October 2006 | Volume 9 | No. 1

Policy & Legislation

President Signs Older Americans Act Reauthorization
Amendments Include Provisions on Elder Justice

On Tuesday October 17, President Bush signed into law H.R. 6197, the Older Americans Act (OAA) of 2006. It is the first time since the OAA was enacted in 1965 that the law formally mentions elder justice.

Among other changes, an amendment to Section 202 of the law authorizes the Assistant Secretary for Aging to appoint an individual within the Administration on Aging (AoA) to be responsible for elder abuse and prevention services, facilitate the creation of a national coordinated multidisciplinary elder justice system, and provide federal leadership to support state efforts in carrying out elder justice programs and activities.

H.R. 6197 also authorizes AoA to develop objectives, priorities, policies and a long term plan for uniform data collection and reporting by states and carry out a national incidence and prevalence study of elder abuse, neglect, and exploitation in all settings.

Under Title VII, Vulnerable Elder Rights Protective Activities, a new provision was added which permits the awarding of competitive state grants to promote comprehensive state elder justice systems.

For Native American elders, the reauthorized Act permits grants to assist tribes and other Native American groups in establishing a tribal coordinating council, providing multidisciplinary training and technical assistance, as well as studying various models for elder fatality review teams.

Also, in the reauthorization, Congress highlighted the concepts of financial literacy as a tool to combat financial exploitation, shelters serving older victims, multidisciplinary efforts at the state level, elder fatality review teams, and risk-reduction in nursing homes.

Appropriations for the OAA are pending in Congress. The reauthorization did not specify funding for the new elder justice provisions.

Learn more about this important legislation here …

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"Comprehensive Elder Justice System" Defined

The Older Americans Act of 2006 defines "comprehensive elder justice system" as:

"An integrated, multidisciplinary, and collaborative system for preventing, detecting, and addressing elder abuse, neglect, and exploitation in a manner that –

  1. Provides for widespread, convenient public access to the range of available elder justice information, programs, and services;
  2. Coordinates the efforts of public health, social service, and law enforcement authorities, as well as other appropriate public and private entities, to identify and diminish duplication and gaps in the system;
  3. Provides a uniform method for the standardization, collection, management, analysis, and reporting of data; and
  4. Provides such other elements as the Assistant Secretary determines appropriate."

– H.R. 6197 Older Americans Act of 2006

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Elder Justice Act Still on Table

In the final days just before Congress broke for the election recess, the Elder Justice Act received the support of several more members. In the Senate, Sens. Mike DeWine (R-OH) and John F. Kerry (D-MA) added their names to the list of cosponsors of S. 2010. Sen. DeWine is chairman of the Senate Subcommittee on Retirement, Security, and Aging. Sen. Kerry serves on the Senate Finance Committee.

On the House side, the latest H.R. 4993 cosponsors are Reps. Dennis Kucinich (D-OH), Stephanie Tubbs Jones (D-OH), Jim McDermott (D-WA), Rush Holt (D-NJ), and Howard Berman (D-CA).

The totals are now 29 bipartisan cosponsors in the 100-member Senate and 47 in the House (just over 10% of House members).

Congress will reconvene in early November to finish up work still left on its docket, including appropriations bills and possibly the Elder Justice Act.

For bill status updates, contact the Elder Justice Coalition at (202) 782-4140 or e-mail elderjustice@verizon.net.

Legislative proposals concerning Elder Justice

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2005 White House Conference on Aging Progress on Recommendations

The final report of the 2005 White House Conference on Aging (WHCoA) has been officially released. Given recent developments it is clear that this public forum, which convenes only once each decade, has helped push the elder abuse prevention agenda forward.

The WHCoA delegates adopted 50 very important policy resolutions with far-reaching implications. Among other recommendations were these:

  WHCoA Resolution 1 – "Older Americans Act"
Reauthorize the OAA within the first six months following the 2005 WHCoA
 Action: OAA reauthorization bill (H.R. 6197) passed September 30, signed by President October 17.

