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Running Header: ELDER ABUSE

The Challenges Faced with Elder Abuse


Morgan B. Rodgers
First Colonial High School
Legal Studies Academy

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Abstract

This is a research paper focused on the topic of Elder Abuse. The author goes into direct detail on
the different types of abuse. After in which she writes about the history and the statues and laws
that are available to the elderly today. She includes a component on Elder Law attorney and
follows with, Why people abuse and a Case study making an example of all the facts from the
previous paragraphs. Also including a piece on Actor Mickey Rooney to show an example of
what is going on in semi-recent events today. She then continues to compare Japan and the
United States regarding how Elder Law issues are viewed. After writing detailed paragraphs on
Elder Abuse Victims Diagnosis, she finishes the paper out with a Prevention and Intervention
Strategies section followed by the resolution or conclusion paragraph.

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The Challenges Faced With Elder Abuse


Time. There never seems to be enough. As aging infests the mind, time appears to be in a
close second. A drawn-out race to the finish line that will never end until it ends. In the United
States, people tend to neglect and abuse the elderly. According to the National Center on Elder
Abuse, (NCEA), in 2000, a study interviewing 2000 nursing home residents, 44% said that they
had been abused, and 95% said that they had been neglected or seen another resident neglected.
(NCEA, n.d.) Elder Abuse is a rising issue in America that increases each year. The abuse ranges
from verbally, all the way to manslaughter. As aging takes over, elders are constantly put to a
lesser status and taken advantage of by those around them. Support from the community and
strategized policy advances are needed to create national awareness to detect, prevent, and find a
solution to protect Americas aging population.
What is Elder Abuse?
The National Institute of Justice, (NIJ) , defines elder abuse and mistreatment as,
(A) intentional actions that cause harm or create a serious risk of harm to a vulnerable
elder by a caregiver or other persons who stand in a trust relationship with that elder or
(B) failure by a caregiver to satisfy the elder's basic needs or to protect them from harm.
(NIJ, 2007, para 2)
This abuse includes physical, sexual, emotional/psychological, financial, and neglect.
According to the NCEA physical abuse is defined as the use of physical force that will result in
injury, pain or impairment. Sexual abuse is defined as the non-consensual sexual contact with a
person. Sexual abuse includes, rape, unwanted touching, nudity and may include but is not
limited to assault or battery. Emotional abuse is defined as, an infliction of pain that is done
through verbal or no verbal acts. Financial abuse is defined as, the illegal or improper use of an
elder's funds. (NCEA, Types of Abuse, n.d.) At often times, the terms abuse and neglect get
confused because they can be almost defined as the same thing. Abuse is more referring to the
intentional harms towards an elder when neglect is referring to withholding from doing

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something for the elder. (Quinn & Tomita, 1986)


Historical Research
In the 1950s and 60s, public welfare made an approach to providing services. Protective
service units were created to help provide social services, legal assistance, and guardianship. In
the 1970s there were Adult Protective services nationwide with the enacting of the Social
Security Act. Also, there was a recognizing of Battered old Person Syndrome by Robert Butler
(Anetzeberger, n.d.). Dr. Xin Q. Dong was the first speaker at the session, Ethical Dilemmas in
Elder Abuse: Successful Resolutions of Challenging Cases at the American Geriatrics Societys
2006 Annual Scientific Meeting. Dr. Dong is from the Geriatrics section at Rush University
Medical Center in Chicago Illinois. In the article, The Ethical Challenges of Elder Abuse,
written by Mark Williams, MD, according to Dr. Dong, The legal history of elder abuse
formally began in 1978 in the US House of Representatives. (Legal, n.d.) The first research on
elder abuse was done in Cleveland at the Chronic Illness Center. Around 1980 and 1986, 26
states passed laws requiring that you report elder abuse. The 1980s is really when the national
recognition of elder abuse happened. The Older Americans Act was passed as well. The first
elder abuse research forum was held at the University of New Hampshire. In 1987 Omnibus
Budget Reconciliation on elder abuse was given. A group of people came together and formatted
the National Committee for the Prevention of Elder Abuse and the Journal of Elder Abuse and
Neglect. In the 90s the National Center on Elder Abuse was created and the National
Association of Adult Protective Services Administrators (History, n.d). The Title VII of the
Older Americans Act or the Vulnerable Elder Rights Protection was established (Anetzeberger,
n.d.). By the time 1997 rolled around, 42 states had enacted legislation.
Statutes and Laws

