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[edit] Introduction

As people move into their elder years they may become increasingly dependent on surrounding family members. This gradual loss of independence can give rise to the opportunity for caregivers to exploit these individuals. The exploitation of elders is considered elder abuse/neglect and can occur in a variety of forms. Males and females can be equally susceptible to elder abuse, and the perpetrators are typically family members or caregivers. Elder abuse can have a long-term effect on both genders and intervention is vital for rehabilitation.

[edit] Types of Elderly Abuse

Elderly abuse comes in many different forms. Not all victims are exposed to every form of abuse; however, all forms are harmful to the victim in different ways. There are six types of elderly abuse: sexual abuse, emotional abuse, physical abuse, neglect, abandonment and financial abuse.

[edit] Sexual Abuse

Sexual abuse is probably one of the most traumatizing types of elder abuse. Sexual abuse of the elderly includes sexual harassment, indecent assault and rape. In the majority of cases the perpetrator is not someone that the victim knows [1] The target of this type of assault is typically a woman in her 70’s or 80’s. [1] It usually occurs with the perpetrators intention of robbing the victim in his or her home[1]. These scenarios are most likely to occur at night or in the early hours of the morning. The perpetrator is often trying to display power[1]. In these types of assaults the victim is usually left seriously injured or dead [1] .

[edit] Emotional Abuse

The emotional abuse of an elderly person is usually occurs over a prolonged period of time. This type of abuse comes in the form of name calling, yelling at the victim, refusing to show the victim any type of love or compassion, and in some cases, cutting the victim off from the outside world. [2] This type of abuse is equally likely to happen to male or female victims. The victim is often abused in these situations by their caregiver[2]. The lack of attention the victim receives makes them feel undervalued and overlooked. It often leaves the victim confused as to the reason for the abuse; this may lead to victims blaming themselves for the treatment they are receiving[2].

[edit] Physical Abuse

The physical abuse of an elderly person involves the victim is being physically harmed. This type of abuse is usually done by the victim’s caregiver and is likely to target the victim’s head and torso. Often, the only way that a victim receives help in this situation is if a family member or a health care provider notices the signs of physical abuse on the victim’s body [3] Often, the abuser is the victim’s own children and the chances of this abuse occurring rise when the child of the victim is abusing alcohol.

[edit] Neglect

Elderly neglect is the major type of abuse that the elderly are experience. Neglect is when the victim’s caregiver or family members do not provide proper care to an individual [4]. This includes: failure to provide proper health care, leaving the elderly individual alone for an extended period of time, or not providing the victim with any form of companionship[4]. The individual is left alone without any feelings of togetherness, love or concern from family members. In this situation the victim feels very alone and has no reassurance that anyone cares for his or her wellbeing[4]. They are often living in fear for their health because the are not able to actively help themselves to seek treatment and their abilities to live without assistance are fairly minimal[4].

[edit] Abandonment

Abandonment is actually intense form of neglect. Abandonment has all the characteristics of neglect; however, in addition, the victim's perpetrator has absolutely no desire to provide any type of care or assistance to the victim. [5] They have essentially been cut out of the perpetrators life all together. The perpetrator is often the victim’s child. [5]. Although both men and women can experience this type of abuse, men tend to be at the most risk. Fathers tend to be abandoned by their children the most because they put less effort into staying connected to their children [5]. Fathers are also less likely to try to resolve any conflicts between themselves and their children, which may lead negative feelings between the father and child which causes abandonment.

[edit] Financial Abuse

Financial abuse is the most publicly recognized type of elder abuse. Financial abuse involves the elderly individual's primary caregivers or family members taking advantage of the victim’s finances [2]. In other words, the victim is being used for the perpetrators financial gain. This can happen to men and women and is typically inflicted upon them by their own children.

The abuse of elderly people is a disturbingly common scenario. It is important to understand the types of abuse that elderly people may experience in order to help with the prevention of such treatments.

[edit] Victims and Perpetrators

[edit] Victims

Determining whom the victims and abusers are is a key subject in elderly abuse and neglect requiring consideration. Most commonly affected by abuse are individuals aged 60-98+ years old, with the majority of victims between the ages of 70-80 years old. The National Elder Abuse Incidence Study (1998) supports these findings, reporting that women are more likely to experience elderly abuse in comparison to men.[6] However, Roberto, Teaster and Nikzad (2007) reported that there are numerous cases of male victims of sexual abuse.[7] Further, research indicates that men with physical, cognitive or emotional disabilities are at an increased risk of elder sexual abuse[7]. These incidents of abuse can happen in the home as well as in private care institutions.[1]

While elderly abuse tends to be thought of as the victimization of a primarily female victims, Stratton and Moore (2007) argue that men are also subject to victimization. Specifically, men are more likely than women to be victims of abandonment.[5]. Stratton and Moore (2007) further reported that male victims of elderly abuse are less likely to report their situation (p.79), which could provide an explanation for the higher number of abuse cases reported by females over males [5]. Perhaps the low reporting rate of males is the reason why elderly abuse is primarily thought of as female victimization.

