Objectives: Japan enacted the elder abuse law in April 2006. The present study was aimed to examine the progress of systems development and difficulties with implementing activities in municipal governments for dealing with elder abuse after the law. Methods: Between 11 and 22 December 2006 a paper questionnaire was sent to all 1840 Japanese municipalities and received 917 responses (49.8%). The municipalities were divided into three groups according the number of elder abuse management activities they had implemented: an advanced group (N = 257), a middle group (N = 348), and a less advanced group (N = 312). Results: The law increased the implementation of activities related to reporting systems (46.2-49.1%) and activities for increasing awareness of elder abuse among service providers (30.7-35.8%). The most frequent activities with no plans for implementation were the establishment of intervention teams (43.7-55.5%) and multi-agency networks (47.7-64.2%). All groups reported difficulties carrying out home visits to investigate reported cases of abuse (53.6-61.5%) and difficulties approaching reported cases where there was resistance to outside support (42.4-76.6%). Conclusions: The law was significant step in activities related to reporting systems and activities for increasing awareness among service providers. Further policy should address how to establish intervention teams and multi-agency networks, how to carry out home visits to investigate reports, and how to approach cases resistant to outside support.
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