Elder abuse is a growing problem which although worldwide in nature, seems to have a high prevalence in America. The abuse of the elderly takes many forms, including physical abuse or battering and emotional or verbal abuse. The unfortunate reality of this situation is that the elderly are often in a vulnerable situation. They may be physically unable to care for themselves, or they may have a deteriorating condition which affects their mental faculties and thus susceptible to various forms of abuse by those who actually care for them.
The focus of this paper is on the various explanations for the emerging problem we know as elder abuse. This essay, although brief in nature, will look at five articles and discuss the reasons these authors/researchers suggest for the emergency of this social problem. The paper will also define what is meant by elder abuse and attempt to provide some insights for social workers who will provide services in this area.
Shaw (1998) notes that one of the real difficulties in obtaining data on elder abuse from their caregivers is the fact that these situations are primarily taking place in institutions where there may be little or no formal means to substantiate the abuse. The fact is that elderly people who live in an institutional setting are, for the most part, quite frail and fragile. They might not even remember if a situation occurred, or they may not be able to articulate it so that someone can fully understand them. Thus, when a situation of abuse occurs, it is often very difficult to gain verifiable data from those who have been abused. Also, since many residents of these institutions may have nowhere else to go and no one else to take them in, they may hesitate to raise the issue of abuse for fear of reprisals. Shaw also indicates that the stress of working in such an environment may inadvertently cause some staff to take their stressors out on their patients (1998, p.11). She also points to working conditions in such institutions which are often less than adequate and provide little likelihood of advancement, or appreciation. “Inadequate pay and sense of not being appreciated by management contribute to staff member’s anger and risk of losing immunity. In a review of theories and causations of workplace violence, economic inequality, lack of resources, generated feelings of hostility, resentment, and aggression expressed at available targets” (Shaw, 1998, p. 14). Ultimately, Shaw suggests that one of the primary causes for elder abuse in some American institutionalized settings is the fact that staff feel unappreciated and therefore take out their anger on the patients who are vulnerable.
Teaster and Roberto (2004) conducted a study on the sexual abuse of older adults. The first point they make is that this is one of the least reported aspects of elder abuse. They also state that the majority of victims of abuse are older women between the ages of 70 and 89. These authors suggest that sexual abuse of the elderly takes place both in private and institutional settings. However, much like Shaw’s research (1998), they agree that there is a lack of empirical data on this subject and therefore much additional research is required. After a five year study they concluded the following with respect to elder abuse. The majority of victims tend to be women, the pattern of abuse demonstrates that it is an ‘ongoing’ problem for an individual approximately 16% of the time, both family members and caregivers abuse the elderly and a very low percentage of cases actually went to court – 5% (p. 5).
These same authors also point to a British study conducted in 1993 which suggests that the majority of sexual abuse of the elderly takes place in institutionalized settings and not in private homes. The research of Teaster and Roberto (2004) confirms that elderly people with functional and cognitive limitations are the highest risk for multiple forms of abuse especially as nursing home residents. They are the individuals who are least able to understand what is happening to them and to stand up for themselves in the face of their abuse. “Self-care limitations enhanced by the dependency and vulnerability of the older adults [which] may have increased their susceptibility to being abused” (p. 793). Their research also confirms that specific studies have revealed the majority of abusers of the elderly in nursing are the staff themselves (p.794).
Bergeron and Gray (2003) researched the ethical dilemmas and problems in reporting elder abuse. They too agree that caregiver abuse is becoming all too common. In addition, they state that their research revealed similar problems to those of Shaw (1998) and Teaster and Roberto (2004) most notably that caregivers experience such a high degree of stress in their job that they are taking this stress out on nursing home residents. While they agree that these stressors might be one of the problematic areas, they state that under-reporting of the problem may be just as responsible for the lack of initiatives in this area. The authors state that several factors contribute to the low reporting percentage in elder abuse: the physical and social isolation of elderly people, lack of uniform laws and legislation on reporting procedures, and the general resistance of family and professionals to report the abuse (p. 97). Bergeron and Gray (2003) dispute the fact that the majority of abuse takes place in institutional settings. Their research suggests that a high percentage of abuse also takes place among families where one or two family members are responsible for an elderly relative.
