Understanding Elder Abuse (Part One of Two)

A new review article explores the complex issues surrounding elder abuse

Posted Aug 03, 2016

It was originally called "granny bashing" when the first stories about elder abuse came out in the 1970s. 

Since then, elder abuse has become recognized as a serious social problem that is far more prevalent than most of us care to admit.  According to the 2009 National Elder Mistreatment Survey, at least ten percent of elderly people living in American communities (4.3 million people)  experience one or more forms of elder abuse each year. This can involve financial abuse by a family member (5.2 percent), financial abuse by a stranger (6.5 percent), emotional abuse (4.5 percent), or potential neglect by a caregiver (5.1 percent).  More rarely, elder abuse can take the form of physical abuse (1.6 percent) and sexual abuse (0.6 percent) though these last two categories, along with emotional abuse, often go unreported by seniors.

Among the various reasons many elders have for not reporting what is happening to them are feelings of embarrassment, believing that they are somehow responsible for their abuse, fear of retaliation,  fear of being placed in a nursing home, not believing that help is available for them, or simply accepting that long-term abuse is "the way it's always been" and just putting up with it.  Even when people in the community, whether strangers or family members, become aware that the abuse is happening, they may often refuse to get involved believing there is nobody available to help.   

Recognizing how widespread elder abuse actually is, the 2015 White House Conference on Aging listed elder abuse, neglect, and financial exploitation as one of the the four priority topics discussed. But, as a new review article published in American Psychologist, points out, real solutions to the problem of  elder abuse remain elusive.  Written by Karen A. Roberto of Virginia Tech's Center for Gerontology and Institute for Society, Culture, and Environment, the article attempts to clear up many of the misunderstandings surrounding elder abuse as well as identifying gaps in research, treatment, and laws protecting seniors.  As Roberto points out, even coming up with a proper term for what we call elder abuse can be tricky.   Though terms such as "elder abuse", "elder mistreatment", and "elder maltreatment" are often used interchangeably in most settings, there is still disagreement over what can be considered abuse and what can't.  

Whatever term is used, most definitions recognize five different forms of abuse targeting the elderly:

  • Physical abuse -  any use of physical force that can cause bodily injury, pain, or physical impairment.  This can include hitting, slapping, punching, shoving, pinching, or burning.
  • Sexual abuse - any non-consensual sexual contact of any kind.  Unwanted sexual touching, sexual assault, sexual nudity, and forcing elders to witness nudity
  • Psychological or emotional abuse - inflicting anguish, distress, or trauma through verbal or non-verbal acts.  Can include name calling, yelling, swearing, insulting, or making threats
  • Financial abuse and exploitation - illegal or improper use of an older person's property or financial assets.  Embezzlement, misuse of funds, taking money under false pretenses, forgery.
  • Neglect or abandonment - intentional or unintentional refusal to provide basic necessities of care.  Failure to provide food, water, clothing.  Withholding proper attention or failure to meet the necessities of life.

In many cases, elders may experience more than one form of abuse.  Women appear more likely to be victimized than men though some experts argue that there is a gender bias at work since older men are less likely to report the abuse or ask for help.  There are other factors that seem to influence the likelihood of elder abuse as well.   National findings suggest that seniors aged 60 to 69 are more likely to face abuse though this often depends on the kind of abuse taking place (as one example, seniors over the age of 75 are more vulnerable to financial abuse). 

The one  factor most likely to increase the risk of being victimized is cognitive impairment.  Even in the early stages of dementia, seniors are particularly vulnerable to financial abuse while family members, including spouses, may be more likely to engage in physical intimidation or neglect if they feel overwhelmed by the responsibility of care involved with conditions such as Alzheimer's disease

As for who would carry out this kind of abuse and why, no two cases are exactly alike.  Most  elder abuse involves family members (including children, nephews/nieces, grandchildren, or spouses).  According to national statistics, about one-fourth of all elder abuse is committed by a spouse or partner. Spousal abuse is often harder to identify since it usually involves verbal and emotional intimidation rather than physical abuse (which would be more difficult to hide).

Elder abuse committed by adult children often involves preexisting problems with drug or alcohol abuse, a history of mental illness, or chronic unemployment.  Parents whose children depend on them for financial support seem to be especially vulnerable to abuse though there is no clear explanation as to why.   Abuse can also occur in households where adult children feel overwhelmed by the stress involved in caring for a parent who is partially or totally disabled. 

But it isn't just family members or spouses who may be prone to abusing the elderly.   Cases of abuse committed by retirement home staff, nurses, and other professional or volunteer caregivers can also occur. This often takes the form of financial abuse with caregivers manipulating elder patients to allow them to access their life savings.  Elderly people are often seen as easy marks for fraud or extortion leading to them being deliberately targeted by scammers and confidence artists who specialize in fleecing seniors. 

For those who have experienced elder abuse, the prognosis is often bleak.  While the consequences of physical abuse are obvious enough, with visible injuries such as broken bones, bruises, and brain trauma, the psychological effect of elder abuse is typically harder to recognize and treat. Along with the stress associated with the abuse itself, there is also the emotional impact of being victimized by a trusted family member or caretaker.  

It's hardly surprising that the long-term consequences of elder abuse can often lead to significant medical problems for the victims. This can include being prematurely institutionalized, the development of new medical problems linked to stress or trauma, and even death.

More on this next week.

To be continued

More Posts