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It has been found that many states combine the protection of elderly people with those of
physically challenged adults, and elder laws are often referred to as, adult protection service rules
(Simon, 1992). Research shows that 70% of reports are of people ages 65 and older (Simon).
Nationally, Elder Abuse Protection (EAP) laws have three primary functions in common: To
collect reports of suspected abuse, neglect, and financial exploitation and manage statistics and
assess for client services needs. To make every effort to reduce risk to elderly individuals by
providing community education and intervention through casework and referrals to community
services. Lastly, to interface with the courts and law enforcement agencies in certain types of
cases (Simon, 1992; Tatara, 1995).
Elder laws differ from state to state; this makes it important for people to know what
information is available. By doing research, I have found there are primarily three major
differences. One is that some state requires mandatory reporting of elder abuse and others dont.
Another is the target population that the elder laws will reach. Lastly, laws differ in the medical
areas that allow practitioners to conduct investigations of alleged abuse and neglect and to
intervene in cases that are substantiated.
Currently, the elderly have access to H.R.3090, The Elder Protection and Abuse
Prevention Act. This act replaces the Older Americans Act of 1965 ("H.R.3090 - 113th
Congress (2013-2014): Elder Protection and Abuse Prevention Act," n.d.). This Act enacts a
legislation for appropriate training in elder abuse prevention. Updates are going to be made
periodically for the protection of the elderly. There has to be a full collaboration between all
government and assistance systems that serve older individuals. The assistant secretary gains the
right to establish a National Adult Protective Services Resource Center to improve the capacity
of the state. This Act also requires organizations that go towards the beneficial elements of the
elderly. As a positive outlook, the Assistant Secretary can award grants with eligible
organizations ("H.R.3090 - 113th Congress (2013-2014): Elder Protection and Abuse Prevention

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Act," n.d.). Throughout 11 states in 2014, legislation was enacted that addresses fall among
older adults (NCSL, n.d.).
Elder Abuse Prevention Services is a programs to assist older individuals, their families,
and caregivers, to prevent and remedy neglect or exploitation, United States Code (USC) 3002
(22) & (23). Elder Abuse prevention services also should concentrate on public education,
United States Code (USC) 3058i. Abuse, neglect or exploitation of older persons must be
reported to the local Department of Social Services as well as anyone that is suspected to be a
part of elder abuse, Virginia Code 63.1-53.3.
One of the oldest documents found in history made by Hippocrates is the Hippocratic Oath. A
complete summary of this would be that physicians must treat the ill to the best of their ability,
preserve a patient's privacy and to teach medicine to the next generation and so on (Lasagna,
2004).
In Virginia, all adults have a right to what is called an Advance Directive. This is when
they put their wishes about medical care in writing. Two types of advance directions are, Power
of Attorney for Heath Care where you have another person to make your health care decisions
for you and a Living will where you can state your wishes. This includes life-prolonging
treatment or if you want to remain on life support if something happens (Seitz & Brownell,
1952).
Elder Law Attorneys
Elder Law Attorneys are necessary because they can educate clients and families with the
information they need to know to be successful. The attorneys serve as a community resource or
expert, for those around them. These attorneys can recognize abuse, neglect, and exploitation and
report it to the proper place. By being associated with the law they can offer legal strategies that
will help improve the quality of life for the abused and their family. This includes counseling,
assist clients when they need different services and advising customers to take a particular
precaution when perusing an area.

