was relatively successful in delivering the questionnaires. About 75 percent of the instruments were retrieved in completed usable form from each sample. All blocks selected had more than ten homes. In the first data-gathering period, 117 questionnaires were returned from the 150 questionnaires distributed. In the second data-gathering period, 134 completed instruments were returned of the 200 delivered. In the third data-gathering period, 159 completed instruments were returned of 200 delivered. Findings A comparison of totals from the 1980 (1986–87) and 1990 (1991–92) census adjusted for the removal of students and patients found the selected demographic
E. Morgan et al. / Journal of Criminal Justice 34 (2006) 275–283
variables, with the exception of gender, matched the population within ± 3 percent. There were more women in the sample than in the population for all three sessions. While women were slightly overrepresented in the population of Tuscaloosa, they were moderately overrepresented in the two samples. In the first sample, 65.0 percent of the subjects were women, and in the second sample 61.2 percent of the sample were women. In the third sample, 62.7 percent of the sample were women. Instruments were delivered in afternoon and evening shifts. While the day shifts were expected to encounter a greater number of women as first contacts, the next birthday method should have neutralized this potential bias. First, it should be noted that the subjects strongly endorsed all of the physical force items in all years as elder abuse (see Table 1). While there was a slight consistent reduction in level of endorsement from 1986–87 to 1996–97, none of the differences were significant. In all instances, more than 63 percent of the subjects endorsed the items as “always elder abuse.” The same pattern could be observed for neglect items with lower levels of endorsement, with the exception of a significant decrease in the subjects' willingness to endorse “always abuse” for not spending time with the elder. For psychological abuse, both “criticize the elder” and “not loving the elder” were significantly more likely to be endorsed as “always abuse” in 1996–97 than in 1986–87. Mixed results were found for financial abuse with “forcing the elder out of his or her home” decreasing and “preventing the elder from spending her or his own money” increasing from 1986–87 to 1996–97. No significant relationships were found between the various demographic variables and abuse items, with the
281
exception of the relationship between race and several of the physical abuse items. In order to examine the relationships between the demographic variables, one scale (orientation toward elder abuse) and four sub– scales (neglect, physical abuse, psychological abuse, and financial abuse) were created. All five scales approximated truncated normal distributions (equivalent mean, medians, and modes, with relatively high frequencies for the extreme values). These scales will be treated as low–level interval scales in some analyses. In examining the relationships between the scales and demographic variables, two significant but minor relationships were found. For race (p = .026), White subjects (mean = 17.07) were slightly more likely to endorse physical abuse items than African American subjects (mean = 16.18). A significant relationship was also found between age and physical abuse (p = .019) with willingness to endorse physical abuse decreasing as age increased (Rho = −.119). Support for criminalization of elder abuse increased over the ten-year data collection period (see Table 2). All three measures of criminalization were significant with endorsement of the need for a misdemeanor statute decreasing (63.1 percent), while endorsement of the need for a felony statute (90.3 percent) and the use of prison for elder abusers (80.2 percent) increasing in 1996–97. About 84 percent of those who endorsed a misdemeanor statute also endorsed the need for a felony statute. Support of the effectiveness of criminalization remained fairly stable (perceived as wrong 84.9 percent; law prevent 57.3 percent) with 69.4 percent of the subjects in 1996–97 stating that they believed that a statute would be enforced if passed. From 1986 to 1987, the subjects became more punitive in their orientation (p ≤ .001) (see Table 3).
Table 2 Perceptions of the impact of and potential for criminalization by year Criminalization item
Year 1986–87
Year 1991–92
Year 1996–97
Yes
Percent
Yes
Percent
Yes
Percent
Criminalization In favor of a new misdemeanor statute ⁎⁎⁎ In favor of a new felony statute ⁎ Punish by putting elder abuser in prison ⁎⁎⁎
84 88 41
31.0 85.4 48.2
98 94 63
36.2 79.7 56.8
99 131 105
32.8 90.3 80.2
Impact Others will see elder abuse as wrong if illegal A new law would prevent elder abuse If elder abuse were illegal, law would be enforced ⁎⁎
89 53 56
87.3 53.0 54.4
108 77 65
87.7 64.2 52.0
118 82 100
84.9 57.3 69.4
⁎ P < .05 Pearson's for chi square. ⁎⁎ P < .01 Pearson's for chi square. ⁎⁎⁎ P < .001 Pearson's for chi square.
282
E. Morgan et al. / Journal of Criminal Justice 34 (2006) 275–283
Table 3 Preferred punishment by year Preferred punishment
Noncriminal justice or no punishment In favor of a fine as punishment In favor of a misdemeanor punishment In favor of a felony with one year in prison In favor of a felony with 2–5 years in prison In favor of a felony with 6+ years in prison Total
Year 1986–87
Year 1991–92
Year 1996–97
Total
#
Percent
#
Percent
#
Percent
#
Percent
10 9 25 24 6 11 85
11.8 10.6 29.4 28.2 7.1 12.9 100.0
7 9 32 29 14 20 111
7.3 8.1 28.8 26.1 12.6 18.0 100.0
3 5 18 3 41 61 131
2.3 3.1 13.7 2.3 31.3 46.6 100.0
20 23 75 56 61 92 237
6.1 7.0 22.9 17.1 18.7 28.1 100.0
Note: P < .001 Pearson's for chi square for type of punishment by year.