  WHCoA Resolution 8 – "Improving Response to Mental Illness"
Improve recognition, assessment, and treatment of mental illness and depression among older Americans.
 Action Taken: Language included in the OAA reauthorization. Specifically, new provisions authorize:

  • An officer at the U.S. Administration on Aging to be responsible for mental health services authorized under the OAA.
  • Grants to states for development and operation of systems for the delivery of mental health screening and treatment services for older adults.
  • Grants to states for programs to increase public awareness, reduce stigma, and reduce age-related prejudice and discrimination regarding mental disorders in older adults.

  Resolution #15 – "Protection from Abuse and Neglect" Create a national strategy for promoting elder justice through the prevention and prosecution of elder abuse.
 Action Taken: Older Americans Act contains provisions; Elder Justice Act pending Congressional

  Resolution #45 – "Prosecution of Financial Crimes" Strengthen law enforcement efforts at the federal, state, and local level to investigate and prosecute cases of elder financial crime.
  Action Taken: Older Americans Act contains some provisions; Elder Justice Act pending
       Congressional action.

Read more >> www.whcoa.gov/about/about.asp#report

Sharing Ideas: Promising Practices Spotlight

A Little Money Goes a Long Way
Reaching Out Locally, Nationally, and Globally

In the lead up to World Elder Abuse Awareness Day, as reported earlier, NCEA awarded 12 mini- grants to organizations around the country for grassroots outreach aimed at raising public awareness and understanding of elder abuse.

World Elder Abuse Awareness Day became a rallying point for reaching out locally, nationally, and globally. There's little question that a little seed money can go a long way.

For those of you wanting to step up your efforts in reaching out, NCEA has created a very practical, quick-reference guide. This new online tool, called the Elder Abuse Prevention Outreach Kit, is full of tips, examples of public education efforts, and public outreach advice.

Follow this link to learn more >> www.elderabusecenter.org/default.cfm?p=outreachkit1.cfm

Highlights from Mini-Grants

Community outreach, obviously, take many forms. Here are just a few highlights of strategies from the mini-grants, to give you a flavor of the possibilities:

Police community outreach in Pueblo included a public session for older area residents. Participants learned about police procedures and the importance of adult protection, among other topics. In addition to this forum, training was provided to foster grandparents, PSAs aired on local stations, and flyers were distributed to local doctors and senior services providers.

  Contact: Pat Heine, Police Officer, (719) 553-2519, pheine@pueblo.us

Publicity for this statewide effort included, among other things, a presentation to the Delaware House of Representatives. To extend the outreach, a conference was held in late summer on Family Caregiving and Elder Protection.

  Contact: Rev. Robert P. Hall, Executive Director, (302) 225-1040 deccf@aol.com

Flyers and custom imprinted pencils were disseminated at congregate meal sites and through home-delivered meals programs in a 5-county area of central Illinois. Prairie Council on Aging, through its elder protective services program, offers intensive counseling, support, and advocacy for victims of elder abuse.

  Contact: Mary Holmes, Executive Director, (217) 479-4600, pcaging@pcaging.com

Outreach tools included flyers, commemorative silver ribbons, and laminated cards imprinted with local APS numbers and Kentucky Elder Abuse hotline. To raise community-wide awareness, ribbons were given out to local businesses, and laminated cards were provided to all transportation providers.

  Contact: Randa Ramsey, (270) 886-9484, (800)-928-7233, randa.ramsey@ky.gov

NCEA mini-grant dollars helped to fund community lectures on elder abuse prevention. Additionally, proclamations were issued by the Governor and local Prince George's County officials.

  Contact: Rev. Joshua Nathan, (240) 505-6160, joshnathan@comcast.net

To learn more about all 12 projects funded for World Elder Abuse Awareness Day, visit the NCEA Web site >> www.elderabusecenter.org/pdf/WorldElderAbuseAwarenessDaySummaryReport.pdf.

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Tell Us Your Story

Do you, or someone you know, have a successful model of elder abuse prevention and response or example of local cooperation? Let us know and we'll spread the word. Experience makes a difference.

Share a "promising practice" >> www.elderabusecenter.org/default.cfm?p=addpractice.cfm

NCEA News & Resources

A Fond Farewell and Warm Welcome

The National Center on Elder Abuse bids fond farewell to longtime NCEA Partner Joanne Otto. After many years of dedicated service, Joanne recently retired from the position of Executive Director at the National Adult Protective Services Association (NAPSA).

