Victims Of Elder Mistreatment Research Articles

RELATIONSHIP BETWEEN INFORMAL AND FORMAL HELP-SEEKING BEHAVIORS FOR ELDER MISTREATMENT AMONG CHINESE IMMIGRANTS

Abstract Purpose Help-seeking minimizes the consequences from elder mistreatment (EM). However, formal help-seeking could be challenging for older immigrants due to cultural and linguistic barriers. Informal supporters have been shown to promote formal help-seeking among EM victims. This study aimed to examine whether informal help facilitates U.S. Chinese EM victims with seeking help from formal sources. Methods Data were derived from the Population Study of Chinese Elderly in Chicago. EM measurements included psychological, physical, sexual mistreatment, financial exploitation, and caregiver neglect. Seeking help from informal and formal sources were evaluated. Descriptive statistics and multinominal logistic regression were conducted. Results Among 450 EM victims, 53.48% of them sought informal help, 31.75% did not seek any help, 11.42% sought both informal and formal help, and 3.34% sought formal help. The most common informal sources were adult children, partners, and friends/neighbors. The most common formal sources were community social services organizations, followed by legal criminal justice systems. Compared to those who did not seek any help, victims who reported more emotional closeness within their social network and experienced financial exploitation were more likely to seek help from formal sources. However, informal help-seeking was not significantly associated with formal help-seeking. Conclusion/implication: The findings suggest that most U.S. Chinese older adults who experienced EM did not seek formal help. Higher levels of contact with social networks could increase seeking help from formal sources. However, future research is needed to explore why informal supporters did not facilitate seeking help from formal sources in Chinese EM victims.

Traumatic Events and Health: An Ecological and Life Course Perspective

During the past decades, researchers have shown an increasing interest in the study of traumatic events among aging populations. The majority of studies on trauma focus on mental health, which overlooks the possibility that trauma may also have an adverse effect on other health outcomes, such as cognitive function. A number of studies focus on a single traumatic event. However, this approach may underestimate its health impact as many people experience multiple forms of traumatic events. Indeed, the impact of traumatic events on health depends on the event itself (e.g., single or multiple forms, time) as well as ecological factors. This symposium aims to address the above limitations. The first longitudinal study An Ecological Model of Risk Factors in Elder Mistreatment (EM) Victims tested different dimensions of the ecological model to prevent recurrence of EM. The second study Polyvictimization and Cognitive Function in an Ethnic Minority Aging Population explored whether exposure to multiple forms of EM affects cognitive function. The third study Traumatic Events and Cognitive Function: Does Time Matter? examined whether traumatic events happened in childhood, adulthood, or old age will influence late-life cognitive function. The fourth study Face-saving and Help-seeking among Older Adults with EM identified cultural determinants of help-seeking behaviors in EM victims. This symposium will advance knowledge in the health consequences of polyvictimization and exposure to traumatic events in different life stages. It will also inform interventions to stop the recurrence of EM in immigrant families and enhance the help-seeking behaviors of ethnic minority older adults.

Elder Abuse Victims During the COVID-19 Pandemic: Administrative Data From San Francisco Adult Protective Services

This study examined elder mistreatment victims’ experiences at the beginning of the COVID-19 pandemic. San Francisco Adult Protective Services (APS) caseworkers conducted phone interviews to inquire about clients’ awareness of COVID-19 and unmet needs. Nine-hundred-and-thirty-four (71%) of 1,313 APS’ past clients or their collaterals were interviewed, with 741 (79%) responding positively to COVID-19-awareness questions, and 697 (75%) having no unmet needs. Binary logistic regression with Firth adjusted maximum likelihood estimation method revealed that older persons (p < .05), self-neglectors (p < .05), and victims of neglect (p < .05) were less aware of COVID-19. Unmet needs varied by mistreatment type. Victims of isolation were more likely to have medical needs (p < .05), while victims of emotional abuse were more likely to report loneliness (p < .001). Collaboration between service providers is key in assisting victims experiencing unmet needs to live safely in a public health crisis.

Lack of Association of Elder Mistreatment With Mortality.

