STATE OF AGING IN CENTRAL INDIANA

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Safety and Abuse

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Persona

Nair

73 years old
Owned a grocery store
Volunteered for her church
Nair is a 73-year-old Korean woman living on the near-northwest side of Indianapolis. She and her husband emigrated from South Korea in the 1970s and ran a small grocery store in their neighborhood before his death 10 years ago. She then ran it alone for two years before selling it off. Since then, Nair has lived on Social Security checks and a modest nest egg from the insurance policy her husband bought when they were in their 40s. A nearby Korean Presbyterian church is the center of her social life. She takes part in regular activities for seniors and helps organize and operate the church’s food pantry. 

About a year ago, during one of her after-lunch walks, Nair passed a pop-up “clinic” in a storefront near where her grocery used to be. A sign in the window advertised free hearing tests, so Nair filled out a form and took the test. The administrator reported that she did in fact have hearing loss, and he said a representative would be in touch soon with solutions. In the meantime, Nair mentioned the test to a friend at church, who told her it was a scam. The first two times the clinic called Nair’s home, she politely said she wasn’t interested. Then she quit taking the calls, which tapered off after a couple of months. Even so, Nair has noticed a spike in the number of scam calls she gets. There are often four a day or more, from people claiming to be Medicare representatives to people posing as her grandchildren. She wonders if information on the forms she filled out at the pop-up clinic made it onto some kind of list used by scammers. 

Nair’s main worry, though, is for her safety. She loves to walk, especially to her church and to the local parks. Lately, though, she’s stopped walking more than two or three blocks from home. She feels more vulnerable than she used to, both because of her age and because of TV reports she sees about rising crime rates. The steady stream of scam calls also adds to her levels of stress—as does a new situation involving a nephew who lives on the other side of the city. Nair is on good term with her sister, but they were never close, and she had little contact with the nephew—the sister’s 23-year-old son—for years. But one Saturday afternoon, three months ago, he showed up for a visit. He wanted to make sure she was getting along okay, he said. He subsequently showed up at her home unannounced two more times. After the most recent visit, as he was leaving, the nephew asked her for $300 to help out with unexpected car repairs. She gave him $20 and said it was all she could do, given her limited income. Although he thanked her and left, Nair worries that his visits—and the requests for money—will become a regular thing. She also worries what will happen if he asks for money again and she tells him no. 

Personas are sketches of fictional people that represent real challenges and circumstances highlighted in this report. They are a useful way to imagine how these statistics impact the lives of individuals and families.
Perceived personal safety may be crucial for older adults to age in place with a positive outlook. However, safety varies based on where one lives and the resources one has for maintaining social supports and effective caregiving. This section of the report describes elder abuse and crime, including perceptions and experiences affecting the physical safety of older adults. Key findings include:

  • Nationally and in Indiana, one in ten adults age 65 and older experiences abuse each year, and this is likely underreported.
  • Indiana’s Adult Protective Services has historically lacked sufficient resources and structure to provide social service-related support for endangered older adults in the state.
  • Older adults report increases in fraud and scams, which make them feel less safe.
  • Compared to 2017, more older adults are concerned about “being the victim of a crime,” but also feel more positively about safety in their own community.
  • In 2021, 2.9 percent of older adults in Central Indiana were victims of fraud, property crime, or violent crime.

Elder Abuse

According to the National Center on Elder Abuse, elder abuse includes “any knowing, intentional or negligent act by a caregiver or any other person that causes harm or a serious risk of harm to an older adult.”1 Most definitions of elder abuse include physical, sexual, emotional and financial abuse, as well as neglect and self-neglect.