Over the years, Joanne has been a true leader in the elder abuse field. Her zest for enhancing training for state and local adult protective services (APS) fit perfectly with our interest to identify needs and develop model curricula for frontline APS staff related to professional development. We're grateful for Joanne's many contributions and wish her the best in her future endeavors.

A warm welcome is extended to Kathleen Quinn, who took over the reins as NAPSA Executive Director on October 1. Kathleen is a past president of NAPSA and well acquainted with the work of NCEA. Most recently, she served with the Illinois Attorney General's Office and Illinois Department of Aging.

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NCEA Awarded Continuation Funding

We are very pleased to announce that continuation funding for NCEA, awarded from the U.S. Administration on Aging, has been approved for 2006-2007. The coming year promises to be challenging and exciting.

Building bridges with emerging Aging and Disability Resource Centers (ADRCs), and other allied professions is one of our key priorities for partnership and promising practices development.

As we move forward into a new year, we encourage you to ask us questions, share your insights, and give us feedback. Here's how to contact us:

NCEA Partners

Sara Aravanis, NCEA Director and Associate Director for Elder Rights
National Association of State Units on Aging
1201 15th Street, NW, Washington, DC 20005-2800
(202) 898-2578

Kathleen Quinn, Executive Director
National Adult Protective Services Association
920 S. Spring Street, Suite 1200, Springfield, Illinois 62704
(217) 523-4431 / Fax (217) 522-6650

Karen Stein, PhD, Director
Clearinghouse on Abuse and Neglect of the Elderly
University of Delaware, Newark, DE 19716
(302) 831-3525 / Fax: (302) 831-3587

Lori Stiegel, JD, Associate Staff Director
American Bar Association Commission on Law and Aging
740 15th Street, NW, Washington, DC 20005-1009
(202) 662-8692 / Fax (202) 662-8698

Randy Thomas, President
National Committee for the Prevention of Elder Abuse
1612 K Street, NW, Suite 400, Washington, DC 20006
(202) 682-4140 / Fax (202) 223-2099
ncpea@verizon.net / rthomas149@aol.com

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New NCEA Resources

  NCEA State Elder Abuse Prevention Resource Directory

Looking for help in finding information? The NCEA State Resource Directory is a new resource designed to help individuals find relevant state-specific government agencies and programs, laws, statistics, and other information quickly.

Simply click on the State-by-State map to find links >> www.elderabusecenter.org/default.cfm?p=stateresources.cfm

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  New in the CANE Bibliography Series –
Financial Exploitation of the Elderly: An Update of the Literature

An updated bibliography of the literature 2004-2006 has been prepared by the Clearinghouse on Abuse and Neglect of the Elderly (CANE) to support the work of practitioners, scholars, and others in combating the exploitation of seniors.

Available on the NCEA Web site at >> www.elderabusecenter.org/default.cfm?p=CANE_FinancialExploitation.cfm

Also see Financial Abuse, Undue Influence, Scams, and Protection of Assets: An Annotated Bibliography, 2003 >> www.elderabusecenter.org/default.cfm?p=cane_finabuse.cfm

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Sign up today for the National Center on Elder Abuse Listserve

NCEA Elder Abuse listserve provides a free, 24-hour, 7-day-a-week online link to others who are working on elder abuse issues. The NCEA listserve is a discussion forum for professionals working in elder abuse or allied fields. Membership is restricted to adult protective services practitioners and administrators, aging services practitioners and administrators, educators, health professionals, judges, lawyers, law enforcement officers, prosecutors, policy makers, and researchers.

To request a subscription to the Elder Abuse listserve, just fill out the form at www.elderabusecenter.org/default.cfm?p=listservesubscribeform.cfm, or If you prefer, you can e-mail the list manager at lstiegel@staff.abanet.org. All requests must include the information below:

  • Your name, profession, and e-mail address
  • A statement of your interest or expertise in elder abuse or adult protective services
  • Employer's name (if applicable) and address
  • Phone number (so that you can be contacted in the event of an e-mail problem)

See our Web site for more details.

