Elder Abuse

• Background
• Overview
• Physical Abuse
• Sexual Abuse
• Psychological Abuse
• Financial Abuse
• Neglect
• Bibliography
• For Additional Information

  • There are presently about 39 million individuals over the age of 65; the U.S. Census Bureau projects that more than 62 million Americans will be 65 or older in 2025 (McCoy and Hansen, 2004).

  • Older women (67%) are far more likely than men (32%) to suffer from abuse and slightly more than half of the alleged perpetrators of elder abuse were female (53%). (National Center on Elder Abuse Study, 2004).

  • Twenty percent of elder abuse involved caregiver neglect; 15% centered on emotional, psychological, or verbal abuse; 15% involved financial exploitation; 11% was physical abuse, and 1% was sexual abuse (Teaster, National Center on Elder Abuse, 2006).

  • In 2004, Adult Protective Services received a total of 565,747 reports of elder abuse for persons of all ages from 50 states, plus Guam and the District of Columbia, and investigated 461,135 reports. Of that number, APS substantiated 191,908 reports of elder abuse for victims of all ages, representing a 16% increase from the 2000 survey. (National Center on Elder Abuse Study, 2004).

  • Because older victims usually have fewer support systems and reserves – physical, psychological, and economic – the impact of abuse and neglect is magnified, and a single incident of mistreatment is more likely to trigger a downward spiral leading to loss of independence, a serious complicating illness, and even death. (Burgess and Hanrahan, 2006).

  • Of alleged perpetrators of elder abuse, 33% were adult children, 22% were other other family members; 16% were strangers, and 11% were spouses/intimate partners (Teaster, National Center on Elder Abuse, 2006).

Background

According to the Attorney General's Family Violence Task Force, references to elder abuse can be traced throughout Greek mythology, the writings of Shakespeare and modern literature. Yet, it has only been in the last twenty years that serious attention has been given to family violence and elder abuse. Perhaps, at least in part, this elevated consciousness can be attributed to the increasing numbers of aging Americans (Commonwealth of Pennsylvania, 1988).

An important step towards recognizing elder abuse occurred in 1978 when Suzanne Steinmetz presented her research on the abuse of the elderly to the Congressional Subcommittee hearings on domestic violence. Her testimony prompted the House Select Committee on Aging, chaired by the late U.S. Representative Claude Pepper, to further examine the mistreatment of the elderly. The "Pepper Committee" subsequently introduced the term "elder abuse," and alerted the nation to the widespread severity of this problem (Commonwealth of Pennsylvania, 1988).

Overview

The effects of the baby boom and increased life expectancy have both contributed to the immediate and projected increase in the number of elderly Americans. Medical advances and the implementation of "protective legislation" have greatly increased the length of life for many Americans (Griffin and Williams, p. 19, 1992).

Yet, other simultaneous societal changes may have contributed to the predisposition of some individuals to become abusive towards the elderly. In previous generations extended family members could share the responsibility of caring for the aging. However, increased mobility, strained economic times and smaller nuclear families have limited familial resources. Currently, the responsibility of elder care usually falls on a select few (Griffin and Williams, p. 20, 1992).

The definitions and statistics regarding elder abuse vary. They range from estimates that one out of ten persons living with a family member is subject to abuse-approximately 2.5 million a year (Griffin and Williams, p. 20, 1992)--to 1 in 25 elderly persons being victimized annually (Heisler, 1991). Still others conclude that 3.6 percent of our Nation's elderly citizens are victims of abuse each year (Commonwealth of Pennsylvania, 1988). Most researchers agree that the abuse of the elderly fall within the five following categories: physical abuse, sexual abuse, psychological abuse, financial abuse and neglect.

Physical Abuse

"Non-accidental physical force that results in injury" (Commonwealth of Pennsylvania, 1988).

Indicators:

• fractures and dislocations;
• lacerations and abrasions;
• burns;
• injuries to the head, scalp, face; and/or
• bruises-on upper arms (from shaking), around wrists or ankles (from being tied down), in shapes similar to objects, inside of thighs or arms (Bloom, p. 41, 1989).

Physical frailty, decreased physical ability, and vision and audio impairments make older persons especially susceptible to physical abuse (NOVA, 1985).

Sexual Abuse

"Non-consensual sexual contact" (Commonwealth of Pennsylvania, 1988).

Indicators:

• sexually transmitted diseases; and/or
• pain, itching, bleeding or bruising in the genital area.

As elderly victims are less physically able, often all that is needed to subdue them during a sexual assault is intimidation by physical force (Muram, Miller and Cutler, 1992).

Psychological Abuse

"Infliction of mental anguish by threat, intimidation, humiliation, or other such conduct" (Commonwealth of Pennsylvania, 1988).

Indicators:

• low self-esteem;
• overly anxious or withdrawn;
• extreme changes in mood;
• depression;
• suicidal behavior; and/or
• confusion or disorientation (Bloom, p. 41, 1989).

Diminished ability to cope with stress, termed a "decrease in homeostatic capacity," as well as the state of "chronic loss" that often accompanies aging (i.e., loss of one's home, peers, spouse, etc.), renders elders susceptible for psychological abuse (NOVA, 1985).

Financial Abuse

"Unauthorized use of funds or property" (Commonwealth of Pennsylvania, 1988).

Financial abuse or exploitation involves the theft or conversion of money or property belonging to an elder, accomplished by force, misrepresentation, or other illegal means often by taking advantage of the elder's partial or total lack of legal competency (Hyman, p. 6, 1990).

The loss of what may appear to be a minimal amount of money to some may account for a substantial loss for an elder person. It may result in the elder having to go without food, medication, or possibly his or her apartment.

Neglect

"Failure to fulfill a caretaking obligation" (Commonwealth of Pennsylvania, 1988).

