That there are people who prey on older people is truly heartbreaking.

Especially when abuse is perpetrated by presumed caregivers, family, or fellow residents of a care facility.

But it’s happening more frequently than ever, according to the US Adult Protective Services (APS), which is usually the first service notified of abuse. And it’s only going to get worse as the Baby Boom generation ages.

The 2010 U.S. Census recorded the greatest number and proportion of people 65 and older in census history: 40.3 million, or 13% of the total population.

By 2050, people 65 and older are expected to make up 20 percent of our population.

Indeed, the fastest growing segment of our population today is those 85 and older. In 2010, there were 5.8 million people in that cohort. By 2050, it is projected that there will be 19 million people aged 85 or older.

All of them are now, and in the future, potential victims of abuse.

What is elder abuse?

It was difficult for the care community to define elder abuse—there are, sadly, so many different kinds. But some precision is required to guide professionals as to when and how to intervene.

It’s generally agreed today that elder abuse is any form of mistreatment that results in harm or loss to an older person, and that these are the main types:

• Physical abuse is physical force that results in bodily injury, pain, or impairment. It includes assault, battery, and inappropriate restraint.
• Sexual abuse is non-consensual sexual contact of any kind with an older person.
• Domestic violence is an escalating pattern of violence by an intimate partner where the violence is used to exercise power and control.
• Psychological abuse is the willful infliction of mental or emotional anguish by threat, humiliation, or other verbal or nonverbal conduct.
• Financial abuse is the illegal or improper use of an older person’s funds, property, or resources.
• Neglect is the failure of a caregiver to fulfill his or her care giving responsibilities.
• Self-neglect is failure to provide for one’s own essential needs.

These are serious enough transgressions, globally, that the World Health Organization (WHO) states in no uncertain terms: “Elder abuse is a violation of human rights and a significant cause of illness, loss of productivity, isolation and despair.”

The dreadful impact of elder abuse

It’s difficult enough to be “elder.” Even those in the best of health experience a barrage of unwelcome health effects.

Adding abuse to the list has truly tragic outcomes.

In one study, elders who experienced even modest abuse had a 300 percent higher risk of death when compared to those who had not been abused.

Abuse victims also have significantly higher levels of psychological distress and lower perceived self-efficacy than those who have never been victimized.

Worse still, victims whose abuse was violent are far more likely to experience extraordinary symptoms of relatively routine aches and pains in their age cohort, including:

• Bone or joint problems
• Digestive problems
• Depression or anxiety
• Chronic pain
• High blood pressure
• Heart problems

Who could do such a thing?

In a national study of elder abuse, the vast majority—nearly 90 percent—of abusers were family members, most often adult children, spouses, and partners.

Family members who abuse drugs or alcohol, who have a mental or emotional illness, and who resent their caregiving responsibilities abuse at higher rates than those who do not.

How prevalent is elder abuse?

It’s extremely difficult to know with any certainty—there are so many variables. One thing is certain: a vast percentage of abuses are never reported. Many victims are ashamed, many fear retribution in the form of additional abuse, many suffer from a cognitive impairment…the list of reasons is endless.

One study estimated that only 1 in 14 cases of elder abuse is ever reported to authorities. A New York State Elder Abuse Prevalence Study found that for every known case, there were 24 that were unknown.

The care community’s best estimate is that around 10 percent of elders will experience abuse of some sort. Do the math, using the 2010 count of 65 and older adults: 40.3 million x 10% = 4.3 million tragedies.

Who is at risk?

Most studies show that older women are more likely than older men to be victims of abuse. Those who are about 65-75 are at greater risk of abuse.

This could be because this group, the “young old”, more often live with a spouse or with adult children—sadly, the two groups most likely to abuse.

What should you do?

lf you’ve been abused or are being abused, please, please tell someone you trust—your doctor, lawyer, pharmacist, clergy member, anyone you think can help. Or contact one of the care agencies for the elderly in your community. Do not be ashamed.

If you suspect someone else is being abused—do exactly the same thing.

Preventing or correcting even one tragedy is everyone’s duty.

References

• Department of Health and Human Services, National Center on Elder Abuse, Administration on Aging, Statistics/Data.
• Campion, E., Editor. Review article: Elder Abuse, Lachs, MS., Pillemer K.
• N Engl J Med 2015; 373:1947-1956 November 12, 2015 DOI: 10.1056/NEJMra1404688
• World Heath Orgnaization (W.H.O.), Elder Abuse.
• Lachs MS, Pillemer K. Elder abuse. Lancet 2004;364:1263-1272
• Marak, C. Signs of Elder Abuse

Last Updated: September 30, 2020
Originally Published: January 20, 2016