Research & Scholarship

  "Violent Crime Victimization Increases the Risk of Nursing Home Placement in Older Adults"
by Mark Lachs, MD, mslachs@mail.med.cornell.edu, Weill Medical College of Cornell University, et al.
Gerontologist, Volume 46, No. 5 / October 2006

This study draws from data collected by the New Haven Established Populations for Epidemiological Studies in the Elderly (EPESE). Of 2,321 community-residing older adult members of the EPESE cohort in 1985, 482 (21%) experienced victimization over the 10-year follow-up; 747 (32%) experienced nursing home placement. Most victimization episodes were non-violent and non-injurious. Analysis revealed, however, that violent victimization conferred an independent increased risk of nursing home placement, which exceeded the increased risk associated with other variables traditionally thought to be predictive of placement (such as functional and cognitive impairment, and social network size).

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  "Development of a Screening Tool for Identifying Elderly People at Risk of Abuse by Their Caregivers"
by M. Cohen, S. Halevi-Levin, R. Gagin, and G. Friedman, Haifa University, Rambam Medical Center
Journal of Aging and Health, Vol. 18, No. 5 / October 2006

This study developed and tested a new screening tool to identify elders at high risk of abuse. The tool was adapted from the Reis and Nahmiash's Indicators of Abuse (IOA) screen. The Expanded IOA questionnaire (E-IOA) was found to be a reliable and valid. Indicators proved to be a significant predictor of evident signs of abuse, according to the researchers. The E-IOA correctly identified 92.7% as being at high risk and 97.9% of those who did not suffer abuse. Major indicators for risk were behavioral problems, emotional problems, and caregiver-elder family problems.

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  "Mandatory Reporting of Elder Abuse: Between a Rock and a Hard Place"
by Michael A. Rodriguez, MD, MPH, MRodriguez@mednet.ucla.edu, Steven P. Wallace, PhD; Nicholas H. Woolf, PhD, and Carol M. Mangione, MD, MSPH, University of California at Los Angeles.
Annals of Family Medicine, Vol. 4, No. 5 / September-October 2006

Despite mandated reporting laws, physicians have low rates of reporting elder abuse. To learn about the factors that may influence reporting, the authors of this study interviewed 20 primary care physicians practicing in the Los Angeles area. Three push and pull factors were identified: 1) Patient-physician rapport; 2) patient quality of life, and 3) physician control or ability to decide what is in the best interest of the patient. "These paradoxes appear to be primarily hidden or unconscious, yet they influence the conscious decision process of whether to report," the authors conclude.

On the Web >> www.annfammed.org/cgi/content/full/4/5/403

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  "Nutritional Status Is Altered in the Self-Neglecting Elderly"
by Scott M. Smith, PhD, scott.m.smith@nasa.gov, Nutritional Biochemistry Laboratory, NASA Lyndon B. Johnson Space Center, Houston, Tex., et al.
The Journal of Nutrition, Vol. 136, No.10 / October 2006

This study from the Consortium for Research in Elder Self-Neglect (CREST) reports on the nutritional status of self-neglecting elders. The research findings document that self-neglectors are at risk for altered nutritional status. Among the nutrient deficiencies identified are folate (one of the B vitamins), antioxidants (beta-carotene, vitamins C, E, and A), and vitamin D.

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  "Public Definitions and Endorsement of the Criminalization of Elder Abuse"
by Etta Morgan, PhD, etta.morgan@jsums.edu, Jackson State University, Mississippi, Ida Johnson, PhD, University of Alabama, Tuscaloosa, and Robert Sigler, PhD, University of Alabama, Tuscaloosa.
Journal of Criminal Justice, Vol. 34, No.3 / May-June 2006

This longitudinal cross sectional 10-year study offers insights about public attitudes toward the criminalization of elder abuse. The findings showed that the public endorses a fairly broad definition of elder abuse; strongly endorses the creation of misdemeanor and felony statutes; strongly endorses the use of prison to punish abusers; and believes that the criminalization of elder abuse would be effective in reducing elder abuse.

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Note: Scholarly literature is often published online before print publication. Check individual publisher sites for full-text availability. Many publishers offer pay-per-article service.

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To see abstracts of more published studies, visit the Clearinghouse on Abuse and Neglect of the Elderly at http://db.rdms.udel.edu:8080/CANE/index.jsp. For assistance in obtaining references, e-mail CANE at CANE-UD@udel.edu.