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Elder abuse is a complex and multifaceted problem. Elder abuse usually requires
multiple people coming together discussing and coming to a resolution about a client. During
this collaboration ethical issues may arise between the parties. According to, What-when-how
these conflicting issues are:
(1) the legal duty to report certain suspected conduct to law enforcement and
protective services versus victim autonomy and safety; (2) the victims right to selfdetermination versus protection and safety; and (3) when intervening, selecting the least
restrictive alternative versus protection and safety. (Ethical, n.d.)
According to the book, Elder Law in Virginia, Elder Law Attorneys are only called in
times of crisis. The people that take on this role have to have perspective and empathy. It is
important that they also understand the aging process as well. Understanding the aging process
includes, hearing loss, mental diseases, memory loss and any other hardships the elderly have to
face. The most important fact they need to take in is dementia. Dementia affects 19% of a person
between ages 75 and 84. Dementia also affects individuals over the age of 85. Dementia can
branch off into subcategories that include but are not limited to, Alzheimers, Lewy Body
Dementia, Multi-Infarcted Dementia, Parkinsons, and affective disorders.
Why People Abuse
Many sources have come to the conclusion that there is no one particular reason for
people to abuse the elderly. Abuse may happen without the abuser knowing what they are doing
versus a caregiver knowing what they are doing and abusing anyway. Dependency, stress,
addictions, ageism are some of the few categories that has been broken down into why people
abuse. (Edmonton, n.d.)
Often more than not when the elderly have a caregiver those elders become attached or
dependent on their caregiver. They rely on them for assistance for everyday need such as
shopping, changing, using the restroom or even paying bills on time. On the opposite side of the

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spectrum, it is often found with this kind of dependency that the abuser is also dependent on the
elder that leads to the abuse.
In some cases, the violence has come from pent up stress and just happens. This may be a
burst of sudden anger, retaliation, screaming, or hitting based off of the stress that has
accumulated.
According to the Police Department of Edmonton, any forms of addiction can lead to a
person not being able to function properly. This kind of dependency can lead to the abuse of
others. An example of this dependency would be alcoholism. If a man came home drunk and
wasnt able to think correctly, they may hit or yell at the elder that they are caring for. Not
because they feel its needed but because their state of mind is out of wack, and that just seems
the right course of action to them at the time. According to Charmaine Spencer of Simon Fraser
University,
a study examining elder abuse case files from agencies across Canada found that severe
drinking bouts by the abuser lead up to the abuse in 14.6% of the cases. In another 18.7%
of the client records, the clients indicated that the abuse was secondary to alcoholism.
Ageism is another saying for lack of knowledge, so to speak. Ageism is a biased view of
older adults. By deciding how you feel about a certain subject matter, thats how people set
themselves up for failure. Abuse and neglect can be because of a negative view of the elderly that
a person has and is unwilling to change. If these persons find that it is not okay for the elderly to
have an increasing dependence on others that may also impact how they treat the other elders
around them (Edmonton, n.d.).
Case Study
This is a case study on a woman named Edith. Following the case, there will be a breakdown of
its content and material.
Case 1: Edith was a 60-year-old single woman caring for her 85-year-old mother. At a support
group for caregivers, Edith shared that she was an only child and had no relatives or friends to

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help her with caregiving. She was also attempting to work full-time. Edith was obviously under a
great amount of stress and said her doctor told her she needed to come to the support group or
she would have a nervous breakdown. Edith announced she had recently raised her voice to her
mother on several occasions (Ethical, n.d.)
The overarching concern that wells up would be the fact that Edith verbally abused her
mother without realizing what she was doing. Overloading herself with work and caring for her
mother may lead to Edith taking a violent course of action due to all the stress that has been
accumulating.
Taking the group facilitators point of view, should he be required to report that Edith has
in fact been abusing her mother inadvertently? Comparing this support group for caregivers to
that of an Alcoholics Anonymous group; should the group facilitator not break anyones amenity
no matter the situation? What you see hear, what you say here, what you see here, let it stay here;
would this apply or should more drastic measures be taken?
Mickey Rooney Case
In February of 2011, actor Mickey Rooney, as seen in Night at the Museum, starring as
Gus, (Wikipedia, n.d.), at age 90 was
Granted court protection from stepson Chris Aber and his stepdaughter Christina Aber,
after he filed a case against them charging verbal, emotional and financial abuse, and for
denying him such basic necessities as food and medicine (Hutchison, C., n.d.).
Being an alleged victim of elder abuse the court has filed a restraining order stating that
Chris and Christina have to stay 100 feet away from Rooney at all times. Because Rooney fears
for his families safety the court have also ensured protection for his wife, Jan and his stepson
Mark (Hutchison, C., n.d.). Rooney not only fears for their safety but he is concerned that Chris
and Christina may retaliate physically, possibly even kidnap the actor, court documents state. The
reason this case was taken to court was because of financial abuse and neglect. Also Chris Aber
was accused of not letting Rooney have access to his mail and practically making Rooney