Prior research is limited and inconsistent on the degree to which elder mistreatment (EM) is associated with mortality. This study uses data from a 10-year, prospective, population-based study of EM to determine the adjusted effects of EM on older adult mortality, after controlling for other health and socioeconomic covariates. The New York State Elder Mistreatment Prevalence Study conducted a random-sample telephone survey of older adults (n = 4 156) in 2009 (Wave 1). The current study employs EM and covariate data from Wave 1 and data on mortality status through Wave 2 (2019). EM was operationalized both as experiencing EM and as severity of EM. The survey measured overall EM and separate subtypes (emotional, physical, and financial abuse, and neglect). The hypothesis was not supported that abused and neglected older people would have higher rates of death over the study. Individuals who were victims of EM were no more likely to die over the following 10 years, compared with those who were not mistreated, after controlling for covariates. Furthermore, the severity of EM, as measured by the frequency of mistreatment behaviors, also was not associated with mortality risk. The finding that self-reported EM did not raise the risk of earlier death in this sample is encouraging. Future research should work to identify factors that may moderate the relationship between EM and mortality, such as social support/isolation, quality of family relationships, or involvement with formal support service systems.

Elder Mistreatment Victims during the COVID-19 Pandemic: Administrative Data from San Francisco Adult Protective Services

This study examined elder mistreatment victims’ experiences at the beginning of the COVID-19 pandemic, focusing on their COVID-19 awareness and unmet needs. San Francisco Adult Protective Services (APS) caseworkers conducted phone interviews with clients or collaterals (client’s family, trusted other, or service provider) to inquire about clients’ awareness of COVID-19 and unmet needs. Nine-hundred-and-thirty-four (71%) of 1,313 APS’ past clients or their collaterals were interviewed, with 741 (79%) responding positively to COVID-19-awareness questions, and 697 (75%) having no unmet needs. Binary logistic regression with Firth adjusted maximum likelihood estimation method revealed that older persons (p < .05), self-neglectors (p < .05), and victims of neglect (p < .05) were less aware of COVID-19. Unmet needs varied by mistreatment type. Victims of isolation were more likely to have medical needs (p < .05), while victims of emotional abuse were more likely to report loneliness (p < .001). Case notes reflected clients who were well-prepared for the pandemic, versus those who required additional assistance to follow preventative measures of the COVID-19 pandemic to stay home. Although the majority of San Francisco APS’ past clients experienced no unmet needs at the beginning of the COVID-19 pandemic, the prolonged length and intensity of the pandemic could have exacerbated this vulnerable group’s situation. Collaboration between service providers is key in assisting victims experiencing unmet needs to live safely in a public health crisis, especially underserved victims of specific ethnic backgrounds.

Examining nurses' role in Adult Protective Services related to safeguarding older people

AimTo examine the role of Adult Protective Services' (APS's) nurses in helping abused, neglected and exploited older people, this study investigated how nurses' contribution differs from social workers. Though the majority of APS' workforce is staffed by social workers, some programmes also employ nurses.DesignSecondary data analysis using convergent parallel mixed‐method design was conducted.MethodsUsing survey data from the National Adult Protective Services Association, 99 nurses' responses between October 2014 and August 2015 were analysed to examine their agency characteristics, training and qualities, job responsibilities and interprofessional collaboration.ResultsThe majority of nurses work with social workers or other professionals using a multidisciplinary team (MDT) approach. Among those carrying a caseload, 69% (49 out of 71) of nurses work in conjunction with social workers. Out of all nurses, 64% (63 out of 99) indicated participation in at least one MDT. While the responsibilities nurses provided were similar to social workers, nurses were also able to provide healthcare related services, in their professional competencies, without referral.ConclusionNurses in APS are in a privileged position to investigate mistreatment and provide/coordinate direct care for victims.ImpactNot much was known about nurses who directly investigate elder mistreatment and provide services to victims. This study was the first to highlight the nursing workforce in APS, and described the nurses' unique contribution to the field. Nurses functioned as both social workers and healthcare professionals in APS. Since victims of elder mistreatment often suffer from negative physical, psychological and social consequences, having nurses in APS benefits victims to receive and the programmes in providing better care and services.