Trends and Statistics

Nursing Home Abuse Facts 2005: National Ombudsman Reporting System (NORS)
by Mark Miller, National Association of State Units on Aging

For the seventh year in a row, the number one complaint of nursing home residents, according to new data provided in state ombudsman reports, is unanswered call lights, representing nearly 6 percent of the total nursing home complaints handled in 2005 by state ombudsman programs.

The new data also show that complaints about physical abuse ranked 19 out of 128 (significant, considering that the top 20 complaint categories accounted for over half (55%) of the total 241,684 complaints lodged against nursing homes.

Resident-to-resident physical/sexual abuse and verbal/mental abuse were in the top 25 tier of nursing home complaints; gross neglect ranked 31; financial exploitation by family or other person outside the facility ranked 37; and sexual abuse ranked lower at 70.

Overall, the reports of abuse, gross neglect, and exploitation accounted for 6.5 percent of complaints about nursing homes made to ombudsmen.

The good news is that complaints involving physical abuse decreased from 5,426 in 1998 to 4,137 in 2005. Board and care facilities saw a similar decrease in reports.

Abuse, as defined by the Older Americans Act, is willful infliction of injury, unreasonable confinement, intimidation, or cruel punishment with resulting physical harm, pain, or mental anguish. Gross neglect is defined in the Act as willful deprivation by a person, including a caregiver, of goods or services that are necessary to avoid physical harm, mental anguish, or mental illness.

Depending on the state, ombudsman programs may investigate complaints of abuse and neglect, refer such allegations to local adult protective services offices and designated state agencies, or jointly investigate allegations with other agencies.

Mark C. Miller is Senior Program Associate for Elder Rights at the National Association of State Units on Aging. He can be reached at (202) 898-2578 or via e-mail at mmiller@nasua.org.

NASUA is a partner with the National Citizens Coalition for Nursing Home Reform in the operation of the National Long Term Care Ombudsman Resource Center, funded by the Administration on Aging, and offers information and technical assistance to states in regard to the ombudsman programs .

2005 National Ombudsman Reporting System

  Nursing Homes

Resident's Rights: Abuse, Gross Neglect, Exploitation
Complaint category Number of complaints
filed in 2005
Physical abuse 4,137 19
Resident-to-resident 3,372 23
Verbal/mental abuse 3,056 25
Gross neglect 2,399 31

Residents' Rights: Financial, Property
(Except for financial exploitation)
Personal property lost, stolen,
used by others, destroyed
4,878 13

Not Against Facility
Legal-guardianship 2,492 29

  Board and Care Facilities

Resident's Rights: Abuse, Gross Neglect, Exploitation
Complaint category Number of complaints
filed in 2005
Physical abuse 1,132 16
Verbal/mental abuse 1,014 18
Resident-to-resident 906 23
Gross neglect 761 28

Residents' Rights: Financial, Property
(Except for financial exploitation)
Personal property lost, stolen,
used by others, destroyed
1,298 12
Personal funds-mismanaged,
access denied, deposits &
other month not returned
1,025 17

Not Against Facility
Family conflict 967 19
conservatorship, power of
attorney, wills
851 25

Click here for 2005 NORS data tables >> www.aoa.gov/prof/aoaprog/elder_rights/LTCombudsman/

Funding Opportunities

Centers for Disease Control and Prevention (CDC)
2007 Research for Preventing Violence and Violence-Related Injury (R01) Grant Program

CDC's National Center for Injury Prevention and Control has announced that it is seeking applications for research on violence, its causes, and prevention strategies. The 2007 priority research areas are intimate partner violence, sexual violence, and child maltreatment.

  • Letter of Intent Deadline: November 15, 2006
  • Application Deadline: December 15, 2006
  • Total Number of Grant Awards: 4-5

More information >> www.cdc.gov/od/pgo/funding/CE07-010.htm

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Resources for Grant Writers

Calendar/Coming Up

  October 2006
Domestic Violence Awareness Month 2006
Help spread awareness about domestic violence in later life –

Recommended Links
  November 2006
International Network for the Prevention of Elder Abuse (INPEA) to Hold North American Regional Meeting at GSA 59th Annual Meeting

"Elder Abuse the Chameleon"
Georgia Anetzberger, PhD, Keynote Speaker, Professor, Health Administration Program, Cleveland State University.

