Aging Matters | Abuse & Exploitation

It is estimated that one in ten adults over the age of 60 is a victim.  But the truth is we don’t know for certain how many older adults are suffering from abuse. In the eighth edition of Aging Matters, Nashville Public Television explores the issues behind elder abuse, neglect and exploitation. 

Experts suggest that our understanding of elder abuse lies decades behind that of child abuse and domestic violence. Elder abuse is underreported. It lacks clear legal definition and is complicated by ethical challenges.  The system of response is different depending on where you live.

What are the risk factors, what can we do to protect ourselves and our loved ones, and what is our responsibility to intervene for those in need? The questions are simple, but the answers are not.  Find out more in Aging Matters – Abuse & Exploitation.

Abuse & Exploitation: Panel Discussion

Abuse & Exploitation | The Experts

Statistics Explained

What is Elder Abuse?

“Physical, sexual, or psychological abuse, as well as neglect, abandonments, and financial exploitation of an older person by another person or entity, that occurs in any setting (e.g. home, community, or facility), either in a relationship where there is an expectation of trust and/or when an older person is targeted based on age or disability.”

Source:   National Center on Elder Abuse  [Link]

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Where Does Elder Abuse Occur? Most abuse occurs where the elder lives, in their own home.

A relatively small number (1.5 million) and percentage (3.2%) of the 65+ population in 2014 lived in institutional settings. Among those who did, 1.2 million lived in nursing homes. However, the percentage increases dramatically with age, ranging (in 2014) from 1% for persons 65-74 years to 3% for persons 75-84 years and 10% for persons 85+

Source:   Administration on Aging, A Profile of Older Americans: 2015, Page 5  [Link

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Who are the perpetrators?

In a study of 4,156 older adults, family members were the most common perpetrators of financial exploitation of older adults (FEOA) (57.9%), followed by friends and neighbors (16.9%), followed by home care aides (14.9%).18

Source: 18. Peterson, J., Burnes, D., Caccamise, P., Mason, A., Henderson, C., Wells, M., & Lachs, M. (2014). Financial exploitation of older adults: a population-based prevalence study. Journal of General Internal Medicine, 29(12), 1615–23. doi: 10.1007/s11606-014-2946-2 [pdf]

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What are the risk factors?

Several studies have investigated what particular factors might make someone more at risk of becoming a victim of elder abuse. Some key findings in this area are as follows.

  • Low social support has been found to significantly increase the risk of virtually all forms of mistreatment.

  • Dementia is also a risk factor. A 2009 study revealed that close to 50% of people with dementia experience some kind of abuse.16

  • Experience of previous traumatic events—including interpersonal and domestic violence—has been found to increase the risk for emotional, sexual, and financial mistreatment.7

  • Functional impairment and poor physical health are associated with greater risk of abuse among older persons.10,14

  • Women appear to be more likely to be abused than men.11

  • Younger age may be associated with greater risk of abuse. Laumann and colleagues found that adults in their late 50s and 60s are more likely to report verbal mistreatment or financial mistreatment than older adults.11 Acierno and colleagues also found that young-old respondents (aged < 70 years) were more likely than respondents in the old-old group to fall victim to emotional, physical, and financial mistreatment by strangers. However, this difference may be attributable to the absence of institutionalized older adults or their representatives in their sample.7

  • Living with a large number of household members other than a spouse is associated with an increased risk of abuse, especially financial abuse.18

  • Lower income or poverty has been found to be associated with elder abuse. Low economic resources have been conceptualized as a contextual or situational stressor contributing to elder abuse.10

  • The following factors have been found to be associated with financial exploitation of older adults.18

    • Non-use of social services

    • Need for ADL assistance

    • Poor self-rated health

    • No spouse/partner

    • African-American race

    • Lower age

Source: National Center on Elder Abuse  [Link]

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What are the warning signs?

While one sign does not necessarily indicate abuse, some tell-tale signs that there could be a problem are:

  • Bruises, pressure marks, broken bones, abrasions, and burns may be an indication of physical abuse, neglect, or mistreatment.

  • Unexplained withdrawal from normal activities, a sudden change in alertness, and unusual depression may be indicators of emotional abuse.

  • Bruises around the breasts or genital area can occur from sexual abuse.

  • Sudden changes in financial situations may be the result of exploitation.

  • Bedsores, unattended medical needs, poor hygiene, and unusual weight loss are indicators of possible neglect.

  • Behavior such as belittling, threats, and other uses of power and control by spouses are indicators of verbal or emotional abuse.

  • Strained or tense relationships, frequent arguments between the caregiver and elderly person are also signs.

Most importantly, be alert. The suffering is often in silence. If you notice changes in a senior’s personality or behavior, you should start to question what is going on.

Remember, it is not your role to verify that abuse is occurring, only to alert others of your suspicions. Please visit the webpage What If I Suspect Abuse, Neglect, or Exploitation? to learn what you should do if you are concerned that someone you know is being abused.

Source: Administration on Aging, Elder Rights  [Link]