Indicators:

• poor personal hygiene;
• signs of overmedication, undermedication, and/or misuse of medication (Bloom, p. 42, 1989);
• incontinent elder dressed in soiled clothing;
• elder left alone and deprived of stimulation and affection (Skeates and Douglas, 1990); and/or
• malnutrition (Bloom, p. 42, 1989).

The different types of neglect include the following:

Active Neglect:

willful failure to provide care.

Passive Neglect:

inadequate knowledge or infirmity of caretaker, resulting in non-willful failure to provide care.

Self-neglect:

failure of elder to care for her or himself (Commonwealth of Pennsylvania, 1988).

In addition to the abuse that elderly persons are subject to by relatives and/or caretakers in their homes or in institutions, they may also become targets for criminal victimization. Contrary to popular assumptions that elderly citizens are disproportionately victims of crime as a result of their physical limitations, in reality, they are the least victimized age group. Yet, further examination does reveal that elderly persons may be subject to more severe crimes, and that they are more fearful of crime; thus the consequences of victimization are often more detrimental (Commonwealth of Pennsylvania, 1988).

The low victimization rate for elderly persons may be explained by their lifestyles, which limit the amount of time they spend out in the evening and their contact with likely offenders. However, this does not safeguard them from becoming victims of serious crimes. Research indicates that personal larceny with contact (pocket-picking, purse snatching), a significant and dangerous crime as it involves both theft and personal contact, is the most common crime against elderly Americans. Robbery, inclusive of both theft and assault, is second in frequency. In addition, the following are further aspects that characterize the severity of crimes against the elderly:

• Elders are twice as likely as younger persons to be victimized in or near their homes.
• Elders are more often victimized by offenders with weapons, including firearms.
• Elders are more likely than younger persons to be victims of violent crime perpetrated by strangers.
• Elders suffer greater physical, psychological, and financial loss when victimized.
• Elders are more easily injured, heal more slowly, are less resilient emotionally, and are less financially stable than younger victims (Commonwealth of Pennsylvania, 1988).

As the number of aging Americans continues to increase, the abuse and victimization of the elderly will become a national problem of even greater proportion. Effective programs to detect elder abuse and to treat its victims are necessary and should be established in every community.

References

Administration on Aging. (2000). Profile of Older Americans:2000. Washington, DC: U.S. Department of Health and Human Services.

Bloom, Judy S., Pamela Ansell, and Matthew N. Bloom. "Detecting Elder Abuse: A Guide for Physicians." Geriatrics, Volume 44(6), June 1989.

Bureau of Justice Statistics. (2001). Criminal Victimization 2000. Washington, DC: U.S. Department of Justice.

Burgess, A., and N. Hanrahan, "Identifying Forensic Markers in Elderly Sexual Abuse," National Institute of Justice, Washington, DC, 2006.

Commonwealth of Pennsylvania. "Attorney General's Family Violence Task Force: Violence Against Elders." September 1988.

Griffin, Linner Ward and Oliver J. Williams. "Abuse Among African-American Elderly." Journal of Family Violence, Volume 7(1), 1992.

Heisler, Candace J. "The Role of the Criminal Justice System in Elder Abuse Cases." Journal of Elder Abuse and Neglect, Volume 3(1), 1991.

Hyman, Jerry A. "From the Frontlines: Financial Abuse and Legal Assistance." NARCEA Exchange, Volume 2(4), September 1990.

McCoy, K., and B. Hansen.  "Special Report: Havens for Elderly May Expose Them to Deadly Risks," USA Today, May 25, 2004.
Muram, David, Kristin Miller and Amos Cutler. "Sexual Assault of the Elderly Victim." Journal of Interpersonal Violence, Volume 7(1), March 1992.

National Center on Elder Abuse. (September, 1998). National Elder Abuse Incident Study; Final Report. Washington, DC: Administration for Children and Families, Administration on Aging, U.S. Department of Health and Human Services.

National Center on Elder Abuse, 2004 Survey of State Adult Protective Services: Abuse of Adults 60 Years of Age and Older, prepared for the National Center on Elder Abuse, 2006.
NOVA. "The Elderly Crime Victim." Network Information Bulletin, Volume 2(2), September 1985.

Skeates, Elizabeth and Ian Douglas. "Abuse of Elderly People." Nursing, Volume 4(6), 1990.

For further information, please contact:

National Center for Victims of Crime
2000 M Street NW, Suite 480
Washington, DC 20036
Phone: (202) 467-8700
Our helpline is staffed Monday through Friday 8:30am to 8:30pm EST:
Toll-free Helpline: 1-800-FYI-CALL (1-800-394-2255)
Fax: (202) 467-8701
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Email: gethelp@NCVC.org
www.ncvc.org

National Center on Elder Abuse (NCEA)
Clearinghouse on Abuse and Neglect of the Elderly (CANE)
Center for Community Research and Services
University of Delaware
297 Graham Hall
Newark, Delaware 19716
Phone: (302) 831-3525
www.ncea.aoa.gov
www.cane.udel.edu

National Committee for the Prevention of Elder Abuse
1612 K Street, NW
Washington, DC 20006
Phone: (202) 682-4140
www.preventelderabuse.org

National Adult Protective Services Association
1900 13th Street, Suite 303
Boulder, Colorado 80302
Phone: (720) 565-0906
Fax: (303) 443-3361
www.apsnetwork.org

National Center on Elder Abuse
1201 15th Street, NW, Suite 350
Washington, DC 20005
Phone: (202) 898-2586
Fax: (202) 898-2583
www.elderabusecenter.org

Your local prosecutor's office, law enforcement, or state Attorney General's office. Check in the Blue Pages of your local phone book under the appropriate section heading of either "Local Government," "County Government," or "State Government."

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