The endorsement of a noncriminal justice sanction, fines, or a misdemeanor penalty decreased and the endorsement of longer prison sentences increased over the ten-year period. Discussion and policy implications There were two limitations to these findings. First, a longitudinal multiple measure design which will collect data over a ten-year span must be relatively simple, limited, and direct so that the instrument will remain stable and reliable over time. This limited the complexity of the measurement of the variables to be studied. Second, the data were limited to the residents of one medium-sized southern city. These limitations were partially offset by the ability to measure change in basic attitudes toward elder abuse over time and by the measurement of a general population rather than a limited population such as students. The public endorsed a full range of psychological, neglect, and financial items as well as physical abuse items as elder abuse. They defined this behavior as criminal endorsing the creation of a felony offense, but were less willing to send abusers to prison. These definitions and preferences were relatively stable over time; however, the subjects appeared to become more punitively oriented over time. These endorsements were relatively universal with very little differences across the various demographic variables. For the past four decades, limited legislation criminalizing elder abuse had been advanced with many of the proposals becoming law. There was present a national movement to enhance these statutes, which placed additional pressure on law enforcement and the courts to formally process cases of alleged elder abuse. At the same time, there was substantial pressure, particularly in the social service community, to focus on treatment and rehabilitation rather than on punishment as a preferred orientation for addressing elder
abusers. There was an open-ended item measuring the subject's preferred disposition, but relatively few subjects responded. Those who did tended to choose a justice system process rather than a treatment process. This study provided, at best, base line data regarding public perceptions. At the present time, it appeared that public policy was following public preferences for criminalization. Public attitudes do change over time and a questionnaire focusing on the treatment of offenders might generate a different pattern. Recent research focusing on the perceptions of police chiefs and nursing home supervisors (Payne, 2003; Payne & Berg, 2003) should be expanded to permit further clarification of the perceptions of various stakeholders in the elder's environment. There was support for criminalization and a preference for criminalization over treatment; thus, if treatment and preventive programs are to be developed, public education will be essential. While this was consistent with the findings and recommendations of Lane (1997) regarding college-level corrections courses, broader, community based initiatives will be required. References Block, M. R., & Sinnott, J. D. (1979). The battered elder syndrome: An exploratory study (Final Rep. to the United States Administration on Aging). College Park: University of Maryland Center for Aging. Brownell, P., & Wolden, A. (2002). Elder abuse intervention strategies: Social service or criminal justice? Journal of Gerontological Social Work, 40, 83–101. Childs, H., Hayslip, B., Jr., Radika, L., & Reinberg, J. (2000). Young and middle-aged adults' perceptions of elder abuse. The Gerontologist, 40(1), 75–85. Cicirelli, V. G. (1986). The helping relationship and family neglect in later life. In K. A. Pillemer & R. S. Wolf (Eds.), Elder abuse: Conflict in the family. Dover, MA: Auburn House Publishing Company. Daly, J. M., & Jogerst, G. (2002). Statute definitions of elder abuse. Journal of Elder Abuse and Neglect, 13, 39–58.
E. Morgan et al. / Journal of Criminal Justice 34 (2006) 275–283 Douglas, R. L., Hickey, T., & Noel, C. (1980). A study of maltreatment of the elderly and other vulnerable adults: Final report to the United States Administration on Aging and the Michigan Department of Social Sciences. Ann Arbor: University of Michigan. Durea, M. (1933). An experimental study of attitudes toward juvenile delinquency. Journal of Applied Psychology, 12, 522–534. Durham, A. M., III. (1993). Public opinion regarding sentences for crime. Journal of Criminal Justice, 21(1), 1–11. Ferraro, K. F. (1990). Gerontology: Perspectives and issues. New York: Springer Publishing Co. Heisler, C. (2000). Elder abuse and the criminal justice system: New awareness, new responses. Generations, 24(2), 52–59. Jacoby, J. (1989, November). The structure of punishment norms: A theoretical integration of findings from the 1987 National Punishment Survey. Paper presented at the annual meetings of the American Society of Criminology, Bowling Green, KY. Jogerst, G. J., Daly, J. M., Brinig, M. F., Dawson, J. D., Schmuch, G. A., & Ingram, J. G. (2003). Domestic elder abuse and the law. American Journal of Public Health, 93, 2131–2137. Johnson, T. (1986). Critical issues in the definition of elder abuse. In K. A. Pillemer & R. S. Wolf (Eds.), Elder abuse: Conflict in the family. Dover, MA: Auburn House Publishing Company. Kosberg, J. I. (Ed.). (1983). Abuse and maltreatment of the elderly: Causes and interventions. Boston: John Wright/PSG, Inc. Lane, J. (1997). Can you make a horse drink? The effects of a corrections course on attitudes toward criminal punishment. Crime and Delinquency, 43(2), 186–203. Milner, J. S., Robertson, K. R., & Rogers, D. L. (1990). Childhood history of abuse and adult abuse potential. Journal of Interpersonal Violence, 5, 37–48. Moon, A. (2000). Perceptions of elder abuse among various cultural groups: Similarities and differences. Generations, 24(2), 75–81. Moon, A., & Williams, O. (1993). Perceptions of elder abuse and helpseeking behavior among African American, Caucasian American and Korean American elderly women. The Gerontologist, 33(3), 386–395. National Center on Elder Abuse. (1998). The national elder abuse incidence study. College Park: University of Maryland Center for Aging. Oakar, M. R., & Miller, C. A. (1983). Federal legislation to protect the elderly. In J. I. Kosberg (Ed.), Abuse and maltreatment of the elderly: Causes and interventions. Boston: John Wright/PSG, Inc. Pablo, S., & Braun, K. (1997). Perceptions of elder abuse and neglect and help-seeking patterns among Filipino and Korean elderly
283
women in Honolulu. Journal of Elder Abuse and Neglect, 9(2), 63–76. Payne, B. K. (2003). Justification for punishing crimes against the elderly: Perceptions of police chiefs, nursing home professionals, and students. Journal of Offender Rehabilitation, 38, 33–52. Payne, B. K., & Berg, B. L. (2003). Perceptions about the criminalization of elder abuse among police chiefs and ombudsmen. Crime and Delinquency, 49(3), 439–459. Pillemer, K. A., & Finkelhor, D. (1988). The prevalence of elder abuse: A random sample survey. The Gerontologist, 24, 51–57. Quinn, M. J., & Heisler, C. J. (2002). The legal response to elder abuse and neglect. Journal of Elder Abuse and Neglect, 14, 61–78. Rose, A., & Prell, A. (1955). Does the punishment fit the crime: A study in social evaluation. American Journal of Sociology, 61, 247–306. Sellin, T., & Wolfgang, M. (1964). The measurement of delinquency. New York: John Wiley. Sigler, R. T. (1989). Domestic violence in context: An assessment of community attitudes. Lexington, MA: Lexington Press. Sigler, R. T., & Lamb, D. (1995). Community-based alternatives to prison: How the public and court personnel view them. Federal Probation, 59(2), 3–10. Silverstone, B., & Hyman, H. K. (1976). You and your aging parent. New York: Pantheon Press. Steinmetz, S. K. (1981). Elder abuse. Aging, 7, 6–10. Steinmetz, S. K. (1983). Dependency, stress, and violence between middle-aged care givers and their elderly parents. In J. I. Kosberg (Ed.), Abuse and maltreatment of the elderly: Causes and interventions. Boston: John Wright/PSG, Inc. Steuer, J. L., & Austin, E. (1980). Family abuse of the elderly. Journal of the American Geriatrics Society, 28, 372–376. Thurstone, L. (1927). The method of paired comparisons for social values. Journal of Abnormal Social Psychology, 21(4), 384–400. Wolf, R. (2000). The nature and scope of elder abuse. Generations, 24 (2), 6–13. Wood, P. B., & Grasmick, H. G. (1999). Toward the development of punishment equivalencies: Male and female inmates rate the severity of alternative sanctions compared to prison. Justice Quarterly, 16(1), 19–50.
