Physical elder abuse is non-accidental use of force against an elderly person that results in physical pain, injury, or impairment. Such abuse includes not only physical assaults such as hitting or shoving but the inappropriate use of drugs, restraints, or confinement.
In emotional or psychological senior abuse, people speak to or treat elderly persons in ways that cause emotional pain or distress. Verbal forms of emotional elder abuse include intimidation through yelling or threats humiliation and ridicule habitual blaming or scapegoating. Nonverbal psychological elder abuse can take the form of ignoring the elderly person isolating an elder from friends or activities terrorizing or menacing the elderly person Sexual elder abuse is contact with an elderly person without the elder’s consent. Such contact can involve physical sex acts, but activities such as showing an elderly person pornographic material, forcing the person to watch sex acts, or forcing the elder to undress are also considered sexual elder abuse Elder neglect, failure to fulfill a caretaking obligation, constitutes more than half of all reported cases of elder abuse. It can be active (intentional) or passive (unintentional, based on factors such as ignorance or denial that an elderly charge needs as much care as he or she does). This involves unauthorized use of an elderly person’s funds or property, either by a caregiver or an outside scam artist misuse an elder’s personal checks, credit cards, or accounts steal cash, income checks, or household goods forge the elder’s signature engage in identity theft.
Elder abuse is one of the most disturbing and rapidly growing areas of crime in the United States. First recognized by Congress in hearings some 25 years ago, it remains a national disgrace and hidden phenomenon in our communities. While variously defined, elder abuse can encompass arrange of destructive behaviors directed at older adults including acts of commission, considered to be abuse, and acts of omission, categorized as neglect. Abuse and neglect may be intentional or unintentional, financial or material exploitation, and self-neglect (National Center for Elder Abuse, 2003; Hamilton, 2003). All threaten the health and welfare of an older person. The boxes below provide expansion on the definitions of abuse, neglect, and exploitation (Maine DHHS/OES, 2003).
It is estimated that as many as 5 million persons 65 and older are abused in the United States annually. Approximately 84% of all cases of abuse are never reported (Legal Services for the Elderly, 2001). Maine, the nation’s oldest state in median age and second most rural state, has a rate of elder abuse estimated to be above the national average (Hamilton, 2003; Maine DHHS/OES, 2006). In addition, Maine’s elderly suicide rate is among the highest in the United States (Associated Press, 2002). In Maine, it is estimated that only one of every 14 incidents of elder abuse is reported (Legal Services for the Elderly, 2001). This represents an estimated total of approximately 14,000 victims annually, the vast majority of whom are unknown to the state’s health and welfare system and therefore do not benefit from the services available to address elder abuse, neglect, and interpersonal violence (Hamilton, 2003; Maine DHHS/OES, 2006). The majority of cases of elder abuse go unreported making it a hidden problem within the communities that we live in. There are many reasons why abuse goes undetected. Often the abuser is a family member and caregiver who is the sole lifeline for the dependent victim’s basic needs. Many older adults tolerate abuse rather than risk losing the close personal ties of the abusive family member who is most often a child or a spouse. Victims tend to minimize the seriousness of the abuse so as not to place the abuser at risk, or fearing institutionalization, to jeopardize their living arrangement.
There is a common belief that these types of issues are “family matters” and should be handled within the family itself. However, because the abuser is often times a member of the family, there is a tendency for other family members to cover up the situation. Also, there is a tendency for the victim to blame him or herself for the abuse or want to protect the abuser from “getting in trouble.” There has been some progress over the last few decades in raising public awareness of the epidemic of elder abuse in America. There have been research studies, demographic reports, as well as anecdotal studies focused on elder abuse. However, despite all of these steps forward, elder abuse can be considered to be where child abuse and domestic violence were 25 years ago (i.e., at the “tip of the iceberg” stage of overall public awareness). There are several reasons for this – elder abuse is not clearly defined, funding for elder abuse intervention and prevention is limited, and the public has not yet taken elder abuse into its vernacular (Solomon, 2006).
In 1998 the Administration on Aging published its final report on The National Elder Abuse Incidence Study. This study advocated for a sentinel approach to elder abuse using the model developed by Westat for officially reporting child abuse (Administration on Aging, 1998). This approach is based on the assumption that reported cases of elder abuse represent only the “tip of the iceberg”, and that most cases are not reported to Elder homicide-suicides usually involve spouses or intimate partners who kill their partners and then commit suicide.
These killings are often prompted by the physical decline, hospitalization or institutionalization of one of the individuals in the relationship. The events are often mistakenly assumed to be ‘double suicides’ or ‘mercy killings’, however, when the cases are looked at with closer scrutiny, it is usually revealed that one partner was not a willing participant. Many homicide-suicides appear to be motivated by the perpetrators’ need to control the other person. In fact, in 33% of such cases, there is a history of domestic violence (Cohen, 1998)