Elder Abuse Essay

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Elder abuse is harm or risk of harm to older adults by trusted other persons. This definition includes the failure of caregivers to protect vulnerable elders from harm or provide them with goods and services, like food or medical care, to meet basic needs. Elder abuse may be intentional or unintentional. It can assume various forms, such as physical, psychological, sexual, or financial abuse, neglect, or abandonment. The effects of these forms may be injury, suffering, loss, or rights violation. Research suggests that abused elders die three times sooner than nonabused elders.

Elder abuse is a major aspect of interpersonal violence. Former U.S. Surgeon General Louis Sullivan declared it to be a public health concern and criminal justice issue. All states and territories have laws authorizing the use of adult protective services to investigate and respond to elder abuse situations. They also have criminal codes to punish the perpetrators in some instances.

History of Problem Recognition

Elder abuse existed prior to modern times. However, it usually was not considered to be a social problem. For example, in early America some Indian tribes forced older members to work until exhaustion, and Hudson Bay Eskimos moved, leaving elderly members behind when there was not enough food for everyone. Among colonists, families sometimes cast out older dependent kin when they were unable or unwilling to provide care. In addition, conflict over property could result in family scorn or worse for older people.

Recognition of elder abuse as a problem began in the 1950s, when many younger family members moved from their hometowns in search of better jobs and other opportunities, leaving older kin behind. Communities became concerned about the possible neglect and exploitation of those who were mentally impaired and living alone, outside of institutions. Adult protective services was created and spread nationwide to address these concerns.

Public recognition of other elder abuse forms was sparked during the mid-1970s to early 1980s. This began with professional writings on a “battered old person syndrome” by geriatrician Robert Butler in 1975 and testimony on “battered parents” by sociologist Suzanne Steinmetz before the U.S. House Science and Technology Committee, which was exploring overlooked aspects of family violence in 1978. Recognition of most other elder abuse forms emerged from pioneering research on the topic. Although often methodologically flawed, these early studies served to characterize the problem, contrast it with child abuse, and speculate on its etiology and scope.

Nature and Scope of the Problem

Elder abuse research has not advanced as rapidly or far as research on most other aspects of interpersonal violence. Reasons for this include funding deficits, few investigators, weak theory, and methodological ambiguities. However limited, existing research does provide a beginning understanding of elder abuse as a complex problem that occurs across settings and affects a large number and diversity of older adults.

Theory and Risk Factors

Various theories have been advanced to explain elder abuse. Most were borrowed from the family abuse literature used to understand either child abuse or partner abuse. Those from child abuse, such as role theory and situational theory, see elder abuse as arising out of inadequate caregiving. Those from partner abuse, like conflict theory and feminist theory, see elder abuse as an issue of power, control, and inequities. None of these theories considers the impact of the aging process. None alone seems sufficient to explain elder abuse in all of its forms and contexts. None has been rigorously tested.

More inquiry has gone into discovering risk factors for elder abuse. Risk factors are characteristics of victims, perpetrators, or environments that indicate the possibility of abuse occurrence. Existing research suggests that elder abuse risk factors may vary by form and have greater potency in combination. Moreover, characteristics of the perpetrator tend to be more predictive of abuse occurrence than those of either the victim or the environment. Perpetrator risk factors include pathology (e.g., alcoholism, mental illness) and financial or housing dependence on the victim. Victim risk factors include reduced functional capacity and problem behaviors, such as those originating out of dementia, like aggressiveness and wandering. Finally, environmental risk factors include social isolation and the victim and perpetrator sharing living quarters.

Prevalence, Incidence, and Reporting

National prevalence studies have been conducted on child abuse and partner abuse. This is not true for elder abuse, despite repeated calls for them and their importance for program planning and public policy purposes. Localized studies in Ohio, Maryland, New Jersey, and Massachusetts suggest an elder abuse prevalence rate of 1% to 10%. Lower figures usually relate to general populations of older adults, higher ones to frail or disabled elders served by health or social service agencies. Variation in prevalence rates also can be attributed to differences in elder abuse definitions and forms used during the investigations. Applying prevalence rates to the current population of older Americans indicates that there may be as many as 5 million victims annually.

