Network of Victim Assistance (NOVA) Victim Services Crime Information

Elder Abuse

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 abuseapproximately 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.

The National Crime Victimization Survey reports that the rate of violent crime victimization of persons ages 65 or older was about 4 per 1,000 (Bureau of Justice Statistics, 2001).
Persons ages 65 or older numbered 34.5 million in 1999, about 13% of the U.S. population (Administration on Aging, 2000).
The National Elder Abuse Incident Study reports that an estimated total of 551,011 elderly persons, aged 60 and over experienced abuse, neglect, and/or self-neglect in domestic settings in 1996 (National Center on Elder Abuse, 1998).
The most frequent forms of elder abuse reported to adult protective service agencies included neglect (48.7%), emotional/psychological abuse (35.4%), financial/ material exploitation (30.2%), physical abuse (25.6%), and abandonment (3.5%) (Ibid).
Adult children are the largest perpetrators of elder abuse (47.3%), followed by spouses (19.3%), other relatives (8.8%), and grandchildren (8.6%) (Ibid).
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 (Pennsylvania Attorney General's Family Violence Task Force Report, 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 (Pennsylvania Attorney General's Family Violence Task Force Report, 1988).

Physical Abuse

"Non-accidental physical force that results in injury" (Pennsylvania Attorney General's Family Violence Task Force Report, 1988).

Indicators:

fractures and dislocations;
lacerations and abrasions;
burns;
injuries to the head, scalp, face; and/or
bruiseson 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" (Pennsylvania Attorney General's Family Violence Task Force Report, 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" (Pennsylvania Attorney General's Family Violence Task Force Report, 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" (Pennsylvania Attorney General's Family Violence Task Force Report, 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" (Pennsylvania Attorney General's Family Violence Task Force Report, 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 (Pennsylvania Attorney General's Family Violence Task Force Report, 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 (Pennsylvania Attorney General's Family Violence Task Force Report, 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 (Pennsylvania Attorney General's Family Violence Task Force Report, 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

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

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.

Muram, David, Kristin Miller and Amos Cutler. "Sexual Assault of the Elderly Victim." Journal of Interpersonal Violence, Volume 7(1), March 1992.

NOVA. "The Elderly Crime Victim." Network Information Bulletin, Volune 2(2), September 1985.

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

For additional information:

American Association for Retired Persons (AARP)

601 E Street, NW
Washington, DC 20049
(202) 434-2277
www.aarp.org

Area Agency on Aging (AAA)

30 East Oakland Avenue
Doylestown, PA 18901
(215) 348-0510 (Administrative Offices)
(800) 243-3767 Older Adult Protective Services

Clearinghouse on Abuse and Neglect of the Elderly

College of Human Resources
University of Delaware
Newark, Delaware 19716
(302) 831-3525
www.aoa.dhhs.gov/aoa/dir/78.htm

Clearinghouse on Family Violence Information

P.O. Box 1182
Washington, DC 20013
(703) 385-7565

National Academy of Elder Law Attorneys

www.naela.org

National Aging Resource Center on Elder Abuse

American Public Welfare Foundation
810 First Street, NE, Suite 500
Washington, DC 20002-4267
(202) 682-2470

National Committee for the Prevention of Elder Abuse

c/o Institute on Aging
The Medical Center of Central Massachusetts
119 Belmont Street
Worcester, Massachusetts 01605
(508) 793-6166

Copyright 1997 by the National Center for Victims of Crime. This information may be freely distributed, provided that it is distributed free of charge, in its entirety and includes this copyright notice.