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preform where he did not want to be. There was no specific cause to why the pair did this to
Rooney. Mickey Rooney died in California at the age of 93 (Wikipedia, n.d.). Money seems to be
the precedent in why Chris and Christina Aber abused Mickey Rooney. In most elder abuse cases
it is found that family members are primarily the abusers. Rooney unlike most elders, had
enough and reported that he was being abused regardless of the consequences.
Every year, an estimated 2.1 million older Americans fall victim to physical,
psychological, sexual, financial, or other forms of abuse and neglect, according to the
American Psychological Association. For every case reported to authorities, experts
estimate there may be as many as five cases that were not reported (Freeman, n.d.).
"All I want to do is live a peaceful life, to regain my life and be happy," Rooney wrote in
a statement quoted by the paper.
I pray to God each day to protect us, help us endure, and guide those other senior citizens
who are also suffering (Freeman, n.d.) . Mickey Rooney
Comparative Research: Japan vs. United States
nd
On October 22 , 2014 in Washington D.C., a conference was held to talk about, Caring
for an Aging Population: U.S.-Japan Comparative Research into the Potential of a PreventionBased Approach. (Ricart & Terrillion, n.d.) America and Japan are so similar yet so different. In
Japan, it has been a major concern that by 2050, 38% of Japans population will be over the age
of 65. In America, there is also a similar concern that by 2050, 21% will be over the age of 65.
(Ricart & Terrillion, n.d.) Ms. Ender Ricart, a Japan Studies Visiting Fellow, East-West Center in
Washington Ph.D. Candidate at the University of Chicago, Department of Anthropology,
discussed the cultural differences between the United States and Japan to show comparatively
how the specifics influenced what people thought about providing care for the elderly. A
complete summary of these points include how in the United States policy makers want costs to
be cut, but the aging specialist wants more protection for the elderly in general. She highlights

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that fact that there is so much miscommunication between everyone, and this ends up leading to
a miss-allocation and a waste of resources. (Ricart & Terrillion, n.d.)
Japan's policy makers and again specialist both want the same thing: to improve the
framework and programs to give the elderly the best quality and quantity of life possible (Ricart
& Terrillion, n.d.). In Japan, elders have the ability to purchase long-term health care coverage.
In the fees covered by the health care they can have extra money to spend on items that are
needed for comfort. This includes slippers, socks, sandals, etc. As the elder population gets older,
there is a possibility for the system to be flooded with elders and this will unbalance the work
they have going on.
In Japans, the elders are placed on a pedestal. Japanese cultural plays a big role in how
they view the elders with their mentality. The Japanese government has convinced the people
that they have a social obligation to either help or allow themselves to be helped.
In the United States, the attitude is different from those in Japan. Trust in the government
is at an all-time low, so when people are being told what to do they are not going to listen. Ms.
Ricart believed that it was this difference that has led Japan to be proactive while their baby
boomer generation is young yet similar urgency in the United States is hard to find (Ricart &
Terrillion, n.d.).
Elder Abuse Victims Diagnosis
A study was conducted with NCEA and found that only 1 in 14 cases of elder abuse ever
gets reported/documented (NCEA, data, n.d). Why is that? Victims of elder abuse and neglect
end up feeling ashamed of what has happened to them. Those being often abused choose not to
report the abuse because the abuser is a family member or someone thats been involved in their
life long enough not to want to face retaliation from the abuser. Many elders just take the abuse
as it comes because it all ends eventually and they learn to cope with whats going on around
them. The biggest ethical dilemma that has been found would have to be how, if the elders tell