According to the U.S. Department of Justice, nationally at least 10 percent of adults age 65 and older will experience some form of elder abuse each year.2 However, elder abuse is often unreported, suggesting these rates could be higher.3 Family members are the most common perpetrators of abuse.4 5

A 2011 study of a national sample of adults age 60 and older found that over the course of a year, 4.6 percent experienced emotional mistreatment, 1.6 percent experienced physical mistreatment and 0.6%percent experienced sexual mistreatment. The majority of these experiences were not reported to the authorities.6 The 2021 Community Assessment Survey for Older Adults (CASOA) age 60 and older found that eight percent of respondents in Central Indiana reported being physically or emotionally abused during the past year.7 This is similar to the state, across which nine percent of respondents reported experiencing these types of abuse.8

Older adults who experience social isolation, cognitive disabilities (including dementia and Alzheimer’s), or physical disabilities are at an increased risk for abuse.9 10 According to key informants, older adults in Central Indiana may experience multiple forms of elder abuse concurrently, such as neglect and other forms of abuse from a perpetrator.11

Elder abuse increased in prevalence during the COVID-19 pandemic. A study conducted by The American journal of geriatric psychiatry of 897 older persons in the United States found that 1 in 10 suffered from elder abuse before the pandemic but that increased to one in five during the pandemic.12 Reasons stated for this surge include an increase in isolation and financial hardships (of both caregiver and older adult) while a sense of community and physical distancing prevented transparency in cases of abuse.

Provider concerns include lack of support to prevent abuse

According to an interview with Indiana’s Adult Protective Services (APS), Indiana is unique in its lack of a public guardianship program and lack of regulation around who is eligible to become a guardian. The interviewee also noted underfunding of APS as a challenge—in 2019, a total of 42 investigators served the entire state of Indiana. Even though this number is an increase from the 30 full-time investigators in 2016, this understaffing makes it difficult to effectively address the needs of a large population of older adults. Indiana’s APS is also the only such service nationally that does not operate as a social service agency, instead serving as a justice system to resolve disputes between abusers and partnering with county prosecutors.13 This means that APS investigators do not have direct access to social services such as emergency placement for adults in life-threatening situations. Instead, they must refer to outside agencies, which often have waiting lists for permanent placement options.14

The present-day social service system is limited in its ability to assist the growing older adult population amid increasing financial abuse.15 While there are some volunteer-based guardianship services available for older adults in the state, only half of the counties in Central Indiana are served by one of these entities.16 In Marion County, the Center for At-Risk Elders (CARE), provides emergency guardianship services to those who need a guardian and lack alternatives. However, according to interviews with service providers, the demand for services is rising at an almost unmanageable rate. In addition to service gaps for guardianship, national research also notes a lack of multicultural frameworks to prevent elder abuse in communities of color, as much research has focused on older adults who are White and middle class.17

One in fifteen older adults reports being physically or emotionally abused.
Source: CASOA 2021 18

Increases in fraud and scams make older adults feel less safe

Between 2014 and 2021, the Office of the Indiana Attorney General received 5,575 consumer calls per year that included complaints of fraud or scams from adults age 60 and older. Roughly one third of these originated from Central Indiana counties.19 This is likely a gross underestimation, as a large proportion of complainants did not report age data.20 According to 2021 CASOA data, across both the state and Central Indiana, 24 percent of older adults reported that being a victim of a fraud or a scam was a least a minor problem during the past year. This represents an increase of four percentage points between 2017 and 2021.21 22 To learn more about factors that can put older adults at a higher risk of being victims of fraud or scams, please read ’Highlighting Equity’ on page 5.9.
23

Older adults participating in focus groups reported feeling targeted and preyed upon through mailings, robo-calls, telephone scams, identity theft and fraud.24 Some experienced a large volume of mailings and phone calls designed to defraud them of their resources. Specifically, they discussed concerns about being targeted for financial scams in which they are asked to provide personal information and cash.

Focus group participants, especially those with lower incomes, were concerned about who would continue to help them manage their finances, as some trusted their children, while others either lacked supportive family members or did not have anyone they could trust.

Consumer complaints from older adults increased until 2016 and then declined until 2019.

Consumer complaints reported to Indiana Attorney General from people age 60+

Fraud and scams are a problem for an increasing share of older adults.
Source: CASOA 2021 25

Crime

New federal crime reporting standards allow us to analyze crimes against older adults. We have focused on three types of crime: fraud, property crimes, and violent crimes. Future reports will include time series, but this report focuses on a 2021 baseline.

Older adults are less likely than the overall population to be the victim of a property or violent crime, but just as likely as the overall population to be the victim of fraud. The fraud rate for older adults in Central Indiana is 5.2 per 1,000 older adults, about the same as the rate of 5.3 per 1,000 people in the overall population. The property crime rate is 17.3 for older adults and 27.4 for the total population, while the violent crime rate 6.7 for older adults and 17.9 for the total population.

