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Preventing & Responding to Domestic & Sexual Violence in Later Life

 

Introduction

This special collection brings together selected materials related to preventing and responding to elder abuse and abuse in later life. It draws from the work of the National Clearinghouse on Abuse in Later Life (NCALL), National Sexual Violence Resource Center (NSVRC), National Center on Elder Abuse (NCEA), National Adult Protective Services Agency (NAPSA) and other organizations. By focusing specifically on domestic and sexual violence (DV/SV) in later life, this special collection highlights the complexities of older people's DV/SV experiences and emphasizes collaborative and multi-pronged approaches to addressing DV/SV in later life. Accordingly, the materials included in this special collection have been organized by their relevance to key stakeholders.

Although particular effort was made to include materials related to addressing elder abuse and abuse in later life in diverse groups of older people, very few materials in this special collection focus on elder abuse and abuse in later life within culturally diverse communities. This limitation is due to significant gaps in current literature.

This special collection was developed by the Minnesota Center Against Violence and Abuse (MINCAVA) in July 2010 and updated by the National Clearinghouse on Abuse in Later Life (NCALL) in June 2013. The National Resource Center on Domestic Violence (NRCDV) updated the collection in May 2014 in preparation for World Elder Abuse Awareness Day (WEAAD), observed each year on June 15th.

Overview and Definitions

 

 

PElder Abuse: A Growing Problem

 

Elder abuse is a hidden yet growing problem in the United States with significant public health and societal implications. It is a tragedy that impacts older adults of all races, cultures, sexual orientations, social classes, geographic areas, faith communities, mental capacities, and physical abilities. Until victim service providers, the justice system, health care professionals, social service agencies, and other community members work together to address this problem, elder abuse will continue unabated, with devastating consequences for older adults and their loved ones.

Although definitions of elder abuse vary, the term generally refers to any physical, sexual, or psychological abuse, neglect, abandonment, or financial exploitation of an older person either within a relationship where there is an expectation of trust and/or when an older person is targeted based on age or disability (U.S. DOJ, 2013). Older adults may be harmed by spouses or partners in heterosexual, gay, or lesbian relationships, adult children or other family members, caregivers or persons in a position of authority such as guardians, lawyers, or interpreters. In some instances older adults may be targeted by strangers and become victims of sexual assault, stalking, or financial exploitation. The various forms of abuse often co-occur (Acierno, 2010; Lifespan of Greater Rochester et al., 2011).

Older victims often experience shame, pain, economic loss, spiritual and physical anguish, institutionalization, and poor quality of life (Beaulaurier et al., 2008; Brandl et al., 2007; Dong et al., 2011). Studies suggest that older adults exposed to physical and verbal abuse have a greater mortality risk than those who did not experience violence (Baker, 2009; Dong et al., 2011; Lachs, 1998).

Research estimates that approximately one in ten older adults living in their homes experience elder abuse each year (Acierno et al., 2010; Beach et al., 2010; Lifespan of Greater Rochester et al., 2011). In addition, evidence is emerging that shows this rate is especially high in racial and ethnic minority groups (Beach et al., 2010; DeLiema et al., 2012). The current economic crisis has further exacerbated the problem, as the frequency of reported financial exploitation of older adults (which is often coupled with other forms of abuse) has increased (Gunther, 2011; MetLife, 2009).

Yet research suggests that cases of elder abuse are significantly underreported. One state study found fewer than 5% of cases come to light (Lifespan of Greater Rochester et al., 2011). Furthermore, a significant number of elder abuse cases that are actually reported or identified end up slipping through the cracks due to a lack of coordination among service providers (Brandl et al., 2007; Connolly, 2010; Lifespan of Greater Rochester et al., 2011).

Description: http://www.aoa.gov/aoaroot/aging_statistics/future_growth/future_growth.aspx

Unfortunately, as 77 million baby boomers age, the problem is only expected to worsen. Within the next 40 years, the number of individuals age 65 and older is projected to more than double so that in 2050, they will account for over 20% of the population (U.S. Census Bureau, 2012).

* The content of this section was adapted from the NCALL information sheet, An Overview of Elder Abuse: A Growing Problem (2013).

What distinguishes abuse in later life from elder abuse?

Abuse in later life (ALL) is the willful abuse, neglect, or financial exploitation of an older adult that is perpetrated by someone in an ongoing relationship (e.g., spouse, partner, family member, or caregiver) with the victim. As such, the term abuse in later life—used by the Office on Violence Against Women, the National Clearinghouse on Abuse in Later Life, and a number of domestic violence and sexual assault programs throughout the country—calls attention to the nexus between domestic violence, sexual assault, and elder abuse.

Other terms are also used to define abuse of older adults. Elder abuse is a broad term that applies to abuse, neglect, and exploitation of an older individual in a trusting relationship with the offender. Elder abuse also includes harm that occurs because an older person is targeted based on age or disability (U.S. DOJ, 2013), such as in contractor scams. In many jurisdictions, elder abuse may also include self-neglect. Abuse of vulnerable, dependent, or at-risk adults generally refers to harm of persons 18 or older who are unable to protect themselves or report the abuse.

