This article explores the principle of self-determination as it relates to victims of elder abuse and neglect. Using newspaper accounts and cases from the author's practice and consulting files, various factors influencing the professional's interpretation of this principle are explored. The notion that self-determination allows victims of abuse and neglect to refuse intervention is challenged. The author concludes that the principle of self-determination and the notion of competency are overly simplified in the social work and elder abuse literature and may be misused by allowing abused older victims to choose to remain in often life-threatening situations. Special focus is given to Adult Protection Service worker, but the author asserts that protecting older people, assisting in creative interventions and developing needed services is a shared professional responsibility.

Elder abuse reporting laws exist in every state to protect elderly people being abused physically or emotionally, suffering from neglect, or experiencing financial exploitation. Support groups for caregivers of elderly individuals may help prevent elder abuse by reducing caregiver stress and linking caregivers to community services. Using case illustrations, the authors raise the dilemmas that group facilitators face when deciding whether to report a group member suspected of abusing his or her elder care recipient. The ethical concerns of reporting or withholding a report are discussed, and recommendations to assist facilitators in this complex decision process are presented.

Currently family preservation is not recognized as a viable approach in elder abuse practice. Yet most elder abuse in domestic settings is perpetrated by family members, and, in cases in which elders are being abused by family members, many times elders choose not to change their living situations. For this article, the author reexamined findings from a 1996 exploratory study the author conducted of decisional factors used by New Hampshire's elder protection service workers to explore the role family preservation had in their elder abuse practice. By comparing the decisional factors found in the original study to an index the author created of characteristics of a family preservation model, several factors were identified as characteristics of a family preservation approach. The findings reveal participants used, to a certain extent, a family preservation approach with little agency and community service provider support. The author concluded that further research should be conducted to see if the family preservation model would help in identifying a universal practice model in elder abuse work to more clearly address some of the complexities of providing intervention to the elderly suffering from domestic violence.

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