Status cited Social Security Act, Code of Federal Regulations, Title 20, Revised April 1, 2004.
Public definitions and endorsement of the criminalization of elder abuse Etta Morgan a , Ida Johnson b , Robert Sigler c,⁎ b c
a Department of Sociology, Jackson State University, Jackson, MS 39217, United States Department of Women's Studies, University of Alabama, P. O. Box 870320, Tuscaloosa, AL 35487-0320, United States Department of Criminal Justice, University of Alabama, P. O. Box 870320, Tuscaloosa, AL 35487-0320, United States
Abstract A longitudinal cross sectional ten-year study was conducted measuring public attitudes toward the definition and criminalization of elder abuse. The study found that the public endorsed a fairly broad definition of elder abuse and that this definition of elder abuse was fairly stable over time. Subjects also strongly endorsed the creation of misdemeanor and felony statutes and strongly endorsed the use of prison to punish elder abusers. The subjects also believed that the criminalization of elder abuse would be effective in reducing elder abuse. © 2006 Elsevier Ltd. All rights reserved.
Introduction Elder abuse is more difficult to examine than other forms of domestic abuse. Valid samples are difficult to obtain, and much of the abuse which is directed toward elders is neither physical nor occurring in a family context. Elder abuse, the most recent form of domestic abuse to be identified as an area of concern which requires justice system intervention is still in the process of criminalization. The justice system is in the process of developing appropriate policies for dealing with allegations of elder abuse; thus, there is a need to know more about this phenomenon. A series of assessments of the public definition of elder abuse and public willingness to criminalize elder abuse were conducted over a period of ten years. This article reports the types of behaviors
⁎ Corresponding author. Tel.: +1 205 348 8091. E-mail address: [email protected] (R. Sigler). 0047-2352/$ - see front matter © 2006 Elsevier Ltd. All rights reserved. doi:10.1016/j.jcrimjus.2006.03.004
that the general public endorsed as elder abuse and preferred punishments over that ten-year period. Literature review Public opinion regarding disposition of criminal cases In 1993, Durham questioned the existence of public opinion regarding sentences for crime. He reviewed the history of research in this area beginning with Thurstone's (1927) early measures of perceived seriousness of crimes tracing the attempts to assess seriousness of crimes and appropriate punishments through the work of scholars such as Durea (1933), Rose and Prell (1955), Sellin and Wolfgang (1964), and others with the National Punishment Survey (Jacoby, 1989) noted as the culmination of research efforts of this type before the 1990s. These studies generally found that the public could rank crimes in terms of severity, that violent crimes were both defined as more serious and deserving of greater punishments, and that, while
276
E. Morgan et al. / Journal of Criminal Justice 34 (2006) 275–283
the public consistently endorsed similar types of dispositions for specific types of crimes, there was less consistency in the degree of severity appropriate in the application of these dispositions. Durham (1993) questioned the validity of such findings suggesting that the judgments that subject's are asked to make are too technical and complex and that the methodology employed in mass surveys is not sufficiently powerful to measure this complex attitudinal set. Two years later Sigler and Lamb (1995), reporting the results of their study of community endorsement of the use of community corrections, acknowledged the difficulty in measuring a very complicated attitude set. They noted the history of research focusing on the acceptance of specific community corrections programs and the general acceptance of community corrections. They reported the development of a fairly sophisticated set of scales for measuring the endorsement of the various dimensions of the attitude set toward community corrections held by a range of justice system personnel and by the general public. The subjects appeared to understand the scales and provided valid responses for assessing perceived effectiveness along a number of dimensions. More recently the attitudes of inmates toward forms of correction had been measured (Wood & Grasmick, 1999) and the attitudes of police and ombudsmen toward the criminalization of elder abuse had been studied (Payne & Berg, 2003). Elder abuse as a justice system problem The problem of elder abuse is not a new phenomenon in society, but like other acts of violence in the family, it too is considered a private matter. Society, as well as the courts, until recently, viewed violence in the family as a private matter among family members and thought it best not to interfere. This attitude persisted for several centuries. Family violence as a societal concern began with children and extended to women through the feminist movement. The scope of family violence has since extended to include elder abuse. The idea of elder abuse was first discussed in British medical journals during the mid-1970s, but was not fully addressed until the latter part of the 1970s in the United States when it was linked to family violence. So many cases of elder abuse were being reported that Congress amended the Social Security Act during the 1960s and 1970s to address the abuse of adults with limited capability. These amendments provided funding to states to establish agencies (more commonly known as Adult Protective Services) to protect those persons deemed incapable of managing their own affairs. Adult
Protective Services provided services to persons eighteen and older, thereby, extending services to the elderly; however, in order to fully protect the elderly from abuse, most state legislators in the 1990s passed some form of elder abuse laws (Wolf, 2000). These statutes are restrictive generally limiting elder abuse to physical abuse with some statutes including some form of financial abuse. This reflects the absence of a clear comprehensive generally accepted definition of elder abuse. The fact that much elder abuse is not domestic abuse further confuses attempts at definition. Elder abuse occurs in both domestic and institutional settings, and elder abuse is more than physical abuse or financial exploitation. According to the National Center on Elder Abuse (1998, p. 1), there are seven types of elder abuse “(1) physical, (2) sexual, (3) emotional, (4) financial/material exploitation, (5) neglect, (6) abandonment, and (7) self-neglect.” Block and Sinnott (1979) developed a list of types of activities that constituted elder abuse, which included poor residential environment, that was