Pamela B. Teaster, PhD

Pamela B. Teaster, Ph.D. is a Professor in the Department of Health Behavior and Director of Doctoral Studies in the College of Public Health at the University of Kentucky. Dr. Teaster is involved in a myriad of additional organizations related to elder justice, public guardianship and public health, including the Kentucky Justice Center for Elders and Vulnerable Adults, which she directs. Dr. Teaster’s contributions to academic elder justice are tremendous; she has published extensively on elder sexual abuse as well as all other forms of elder abuse and exploitation, the role of multidisciplinary teams in elder abuse cases, public guardianship, public policy related to elder abuse and guardianship, the ethics of elder mistreatment and more. Her research, as well as her teaching and mentoring, have inspired numerous awards. Dr. Teaster is often sought as an expert in the field and has presented on elder abuse to groups across the country, including federal officials in Washington DC.

NYCEAC’s Sarah Dion recently sat down with Pam to talk about her career and her vision for the future of the elder justice field.

How did you get involved in the fields of elder justice and elder abuse?

I came to elder abuse from public guardianship, which was the topic of research for my Ph.D. While I was working on the Ph.D., I was asked by one of my committee members to be involved in a listening session for the White House Conference on Aging. I helped facilitate a White House Conference on Aging discussion in a little town called, Wytheville, Virginia and was scared to death because I remember talking to one of my mentors, Willliam (Jim) McCauley, and I said, “Jim, I don’t know anything about elder abuse.” And he remarks, “You’re getting a PhD. Why don’t you read about it?” So I really did read a lot. That was my first brush with elder abuse. The second brush was when my mother told me about an older woman in our church in my hometown who was sexually assaulted in her home. That happened while I was working on my PhD as well, and I swore I’d do something about it, but I didn’t know what that meant at the time I said it.

Had you done any work related to guardianship and elder abuse prior to your PhD?

My undergraduate degree was in English, and my Masters was in Speech and Theatre. I wasn’t thinking anything about guardianship or elder abuse; I was thinking about being a high school drama teacher, which is what I was at the time.

I moved into the area of elder abuse in a fairly facile way from having done the guardianship work during my PhD. Guardianship is a very limited area in terms of funding, and it’s a very narrow area to have as a research agenda. Elder abuse caught my attention because it really involves a lot of the same actors: physicians, psychologists, lawyers, ethicists, gerontologists, administrators and public policy.  They all are intertwined.

It’s common to hear that elder abuse is 40 years behind child abuse and 20 behind domestic violence. What do you hope the field of elder abuse accomplishes in the next 5-10 years?

It’d be nice not to say that anymore! Many fine folks are doing even better science now because there’s money to do it, and the field is more legitimate. There actually are more people working in elder abuse now than ever before. To catch up, the field needs more rigorous work and evidence-based practice. More specifically, the field needs more research on:

• Older adults with dementia: We need to understand what the prevalence of elder abuse is in that population, although we tend to believe it’s high. We miss that group because prevalence studies use random digit dialing, and so they’re asking people who generally have capacity to answer those questions.
• Outcomes and prevention: These are difficult topics to address, but questions include: How do we really prevent elder abuse, and how can we show that we did? What happens to people post-abuse? How do they recover? What makes them able to recover? What costs were incurred at all levels- to the individual, to families, to the agencies and to society as a whole?
• Ethical framework: We need more overt writing on ethical issues and elder abuse. Ethics underpins all the work that’s being done, but ethics and elder abuse need to be married together more formally.
• Elder abuse internationally: We’ve got to bridge the oceans and continents and embrace this as a worldwide issue.

What’s your elevator pitch for young professionals considering a career in elder justice?

If you look at the demographics of mistreatment, adult abuse falls into the big public health problem of adults and older adults, and it’s the most unexplored of the issues facing those populations. You have greater latitude for exploration because it hasn’t been done yet. Early on when I was a new professor, I hand-picked what I wanted to look at because everything needed attention. I found that very exciting. I think you still could have that range because there’s still so much to be done.

What are some of your favorite books about aging?

My top three gerontology-related books are:

• Setting limits: medical goals in an aging society by Daniel Callahan
• Gerotranscendence: A developmental theory of positive aging by Lars Tornstam
• Moral boundaries: A political argument for an ethic of care by Joan Tronto

The first two are books that I love as a gerontologist. The last is about the ethics of care, and while it isn’t exactly “gero,” it’s important to my work and teaching in ethics.

Where do you anticipate elder abuse work taking you in 2014?

There are several things I want to explore:

• Global perspectives of elder abuse. Elder abuse is not an American problem, or a Canadian problem; it is a worldwide problem. I am collaborating with some folks to develop an international elder abuse study and plan to further launch that in 2014.
  
• Outcomes of abuse. I’d like to see what happens to people after recognition of abuse. How many times are they in our system? How were they affected? Were they demoralized by it? Were they decimated by it? Did they die early? Or, were there people who have some protective factors and they were able to recover to some degree?
• Elder exploitation and drug abuse, particularly in rural areas. In rural areas the drug abuse is mostly oxycodone, methamphetamines and heroin. I’m interested in seeing how the prevalence of drug abuse is affecting elder abuse.
• Follow-ups on earlier studies. What has happened to the sexual assault victims we studied 8-10 years ago, particularly as they moved through the system, and what happened to some folks who received involuntary Adult Protective Services?

I hope to write on a few additional topics as well:

• Ethics of elder abuse. I hope to add some thoughts on both the abuse dynamic and the interventions.
• Elder abuse and public health. I’m editing one book on elder mistreatment with Jeffrey Hall (Centers for Disease Control) that will ground elder abuse in public health. I’m also working on another edited book on LGBT elders (with Debra Harley, University of Kentucky) and there’s a part in there- three chapters- on elder mistreatment.