Dr Jennifer E Storey

Although ever present, older adult abuse has not received the same amount of media, government, and research attention as some other crimes. Thankfully, this trend is changing as people begin to realize the prevalence and complexity of the problem. Until recently, no guidance was available for professionals regarding the assessment and management of actual or suspected older adult abuse. The Harm to Older Persons Evaluation or HOPE was developed for the purpose of assisting professionals in identifying risk factors for older adult abuse, evaluating the risk of continued abuse and engaging in case management to reduce risk and protect victims from continued harm.

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For the purposes of the HOPE we define older adult abuse and neglect as the actual, attempted, or threatened physical or serious psychological harm, either deliberate or reckless, of vulnerable older people that is unauthorized and perpetrated by individuals who are in positions of trust, responsibility, or authority with respect to the vulnerable older person. This definition excludes violence committed by strangers, and intimate partner violence as these are already covered by other risk assessment instruments (e.g., HCR-20, B-SAFER, SARA). The violence considered in the HOPE is perpetrated by individuals who have a relationship with the older person, and in the case of spouses, those whose relationships also include elements of dependence and care.

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The identification, investigation, assessment, and management of older adult abuse are tasks that require the expertise and efforts of several types of professionals, including criminal justice, health, social work, care, and mental health professionals. As such, the HOPE was developed to be applicable and useful to a variety of professionals working with older adult abuse victims and perpetrators. The HOPE was also designed to facilitate communication between these professional groups.

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Structured violence risk assessment has been shown to improve professional practice (Otto & Douglas, 2010). There are several different ways to conduct structured violence risk assessments. The HOPE uses the structured professional judgment (SPJ) method. In the SPJ method, decision-making is directed by guidelines that have been developed to reflect the “state of the discipline” with respect to scientific knowledge and professional practice (Borum, 1996). Essentially, the guidelines assist the user by outlining what information and core risk factors should be considered in a violence risk assessment and how to use that information to determine the risk involved in the case and develop appropriate risk management strategies.

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The SPJ method also underlies several widely used risk assessment instruments for other forms of violence including intimate partner violence (B-SAFER, SARA), stalking (SAM), general violence (HCR-20v3) and sexual violence (SVR-20, RSVP).

Displayed below are the 29 risk factors and 4 domains of the HOPE.

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The HOPE is based on a review of over 200 studies on risk factors for older adult abuse. The evidence for each risk factor is outlined in the HOPE manual.

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You can also review the studies on perpetrator and victim risk factors in this publication:

Storey, J. E. (2020). Risk factors for elder abuse and neglect: A review of the literature. Aggression and Violent Behavior.

Copies can be requested via email