Elder Abuse: Types, Causes, and Proposed Research Study

Introduction to Elder Abuse

Elder abuse is perhaps one of the most serious problems affecting older people in the modern world. More than common afflictions like cardiovascular disease or diabetes, elder abuse is recognized globally as a complex and debilitating problem — one that demands decisive and immediate action from the healthcare industry, legislators, the social work sector, and concerned citizens. As the international population of elderly people continues to grow, the problem demands immediate preventative measures. It is important to acknowledge that what happens to the elderly in this regard is largely preventable: it does not have to happen, and its persistence is the mark of a society that in many ways fails to care for its most vulnerable members.

"This emphasis is appropriate because elder abuse is likely the most widespread problem of older people that is largely preventable (unlike many disease conditions of old age). Therefore, a better understanding of causes and prevention of elder abuse should be a major international priority. Fortunately, an improving international scientific literature has accompanied this growing concern, including prevalence studies in a number of countries and international comparative projects" (Pillemer et al., 2015). Prevention is absolutely essential to gaining a handle on this pervasive issue. The more people understand the complexities of this phenomenon, the more healthcare professionals, social welfare professionals, and educated citizens will be able to take strategic action to prevent it.

Types and Prevalence of Elder Abuse

Scholars and experts who have dedicated themselves to this issue have identified five main types of elder abuse. Many people have historically and wrongfully considered elder abuse as merely a physical altercation. While physical violence is certainly one form, elder abuse unfortunately extends to a variety of behaviors that prey on older adults and cause them significant harm. These five types are: "physical abuse, or acts carried out with the intention to cause physical pain or injury; psychological or verbal abuse, defined as acts carried out with the aim of causing emotional pain or injury; sexual abuse, defined as nonconsensual sexual contact of any kind; financial exploitation, involving the misappropriation of an older person's money or property; and neglect, or the failure of a designated caregiver to meet the needs of a dependent older person" (Lachs & Pillemer, 2015). This comprehensive definition shows that elder abuse can manifest in many forms, and that elderly people around the world are suffering in ways no person should have to endure.

It is difficult to determine the full scope and prevalence of elder abuse since, like all forms of abuse, it is not always reported accurately or completely. Research studies that have attempted to gather accurate data on this issue may therefore not capture the full picture. For example, in 2008, Laumann and associates concluded that verbal abuse was the most frequent type of elder abuse, reported by 9% of elderly participants. The next most common form was financial mistreatment at 3.5%, and physical mistreatment was the rarest, occurring in fewer than 1% of participants.

In a similar fashion, a well-known study based in New York found that one in thirteen elderly adults had experienced some form of elder abuse in the previous year. The most common forms were financial manipulation, emotional abuse, verbal abuse, and physical abuse (Lifespan of Greater Rochester, 2011). The data from these studies illuminate how concerted action is crucial to stopping the threat of elder abuse. The mark of a healthy society is seen in how it treats its most vulnerable members — its children, its elderly, and its animals. The continued existence of elder abuse signals that there is urgent work to be done to address, prevent, and ultimately abolish this serious problem.

Literature Review

There is a substantial body of research on elder abuse that offers insight into why the problem manifests and what can be done to prevent it proactively. The study "Interventions for Preventing Elder Abuse" by Baker and colleagues (2017) acknowledges the paucity of evidence and data on this subject and notes that this absence provides little practical guidance. The researchers also criticize the prevalence of "wasteful" research that does nothing to illuminate the core traits of the problem. "Amongst the interventions, there is some evidence that teaching coping skills to family carers of persons with dementia might make the situation better" (Baker et al., 2017). While this intervention may not seem groundbreaking, it reflects a meaningful understanding of why elder abuse occurs. Many people charged with caring for individuals with dementia are not fully prepared for how debilitating and draining that responsibility can be. Many of these caregivers are family members who have not been taught appropriate ways to cope with the very real stressors involved. Teaching useful coping strategies — rather than assuming caregivers will figure things out on their own — is the most effective approach.

The research study "Preventing Elder Abuse in Geriatric Institutions" by Wangmo and colleagues offered comparable insight. Their research highlighted the necessity of implementing solutions that empower healthcare professionals to meet their responsibilities effectively. Some of these solutions, at least in hindsight, are straightforward — such as providing caregivers with better training and education to manage the real stresses of their jobs. For many nurses and clinicians working in geriatrics, there can be an unfounded assumption that these professionals have already received the specific training needed to care for elderly patients and prevent burnout. This is not always the case. Caring for the elderly — particularly those with dementia — is an intensely demanding occupation, and specific training in this area is essential. Implementing "better management of nursing care providers' responsibilities and timely intervention to address abuse and neglect, as well as rotating care providers . . . will allow geriatric institutions, their managers, and nursing care providers to improve quality of care and reduce such negative occurrences in these settings" (Wangmo et al., 2017). Even dedicated professionals are susceptible to burnout when caring for the elderly. Clinicians need breaks, particularly when their patience is running low after long shifts. It is unrealistic — and ultimately counterproductive — to expect nurses and other professionals to maintain boundless patience and stamina without adequate support, and such expectations create conditions where elder abuse is more likely to occur.

The study "Elder Abuse: Systematic Review and Implications for Practice" by Xin Qi Dong (2015) found that educating community members about the risk factors for elder abuse was a worthwhile intervention. This approach helped ensure that all stakeholders understood elder abuse as a real danger even in otherwise healthy communities. The research also emphasized the importance of building strong community networks that elders and their families could rely upon. "Through implementing the CBPR approach, elder abuse intervention programs could build on strengths and resources in the community. Using the CBPR approach, the Family Care Conference (FCC) was developed in a northwestern Native American community" (Dong, 2015). By building strong community resources — such as elder centers and community centers — no single person is left to shoulder the entire burden of care. This creates more resilient communities that grow stronger over time.

References

Baker, P. R., Francis, D. P., Hairi, M., Naqiah, N., Othman, S., & Choo, W. Y. (2017). Interventions for preventing elder abuse: applying findings of a new Cochrane review. Age and Ageing, 46(3), 346–348.

Dong, X. Q. (2015). Elder abuse: Systematic review and implications for practice. Journal of the American Geriatrics Society, 63(6), 1214–1238.

Lachs, M. S., & Pillemer, K. A. (2015). Elder abuse. New England Journal of Medicine, 373(20), 1947–1956.

Laumann, E., Leitsch, S., & Waite, L. (2008). Elder mistreatment in the United States: Prevalence estimates from a nationally representative study. The Journals of Gerontology Series B, Psychological Sciences and Social Sciences, 63(4), S248–S254.

Lifespan of Greater Rochester, Inc., Weill Cornell Medical Center of Cornell University, & New York City Department for the Aging. (2011). Under the radar: New York State elder abuse prevalence study.

Ncea.acl.gov. (2018). National Center on Elder Abuse: What we do, research, statistics/data.

Wangmo, T., Nordström, K., & Kressig, R. W. (2017). Preventing elder abuse and neglect in geriatric institutions: Solutions from nursing care providers. Geriatric Nursing, 38(5), 385–392.