expanded in terms of neglect by Douglas, Hickey, and Noel (1980). Kosberg (1983) developed a comprehensive list of activities that constituted elder abuse. The list included physical abuse, psychological abuse, material abuse, and violation of rights. Johnson (1986) summarized the forms of abuse identified in twenty-one studies of elder abuse and developed a five-stage sequential definition of elder abuse. Her comprehensive list included abuse, neglect, active neglect, passive neglect, physical abuse, physical neglect, psychological abuse, psychological neglect, verbal or emotional abuse, material abuse, medical abuse, exploitation, and violation of rights. While the diversity of definitions of elder abuse that were available when this series of studies were begun produced confusing results in the literature, little had been done since then to clarify this concept (Daly & Jogerst, 2002). In the past, only the strong and healthy survived to old age. With improvements in medical care, less healthy and less strong individuals who require a higher level of care are surviving to old age. Many of those who survive severe illnesses have disabilities and chronic illnesses that require much care (Steinmetz, 1983). The survival of parents with high care needs creates stress for their middle-aged children who are attempting to cope with their own children (Silverstone & Hyman, 1976). Steinmetz (1981) had advanced the concept of generational inversion to explain one pattern which emerges. In generational inverted families, adult children assume the responsibility for one or more elders who are dependent on them for emotional,
E. Morgan et al. / Journal of Criminal Justice 34 (2006) 275–283
financial, physical, or mental support. When faced with the need to care for two or more elders, the amount of stress experienced by caregivers increases greatly, particularly as the degree of dependency increases (Steinmetz, 1983). This stress can lead to the forms of abuse which are the target of legislation designed to protect elders (Oakar & Miller, 1983). Much of what is asserted about elder abuse is essentially speculation. The broad surveys of victims and abuse incidents, which had been conducted for cases involving children and spouses, had not been conducted for cases involving elders at the time this research was initiated (Ferraro, 1990) with limited additional study of this type in the past two decades. Much of the data which were presently available were still found in unpublished manuscripts, reports of the proceedings of congressional committees, and in reports from state and federal agencies. There is a need for expanded research focusing on the nature of elder abuse so that the impact of criminalization can be assessed. The most recent survey found that in 1999 there were 190,005 domestic elder abuse reports from seventeen states, a rate of 8.6 per 1,000 elders; of which 242,430 were investigated in forty-seven of the fifty states and the District of Columbia, a rate of 5.9; and 102, 879 substantiated cases from thirty-five states, a rate of 2.7. States requiring mandatory reporting and tracking of numbers of reports reported significantly higher rates (Jogerst et al., 2003). Estimates of the prevalence of physical abuse in cases of elder abuse ranged from 14 percent (Milner, Robertson, & Rogers, 1990) to 64 percent (Pillemer & Finkelhor, 1988). In the latter study, a broad definition of elder abuse was used (including acts such as pushing and shoving). Neglect was identified as active and passive neglect (Cicirelli, 1986). Active neglect is the refusal or failure to fulfill a care-taking obligation, including a conscientious and intentional attempt to inflict physical or emotional distress on the elder. Passive neglect includes the same behaviors without the intent to do harm. Neglect is relatively invisible as it occurs in private, but tends to be the most common form of abuse (Steuer & Austin, 1980). Perceptions of abuse in some instances according to Moon and Williams (1993) were often predicated on three distinct factors: (1) the intent of the individual, (2) the attendant circumstances, and (3) the nature of the act itself. Pablo and Braun's (1997) study found that acculturation into the American way of life affected various cultures and the attitudes of various groups towards the norms of their culture. Due to the
277
differences in the perception of elder abuse and the lack of knowledge about elder abuse combined with the isolation experienced by some elderly persons, many instances of elder abuse will go unnoticed and unreported (Moon, 2000). One recent study addressed preferred dispositions for elder abusers (Payne, 2003). He asked a sample of police chiefs, students, and nursing home professionals how they believed that cases of elder abuse should be handled. The results indicated that police chiefs and students held more punitive attitudes, while nursing home professionals endorsed more rehabilitative ideals. Childs, Hayslip, Radika, and Reinberg (2000) examined the impact of age and gender in regards to the respondent, victim, or perpetrator as well as the impact of a history of violence either as a victim or perpetrator on one's perception of elder abuse. According to Childs et al. (2000), age tends to impact one's perception of elder abuse among the respondents in regards to psychological abuse. Perceptions of elder abuse were also impacted by the age of the abuser. Additionally, Childs et al. (2000) found that there was some interaction between the respondent's age and gender and the abuser's age. First, middle-aged women judged their peers more harshly than younger women. Second, young men viewed the behaviors of middleaged abusers as more abusive, harmful, and reportable than they viewed the same behaviors committed by an elderly abuser (p. 82). The results from this study also revealed that psychological abuse was not viewed as harmful as physical abuse because of the level of harm experienced by the victim, nor was there a need to report acts of psychological abuse. Interestingly, the perceptions of elder abuse were influenced by a history of violence either in the form of family violence or childhood violence. Childs et al. (2000) noted that middle-aged persons who had experienced high levels of family violence were less critical about abusive behaviors towards the elderly than those who experienced low levels of family violence. They also found that young adults who demonstrated low levels of violent behavior held more abusive attitudes toward a grandparent than those who reported high experienced childhood violence (Childs et al., 2000, p. 83). Attitudes toward the elderly and the criminalization of acts identified as elder abuse have added a new dimension to the understanding of elder abuse and the need to insure that the elderly are protected. It will be difficult for the justice system to develop effective procedures for dealing with elder neglect. Some argue that elder abuse should be treated as a social