Abuse in later life is the segment of elder abuse that focuses specifically on those cases where the abuse is perpetrated by someone in an ongoing relationship (e.g., spouse, partner, family member, or caregiver) with the victim. Sexual abuse and stalking by an offender who is known to the victim or a stranger is also included in the definition. Older persons who fit the statutory definition in their jurisdiction of vulnerable adults and are in a relationship with their abuser may also be victims of abuse in later life. Power and control dynamics, similar to those seen in domestic violence and sexual assault cases involving younger victims, are often present in abuse in later life situations; therefore, older victims may benefit from services provided by domestic and sexual violence programs.

Dynamics of Abuse in Later Life

To formulate an appropriate response to cases of abuse in later life, it is critical to understand the dynamics present. Perpetrators will often strive to exert their power and control over victims so they can coerce or manipulate some benefit for themselves, such as money, a place to stay, access to prescription medication, or sexual gratification (Bancroft, 2002; Stark, 2007). These abusers are often greedy and feel entitled to do whatever necessary to get what they want. They may financially exploit an older adult, feeling entitled to take a Social Security check or empty a bank account. In order to maintain power and control, these abusers typically use various coercive tactics including physical and psychological abuse and isolation. Abusers may intimidate their victims and prevent them from reporting the exploitation or abuse out of fear of retaliation. They may also lie and manipulate family members, friends, and professionals in order to hide or justify their behavior (Bancroft, 2002; Stark, 2007).

In addition to cases of abuse in later life, older adults may be harmed even if power and control dynamics or greed are not present. Domestic and sexual violence victim advocates may have a role to play in these situations as well. For example, sometimes an older adult is harmed by a well-intended caregiver who provides inadequate or inappropriate care. In other cases, an older adult is harmed by a person with an organic medical or mental health condition who is unable to control his or her behavior. In these situations, often the older individual experiences fear and trauma. Many of these older adults who have been harmed can benefit from remedies offered by domestic or sexual violence programs, such as safety planning, emergency housing, or legal advocacy.

Additional factors may be present, further complicating abuse in later life cases. If the abuser is an adult child, victims often protect their child rather than focusing on their own personal safety. Older victims may feel shame, guilt, and embarrassment because they are being abused by their child. Some victims have physical or cognitive limitations that abusers can target to manipulate them through the breaking of assistive devices, the denying of health care or comfort measures, and threatening to place them in a nursing home.

Forms of Abuse in Later Life

Abuse in later life includes physical, psychological, and sexual abuse, neglect, and financial exploitation. Harassment and stalking may also be included. Often forms of abuse co-occur in cases involving abuse in later life.

Self-Neglect: While many state statutes include self-neglect as a form of elder abuse, cases of self-neglect do not fall within the definition of abuse in later life. The phrase abuse in later life was created to acknowledge that older victims generally know and are in a relationship with their abuser. Since there are no offenders when self-neglect occurs, these cases are outside the scope of abuse in later life. Domestic violence and sexual assault victim advocates and criminal justice professionals are less likely to be involved in cases of self-neglect, which typically involve responses by adult protective services, social services agency workers, and health care providers.

Relationship Between Victim and Abuser

Older victims may be abused by intimate partners, adult children, grandchildren, or other family members, caregivers, or persons in positions of authority. Society expects that these relationships are based on trust and care. In the majority of abuse in later life cases the perpetrator is the victim’s family member or intimate partner (Acierno et al., 2010; Lifespan of Greater Rochester et al., 2011). Intimate partner violence may have been present for the entire duration of the relationship or it may emerge later in life as the couple ages. Abuse can occur in heterosexual, lesbian or gay relationships.

Victim Gender

Females, males, and those who don’t identify with a specific gender identity may be victims of abuse in later life. The majority of older victims of intimate partner violence and sexual abuse in later life are women (Acierno, 2013; Bureau of Justice Statistics, 2013).

Victim Age

When defining elder abuse, most states, tribes, and organizations use a minimum age threshold that ranges from 50 to 70. The term abuse in later life applies to victims who are age 50 and older for the following reasons:

Where Abuse Happens

Abuse in later life can take place in any setting (e.g., a house, apartment, residential health care setting, a doctor’s office, or in a public place, such as at work or in a courthouse). Most often, it occurs where the victim resides.

Responding to Abuse in Later Life

By understanding the unique dynamics of abuse in later life, domestic and sexual violence victim advocates can make a difference. Many older victims of abuse benefit from remedies offered by domestic or sexual violence programs such as safety planning, individual or group counseling, emergency housing, and medical or legal advocacy. The criminal justice system may play a beneficial role by holding the offender accountable. Given the complexity of these cases, collaboration with the aging services network, adult protective services, health care providers, and others is often essential.

* The content of this section was adapted from the NCALL information sheet, An Overview Abuse in Later Life (2013).

Abuse in later life and Elder Abuse: Including domestic violence, dating violence, sexual assault & stalking

This section presents resources and research articles that offer an overview of abuse in later life and elder abuse, including domestic violence, dating violence, sexual assault, and stalking. The section on cultural considerations lists some selected materials representing diverse perspectives on elder abuse.

Overview and dynamics
The materials included in this section present information about elder abuse and abuse in later life, with a specific focus on domestic and sexual violence in later life.