The National Elder Abuse Incidence Study (1998) demonstrated that victims aged 60 and older nationwide in the United States were 84% White, 8.3 % Black, 5.1% Hispanic, 2.1% Asian, and 0.4% Native.[6] Elderly abuse from racial and ethnic categories tend to be underrepresented.[6] This could be for a variety of reasons including failure to report, a trend traditionally seen in racial and ethnic groups. Further, each additional racial or ethnic group had its own trends in elderly abuse. For example, Dimah and Dimah (2002) studied elderly abuse and gender differences in African Americans [8]. It was found that older African American’s were more likely to be victims of financial abuse and neglect [8]. However there were no specific gender differences between male and female victims.[8]

[edit] Perpetrators

The National Elder Abuse Incidence Study (1998) found that 52.2% of elderly abuse cases involved male perpetrators, while 47.5% involved female perpetrators.[6] Therefore, offenders of elderly abuse and neglect are most often male, between the ages of 16 to 30. Furthermore, male perpetrators were more likely than females to use physical force in abusive situations, even employing weapons to gain compliance in all forms of elderly abuse.[1] Stratton and Moore (2007) found that adult-children accounted for 47% of elderly abuse perpetrators.[5] Dimah and Dimah (2002) found that both male and female perpetrators studied were involved in caring for their aging relatives.[8] However, males, rather than females, were more often living with the victim during the period of abuse, and daughters tended to be more abusive in comparison to sons.[8]

The National Elder Abuse Incidence Study (1998) found that females perpetrators were responsible in 52.4% of elder neglect cases [6]. Emotional and psychological abuse data showed that 60.1% of perpetrators were male.[6] 62.6% were males in the case of physical abuse, while abandonment more often occurred with males as well at 83.4%.[6] It is interesting to note that neglect was the only type of abuse that was perpetuated almost-equally among males and females [6]. Males were more often perpetrators in all other types of elderly abuse. Karch and Nunn, (2011) supported this notion that the caregivers for victims of elder abuse were most often male [9]. Karch and Nunn (2011) stated that typically the husbands or sons of the victim were more likely to perpetuate abuse rather than wives or daughters [9]. In cases of sexual elder abuse, 88.2% of the perpetrators were male while the remaining 11.8% were female.[7]

To conclude, in order to prevent cases of elderly abuse and neglect there is a strong need for victims to be educated on their rights as well as protection against abuse.[7]

For a more detailed description of demographics of victims and perpetrators of elderly abuse and neglect, please visit The National Elder Abuse Incidence Study

[edit] Effects and Intervention

[edit] Psychological Effects

abused elderly

With the increase of the aging population, it is beneficial for caregivers and professionals to be aware of the impacts of abuse and neglect on the elderly individuals they care for. Recognizing the effects the abuse has on the individuals will aid in the intervention and rehabilitation of the victims. For both males and females, high levels of psychological distress are demonstrated after becoming a victim of elderly abuse. [11] Psychological distress refers to negative perception of oneself,and it is a feeling many victims have. Individuals affected by abuse or neglect and suffering from psychological distress can seek relief through social support. [11] Social support has a favourable effect on the distress levels of many individuals. The support provides the victim with a distraction from his problems and allows the individual to seek help and advice to deal with the abuse and prevent further abusive encounters. [11]

[edit] Effects on Health

Several aspects of the elderly abuse affect women differently than men. Elderly individuals who are abused experience an increase in health conditions when compared to the average aging individual. [12] Physical and mental conditions are often described as chronic health problems which often occur. The consequences from emotional abuse are drastic, including bone ,joint problems, digestive, and heart problems, higher blood pressure, as well as anxiety and depression. [12] When women are abused in various ways multiple times, the risk for health conditions increases.[12]Male victims are also at risk for poorer health and are often in need of a full medical assessment after their mistreatment is recognized.[13]

[edit] Effects on Emotion

When given the opportunity, men are more open to talk about the abuse and mistreatment. However, male victims are not frequently taken seriously and are offered less support, although when support is available emotional gains are portrayed. [13] Contrary to women, after help is sought, men have minimal contact with their social workers while women continue to communicate. [13] Both women and men feel a loss of independence and empowerment.[13] All of the victims have to deal with various losses such as loss of contact with outside people, control over their lives. [11] Abuse and neglect of elders is detrimental to their health and independence.