Trajectory of Depression among Victims of Elder Mistreatment

Individuals exposed to elder mistreatment are affected in dissimilar ways. Most existing studies are cross-sectional and fail to capture the change in mental health of older adults with exposure to elder mistreatment. This study aims to examine depression trajectories of elder mistreatment victims and identify protective factors. Data were drawn from the two-wave Population Study of Chinese Elderly in Chicago (PINE) with 725 participants who reported elder mistreatment at the baseline. Depression was measured by Patient Health Questionnaire-9. Self-mastery was assessed by the Pearlin Mastery Scale. Conscientiousness was evaluated by the NEO Five-Factor Inventory. Multinomial logistic regression was used while controlling demographic factors and recurrence of elder mistreatment. We identified four depression trajectories among elder mistreatment victims: chronic (9.61%), delayed (6.27%), recovery resilience (21.17%), and resistance resilience (62.95%). The chronic group was showing severe depression in both waves. The delayed group experienced a delayed reaction with increasing depression over time. The depression level of the recovery resilience group bounced back from elder mistreatment. The resistance resilience group exhibited low depression over time. Elder mistreatment victims with increasing self-mastery were more likely to be in recovery resilience group than in chronic group (RRR=1.05, 95%CI=1.02-1.09). In addition, elder mistreatment victims with increasing conscientiousness were less likely to be in delayed group than in resistance resilience group (RRR=0.96, 95%CI=0.92-1.00). Healthcare providers and social service agents could focus on elder mistreatment victims with chronic and delayed depression trajectories. Interventions could promote mental health of elder mistreatment victims through improving self-mastery and conscientiousness.

When Helping Hurts: Nonabusing Family, Friends, and Neighbors in the Lives of Elder Mistreatment Victims

Research conducted by the NYC Elder Abuse Center (NYCEAC) at Weill Cornell Medicine and colleagues found that concerned persons experience significant distress knowing about elder abuse and trying to assist victims. Data will be presented from a nationally representative survey which included items on concerned persons in elder abuse. Thirty-one percent of all respondents reported that they had a relative or friend who experienced elder abuse; of these, 61% had attempted to help the victim and over 80% reported the experience is very or extremely stressful (2017). By both knowing about and becoming involved in elder abuse situations, concerned persons experience significant emotional and practical problems and often need professional help. NYCEAC’s Elder Abuse Helpline for Concerned Persons is the first of its kind in the country. The Helpline’s services and structure will be explained, and possibilities for replication in other locations will be explored.

Elder Mistreatment and Psychological Well-Being among Older Americans.

Elder mistreatment is a major public health issue both in the US and around the globe. While extensive research has elucidated the association between elder mistreatment and health in older adults, little is known about the relationship between elder mistreatment and more eudaimonic measures of psychological well-being. Using data from the 2011 wave of the Wisconsin Longitudinal Study, this project examined the association between older adults’ experience with varied forms of elder mistreatment and eudaimonic dimensions of psychological well-being including autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance. Ordinary least squares regression analyses found significant associations between experiences of elder mistreatment and psychological well-being. In particular, older adults who reported feeling that someone was too controlling over their daily lives and older adults who reported making donations to organizations they later worried were not legitimate reported significantly lower scores on all six psychological well-being dimensions. The results of this study suggest the negative effects of elder mistreatment can extend to more eudaimonic feelings of well-being, and programs designed to treat victims of elder mistreatment should incorporate strategies that help strengthen psychological well-being.

Effects of the COVID-19 Outbreak on Elder Mistreatment and Response in New York City: Initial Lessons.

New York City is currently experiencing an outbreak of COVID-19, a highly contagious and potentially deadly virus, which is particularly dangerous for older adults. This pandemic has led to public health policies including social distancing and stay-at-home orders. We explore here the impact of this unique crisis on victims of elder mistreatment and people at risk of victimization. The COVID-19 outbreak has also had a profound impact on the organizations from many sectors that typically respond to protect and serve victims of elder mistreatment. We examine this impact and describe creative solutions developed by these organizations and initial lessons learned in New York City to help inform other communities facing this pandemic and provide guidance for future crises.