278
E. Morgan et al. / Journal of Criminal Justice 34 (2006) 275–283
problem and in clinical, treatment-oriented programs rather than in the justice system (Brownell & Wolden, 2002). A lack of attention from relatives could be characterized as a form of neglect of an elder and could be termed abuse; on the other hand, there could be a difference in expectations held by the actors regarding the level of attention due a parent by a child. That is, elders may perceive themselves as abused not because of a failure on the part of their children to provide services at an acceptable level, but because the level of care the elders receive is less than the level they expect. This does not suggest that elder abuse does not occur; it does suggest that elder abuse is less clear and broader in scope than other forms of domestic abuse, and thus, more appropriate for treatment than for punishment. Elder abuse is also broader in the sense that it frequently extends beyond the home into nursing homes and similar institutions (Sigler, 1989). This difficulty with definition will create difficulties for justice agencies charged with the control of elder abuse. In the past, suspected acts of elder abuse were referred to social service agencies responsible for protecting the elderly in hopes of ending the abuse. While these agencies have been effective in ending some cases of abuse, a number of professionals have come to believe only the criminal justice system will be capable of stopping the abuse, protecting the victim, and holding the offender accountable in serious cases (Heisler, 2000, p. 52). The criminalization of elder abuse is a relatively new focus for the criminal justice system. Perpetrators are now held accountable for their actions because some states have enacted statutes that criminalize various acts of elder abuse and allow for sentence enhancements for elder abuse committed during the commission of other crimes (Heisler, 2000). Various social service and law enforcement agencies have implemented training programs for law enforcement officers, judges, and prosecutors to improve the disposition of cases of alleged elder abuse. Additionally, many social service agencies are now working in conjunction with law enforcement officials so that the case includes information that would otherwise not be available to law enforcement and to insure that the victim's needs are met during the entire criminal justice process. In some states, court procedures have been changed to accommodate elder abuse cases, such as setting early trial dates and controlling the location and manner in which testimony is taken. Finally, some criminal justice agencies use an alternative approach to case building whereby less emphasis is placed on victim participation (Heisler, 2000). There is pressure to further criminalize elder abuse (Quinn & Heisler, 2002).
Community support is essential to the development of effective interventions in cases of elder abuse. The series of surveys reported here measured the breadth of community definitions of elder abuse and the willingness of community members to criminalize elder abuse. Methodology Design characteristics Data were collected with four self-administered questionnaires that were delivered and retrieved from randomly selected households within the city limits of Tuscaloosa, Alabama, a southern city with major educational and mental health institutions and a light industrial base. The four separate surveys shared a common sampling frame, common variables, and common data collection techniques. Data were collected in 1986–87, in 1991–92, and in 1996–97. The first instrument focused on the location of domestic violence within the broader context of social violence. The second, third, and fourth instruments focused on the dimensions of domestic abuse and perceived need for criminalization for specific types of domestic abuse (spouse abuse, child abuse, and elder abuse). Variables While the variables remained fairly constant across the four instruments, there were some differences from one instrument to another in the scales used to measure some of the variables. In the elder abuse instrument, the subjects' willingness to label specific acts that could be seen as neglect or as psychological, financial, or physical abuse was measured by a set of nineteen items that subjects were asked to label as “always elder abuse,” “sometimes elder abuse,” or “never elder abuse.” Physical acts were measured in terms of degree of force and in terms of frequency of use of force. Additional items measured willingness to criminalize elder abuse and preferred penalties. In addition to the primary variables, a number of standard demographic variables were measured. These variables included gender, race, age, education, occupation, marital status, religious activity, and political activity. The last two variables were measured on scales that measured affiliation and perceived level of activity. The population The population for the four surveys was the adult resident population of the city of Tuscaloosa. The
E. Morgan et al. / Journal of Criminal Justice 34 (2006) 275–283
279
Table 1 Endorsement of types of behavior as elder abuse by year Type of behavior
Year 1986–87 Never
Psychological abuse Criticize ⁎⁎⁎ N Percent Call worthless N Percent Cursing N Percent Not love ⁎⁎⁎ N Percent Threaten N Percent Neglect Tie or lock up N Percent Too little food N Percent Inadequate clothing N Percent Physical abuse Hit with hand occasionally N Percent Hit with hand frequently N Percent Hit with fist occasionally N Percent Hit with fist frequently N Percent Hit with stick or belt occasionally N Percent Hit with stick or belt often N Percent Financial abuse Force out of home ⁎ N Percent Prevent spend money ⁎⁎ N Percent
Sometimes
Year 1991–92 Always
Never
Sometimes
Year 1996–97 Always
Never
Sometimes
Always
5 4.4
57 50.4
51 45.1
21 15.9
53 40.2
58 43.9
17 11.0
50 32.3
88 56.8
8 7.0
6 5.2
101 87.8
19 14.4
13 18.8
100 66.8
17 10.9
8 5.1
131 84.0
8 7.0
12 10.4
95 82.6
17 12.8
18 13.5
98 73.7
18 11.5
14 8.9
125 78.6
11 9.7
43 38.1
59 52.2
22 16.5
46 34.6
65 48.9
26 16.8
22 14.2
107 69.0
8 7.0
15 13.0
92 80.0
16 12.1
27 20.5
89 67.4
16 10.3
26 16.7
114 73.0
7 6.1
9 7.9
98 86.0
17 12.9
15 11.4
100 75.7
16 10.0
10 8.5
129 81.5
7 6.1
1 0.9
107 93.0
17 12.8
5 3.8
111 83.4
15 9.6
8 5.1
134 85.4
7 6.0
6 5.2
103 88.8
16 12.0
8 6.0
109 82.0
16 10.2
11 7.0
130 82.8
7 6.0
1 0.9
108 93.1
16 12.0
5 3.8
112 84.2
16 10.3
3 1.9
137 87.8
7 6.0
0 0.0
109 94.0
16 12.1
1 0.8
115 87.1
16 10.3
3 1.9
137 87.8
6 5.2
0 0.0
109 94.8
16 12.0
1 0.8
116 87.2
16 10.2
4 2.5
137 87.3