[edit] Interventions

Responding to elder abuse is crucial. Once the problem has been identified, services must be offered to the victims; however, identification can prove to be a problem and leave victims at a disadvantage. [14]

Most cases are solved while the victims are hospitalized for an unrelated health reason which is generally only a brief period of time, and therefore, a clear assessment tool is needed. [15] Intervention techniques have been improving within the past decade due to the recognized abuse within the aging population.[14] The victim’s willingness to cooperate in intervention and their cognitive abilities that have been disrupted affect the outcomes of the intervention. [16] It is important for professionals to become educated and trained in recognizing and rehabilitating victims from abuse or neglect. [14] The medical team as well as mental health professionals must provide effective and appropriate services. [15]

The rehabilitation process includes: proper assessment and documentation, preventative mechanisms for future cases and various types of interventions. [14]Depending on the type of mistreatment, some of the interventions recommended are: practical help around the house, legal help with documents, therapeutic measures and protection or safety measures. Although, various types of abuse call for different measures and degrees of help. [14] Counselors, social workers and perhaps a medical team may need to be involved. [15] The process of formulation, implementation and termination of unhelpful mechanism demonstrates a strategic way of recovering for the victims.[16] Formulating a plan involves contacting the client, their family and various healthcare professionals to identify information about the abuse or neglect and the patient’s health.[16]

Ultimately, the goal of intervention is to allow the victim to feel a sense of empowerment and independence once again. [14] Intervention is critical to aid in eliminating and lessoning the negative effects on these abused or neglected elders. In order for intervention to occur, the problem must be recognized and reported. The Government of Canada offers several ways to do so on their website:

[edit] Notes and References

  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Jeary (2005). Sexual abuse and sexual offending against elderly people: A focus on perpetrators and victims. The Journal of Forensic Psychiatry and Psychology, 16(2), 328-343.
  2. 2.0 2.1 2.2 2.3 Peretti and Majecen (1991). Emotional Abuse Among the Elderly: Affecting Behavior Variables. Social Behavior and Personality, 19(4), 255-261.
  3. Friedman, Avila, Tanouye and Joseph (2011), A Case-Control Study of Sever Physical Abuse of Older Adults, 59(3).
  4. 4.0 4.1 4.2 4.3 Fulmer, Paveza, VandeWeerd and Fairchild (2005). Dyadic Vulnerability and Risk Profiling for Elder Neglect. ProQuest Nursing & Allied Health Source. 45(4), 525.
  5. 5.0 5.1 5.2 5.3 5.4 5.5 Stratton and Moore (2008). Fractured Realtionships and the Potential for Abuse of Older Men. Journal of Elder Abuse & Neglect.
  6. 6.0 6.1 6.2 6.3 6.4 6.5 6.6 6.7 National Center on Elder Abuse at the American Public Human Services Association In Collaboration with Westat, Inc. (1998). The national elder abuse incidence study: Final report. Washington, DC: National Aging Information Center.
  7. 7.0 7.1 7.2 7.3 Roberto, K. A., Teaster, P. B., and Nikzad, K. A. (2007). Sexual abuse of vulnerable young and old men, Journal of Interpersonal Violence, 22:8, 1009-1023
  8. 8.0 8.1 8.2 8.3 8.4 Dimah, A., & Dimah, K. P. (2002). Gender differences among abused older african americans and african american abusers in an elder abuse provider agency. Journal of Black Studies, 32:5, 557-573
  9. 9.0 9.1 Karch, D., and Nunn, K. C. (2011): Characteristics of elderly and other vulnerable adult victims of homicide by a caregiver: National violent death reporting system – 17 U.S. states, 2003-2007, Journal of Interpersonal Violence, 27:1, 137-157
  10. Kinnison, K. (2009). Genesis Mediation. Retrieved from://
  11. 11.0 11.1 11.2 11.3 Comijs, H.C., Pennix, B.W., Knipscheer, K.P., & Van Tilburg, W. (1999). Psychological distress in victims of elder mistreatment: The effects of social support and coping.Journal of Gerontology: Psychological Sciences, 54.(4), 240-245.
  12. 12.0 12.1 12.2 Fisher, B.S., & Regan, S. L. (2006) The extent and frequency of abuse in the lives of older women and their relationship with health outcomes. The Gerontologist, 46 (2), 200-209.
  13. 13.0 13.1 13.2 13.3 Pritchard, J. (2002). Male victims of elder abuse: Their experiences and needs. Retrieved from experiences-and-needs.
  14. 14.0 14.1 14.2 14.3 14.4 14.5 Penhale, B. (2010). Responding and intervening in elder abuse and neglect. Aging Internations, 35, 235-252.
  15. 15.0 15.1 15.2 Imbody, B., & Vandsburger, E. (2011). Elder abuse and neglect: Assessment tools, interventions, and recommendations for effective service provision. Educational Gerontology, 37 (7), 634-650.
  16. 16.0 16.1 16.2 Quinn, M. J., & Tomita, S.K. (1997). Elder abuse and neglect: Causes, diagnosis, and intervention strategies. New York, NY: Springer Publishing Company.
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