HARNESSING THE POWER OF NETWORKS TO ADDRESS SOCIAL ISOLATION, LONELINESS, DEPRESSION, AND ELDER ABUSE

Challenges to aging and risks to physical health and mortality arise when older adults have untreated mental health needs, experiences social isolation, loneliness, or is a victim of elder abuse. This symposium presents three innovative models that harness the power of networks and collaboration between aging services and an academic medical center to meet the needs of ethnically diverse community seniors. These model programs include: embedded mental health services on-site in community senior centers; Friendly Visiting to homebound seniors; and PROTECT intervention to treat elder abuse victims’ mental health needs. Research from these innovative, collaborative programs indicate that over 50% of senior center members screened positive for depression and anxiety (higher than the national average of 3-20%), social isolation, loneliness, and elder abuse. Of the 75% who engage in treatment, 37.3% and 41% showed a 3-month improvement of depression and anxiety, respectively. For seniors who have a friendly visitor, one-third also suffer from depression and/or anxiety. Three months after being visited by a friendly visitor, 42% and 53% see improvement in loneliness and social isolation, respectively. Among victims of elder mistreatment, 33% screened positive for depression or anxiety and 16% reported suicidal ideation. Clients receiving the PROTECT intervention had a greater decrease in depression, felt services were more useful, and reported greater improvement in the abuse. To find and build strength in age, it is essential that programs and policy be developed to support collaboration and provide the opportunities for building and utilizing networks across different domains of aging.

THE INTERVIEW FOR DECISIONAL ABILITIES: DEVELOPING THE EVIDENCE BASE FOR ADULT PROTECTIVE SERVICES

Adult Protective Services (APS) workers assess clients for abuse and neglect and are asked to determine the client’s understanding of risks they face. Yet, APS workers have little structured training in how to make such judgements. The Interview for Decisional Abilities (IDA 3.0-CA) is a tool designed for use by APS workers to assess the ability of suspected victims of elder mistreatment to make decisions about the risks they face. This study evaluates the impact of training and use of this tool on the knowledge, experiences and ability of APS workers to determine decisional ability. APS workers and supervisors were recruited from central and northern California APS programs and randomized into either control (n=94) or IDA 3.0-CA training groups (n= 95). Baseline surveys measure knowledge of, and experiences with, assessing decisional ability and determining next steps for case management. Additionally, respondents determine the decisional ability of three case scenarios. Three months post-training, controls and trained subjects complete the same survey with a new set of cases. Preliminary results at baseline indicate there were no statistically-significant differences between trained subjects (n=42) and controls (n=50) in their knowledge scores (78.6% correct vs. 81.0%, p=0.6641) or performance assessing decisional ability in the case scenarios (60.1% correct vs. 63.3%, p=0.3497). Reported experiences assessing decisional ability and determining next steps in case management were also similar for trained subjects and controls. Complete results will be presented regarding change in knowledge scores, experiences, and assessing decisional ability in case scenarios compared across trained subjects and controls.

The Social Relationship Context of Elder Mistreatment.

Elder mistreatment victims at risk of poor physical and psychological health may benefit from increased social support. This article identifies mistreatment victims among community-dwelling older Americans and maps their social networks to guide the design of social support interventions. Using nationally representative survey data from Wave 3 (2015-2016) of the National Social Life, Health, and Aging Project (N = 2,334) and descriptive, latent class, and regression analyses, we estimate the prevalence of mistreatment since age 60, identify the alleged perpetrators' relationships to the victims, and examine victims' social networks. Self-reported lifetime prevalence of elder mistreatment is as high as 21%, depending on the mistreatment behavior measured. Latent class analysis reveals two mistreatment classes: 12% of older adults experienced multiple types of mistreatment (polyvictimization), and 6% experienced primarily financial mistreatment. Although alleged perpetrators are unlikely to appear in older adults' core social networks, the most commonly reported perpetrators are children and relatives. Regression analyses show that experiencing mistreatment since age 60 is associated with having less current social support, more social strain, and fewer kin in the core social network. Older adults reporting polyvictimization also have less-dense core networks. Increasing family support should be done cautiously because children and relatives are frequently named as mistreatment perpetrators. Increasing communication across polyvictimization victims' network members may support their well-being. Providing outside assistance with financial management could benefit financial mistreatment victims.

The feasibility of goal attainment scaling to measure case resolution in elder abuse and neglect adult protective services intervention

ABSTRACTObjectives: This pilot study describes implementation procedures of goal attainment scaling (GAS) and examines the feasibility of using GAS to measure the multifarious intervention outcome of case resolution in elder mistreatment (EM) adult protective services (APS).Methods: Substantiated EM victims (n = 27) were recruited prospectively from the State of Maine APS. An adapted GAS approach was implemented involving development of a pre-populated goal scale menu and web-based GAS application.Results: The GAS menu comprised 18 goals and corresponding scales spanning several domains of case resolution: social support, service access, health/functioning, enhancing independence, and protective measures. The overall GAS process had mean length 33.8 min per case. The mean GAS summary t-score (54.3) aligned with theoretical expectations.Discussion: Without a measure of case resolution, research cannot compare the effectiveness of different EM intervention models. Findings suggest that GAS is a feasible, client-centered strategy to measure the multifarious EM intervention case resolution outcome.