In a 2021 survey, two-thirds (71 percent) of older adults in Central Indiana reported that the overall feeling of safety in their communities was excellent or good. This is equal to the statewide rate and has increased in 2017.26 However, 15 percent of older adults in Indiana and Central Indiana report that being a victim of a crime is at least a minor problem. For the state and the region, this is an increase from 2017.

Concern about being the victim of a crime has risen evan as the feeling of safety in one’s own community has increased. Concern about victimization also far exceeds actual victimization rates. Combining fraud, property, and violent crimes, their were 12,806 crimes with older adult victims in Central Indiana in 2021. That represents 2.9 percent of the population, lower than the 15 percent who report victimization as a problem. Therefore, this likely represents rising concern about crime. However, when reflecting on their own community, an increasing share of older adults feel positively about overall levels of safety.

Data from Marion County also suggests that crime impacts older adults, although these rates may diminish by age. Between 2015 and 2019, the Indianapolis Metropolitan Police Department’s (IMPD) Victim Assistance Unit served 48,882 victims of crime. Of these victims, 6,521 (13 percent) were between 41 and 60 years of age, while 1,313 (3 perent) were over the age of 60. 27

Crime against older adults

Fraud, property, and violent crimes with older adult victims per 1,000 older adults

Most older adults feel that their community is safe.
Source: CASOA 2017 28
Fewer older adults report being a victim of a crime in 2017 than in 2013.
Source: CASOA 2017 29
Even when older adults are not direct victims of crime, neighborhood crime around them can have a negative effect on older adults, who may not feel safe or may be fearful of leaving their homes. One key informant shared that older adults in her community have a fear of telling others that they are home alone, out of fear of their homes being robbed. Additionally, fear of crime is associated with lower social participation among older adults.30

Neighborhoods with greater socioeconomic inequities have greater levels of violent crime. The socioeconomic characteristics of a neighborhood can lead to crime; however, this relationship is reciprocal, as crime can negatively impact the socioeconomic characteristics of a neighborhood.31 In areas with violent crime, experiences of violence are a cause of psychological distress among residents.32

During several focus groups conducted to inform this report, older adults living in Marion County noted that crime in their neighborhoods and around their homes prevents them from conducting regular business or enjoying where they live. Specific crimes mentioned include robberies, drugs and gun violence. One individual who lived near a running path opted to run laps around her block instead, out of fear of being robbed or attacked. Another person who relied on walking and the bus for transportation mentioned carrying mace and a knife for protection. Another participant reported her grandson was murdered in September 2019 during a robbery. Addressing crime is important to the sense of security and quality of life of older adults living in an area, and it disproportionately affects different Indianapolis neighborhoods.

What factors put older adults at a higher risk for fraud victimization?

Conflicting data exists about whether certain older adult populations are at a higher risk for fraud victimization. However, research has shown that older adults in general are more vulnerable to fraud and scams.

Individual factors:

Declines in cognitive functioning

Older adults with mild cognitive impairment or dementia are more likely to make impaired financial decisions and are less able to discern when fraudulent activities are occurring.33

Low income and low financial literacy

Older adults with lower income and low financial literacy have a higher susceptibility to fraudulent schemes.34

  This is of particular concern for older adults, who have been found to have high levels of financial illiteracy. This can impact their ability to recognize scams. In one study, over two-thirds of older telemarketing fraud victims said it was difficult to identify fraud when they encountered it.35

Interpersonal factors: Social isolation

Older adults who are socially isolated are at higher risk for being victims of fraud. These individuals often have strong urges to connect with others, which can make them easy targets for financial abusers. Fraudsters may build “friendships” with these older adults in a ploy to win their trust and exploit them financially. Additionally, older adults who live alone are often easy targets due to less contact with family members.36

Policy factors: Unclear avenues for fraud reporting

Many older adults who are fraud victims do not report it, due in part to a lack of knowledge on where or how to report.37 Even when there is information available on reporting, there may be a lack of clarity or ease in the process. For example, the Indiana Attorney General’s website lists four different organizations and contact numbers for reporting financial exploitation, depending on the type of scam and individuals involved.38 Similarly, even when elder fraud is reported, there are not always adequate resources to investigate or solve these cases. A 2016 IndyStar investigation found that elder financial abuse cases reported to APS were often the lowest priority to investigate due to the organization’s limited resources. One APS official shared that as a result, they did not open some financial exploitation cases until up to seven years after the exploitation had occurred.39 Low levels of reporting and prosecution can further embolden scammers to continue targeting older adults, as there are often few consequences.