A national elder abuse incidence study was conducted by the National Center on Elder Abuse. It concluded that 450,000 abuse victims age 60 and over were seen by adult protective services and agencies serving older people in 1996. The most commonly encountered elder abuse form was neglect, followed by psychological abuse, financial abuse, and physical abuse. Only 1 in 5 of the situations were reported to adult protective services, although mandatory elder abuse reporting exists in all but a handful of states. As low as this reporting ratio seems, it is higher than estimates emerging out of prevalence studies (i.e., 1 in 14). An analysis of 2004 elder abuse reports to adult protective services nationwide identified a rate of 833 for every 100,000 older adults.

Victim and Perpetrator Profiles

Research findings and reports to adult protective services indicate that the typical elder abuse victim is female, age 75 or older, and living in her own home. She has experienced more than one abuse form and multiple occurrences of the problem. Usually her perpetrator is an adult child, spouse, or other family member. Typically the perpetrator is female as well. Profile specifics, however, vary by abuse form. For instance, physical abuse victims tend to be younger and more functionally independent. Neglect victims tend to be older and functionally impaired.

Cultural Variation

There is some evidence of elder abuse variation by cultural grouping. For example, Korean American elders tend to attach a narrower meaning to elder abuse and show less willingness to seek help in addressing it than do Caucasian American or African American elders. Japanese Americans are more likely to seek help from family in elder abuse situations than are European Americans, Hispanics, or African Americans.

Problem Response

Five major systems have responsibility for intervening in elder abuse situations: (1) The lead system is adult protective services. It is authorized by law to receive and investigate elder abuse reports and then to determine the need for protective services to correct or discontinue the situation. (2) Law enforcement acts to address violations of law and represents first responders in many crisis situations. (3) Health care offers emergency and ongoing treatment for the effects of elder abuse. It also is the system best positioned to detect and report the problem. (4) Aging Network represents the vast group of supportive and clinical services for older adults created out of the Older Americans Act, and it can help victims manage at home without an abusive caregiver as well as provide support for older adults who are socially isolated and at risk of elder abuse. (5) Domestic violence programs work to ensure safety for victims of domestic violence, including those in later life. They also attempt to hold perpetrators accountable for their violent behavior.

In an effort to provide a coordinated response to elder abuse situations, many communities have formed multidisciplinary teams with representatives from these systems. Multidisciplinary teams are used for problem identification and treatment recommendation. They provide a more holistic perspective than any single system can offer and ensure that no system has the sole responsibility for handling challenging elder abuse situations.


  1. Anetzberger, G. J. (Ed.). (2005). The clinical management of elder abuse. Binghamton, NY: Haworth Press.
  2. Lachs, M. S., Williams, C. S., O’Brien, S., Pillemer, K. A., & Charlson, M. E. (1998). The mortality of elder mistreatment. Journal of the American Medical Association, 280(5), 428–432.
  3. National Center of Elder Abuse. (1998, September). The National Elder Abuse Incidence Study: Final report. Available at http://www.elderabusecenter.org
  4. National Research Council. (2003). Elder mistreatment: Abuse, neglect, and exploitation in an aging America. Washington, DC: National Academies Press.
  5. Pillemer, K. A., & Wolf, R. A. (Eds.). (1986). Elder abuse: Conflict in the family. Dover, MA: Auburn House.
  6. Tatara, T. (Ed.). (1999). Understanding elder abuse in minority populations. Philadelphia: Brunner/Mazel.

Teaster, P. B., Dugar, T. A., Mendiondo, M. S., & Otto, J. M. (2005, May 12). The 2004 survey of state adult protective services: Abuse of adults 60 years of age and older. Available at https://ncea.acl.gov/resources/docs/archive/2004-Survey-St-Audit-APS-Abuse-18plus-2007.pdf

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