Improving Quality of Care in Hospitals for Victims of Elder Mistreatment: Development of the Vulnerable Elder Protection Team

Hospitals have an opportunity to improve the quality of care provided to a particularly vulnerable population: victims of elder mistreatment. Despite this, no programs to prevent or stop elder abuse in the acute care hospital have been reported. An innovative, multidisciplinary emergency department (ED)-based intervention for elder abuse victims, the Vulnerable Elder Protection Team (VEPT), was developed at NewYork-Presbyterian / Weill Cornell Medical Center (New York City). The VEPT is a consultation service available 24 hours a day/7 days a week to improve identification, comprehensive assessment, and treatment for potential victims of elder abuse or neglect. All ED providers have been trained on how to recognize signs of elder mistreatment. Any provider can activate the VEPT via a single page/telephone call, which triggers the VEPT's often time-consuming, complex assessment of the potential mistreatment victim. First, the ED social worker on duty performs the initial bedside assessment and separately interviews the potential perpetrator and/or caregiver. He or she then contacts the on-call VEPT medical provider to discuss next steps and other team members' potential involvement. For patients admitted to the hospital, the VEPT connects with the inpatient social workers and medical team to ensure appropriate follow-up and care planning. The VEPT program was launched in April 2017 after comprehensive training. Its impact will be measured by tracking the short-term and long-term mistreatment-related outcomes, as well as medical, mental health, functional, psychosocial, and legal outcomes of the vulnerable ED patients for whom the team provides care.

Emergency Medical Services Perspectives on Identifying and Reporting Victims of Elder Abuse, Neglect, and Self-Neglect

BackgroundEmergency Medical Services (EMS) providers, who perform initial assessments of ill and injured patients, often in a patient's home, are uniquely positioned to identify potential victims of elder abuse, neglect, or self-neglect. Despite this, few organized programs exist to ensure that EMS concerns are communicated to or further investigated by other health care providers, social workers, or the authorities. ObjectiveTo explore attitudes and self-reported practices of EMS providers surrounding identification and reporting of elder mistreatment. MethodsFive semi-structured focus groups with 27 EMS providers. ResultsParticipants reported believing they frequently encountered and were able to identify potential elder mistreatment victims. Many reported infrequently discussing their concerns with other health care providers or social workers and not reporting them to the authorities due to barriers: 1) lack of EMS protocols or training specific to vulnerable elders; 2) challenges in communication with emergency department providers, including social workers, who are often unavailable or not receptive; 3) time limitations; and 4) lack of follow-up when EMS providers do report concerns. Many participants reported interest in adopting protocols to assist in elder protection. Additional strategies included photographically documenting the home environment, additional training, improved direct communication with social workers, a dedicated location on existing forms or new form to document concerns, a reporting hotline, a system to provide feedback to EMS, and community paramedicine. ConclusionsEMS providers frequently identify potential victims of elder abuse, neglect, and self-neglect, but significant barriers to reporting exist. Strategies to empower EMS providers and improve reporting were identified.

Elder Mistreatment Perpetrators with Substance Abuse and/or Mental Health Conditions: Results from the National Elder Mistreatment Study.

A large portion of persons who commit elder mistreatment have long been known to have indicators of substance abuse and/or mental health conditions (SAMHC). However, few studies have specifically examined elder mistreatment by persons with SAMHC, preventing the development of specialized intervention strategies. Using results from the National Elder Mistreatment Study, the current article examines victim, perpetrator, and interaction characteristics between cases of emotional and physical elder mistreatment in which the perpetrator is reported to have vs. not have SAMHC. Chi square tests and Mann-Whitney-Wilcoxon non-parametric tests were performed. 210 perpetrators of emotional elder mistreatment were reported to have SAMHC with 412 perpetrators of emotional mistreatment reported to not have SAMHC. 57 perpetrators of physical elder mistreatment were reported to have SAMHC with 38 perpetrators of physical mistreatment not having SAMHC. Emotional elder mistreatment committed by persons with SAMHC was associated with the following characteristics: perpetrator-unemployment, history of involvement with police, and fewer friendships; victim-female gender, greater emotional problems, and greater occurrences of lifetime emotional mistreatment; interaction-co-residence, and reporting of mistreatment to authorities. Physical elder mistreatment committed by persons with SAMHC was associated with police involvement of the perpetrator and greater occurrences of lifetime physical mistreatment experienced by the victim. These findings indicate that victims of elder mistreatment by persons with SAMHC are in particular need of intervention services as they have greater histories of mistreatment and experience greater emotional problems. Implications for effectively intervening in cases of elder mistreatment by persons with SAMHC are discussed.

