Elder abuse: forms, impacts, and prevention strategies

Elder Abuse

First question: Is elder abuse more prevalent today than in pre-industrial America? That is an impossible question to answer with absolute certainty due to the lack of data that was kept in the 19th Century. However, that having been said, in the book Elder Abuse: Conflict in the Family (p. 12) the author asserts, "…there is almost no evidence of direct abuse of the elderly in the 19th and early 20th centuries" (Pillemer, et al., 1986). But the authors go on to say there is the possibility that the elderly "were simply not seen as sufficiently important to warrant reformist attention" or that abuse was "concealed" in some way to save families from embarrassment (Pillemer, p. 12).

One thing is certain, and that is the reporting of incidents of elder abuse in the 21st century is pervasive and is bringing the issue into the bright light of day. According to the National Elder Abuse Incidence Study (Executive Summary), the problem is enormous and requires the attention of political leaders, healthcare professionals, the news media and others in the communities where older people live. To wit, the 1998 report (albeit 12 years old) asserts that there were about 450,000 older people in domestic settings who were reported to have been abused in 1996. Another 551,000 were neglected in 1996. Of those, females were abused more often and those 80 years of age or older were abused and neglected "at two to three times their proportion of the elderly population" (National elder Abuse Incidence Study).

Meantime in 2006, the State Adult Protective Services (APS) reported that in 2004, there were 565,747 reports of abuse to elderly people, an increase of 19.7% from the year 2000 (Teaster, et al., 2006). Of those reports, the APS investigated 461,135, 16.3% more than were investigated in 2000. And of those 461,135 investigations, the APS "substantiated 191,908 reports" of elder abuse. Still, notwithstanding those statistics, there may be more abuse than is reported. The white paper by the National Center on Elder Abuse (NCEA) reflects that physicians may not be reporting incidents of violence against older people because they "generally have little training in recognizing and addressing abuse" and also they may be "hesitant in identifying" abuse. That is because older patients bruise very easily (hence it would be conjecture that a bruise might have been the result of violence); also doctors may be reluctant to report a certain condition as abuse simply because they would (by law) then have to report it. Reporting a possible incident of abuse against an older patient would mean the doctor would have to testify in court, and might be concerned "they are making a legal judgment" (NCEA).

Second question: In situations where the sandwich generation includes the father and mother -- both working full time -- and along come their parents who are now staying with them because they are unable to care for themselves, there is naturally going to be some tension. That is because the father and mother have had their house to themselves for the past 5 years, to live the way they always lived since the kids were gone, and that means they could be flirty with each other, watch a movie in peace, or get out of each other's way in a home culture that has been well established. But now there are two elderly people in the house who can't do for themselves, don't have the money to provide for themselves, and need near constant attention.