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whats going on, they will have the fear of the abuser coming back to them and abusing them
further no matter what type of abuse it is.
There are many reasons why victims dont tell according to Elder Abuse and Neglect
Second Edition. This includes privacy of their life and their familys lives. They dont want to be
publicly exposed. The elders question their motives such and who will believe them at the end of
the day. Spouses have the shame and embarrassment that they cant take care of themselves any
longer. The Elders tend to accept the abuse as it comes praying it will end as in all things do.
Elders have the anxiety of what will happen if an outside finds out about whats been going on at
home. Apart of this concern is that their abuser will be put in jail, and they will have no one to
care for them. Being abused has the possibility of being placed in a nursing home. In this book, it
talks about how, older persons without a reasonable doubt find that when they are put in an
institution, it is a prelude to death. They fear not being accepted by their children and no visitors.
Some victims of the abuse take it out of loyalty to their family. Elderly victims of mistreatment
fear rejection and disruption of their home lives, even if they are severely abused. The elders find
pride in survival, this is where they feel the violence isnt as bad as it seems and they learn to
accept it as it comes. Others find it as means of Religious Justification. God has a plan and if this
is the plan, for now, it will accepted as fate and what you offer up will be taken. Elder abuse is a
severe crime, and if the elderly have a mindset such as those above, nothing will be able to get
fixed and a solution will never be found (Pippidis & Stein, 1990).
Intervention and Prevention Strategies
In the 1960s, Robert Butler coined the phrase ageism, which he defined as:
A process of systematic stereotyping of and discrimination against people because they
are old, just as racism and sexism accomplish this with skin color and gender. Senior
citizens are categorized as senile, rigid in thought and manner, old-fashioned in morality
and skills Ageism allows the younger generations to see older people as different from

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themselves; thus they subtly cease to identify with their elders as human beings
(Robert Butler, Why Survive? Being Old in America, 1975) (NCEA, Prevention, n.d)
Many people suggest ageism is a cause from elder abuse neglect and exploitation.
However, we currently do not have enough research to prove that theory. Although it addresses
the causes of abuse, neglect, and exploitation, it also contributes to the disadvantages that the
elderly face every day against society. The National Center on Elder Abuse suggests that if we
address the ageist attitudes within the community we can reduce the occurrence of elder abuse
and increase public awareness (NCEA, Prevention, n.d.).
With the community taking the time to communicate about whats going on with the
older populations, there is a better chance that intervention and prevention can be accomplished.
According to the National Center on Elder Abuse, Public awareness efforts are communication
tools for promoting or improving health and well-beings (NCEA, Prevention, n.d.).
Communication provides more knowledge and reinforces awareness of any important or nonimportant information. Discussion prompts action and increases the demand or support of
services within an area.
Unlike sexual offenders, there isnt a criminal database for elder abusers. According to
NCEA, abuse registries are often considered a prevention line of defense (NCEA, Prevention,
n.d.). If there was a possibility that the government could register all the criminal activity going
on with elder abuse into one place, there is a chance that prevention strategies will become easier
in the long haul. Abuse registries are connected to background checks in job applications. Having
this registry would allow employers to keep out suspected criminals who are flagged during the
background check.
Resolution

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Elder Abuse is increasing each year. In many parts of the world elder abuse occurs with
little recognition or response. The global population of those 60 and older is estimated to reach
1.2 billion according to the United Nations (Elder, n.d.). Approximately one in every 10 aged
60+ has experienced a form of abuse. A second study estimates that only one in 14 cases get
reported to the authorities. Support from the community and strategized policy advances are
required to protect Americas aging population.

References

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Anetzeberger, G., Ph.D. (n.d.). A Concise History of Elder Abuse. Retrieved from
http://www.giaging.org/documents/A_Concise_History_of_Elder_Abuse.pdf
Edmonton Police. (n.d.). Why Elder Abuse Happens. Retrieved from
http://www.edmontonpolice.ca/CommunityPolicing/FamilyProtection/ElderAbuse/WhyElderAb
useHappens.aspx
Elder, older people, aging, aging, abuse, human rights, dignity, neglect, exploitation,
maltreatment. (n.d.). Retrieved from http://www.un.org/en/events/elderabuse/
Ethical and Legal Issues, Treating Elder Abuse. (n.d.). Retrieved from http://what-whenhow.com/interpersonal-violence/ethical-and-legal-issues-treating-elder-abuse/
Ethical dilemmas of reporting suspected elder abuse. (n.d.). Retrieved from
http://www.biomedsearch.com/article/Ethical-dilemmas-reporting-suspectedelder/96644088.html
Freeman, D. (n.d.). Mickey Rooney, elder abuse victim? Retrieved from
http://www.cbsnews.com/news/mickey-rooney-elder-abuse-victim/
History of API. (n.d.). Retrieved from http://friendshipmeals.org/history-of-api/
H.R.3090 - 113th Congress (2013-2014): Elder Protection and Abuse Prevention Act. (n.d.).
Retrieved from https://www.congress.gov/bill/113th-congress/house-bill/3090