  1. National Center on Elder Abuse, “NCEA – FAQ,” accessed February 4, 2021, https://ncea.acl.gov/FAQ.aspx.
  2. U.S. Department of Justice, “Elder Abuse Statistics,” n.d., https://www.justice.gov/file/1098056/download.
  3. Ananda B. Amstadter PhD et al., “Do Incident and Perpetrator Characteristics of Elder Mistreatment Differ by Gender of the Victim? Results from the National Elder Mistreatment Study,” Journal of Elder Abuse & Neglect 23, no. 1 (December 30, 2010): 43–57, https://doi.org/10.1080/08946566.2011.534707.
  4. Ron Acierno et al., “Prevalence and Correlates of Emotional, Physical, Sexual, and Financial Abuse and Potential Neglect in the United States: The National Elder Mistreatment Study,” American Journal of Public Health 100, no. 2 (February 1, 2010): 292–97, https://doi.org/10.2105/AJPH.2009.163089.
  5. “Elder Abuse Statistics & Facts | Elder Justice,” National Council on Aging, May 17, 2015, https://www.ncoa.org/public-policy-action/elder-justice/elder-abuse-facts/.
  6. Amstadter et al., “Do Incident and Perpetrator Characteristics of Elder Mistreatment Differ by Gender of the Victim?”
  7. National Research Center, “CICOA Aging and In-Home Solutions Full Report,” Community Assessment Survey for Older Adults (TM) (Boulder, CO: National Research Center, 2021).
  8. National Research Center, “State of Indiana Full Report,” Community Assessment Survey for Older Adults (TM) (Boulder, CO: National Research Center, 2021).
  9. Karl Pillemer et al., “Elder Abuse: Global Situation, Risk Factors, and Prevention Strategies,” The Gerontologist 56, no. Suppl_2 (April 1, 2016): S194–205, https://doi.org/10.1093/geront/gnw004.
  10. Boye Fang and Elsie Yan, “Abuse of Older Persons With Dementia: A Review of the Literature,” Trauma, Violence, & Abuse 19, no. 2 (April 1, 2018): 127–47, https://doi.org/10.1177/1524838016650185.
  11. Thirty-five key informant interviews with caregivers and service providers were conducted during 2019 and 2020 to collect input on issues facing the older adult population in Central Indiana. Public and not-for-profit sector leaders and service providers who are knowledgeable about service systems and issues pertaining to older adults in Central Indiana were identified and interviewed as key informants during report preparation.
  12. Chang, E. S., & Levy, B. R., “High Prevalence of Elder Abuse During the COVID-19 Pandemic: Risk and Resilience Factors” (2021), https://doi.org/10.1016/j.jagp.2021.01.007
  13. “How the State Failed to Protect Shirley Jarrett,” accessed February 4, 2021, https://www.indystar.com/story/news/investigations/2016/01/10/state-underfunded-adult-protective-services-agency-day-away-exploding/78526046/.
  14. Family and Social Services Administration and Indiana Prosecuting Attorneys Council, “Report on Adult Protective Services,” December 1, 2016, https://www.in.gov/ipac/files/Adult Protective Services Report – SEA 192-2016.pdf.
  15. Family and Social Services Administration and Indiana Prosecuting Attorneys Council.
  16. Indiana Office of Court Services, “Volunteer Advocates for Seniors and Incapacitated Adults Program List,” n.d., https://www.in.gov/judiciary/iocs/files/ad-guard-directory.pdf.
  17. Janice Joseph and Arleen Gonzalez, “Elder Abuse in Communities of Color in the United States: A Literature Review,” in Perspectives on Elderly Crime and Victimization, ed. Peter C. Kratcoski and Maximilian Edelbacher (Cham: Springer International Publishing, 2018), 125–39, https://doi.org/10.1007/978-3-319-72682-3_7.
  18. Community Assessment Survey for Older Adults, (2021), National Research Center Inc. https://cicoa.org/news-events/research/.
  19. Office of the Indiana Attorney General, “Consumer Calls and Complaints Dataset,” 2020 2013.