When: Friday, November 17, 2006
  1:30-4:30 PM
Where: Gerontological Society of America 59th Annual Scientific Meeting
  Adam's Mark Hotel, Dallas Texas
  Room Location: Majestic 9

Register online at GSA www.agingconference.com/about_the_meeting.cfm

To stay updated on INPEA or sign up to become member, visit >> http://0044c40.netsolhost.com/membership.html

  U.S. Department of Justice
Office for Victims of Crime Spring 2007 Training Program

Office for Victims of Crime (OVC) Professional Development Scholarships are available providing up to $1,000 for individuals and up to $5,000 for multidisciplinary teams of victim service professionals seeking continuing education opportunities.

View full schedule and register online >> http://ovc.ncjrs.gov/notices/trainingcalendar_101806.html

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Check our Web site often for more dates and events elderabusecenter.org/default.cfm?p=conferencesevents.cfm

New on the Bookshelf

  Elder Abuse Detection and Intervention: A Collaborative Approach
by Bonnie Brandl, MSW; Carmel Dyer, MD; Candice Heisler, JD; Joanne Otto, MSW; Lori Stiegel, JD; and Randolph Thomas, MA
Springer Publishing Company / August 2006

A new book by Springer, Elder Abuse Detection and Intervention: A Collaborative Approach, has been released. Contributors to this important new volume include NCEA partners Lori Stiegel of the ABA Commission on Law and Aging, Joanne Otto (recently retired) of the National Adult Protective Services Association, and Randy Thomas of the National Committee for the Prevention of Elder Abuse.

The authors cover the major themes of the book in five sections. Among the topics explored are identification and reporting; systemic responses to elder abuse; effective interventions and informal collaborations; and a collaborative model for holding abusers accountable.

The book can be ordered at www.springerpub.com/prod.aspx?prod_id=3114x

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  Maltreatment of Patients in Nursing Homes: There Is No Safe Place
by Diana K. Harris, MA and Michael Benson, PhD
The Haworth Pastoral Press, 2006

This book, Maltreatment of Patients in Nursing Homes, draws from a survey of employees, administrators, and family members of patients in 47 nursing homes throughout the U.S.

  • Types of physical abuse found in nursing homes (restraints, sexual abuse, neglect);
  • Who, what, and why of nursing home thefts/elder financial abuse (trust accounts, bank accounts, improper charges for services and drugs, identity theft);
  • Types of psychological abuse (abandonment, segregation, childlike treatment, verbal abuse); effects of psychological abuse (depression, learned helplessness, psychiatric disorders); and
  • Reasons behind employee abusive behavior (staff turnover, job burnout, job dissatisfaction, caregiver stress).

The book can be ordered from your local bookstore or directly from Haworth Press, Inc. www.haworthpress.com/store/product.asp?sid=D2JSXVVXMM

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  Measuring Intimate Partner Violence Victimization and Perpetration: A Compendium of Assessment Tools
by M. P. Thompson, PhD, Department of Public Health Sciences, Clemson University, et al.
National Center for Injury Prevention and Control, 2006

The National Center for Injury Prevention and Control has published a new "must-have reference" for researchers and prevention specialists. This collection of reliable, already validated assessment tools is available for free download. Examples of assessment tools include:

Assessment tools: victimization

Assessment tools: perpetration

Click here to download the entire compendium >> www.cdc.gov/ncipc/dvp/Compendium/Measuring_IPV_Victimization_and_Perpetration.htm


Policy & Legislation

Sharing Ideas: Promising Practices Spotlight

NCEA News & Resources

Research & Scholarship

Trends & Statistics

Funding Opportunities

Calendar/Coming Up

New on the Bookshelf

NCEA Newsletter

is published 10 times a year by


October 2006
Volume 9, No. 1
Sara Aravanis, Director
Susan Coombs Ficke, Contributing Writer/Editor

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The NCEA Newsletter is supported in part by a grant, No. 90-AM-2792, from the U.S. Administration on Aging, Department of Health and Human Services.

Points of view or opinions expressed in this publication do not necessarily represent the official views of AoA/HHS or any of the NCEA's affiliated partners.

NCEA always welcomes news from the field. Please direct comments and suggestions to the editor, Susan Coombs Ficke sficke@nasua.org


National Association of State Units on Aging
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