What Does Success Mean in the Context of Elder Abuse Intervention from the Perspective of Victims?

Background and Purpose: Adult protective services (APS) and other community-based agencies respond to hundreds of thousands of elder abuse cases each year in the United States. Despite rising caseloads nationwide, little is known about what constitutes success in the context of elder abuse response intervention. Without understanding intervention success, practitioners lack a compass to guide practice and researchers are constrained in developing meaningful outcome measures. The purpose of this study was to explore the meaning of elder abuse intervention success from the perspective of victims themselves toward the development of a victim-centric taxonomy of outcomes.

Methods: Guided by a phenomenological qualitative methodology, this study conducted in-person, semi-structured interviews with a sample of elder abuse victims (n = 40) recruited from APS in the states of Maine, New York, and California, as well as a community-based elder abuse social service program in New York City. Data analysis followed an iterative, constant comparison process that allowed themes to emerge and become reorganized as new transcript information became available. To enhance trustworthiness, two researchers independently analyzed transcript data to identify, sort, and cluster key transcript statements into themes. They cross-checked codes during in-person meetings to compare coding approaches and arrived at common categories. Analysis was facilitated using NVivo software.

Results: Outcomes of success were identified across broad domains related to the victim, perpetrator, victim-perpetrator relationship, family system, and home environment. More specifically, common themes represented outcomes related to victim safety, autonomy, social support, and state of mind; perpetrator launching/independence and aggression; victim-perpetrator separation; and the tone of the home atmosphere.

Conclusions and Implications: For decades, the field of elder abuse has struggled to understand how to define success in the context of community-based intervention from a client-centered perspective. The taxonomy developed in this study provides a comprehensive and conceptually organized range of successful outcomes to serve as infrastructure for the development of meaningful intervention outcome measures. This study represents one of the largest efforts to understand and integrate the perspective and needs of victims into elder abuse intervention practice/research to date.