7 6.0
0 0.0
109 94.0
17 12.8
0 0.0
116 87.2
16 10.3
1 0.6
138 89.1
7 6.0
0 0.0
109 94.0
17 12.8
0 0.0
116 87.2
16 10.2
3 1.9
138 87.9
7 6.1
0 0.0
108 93.9
16 12.0
1 0.8
116 87.2
16 10.3
5 3.2
135 86.5
7 6.1
25 21.9
82 72.0
18 13.6
43 32.6
71 53.8
17 10.9
36 23.1
103 66.0
7 6.1
68 59.1
40 34.8
18 13.7
73 55.7
40 30.6
18 11.7
60 39.0
76 49.3
(continued on next page)
280
E. Morgan et al. / Journal of Criminal Justice 34 (2006) 275–283
Table 1 (continued) Type of behavior
Year 1986–87 Never
Spend elder's money N Percent
7 6.1
Sometimes 24 20.9
Year 1991–92 Always 84 73.0
Never
Sometimes
17 13.0
26 19.8
Year 1996–97 Always 88 67.2
Never
Sometimes
Always
17 10.9
36 23.1
103 66.0
⁎ P < .05 Pearson's for chi square. ⁎⁎ P < .01 Pearson's for chi square. ⁎⁎⁎ P < .001 Pearson's for chi square.
campuses of Stillman College and the University of Alabama and the student housing area adjacent to the university campus were excluded to eliminate nonresident students from the population. The reservations of the mental health facilities and the Veterans Administration Hospital were excluded to eliminate nonresident patients from the population. This process might have excluded a small number of Tuscaloosa residents, introducing a small bias, which was outweighed by the bias that would result if the student and patient populations were included. The sample In the first data-collection period (1986–87), four separate stratified random samples were drawn from the population. The data were collected in three separate two to three-month periods. In the second and third datagathering period (1991–92 and 1996–97), a single stratified random sample was drawn from the population, with all four instruments delivered during a ninemonth period. At the beginning of each data-gathering session, a city map was obtained from the City Engineer's Office. The grids formed by the latitude and longitude lines on the maps constituted the first set of strata, and city blocks constituted the second strata. The number of city blocks in each section was counted, and a number of units were assigned to each section based on its portion of the total blocks in the city. In all, 150 units were selected for each instrument in the first period, and 200 units were selected for each instrument in the second and third periods. One house was selected from each during the first collection period. Four houses were selected from each block during the second and third data-gathering period. Each randomly selected household received one questionnaire. If an apartment building was selected, the list of random numbers was used to select an apartment. The next-oldest-birthday method was used to select one adult from each household.
Adult was defined as a permanent Tuscaloosa resident over eighteen years of age. The collection of data The questionnaires were placed in campus mail envelopes for delivery. These envelopes were delivered and retrieved by research assistants working in teams. Each team consisted of one driver and one contact person. All of the contact persons were women. The contact person would introduce herself and ask for the adult with the next birthday. If the subject was not at home, the contact person would leave the questionnaire with the person who answered the door with instructions to give the questionnaire to the subject with an explanation and request for assistance. She would leave the envelope and questionnaire with instructions to place the questionnaire in the envelope when completed or to place the uncompleted questionnaire in the envelope if the subject decided not to participate. The contact person would make arrangements to return to retrieve the questionnaire two days later. Subjects were asked to leave the completed instruments outside the front door for retrieval if they left home. If an instrument was not retrieved on the return trip, the team would make up to three additional trips in an attempt to retrieve the questionnaire. This approach was relatively successful in delivering the questionnaires. About 75 percent of the instruments were retrieved in completed usable form from each sample. All blocks selected had more than ten homes. In the first data-gathering period, 117 questionnaires were returned from the 150 questionnaires distributed. In the second data-gathering period, 134 completed instruments were returned of the 200 delivered. In the third data-gathering period, 159 completed instruments were returned of 200 delivered. Findings A comparison of totals from the 1980 (1986–87) and 1990 (1991–92) census adjusted for the removal of students and patients found the selected demographic
E. Morgan et al. / Journal of Criminal Justice 34 (2006) 275–283
variables, with the exception of gender, matched the population within ± 3 percent. There were more women in the sample than in the population for all three sessions. While women were slightly overrepresented in the population of Tuscaloosa, they were moderately overrepresented in the two samples. In the first sample, 65.0 percent of the subjects were women, and in the second sample 61.2 percent of the sample were women. In the third sample, 62.7 percent of the sample were women. Instruments were delivered in afternoon and evening shifts. While the day shifts were expected to encounter a greater number of women as first contacts, the next birthday method should have neutralized this potential bias. First, it should be noted that the subjects strongly endorsed all of the physical force items in all years as elder abuse (see Table 1). While there was a slight consistent reduction in level of endorsement from 1986–87 to 1996–97, none of the differences were significant. In all instances, more than 63 percent of the subjects endorsed the items as “always elder abuse.” The same pattern could be observed for neglect items with lower levels of endorsement, with the exception of a significant decrease in the subjects' willingness to endorse “always abuse” for not spending time with the elder. For psychological abuse, both “criticize the elder” and “not loving the elder” were significantly more likely to be endorsed as “always abuse” in 1996–97 than in 1986–87. Mixed results were found for financial abuse with “forcing the elder out of his or her home” decreasing and “preventing the elder from spending her or his own money” increasing from 1986–87 to 1996–97. No significant relationships were found between the various demographic variables and abuse items, with the
281
