What is Elder Abuse?
Most older people do not experience abuse. But, unfortunately, there are ways in which an older person can be harmed or abused by others. An older person may also experience more than one form of abuse at any given time.
Elder abuse is defined as -
''A single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person or violates their human and civil rights.'' (Protecting our Future, Report of the Working Group on Elder Abuse, September 2002)
65 years of age is taken as the point beyond which abuse may be considered to be elder abuse.
What forms can Elder Abuse take?
There are several forms of abuse, any or all of which may be carried out as the result of deliberate intent, negligence or ignorance.
- Physical abuse, including hitting, slapping, pushing, kicking, misuse of medication, restraint or inappropriate sanctions.
- Sexual abuse, including rape and sexual assault, or sexual acts to which the older adult has not consented, or could not consent, or into which he or she was compelled to consent.
- Psychological abuse, including emotional abuse, threats of harm or abandonment, deprivation of contact, humiliation, blaming, controlling, intimidation, coercion, harassment, verbal abuse, isolation or withdrawal from services or supportive networks.
- Financial or material abuse, including theft, fraud, exploitation, pressure in connection with wills, property, inheritance or financial transactions, or the misuse or misappropriation of property, possessions or benefits.
- Neglect and acts of omission, including ignoring medical or physical care needs, failure to provide access to appropriate health, social care or educational services, the withholding of the necessities of life such as medication, adequate nutrition and heating.
- Discriminatory abuse, including ageism, racism, sexism, that based on a person's disability, and other forms of harassment, slurs or similar treatment.
How Common is Elder Abuse?
Establishing an accurate baseline of the prevalence of elder abuse is difficult. It is not always appropriate to draw generalisations from results of prevalence surveys due to problems with definitions and with research data and methodology. Most global researchers agree that somewhere in the region of 4-5% of the population of older people are potentially effected by abuse or neglect and that the majority of those affected by abuse are women. International prevalence studies suggest that between 3 and 5% of older people are victims of elder abuse when all types of abuse are considered. The more severe forms of abuse, such as physical and sexual are relatively rare (World Health Organisation 2002).
The first prevalence study of elder abuse for the UK undertaken by researchers from King’s College Institute of Gerontology and Social Care Workforce Research Unit and with the National Centre foe Social Research (NatCen) was published in June 2007. 2,100 older people in England, Scotland, Wales and Northern Ireland took part in the survey, between March and September 2006. It included older people aged 66 years and over. It did not include people living in institutions like the NHS or Care Homes, or people with dementia. Overall 2.6% of older people living in the community were found to have experienced mistreatment from a relative, friend or professional carer. This figure indicates that one out of every forty older people visiting their GPs may be a victim. When figures were broadened to include neighbours and acquaintances, the overall prevalence increased from 2.6% to 4.0% of older people over the age of 66 being abused while living in their own home. This equates to about 342,000 people.
Applying the WHO figure of approx. 3 to 5% to Ireland could mean that 12,000 to 21,500 could be victims of elder abuse.
Who might abuse?
A wide range of people may abuse older people, including relatives and family members, professional staff, paid care workers, volunteers, other service users, neighbours, friends and associates.
Where might abuse occur?
Abuse can take place in any context. It may occur when an older person lives alone or with a relative; it may occur within residential or day-care settings, in hospitals, home support services and other places assumed to be safe, or in public places.
Patterns of abuse and abusing vary and reflect different circumstances:
- Long-term abuse, in the context of an ongoing family relationship, such as domestic violence or sexual abuse between spouses or generations.
Opportunistic abuse, such as theft occurring because money has been left around.
Situational abuse, which arises because pressures have built up and/or because of the difficult or challenging behaviour of the older person.
- Neglect of a person's needs because those around him or her are not able to be responsible for their care; for example if the carer has difficulties because of debt, alcohol or mental health problems.
- Unacceptable 'treatments' or 'programmes', which include sanctions or punishment, such as the withholding of food and drink, seclusion, the unnecessary and unauthorised use of control and restraint, or the over, or under, use of medication.
- Racist, ageist and other discriminatory practices by staff, including ageism, racism and other discriminatory practices, which may be attributable to the lack of appropriate guidance.
- Misappropriation of benefits and/or use of the person's money by other members of the household or by care staff.
- Fraud or intimidation in connection with wills, property or other assets
Reasons why Incidents of Elder Abuse go Unreported?
- Non-recognition – Victims might not be aware that the abuse is abnormal or wrong
- Confusion – Victims attributing feelings about the abuse to dementia etc.
- Control – Victims may perceive the event as under their control; perceive abilities to cope with the abuse; or fear that if the abuse is disclosed, someone else will take control of their life.
- Rationalisation – Self-blame; "It could have been worse"; Feeling they are getting what they deserve, for example, if they feel they were a bad parent. Elders often feel they have lost control of their lives and are to blame for the abuse.
- Shame – Fear of being judged by others
- Fear of abandonment/dependency – "If the abuser leaves who will take care of me?"
- Fear of being placed in an institution
- A belief that the Gardaí or the social services cannot help them
A belief that they cannot prove that the abuse is happening
If you, or somebody you know is experiencing elder abuse visit our Help for older people who are experiencing abuse in the home page