  20. These numbers are likely a fraction of the complaints received, since very few complainants gave their ages – for example, in 2020, 944 complainants age 60+ made a total of 1,402 complaints. However, during that year, a total of 22,752 complainants who did not report their ages made a total of 27,337 complaints.
  21. National Research Center, “State of Indiana Full Report,” 2017
  22. National Research Center, “State of Indiana Full Report,” Community Assessment Survey for Older Adults (TM) (Boulder, CO: National Research Center, 2013).
  23. Community Assessment Survey for Older Adults, (2017), National Research Center Inc. https://cicoa.org/news-events/research/.
  24. Nine focus groups with older adults were conducted during 2019 and 2020 to collect input on issues facing the older adult population in Central Indiana. The focus groups composed of older adults were assembled with the identification and recruitment assistance of community service providers. These focus groups were conducted by researchers, in person prior to the COVID-19 pandemic, and by Zoom after the pandemic began. The questions asked of the focus group participants were discussed and agreed upon by research faculty and staff.
  25. Community Assessment Survey for Older Adults, (2021), National Research Center Inc. https://cicoa.org/news-events/research/.
  26. National Research Center, “CICOA Aging and In-Home Solutions Full Report,” 2017.
  27. Indianapolis Metropolitan Police Department, “Victim Assistance Unit Data,” 2020.
  28. Community Assessment Survey for Older Adults, (2017), National Research Center Inc. https://cicoa.org/news-events/research/.
  29. Community Assessment Survey for Older Adults, (2017), National Research Center Inc. https://cicoa.org/news-events/research/.
  30. Arlesia Mathis, Ronica Rooks, and Daniel Kruger, “Improving the Neighborhood Environment for Urban Older Adults: Social Context and Self-Rated Health,” International Journal of Environmental Research and Public Health 13, no. 1 (January 2016), https://doi.org/10.3390/ijerph13010003.
  31. John R. Hipp, “Income Inequality, Race, and Place: Does the Distribution of Race and Class Within Neighborhoods Affect Crime Rates?*,” Criminology 45, no. 3 (2007): 665–97, https://doi.org/10.1111/j.1745-9125.2007.00088.x
  32. Aaron Curry, Carl Latkin, and Melissa Davey-Rothwell, “Pathways to Depression: The Impact of Neighborhood Violent Crime on Inner-City Residents in Baltimore, Maryland, USA,” Social Science & Medicine 67, no. 1 (July 1, 2008): 23–30, https://doi.org/10.1016/j.socscimed.2008.03.007.
  33. Jingjin Shao et al., “Why Are Older Adults Victims of Fraud? Current Knowledge and Prospects Regarding Older Adults’ Vulnerability to Fraud,” Journal of Elder Abuse & Neglect 31, no. 3 (May 27, 2019): 225–43, https://doi.org/10.1080/08946566.2019.1625842.
  34. Bryan D. James Phd, Patricia A. Boyle Phd, and David A. Bennett Md, “Correlates of Susceptibility to Scams in Older Adults Without Dementia,” Journal of Elder Abuse & Neglect 26, no. 2 (March 15, 2014): 107–22, https://doi.org/10.1080/08946566.2013.821809.
  35. Shao et al., “Why Are Older Adults Victims of Fraud?”
  36. Shao et al
  37. Clifton B. Parker, “Stanford Study Urges More Accurate Estimates of Financial Fraud,” Stanford University, December 16, 2013, http://news.stanford.edu/news/2013/december/elder-fraud-study-121613.html.
  38. “Attorney General: Numbers for Reporting Financial Exploitation,” accessed February 4, 2021, https://www.in.gov/attorneygeneral/2581.htm.
  39. “Financial Exploitation Cases Burden Seniors, Indiana,” accessed February 4, 2021, https://www.indystar.com/story/news/investigations/2016/01/17/financial-exploitation-cases-burden-seniors-indiana/78810678/.