exception of the relationship between race and several of the physical abuse items. In order to examine the relationships between the demographic variables, one scale (orientation toward elder abuse) and four sub– scales (neglect, physical abuse, psychological abuse, and financial abuse) were created. All five scales approximated truncated normal distributions (equivalent mean, medians, and modes, with relatively high frequencies for the extreme values). These scales will be treated as low–level interval scales in some analyses. In examining the relationships between the scales and demographic variables, two significant but minor relationships were found. For race (p = .026), White subjects (mean = 17.07) were slightly more likely to endorse physical abuse items than African American subjects (mean = 16.18). A significant relationship was also found between age and physical abuse (p = .019) with willingness to endorse physical abuse decreasing as age increased (Rho = −.119). Support for criminalization of elder abuse increased over the ten-year data collection period (see Table 2). All three measures of criminalization were significant with endorsement of the need for a misdemeanor statute decreasing (63.1 percent), while endorsement of the need for a felony statute (90.3 percent) and the use of prison for elder abusers (80.2 percent) increasing in 1996–97. About 84 percent of those who endorsed a misdemeanor statute also endorsed the need for a felony statute. Support of the effectiveness of criminalization remained fairly stable (perceived as wrong 84.9 percent; law prevent 57.3 percent) with 69.4 percent of the subjects in 1996–97 stating that they believed that a statute would be enforced if passed. From 1986 to 1987, the subjects became more punitive in their orientation (p ≤ .001) (see Table 3).
Table 2 Perceptions of the impact of and potential for criminalization by year Criminalization item
Year 1986–87
Year 1991–92
Year 1996–97
Yes
Percent
Yes
Percent
Yes
Percent
Criminalization In favor of a new misdemeanor statute ⁎⁎⁎ In favor of a new felony statute ⁎ Punish by putting elder abuser in prison ⁎⁎⁎
84 88 41
31.0 85.4 48.2
98 94 63
36.2 79.7 56.8
99 131 105
32.8 90.3 80.2
Impact Others will see elder abuse as wrong if illegal A new law would prevent elder abuse If elder abuse were illegal, law would be enforced ⁎⁎
89 53 56
87.3 53.0 54.4
108 77 65
87.7 64.2 52.0
118 82 100
84.9 57.3 69.4
⁎ P < .05 Pearson's for chi square. ⁎⁎ P < .01 Pearson's for chi square. ⁎⁎⁎ P < .001 Pearson's for chi square.
282
E. Morgan et al. / Journal of Criminal Justice 34 (2006) 275–283
Table 3 Preferred punishment by year Preferred punishment
Noncriminal justice or no punishment In favor of a fine as punishment In favor of a misdemeanor punishment In favor of a felony with one year in prison In favor of a felony with 2–5 years in prison In favor of a felony with 6+ years in prison Total
Year 1986–87
Year 1991–92
Year 1996–97
Total
#
Percent
#
Percent
#
Percent
#
Percent
10 9 25 24 6 11 85
11.8 10.6 29.4 28.2 7.1 12.9 100.0
7 9 32 29 14 20 111
7.3 8.1 28.8 26.1 12.6 18.0 100.0
3 5 18 3 41 61 131
2.3 3.1 13.7 2.3 31.3 46.6 100.0
20 23 75 56 61 92 237
6.1 7.0 22.9 17.1 18.7 28.1 100.0
Note: P < .001 Pearson's for chi square for type of punishment by year.
The endorsement of a noncriminal justice sanction, fines, or a misdemeanor penalty decreased and the endorsement of longer prison sentences increased over the ten-year period. Discussion and policy implications There were two limitations to these findings. First, a longitudinal multiple measure design which will collect data over a ten-year span must be relatively simple, limited, and direct so that the instrument will remain stable and reliable over time. This limited the complexity of the measurement of the variables to be studied. Second, the data were limited to the residents of one medium-sized southern city. These limitations were partially offset by the ability to measure change in basic attitudes toward elder abuse over time and by the measurement of a general population rather than a limited population such as students. The public endorsed a full range of psychological, neglect, and financial items as well as physical abuse items as elder abuse. They defined this behavior as criminal endorsing the creation of a felony offense, but were less willing to send abusers to prison. These definitions and preferences were relatively stable over time; however, the subjects appeared to become more punitively oriented over time. These endorsements were relatively universal with very little differences across the various demographic variables. For the past four decades, limited legislation criminalizing elder abuse had been advanced with many of the proposals becoming law. There was present a national movement to enhance these statutes, which placed additional pressure on law enforcement and the courts to formally process cases of alleged elder abuse. At the same time, there was substantial pressure, particularly in the social service community, to focus on treatment and rehabilitation rather than on punishment as a preferred orientation for addressing elder
abusers. There was an open-ended item measuring the subject's preferred disposition, but relatively few subjects responded. Those who did tended to choose a justice system process rather than a treatment process. This study provided, at best, base line data regarding public perceptions. At the present time, it appeared that public policy was following public preferences for criminalization. Public attitudes do change over time and a questionnaire focusing on the treatment of offenders might generate a different pattern. Recent research focusing on the perceptions of police chiefs and nursing home supervisors (Payne, 2003; Payne & Berg, 2003) should be expanded to permit further clarification of the perceptions of various stakeholders in the elder's environment. There was support for criminalization and a preference for criminalization over treatment; thus, if treatment and preventive programs are to be developed, public education will be essential. While this was consistent with the findings and recommendations of Lane (1997) regarding college-level corrections courses, broader, community based initiatives will be required. References Block, M. R., & Sinnott, J. D. (1979). The battered elder syndrome: An exploratory study (Final Rep. to the United States Administration on Aging). College Park: University of Maryland Center for Aging. Brownell, P., & Wolden, A. (2002). Elder abuse intervention strategies: Social service or criminal justice? Journal of Gerontological Social Work, 40, 83–101. Childs, H., Hayslip, B., Jr., Radika, L., & Reinberg, J. (2000). Young and middle-aged adults' perceptions of elder abuse. The Gerontologist, 40(1), 75–85. Cicirelli, V. G. (1986). The helping relationship and family neglect in later life. In K. A. Pillemer & R. S. Wolf (Eds.), Elder abuse: Conflict in the family. Dover, MA: Auburn House Publishing Company. Daly, J. M., & Jogerst, G. (2002). Statute definitions of elder abuse. Journal of Elder Abuse and Neglect, 13, 39–58.