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Hutchison, C. (n.d.). Mickey Rooney. Retrieved from


http://abcnews.go.com/Health/Wellness/mickey-rooney-90-victim-alleged-elderabuse/story?id=12934033
Lasagna, L. (2004). Hippocratic Oath. Retrieved from
http://www.medicinenet.com/script/main/art.asp?articlekey=20909
Legal Issues in Elder Abuse. (n.d.). Retrieved from
http://www.medscape.org/viewarticle/532943
NCEA. (n.d.). Prevention Strategies. Retrieved from
http://www.ncea.aoa.gov/Stop_Abuse/Prevention/Strategies/index.aspx
NCEA. (n.d.). Statistics/Data. Retrieved from http://www.ncea.aoa.gov/Library/Data/
NCEA. (n.d.). Types of Abuse. Retrieved from http://ncea.aoa.gov/FAQ/Type_Abuse/
NCSL. (n.d.). Elderly Falls Prevention Legislation and Statutes. Retrieved from
http://www.ncsl.org/research/health/elderly-falls-prevention-legislation-and-statutes.aspx
NIJ. (2007). Elder Abuse. Retrieved from http://nij.gov/topics/crime/elderabuse/Pages/welcome.apex
Pippidis, M., & Stein, K. F. (1990). Elder abuse and neglect a synthesis of research.
Washington, D.C.: National Aging Resource Center on Elder Abuse.

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Quinn, M. J., & Tomita, S. K. (1986). Elder abuse and neglect: Causes, diagnosis, and
intervention strategies. New York, NY: Springer Pub.
Ricart, E., & Terrillion, A. (n.d.). Caring for an Aging Population: U.S.-Japan Comparative
Research into the Potential of a Prevention-Based Approach. Retrieved from
http://www.eastwestcenter.org/events/caring-aging-population-us-japan-comparativeresearch-the-potential-prevention-based-approach)
Seitz, C. J., & Brownell, E. A. (1952). Legal Aid in the United States. Virginia Law Review,
38(1), 134. doi:10.2307/1069203
Simon, M. L. (1992). An exploratory study of adult protective service programs' repeat elder
abuse clients. Washington, DC: American Association of Retired Persons.
Tatara, T. (1995). An analysis of state laws addressing elder abuse, neglect, and exploitation: A
final report. Washington, DC: National Center on Elder Abuse
Tatara, T. (1993). Understanding the nature and scope of domestic elder abuse with the use of
state aggregate data: Summaries of the key findings of a national survey of state APS and
aging agencies. Journal of Elder Abuse & Neglect, 5, 35-57
Wikipedia. (n.d.). Mickey Rooney. Retrieved from
https://en.wikipedia.org/wiki/Mickey_Rooney

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Grading Rubric for Almost Final Graded Draft


Criterion

4 -- Advanced

3 Above

2 Proficient

1 -- Emerging

Average
Mechanics,

Zero to very
few errors

A few errors

Several errors

Many errors
inhibit the
reading of the
text

Academic
language used
throughout
paper Law is
a major
presence

Academic
language used
through most
of paper Law
is a presence

Academic
language used
for some of
paper Lacking
law

Paper lacks
academic
language
informal
throughout

Usage,

Zero to very

A few errors

Several errors

Sentence

few errors

Many errors
inhibit reading
of text

All present
needs to fix a
few errors

All present
need to fix
several errors
or somewhat
incomplete

Missing pieces

Grammar,
Spelling
Academic
Voice and Law

Law is missing
entirely

Structure
Title,
Abstract,

All present and


correct

Body,
Reference

Uniform LSA Scoring convention


16 = 100

12 = 88

8 = 76

4 = 64

15 = 97

11 = 85

7 = 73

No submission = no score

14 = 94

10 = 82

6 = 70

13 = 91

9 = 79

5 = 67

Please do the following for final: Go through and fix everything marked
let me know if you have any questionsalsoadd another casethis one
is interesting it is about an aging former child star:

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