Litwin and Zoabi (2004) concur that there is insufficient research and “hard” data on the subject of elder abuse. They state that there is a specific lack of data on the problem in Third World countries where modernization and Western values may be encroaching on traditional small-scale societies. These authors conducted a study on abuse among elderly Arabs in Israel. They came to two very meaningful and interesting conclusions. First, their research revealed that weak social networks and the lack of a diverse support network led to a greater likelihood of abuse. The authors reasoned that this led to a greater vulnerability of the individual and also a greater likelihood that the person did not know who to turn to for advice or support when the abuse took place. Second, they identified the fact that modernization is most definitely a factor in these cultures where traditional values are being questioned and no longer adhered to in the same way. “The finding that modernization and its concomitant, the lack of social integration, accounted for the vast majority of the variance in abuse status in the study sample is the major contribution of this analysis …the study also suggests that the dominant correlate of elder abuse among populations in situations of cultural change seems to be the process of modernization and its associated phenomena” (p.140).
Seaver’s (1996) research is the one study that deviated from the previous articles. She researched the patterns in domestic violence among older women. She points to the various reasons why older women (much like younger women) remain in a relationship even though they are aware of its abusive nature. One of the primary factors she discusses is that abuse itself is not only a violent relationship but one of power. Much like residents in a nursing home who are often powerless at the hands of their abusers, many older women feel powerless within the domestic situation as well.
From this brief review, one can see that there is a definite role for professional social workers. First, they have the training to provide and facilitate support groups for caregivers. In this way, they provide an outlet for their frustrations and concerns. Second, social workers are in a role to report abuse and empower elderly individuals to cope with a very difficult situation. Social workers can also serve as advocates and promote knowledge about and prevention of elder abuse. They can also promote that their local libraries carry the appropriate literature on elder abuse. Finally, they suggest that some social workers should actually specialize in the field of gerontology thus giving them additional knowledge and expertise in the field. Finally, social workers will need to take into account cultural and other factors when dealing with the complex issue of elderly abuse. Nevertheless, they have a key role to play most specifically in terms of helping people cope with abuse and also hopefully to reduce the incidents of abuse in their communities.
Each of these articles confirms that not only is elder abuse a growing social problem, but there is still a definite lack of statistical data on this issue. The fact that many elderly people who are abused are reticent to report, or perhaps incapable of reporting their abuse only adds to the problem. In addition, each of these articles notes that since at least a good portion of the abusers are the caregivers themselves, there is an intricate problem with actually acknowledging, let alone reporting the abuse.
Editors Note: To crimes that really make me sick are child abuse, and elder abuse. There is nothing more cowardly than picking one a defenseless human being. The case of Brianna Broitzman and Ashton Larson immediately come to mind, and let’s not forget their friends, Alicia Heilmann and Morgan Walton.
Bergeron, R.L., & Gray, B. (2003). Ethical dilemmas of reporting suspected elder abuse. Social Work, 48(1), 96-106.
Litwin, H., & Zoabi., S. (2004). A multivariate examination of Explanations for the occurrence of elder abuse. Social Work Research, 28(3), 133-143.
Seaver, C. (1996). Muted lives: older battered women. Journal of Elder Abuse & Neglect, 8(2), 3-22.
Shaw, M. M. C. (1998). Nursing home residents abuse by staff: exploring the dynamics. Journal of Elder Abuse & Neglect, 9(4), 1-21.
Teaster, P.B., & Roberto., K. (2004). Sexual abuse of older adults — APS cases and outcomes. The Gerontologist, 44(6), 788-796.