E. Morgan et al. / Journal of Criminal Justice 34 (2006) 275–283 Douglas, R. L., Hickey, T., & Noel, C. (1980). A study of maltreatment of the elderly and other vulnerable adults: Final report to the United States Administration on Aging and the Michigan Department of Social Sciences. Ann Arbor: University of Michigan. Durea, M. (1933). An experimental study of attitudes toward juvenile delinquency. Journal of Applied Psychology, 12, 522–534. Durham, A. M., III. (1993). Public opinion regarding sentences for crime. Journal of Criminal Justice, 21(1), 1–11. Ferraro, K. F. (1990). Gerontology: Perspectives and issues. New York: Springer Publishing Co. Heisler, C. (2000). Elder abuse and the criminal justice system: New awareness, new responses. Generations, 24(2), 52–59. Jacoby, J. (1989, November). The structure of punishment norms: A theoretical integration of findings from the 1987 National Punishment Survey. Paper presented at the annual meetings of the American Society of Criminology, Bowling Green, KY. Jogerst, G. J., Daly, J. M., Brinig, M. F., Dawson, J. D., Schmuch, G. A., & Ingram, J. G. (2003). Domestic elder abuse and the law. American Journal of Public Health, 93, 2131–2137. Johnson, T. (1986). Critical issues in the definition of elder abuse. In K. A. Pillemer & R. S. Wolf (Eds.), Elder abuse: Conflict in the family. Dover, MA: Auburn House Publishing Company. Kosberg, J. I. (Ed.). (1983). Abuse and maltreatment of the elderly: Causes and interventions. Boston: John Wright/PSG, Inc. Lane, J. (1997). Can you make a horse drink? The effects of a corrections course on attitudes toward criminal punishment. Crime and Delinquency, 43(2), 186–203. Milner, J. S., Robertson, K. R., & Rogers, D. L. (1990). Childhood history of abuse and adult abuse potential. Journal of Interpersonal Violence, 5, 37–48. Moon, A. (2000). Perceptions of elder abuse among various cultural groups: Similarities and differences. Generations, 24(2), 75–81. Moon, A., & Williams, O. (1993). Perceptions of elder abuse and helpseeking behavior among African American, Caucasian American and Korean American elderly women. The Gerontologist, 33(3), 386–395. National Center on Elder Abuse. (1998). The national elder abuse incidence study. College Park: University of Maryland Center for Aging. Oakar, M. R., & Miller, C. A. (1983). Federal legislation to protect the elderly. In J. I. Kosberg (Ed.), Abuse and maltreatment of the elderly: Causes and interventions. Boston: John Wright/PSG, Inc. Pablo, S., & Braun, K. (1997). Perceptions of elder abuse and neglect and help-seeking patterns among Filipino and Korean elderly
283
women in Honolulu. Journal of Elder Abuse and Neglect, 9(2), 63–76. Payne, B. K. (2003). Justification for punishing crimes against the elderly: Perceptions of police chiefs, nursing home professionals, and students. Journal of Offender Rehabilitation, 38, 33–52. Payne, B. K., & Berg, B. L. (2003). Perceptions about the criminalization of elder abuse among police chiefs and ombudsmen. Crime and Delinquency, 49(3), 439–459. Pillemer, K. A., & Finkelhor, D. (1988). The prevalence of elder abuse: A random sample survey. The Gerontologist, 24, 51–57. Quinn, M. J., & Heisler, C. J. (2002). The legal response to elder abuse and neglect. Journal of Elder Abuse and Neglect, 14, 61–78. Rose, A., & Prell, A. (1955). Does the punishment fit the crime: A study in social evaluation. American Journal of Sociology, 61, 247–306. Sellin, T., & Wolfgang, M. (1964). The measurement of delinquency. New York: John Wiley. Sigler, R. T. (1989). Domestic violence in context: An assessment of community attitudes. Lexington, MA: Lexington Press. Sigler, R. T., & Lamb, D. (1995). Community-based alternatives to prison: How the public and court personnel view them. Federal Probation, 59(2), 3–10. Silverstone, B., & Hyman, H. K. (1976). You and your aging parent. New York: Pantheon Press. Steinmetz, S. K. (1981). Elder abuse. Aging, 7, 6–10. Steinmetz, S. K. (1983). Dependency, stress, and violence between middle-aged care givers and their elderly parents. In J. I. Kosberg (Ed.), Abuse and maltreatment of the elderly: Causes and interventions. Boston: John Wright/PSG, Inc. Steuer, J. L., & Austin, E. (1980). Family abuse of the elderly. Journal of the American Geriatrics Society, 28, 372–376. Thurstone, L. (1927). The method of paired comparisons for social values. Journal of Abnormal Social Psychology, 21(4), 384–400. Wolf, R. (2000). The nature and scope of elder abuse. Generations, 24 (2), 6–13. Wood, P. B., & Grasmick, H. G. (1999). Toward the development of punishment equivalencies: Male and female inmates rate the severity of alternative sanctions compared to prison. Justice Quarterly, 16(1), 19–50.
Status cited Social Security Act, Code of Federal Regulations, Title 20, Revised April 1, 2004.