Physical Abuse of Elderly Adults: Victim Characteristics and Determinants of Revictimization.

To describe victim characteristics and determinants of recurrent physical abuse of elderly. Multicenter retrospective analysis of multiple data systems to study victims of elder mistreatment in the greater Chicago metropolitan area. Five teaching hospitals with Level 1 trauma centers. Individuals aged 60 and older treated for physical and sexual abuse between 2000 and 2011. History of revictimization was based on hospital admission histories, Adult Protective Services records, and self-report. Death records were also linked to participant files. Fifty-eight individuals (52.3%) out of 111 cases suffering physical abuse had documented histories of revictimization. Based on multivariable models, individuals who were female, widowed, diagnosed with dementia, and returning to the home where the perpetrator lived or visited were substantially more likely to be revictimized. Revictimized individuals were more likely to be assaulted through unarmed force by a proximal relative, in particular a husband, boyfriend, child, or child-in-law. Based on hospital records, only 57% of community-dwelling cases had their abuse reported to Adult Protective Services or the police, and only 26.6% had Adult Protective Services investigations on record. Better screening that connects victims of abuse with community services, police action, and alternative residential options is important in reducing the risk of revictimization and connecting individuals with resources that can improve their safety at home, regardless of whether it is in the community or a residential facility.

Varying Appraisals of Elder Mistreatment Among Victims: Findings from a Population-Based Study.

Prior elder mistreatment (EM) research has not examined subjective assessments of problem seriousness from the perspective of victims. This study sought to describe the variation in appraisals of perceived EM seriousness among victims of emotional abuse, physical abuse, and neglect and to examine factors that influence varying appraisals using neutralization theory. Data came from a subsample of EM victims (n = 191) drawn from a representative, population-based study (n = 4,156) of community-dwelling, cognitively intact older adults in New York State. The Conflict Tactics Scale and Duke Older Americans Resources and Services scales were adapted to assess EM. Subjective appraisal of abuse/neglect was measured according to ordinal levels of victim-perceived seriousness and predicted using ordinal regression. Emotional abuse was appraised less seriously among victims who were both functionally impaired and dependent upon the perpetrator, lived with the perpetrator, and of increasing age. Emotional abuse was perceived with greater seriousness among victims enduring more frequent/varied abuse and when the perpetrator was distally-related. Neglect was appraised with lower seriousness among female victims and greater seriousness if perpetrated by a paid homecare attendant or in scenarios involving more frequent/varied unmet needs. Findings carry implications for understanding victim help-seeking behavior and informing EM measurement.

When Helping Hurts: Nonabusing Family, Friends, and Neighbors in the Lives of Elder Mistreatment Victims

Elder mistreatment is an epidemic with significant consequences to victims. Little is known, however, about another affected group: nonabusing family members, friends, and neighbors in the lives of the older victim or "concerned persons." This study aimed to identify (a) the prevalence of adults aged 18 and older who have encountered an elder mistreatment situation, (b) the proportion of these who helped the elder victim, and (c) the subjective levels of distress experienced by respondents who helped the victim versus those who did not. Data were collected from a nationally representative telephone survey of 1,000 adults (18+). Multiple linear regression was used to test the relationship between "helping status" and personal distress attributed to an elder mistreatment, defined as someone aged 60 and older experiencing violence, psychological abuse, financial exploitation, or neglect by a caregiver. Nearly 30% of adults knew a relative, friend, or neighbor who experienced elder mistreatment. Of these, 67% reported personal distress resulting from the mistreatment at a level of 8 or more out of 10. Assuming a helping role was associated with significantly higher levels of personal distress. Greater distress was also associated with being a woman, increasing age, and lower household income. Knowing about an elder mistreatment situation is highly distressing for millions of adults in the United States, particularly for those assuming a helping role. We suggest intervention approaches and future research to better understand the role and needs of concerned persons.